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Valuable information. I bookmarked it. Quantum Biofeedback. Useful information. I really appreciate this post. I have been looking all over for something like this! The time spent completing the questionnaire was about 15 min. Therefore, the variables under study have been dichotomized in normal and pathological, grouping the participants in either one of the two conditions for each scale administered. Descriptive analyses were performed for all variables. Chi-square tests and multivariate logistic regression models were used to assess the association between risk factors and the presence of insomnia, sleep disorders, depression, and anxiety.

Stata Statistical Software: Release Nine hundred sixty-four hospital workers Their main sociodemographic, occupational, and clinical data are summarized in Table 1. In particular, 94 subjects 9. Two hundred eighty participants In the last group of subjects, According to the scales administered Fig. Many participants had an increase in sleep latency, but most of them reported a reduction in sleep duration and maintenance, as well as a decrease in sleep quality and efficiency and significant daytime dysfunction.

Nightmares were reported by many participants. At univariate analysis, the scores of the sleep scales administered showed the following significant associations. Pathological PSQI scores i. Pathological SCI scores i.

Moreover, At multivariate analysis, including significant variables at univariate analysis, the pathological scores of the administered scales were significantly associated with the following variables Table 5 :. In this questionnaire-based cross-sectional multicenter study, we evaluated the prevalence and potential predictive factors of sleep disorders, mainly insomnia, and mental health disturbances—i.

Several studies and reviews have already highlighted multiple psychological effects of COVID outbreak on the mental well-being of health personnel, including depression and anxiety but also sleep problems, burnout, and posttraumatic stress disorders [ 2 ]. In , some authors stated the need to collect high-quality data on the mental health effects of the COVID pandemic across the whole population and vulnerable groups [ 16 ].

In line with this call, we decided to investigate sleep and psychiatric disorders in the entire population of hospital workers, including frontline and non-frontline healthcare providers but also non-healthcare workers. This study design allowed us to differentiate sleep and mental health disturbances directly associated with pandemic-related healthcare issues from those that were more extensively related to a sudden work and lifestyle transformation in hospital staff.

In line with the previous studies, in our population, we documented alarming rates of sleep disorders In terms of sleep quality, Out of the total Moreover, our data confirm that—independently from the pandemic—health professionals seem to be more prone to poor quality of sleep, probably because of the general stressors they are generally exposed to [ 4 ].

Prolonged sleep latency but mainly reduced sleep duration and continuity were reported by most participants in our study. Furthermore, many of them complained of sleep quality and sleep efficiency reduction and expressed concerns about daytime dysfunction and waking performance. Interestingly, many subjects reported nightmares, thus suggesting a relationship between daily mental activity during the pandemic and sleep disturbances [ 19 ]. The multivariate analysis showed a strong association of the presence of sleep disorders, especially insomnia, with female gender, divorced marital status, self-isolation, modified duties during the COVID outbreak, and chronic diseases.

Other studies during the COVID pandemic found that female health workers had worse sleep quality than male ones [ 17 , 20 ]. Previous epidemiological studies revealed that female sex represents a risk factor for insomnia, with a hazard ratio of 1. One of the first survey conducted in China among medical staff involved in the COVID outbreak found that factors related to insomnia included perceived lack of psychological support, having high levels of uncertainty and being worried about infection [ 6 ].

Analogously, Xiao et al. In accordance with these findings, we suggest that in our population, divorced and isolated people were at higher risk of insomnia in our sample due to a lack of social or family support systems to stabilize emotions, share experiences, and maintain social connections. A possible explanation of a higher prevalence of insomnia in subjects with chronic diseases might be related to their worries about being affected by COVID Indeed, since the beginning of the pandemic, it was evident that patients with comorbidities had an increased risk to develop a more severe disease.

Thus, the concern about personal health may impact sleep quality induced by anxiety symptoms [ 23 ]. Finally, especially during the first peak of the COVID outbreak, many healthcare workers were asked to change their duties, and after a brief training, they were included into the frontline battle against COVID Moreover, frequent policy changes and unclear case management standards induced an increased level of stress and anxiety, favoring the onset or the worsening of sleep disorders.

Other than sleep disorders, as stated above, our results provide evidence that a high proportion of hospital workers also experienced significant levels of anxiety These data are in line with recent literature results although the different scales and population selection criteria adopted by each study caused great heterogeneity of anxiety and depression prevalence [ 2 , 24 ].

In this study, depressive symptoms were significantly associated with self-isolation, modified work schedules, and chronic diseases, while anxiety showed a strong association with teleworking.

We already discussed how isolation and chronic diseases could favor psychological burden in hospital workers because of lack of psychological support and greater concerns about the risk of infection. Moreover, during the COVID outbreak, healthcare workers were frequently asked to change their work schedules and underwent an overwhelming workload pressure.

Previous studies showed that work overload represents a critical cause of exhaustion, which led health professionals to burnout and which in turn may affect hospital outcomes such as the quality and safety of provided care [ 25 ]. Furthermore, in our study, we found that sleep disorders, insomnia, and depression during the pandemic were more prevalent among subjects who already suffered from sleep disorders before the COVID outbreak.

The bidirectional link between sleep problems and mental health disturbances is well known, and insomnia has recently been identified as an independent clinical predictor of depression and suicide risk [ 26 , 27 ]. The same lack of association was encountered for the type of occupation because frontline healthcare workers were not more affected than non-frontline healthcare workers or non-healthcare workers.

Data from the literature on this topic are discordant. Indeed, most studies found that being on the frontline represented a risk factor for developing the mental health concerns and that medical staff had greater fear, anxiety, and depression levels than administrative staff or general population [ 24 ]. However, a minority of studies revealed opposite results, as we found in our population. In particular, Li et al.

Similarly, Tan BYQ et al. Therefore, according to our data, we can hypothesize that non-healthcare hospital workers faced the same general stressors as frontline and non-frontline health professionals during the pandemic.

We can exclude that the presence of a previous sleep disorder contributed to level responses to the outbreak across the three groups, considering that only a minority reported prior sleep disturbances and that most were of new onset. The high rate of transmission of SARS-CoV-2 infection and the need for a thorough and fast reorganization of most hospital activities might have triggered similar levels of stress for both administrative and healthcare hospital staff.

It should be also considered that the latter, especially if on the frontline of COVID management, had easier availability of protective equipment, thus reducing the feelings of danger and exposure to unsafe conditions.

Another finding of our study is that teleworking was significantly associated with higher anxiety scores at STAI-Y. Although this has been previously reported [ 30 ], it remains a matter of debate given the mounting evidence of healthier quality of life and emotional state among people working remotely from home [ 31 ]. Of note, responders on teleworking did not report a higher percentage of sleep disorder complaints nor of depression.

Teleworkers reported higher levels of anxiety, stress, and fatigue compared to their office-based counterpart, even prior to the pandemic, which is perhaps associated with technological overload and pervasive use of online surveillance and monitoring of work. Considering the increased popularity and prospective intensification of this work modality, not only among hospital workers, the adequate prevention of its possible risks is mandatory.

Despite promoting flexible work scheduling, teleworking may indeed enhance affective distress due to an increase in the amount of hours spent working online at home as compared to working at the office and due to the limitation of interpersonal relationships with colleagues [ 30 ].

Therefore, clinicians and health authorities should be alert to the possibility of hospital staff developing sleep and mental health disorders while facing the COVID pandemic and even after the long-awaited conclusion of this outbreak. The findings of this study should direct future research to establish the role of psychological distress during emergency conditions, such as during a pandemic, in the development of sleep and mental disorders so that preventive and clinical management strategies can be developed.

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