key: cord-0765716-r1yzw66o
authors: Wang, Jing; Gong, Yanhong; Chen, Zhenyuan; Wu, Jianxiong; Feng, Jie; Yan, Shijiao; Lv, Chuanzhu; Lu, Zuxun; Mu, Ketao; Yin, Xiaoxv
title: Sleep disturbances among Chinese residents during the Coronavirus Disease 2019 outbreak and associated factors
date: 2020-08-07
journal: Sleep Med
DOI: 10.1016/j.sleep.2020.08.002
sha: 07a69ba309ccd7946ce556f661f51502722865aa
doc_id: 765716
cord_uid: r1yzw66o

OBJECTIVES: Sleep status can affect the body's immune status and mental health. This study aims to investigate the sleep status of Chinese residents during the outbreak of Coronavirus Disease 2019 (COVID-19) and to evaluate its related risk factors. METHODS: This research carried out a cross-sectional survey in February 2020 (during the COVID-19 outbreak) to investigate the sleep status of residents nationwide in the form of an online questionnaire. Of the 8,151 respondents, 6,437 were eventually included in the analysis. Logistic regression is applied to analyze the associated factors affecting residents’ sleep quality. RESULTS: During the COVID-19 outbreak, the incidence of sleep disturbances in residents was 17.65%. Increased risk of sleep disturbances was found to be associated with older age, female gender, and poor self-reported health status. Moreover, the odds ratios (ORs) were 1.42 (95%CI: 1.1-2.64), 1.35 (95%CI: 1.16-1.59), 5.59 (95%CI: 4.32-7.23), respectively. Those residents who believed COVID-19 had caused a high number of deaths or who thought COVID-19 was not easy to cure were more likely to experience sleep disorders, and the ORs were 1.73 (95%CI: 1.43-2.09), 1.57 (95%CI: 1.29-1.91), respectively. Regular exercise was a protective factor for sleep disturbances, OR =0.77 (95%CI: 0.63-0.93). CONCLUSIONS: During the outbreak of COVID-19, nearly one-fifth of participants had sleep disorders. It is necessary to pay more attention to people at high risk for sleep disturbances during the outbreak, adopt effective risk communication methods, enhance residents’ rational understanding of COVID-19, and develop practical indoor exercise programs for general public to improve sleep quality.

The 2019 novel Coronavirus Disease (COVID-19) pandemic poses a serious 30 threat to global health [1, 2] . To control the spread of the epidemic, countries around 31 the world have adopted a series of effective measures, such as city lockdowns, home 32 quarantine and production suspension [3, 4] . These measures have achieved 33 conspicuous results. However, these measures inevitably bring inconvenience to 34 residents' lives, which changes their lifestyles and further affects their health. 35 Sleep is an essential part of our daily life and a significant predictor of residents' In our study, self-reported economic status was surveyed using a question,

"What do you think of your current financial situation?" with four response options, 94 J o u r n a l P r e -p r o o f "very bad", "bad", "fair", and "good". The self-perceived physical health was 95 measured using a single question, "What do you think of your current status of 96 health?" with three response options, "good", "fair", and "bad". The exercise status 97 of residents during the COVID-19 outbreak was assessed by the question, "How 98 often do you currently exercise per week? (more than 30 minutes at a time, eg, yoga, 99 aerobic dance, etc.)" with three response options, "basically no or very little 100 exercise", "once or twice a week", and "3 times or more per week".

The following two questions were set to investigate the residents' perception of perceived difficulty of COVID-19 treatment (P <0.05). There were no significant 132 differences in sleep disturbances among participants in terms of region and gender.

The main symptoms of the 1136 residents with sleep disturbances were "cannot get 134 to sleep within 30 minutes" (1026, 90.32%) and "wake up in the middle of the night 135 or early morning" (848, 74.65%) ( Table 3) . 

To the best of our knowledge, this study is the first large-scale investigation to J o u r n a l P r e -p r o o f Table 3 . Main symptoms of the residents with sleep disturbances (n =1136).

Sleep quality and influencing factors in residents (≥ 18 years old) of Xuzhou 302 city in 2013

A Survey on Sleep Quality of the People Aged

Liaoning Province. Health Education and Health Promotion

Longitudinal assessment of community 309 psychobehavioral responses during and after the 2003 outbreak of severe 310 acute respiratory syndrome in Hong Kong. Clinical infectious diseases : an 311 official publication of the Infectious Diseases Society of America

Mental health status of people isolated due 314 to Middle East Respiratory Syndrome

Prevalence of psychiatric morbidity and 317 psychological adaptation of the nurses in a structured SARS caring unit 318 during outbreak: a prospective and periodic assessment study in Taiwan