How Has the COVID-19 Pandemic Affected Sleep Quality in Health Care Workers?

Both frontline and nonfrontline health care workers (NFLHCW) were found to experience stark levels of stress and poor sleep quality amid the coronavirus disease 2019 (COVID-19) pandemic, with being female and having a professional background indicated as predictors of these effects, according to study findings published in Sleep and Breathing.

Compared with other fields of work, physicians are at an increased risk of burnout due to a myriad of factors, which include inadequate sleep. As the pandemic has caused surges in admissions for hospitals and health care systems, the American Academy of Sleep Medicine (AASM) sought to highlight this potentially intensified risk by issuing a position statement on the significance of sufficient sleep among physicians.

The researchers noted that few studies have concentrated on the sleep quality of health care workers during COVID-19 or other pandemic events. They wanted to examine sleep disturbances of frontline health care workers (FLHCW) and compare it with sleep quality findings of NFLHCW.

In the cross-sectional study, 257 health care workers (FLHCW, n = 129; NFLHCW, n = 128) from facilities of the Ministry of Health, Bahrain, were recruited. Participants completed an online questionnaire that included socio-demographics, the Pittsburgh Sleep Quality Index (PSQI), and the Perceived Stress Scale (PSS), which was then used to evaluate sleep disturbances and stress levels. Scores of FLHCW and NFLHCW were compared through descriptive statistics, in which poor sleep quality was defined as PSQI ≥5 and moderate to severe stress as PSS ≥14.

To delineate predictors of poor sleep quality, moderate-severe stress, and comorbid poor sleep quality and moderate-severe stress, the researchers utilized univariate and multivariate binary logistic regressions

After examining both groups, the mean overall PSQI and PSS scores were indicated as 7.0 (3.3) and 20.2 (7.1), respectively. In comparing both groups, FLHCW were found to score higher on the PSQI and PSS than NFLHCW, but these differences were not statistically significant. In fact, both groups exhibited high levels of poor sleep quality (75% and 76%, respectively), moderate-severe stress (85% and 84%), and comorbid poor sleep quality and moderate-severe stress (61% and 62%).

There were no predictors identified for poor sleep quality, but female sex was noted an independent predictor (odds ratio [OR], 2.0; 95% CI, 1.1-4.0; P = .04) for moderate-severe stress. For comorbid poor sleep quality and moderate-severe stress, female sex (OR, 2.0; 95% CI, 1.1-3.5; P = .01) and being a health-allied, nonphysician (OR, 0.7; 95% CI, 0.5-1.1; P = .05) were both indicated as independent predictors.

Echoing concerns from the AASM, the study authors concluded, “During pandemics, preventive interventions aiming to maintain the health condition of health care workers are warranted.”

Reference

Jahrami H, BaHammam AS, AlGahtani H, et al. The examination of sleep quality for frontline healthcare workers during the outbreak of COVID-19. Sleep Breath. Published online June 26, 2020. doi:10.1007/s11325-020-02135-9