Sleeping under the waves: A longitudinal study across the contagion peaks of the COVID-19 pandemic in Italy

After the March-April 2020 coronavirus disease 2019 (COVID-19) outbreak, a second contagion wave afflicted Europe in the autumn. The present study aimed to evaluate sleep health/patterns of Italians during this further challenging situation. A total of 2,013 Italians longitudinally participated in a web-based survey during the two contagion peaks of the COVID-19 outbreak. We investigated the risk factors for sleep disturbances during the second wave, and we compared sleep quality and psychological well-being between the two assessments (March-April and November-December 2020). Female gender, low education, evening chronotype, being a high-risk person for COVID-19 infection, reporting negative social or economic impact, and evening smartphone overuse predicted a higher risk of poor sleep and insomnia symptoms during the second wave. Advanced age, living with a high-risk person for COVID-19 infection, and having a relative/friend infected with COVID-19 before the prior 2 weeks were risk categories for poor sleep quality. Living with children, having contracted COVID-19 before the prior 2 weeks, being pessimistic about the vaccine and working in healthcare, were risk factors for insomnia symptoms. The follow-up assessment highlighted reduced insomnia symptoms and anxiety. Nevertheless, we found reduced sleep duration, higher daytime dysfunction, advanced bedtime and wake-up time, and a shift to morningness, confirming the alarming prevalence of poor sleepers (similar to 60%) and severe depression (similar to 20%) in a context of increased perceived stress. The present study showed a persistent impact of the COVID-19 pandemic on sleep and mental health. Large-scale interventions to counteract the chronicity and exacerbation of sleep and psychological disturbances are necessary, especially for the at-risk categories.

Automated summary

This study evaluated the sleep health and patterns of Italians during the second wave of the COVID-19 outbreak, finding that factors such as female gender, low education, evening chronotype, and negative social or economic impact were associated with poor sleep quality and insomnia symptoms. Risk factors for poor sleep quality included advanced age, living with high-risk individuals, and having a relative or friend infected with COVID-19. Insomnia symptoms were linked to factors like living with children and being pessimistic about the vaccine. The study also noted a reduction in insomnia symptoms and anxiety in the follow-up assessment, despite the overall impact on sleep and mental health caused by the pandemic.