Overview of sleep management during COVID-19

The sleep of millions has suffered during the global COVID-19 pandemic. Prevalence rates of 20-45% are reported globally for insomnia symptoms during the pandemic. Affected populations include the public and health care workers. A sleep deprived society faces the increased burden of COVID-related economic disruption, psychosocial problems, substance abuse, and suicide. Disordered sleep is not expected to disappear with control of infection, making interventions acutely necessary. The question becomes how to manage the sleep dysfunction during and after the pandemic. Depression and anxiety are prominent complaints during pandemic restrictions. Insomnia symptoms and fatigue continue even as mood improves in those who are in recovery from COVID-19 infection. Management of disturbed sleep and mental health is particularly needed in frontline health care workers. This overview describes 53 publications, as of February 2021, on disturbed sleep during the pandemic, treatment studies on COVIDrelated sleep disturbance, and need to rely on current treatment guidelines for common sleep disorders. The available research during the first year of COVID-19 has generally described symptoms of poor sleep rather than addressing treatment strategies. It covers digital cognitive behavioral therapy for insomnia (CBT-i) for the public and frontline workers, recognizing the need of greater acceptance and efficacy of controlled trials of CBT for affected groups. Recommendations based on a tiered public health model are discussed.(c) 2021 Elsevier B.V. All rights reserved.

Automated summary

The global COVID-19 pandemic has greatly affected the sleep of millions, with insomnia symptoms being prevalent in 20-45% of the population. Insomnia not only leads to economic disruption and psychosocial problems, but also increases the risk of substance abuse and suicide. As such, interventions for sleep dysfunction during and after the pandemic are urgently needed. This overview of 53 publications highlights the need for treatment strategies and emphasizes the importance of managing sleep and mental health in frontline healthcare workers.