Health Care Workers Experience Increased Insomnia During the Pandemic

The COVID-19 pandemic has been linked to a 44% increase in insomnia disorder among health care workers at a medical-school affiliated health system, according to a study published in the Journal of Clinical Sleep Medicine. The highest rates of insomnia were found among those who spent less time in direct patient care, with approximately 10% of this group reporting in the 17-question survey that their insomnia actually got better in the early months of the pandemic.

The survey, conducted on May 15, 2020, covered basics such as demographics, work habits, mood and anxiety symptoms, and indicators of acute insomnia disorder. Participants were asked to reflect on work assignments for the 2 weeks before SARS-CoV-2 infections began to increase and impact the function of health care facilities and society, as well as the 2 weeks before the survey.

The respondents included 678 faculty physicians, nurses, advanced practice providers, such as nurse practitioners and physician assistants, as well as residents and fellows, 44.5% of whom reported having insomnia prior to the start of the pandemic. The pandemic, according to the study, increased that rate to 64%.

“Insomnia disorder is a patient complaint of poor sleep either in quantity or quality—it can be both—with daytime consequences of their poor sleep,” said Vaughn McCall, MD, in a press release. “They suffer in the daytime because of the nighttime.”

Reported consequences from insomnia included fatigue, malaise, reduced initiative, and gastrointestinal problems. More than half the individuals in the survey reported at least 1 core symptom of depression and at least 1 anxiety symptom was reported by close to 65% of respondents. According to the researchers, the combination of insomnia and anxiety puts individuals at a high risk of suicidal ideations.

Approximately 10% of respondents reported their insomnia had improved after the onset of COVID-19. The researchers said this is potentially because working from home was a good fit for them, though the survey did not ask for details on the subject.

The highest rates of insomnia were found among those not involved in direct patient care. The researchers note that the majority of respondents who spent 30 or more hours each week in direct patient care tended to be younger than those who worked less, and age increases the overall insomnia risk.

Fatigue resulting from those directly involved in hands-on care could also be a factor in promoting better sleep for those who remained on the front line. Those who work from home may also need to balance the online educational demands of school-age children, potentially resulting in insomnia-provoking stress. The lack of a more typically structured day, with generally set times to work, be at home and sleep, might also be a factor, according to the study.

“If you work from home, there is a risk that your sleep is going to fall apart because you don't have your schedule anymore,” McCall said in the release. “Most people don't self-regulate well.”

Respondents were not asked to provide insight on how long they had problems with insomnia before the pandemic or why. The researchers plan to survey the group again when the pandemic has subsided.

REFERENCE

Pandemic significantly increases insomnia in health care workers [news release]. EurekAlert; April 27, 2021. Accessed April 28, 2021. https://www.eurekalert.org/pub_releases/2021-04/mcog-psi042321.php