Insomnia episodes, new-onset pharmacological treatments and other sleep disturbances during the COVID-19 pandemic: a nationwide cross-sectional study in Brazilian health care professionals

Drager, Luciano F; Pachito, Daniela V; Moreno, Claudia R C; Tavares, Almir R; Conway, Silvia G; Assis, Márcia; Sguillar, Danilo A; Moreira, Gustavo A; Bacelar, Andrea; Genta, Pedro R

STUDY OBJECTIVES: To evaluate the impact of COVID-19 pandemic on insomnia and other sleep disturbances in health care professionals. METHODS: A survey was distributed using social media and organizational emails to Brazilian active health care professionals during the COVID-19 outbreak. We explored potential associated factors including age, gender, occupation, workplace, work hours, income, previous infection with COVID-19, recent/current contact with COVID-19 patients, regional number of incident deaths, anxiety, and burnout. We evaluated new-onset/ previous insomnia worsening episodes (primary outcome), new pharmacological treatments, sleep quality, duration, nightmares and snoring (secondary outcomes). RESULTS: A total of 4,384 health professionals from all regions of the country were included in the analysis (44±12 years, 76% females, 53.8% physicians). Overall, 55.7% were assisting patients with COVID-19, and 9.2% had a previous COVID-19 infection. The primary outcome occurred in 32.9% of respondents in parallel to 13% new pharmacological treatments for insomnia. The sleep quality worsened for 61.4%, while 43.5% and 22.8% reported ≥1-hour sleep duration reduction and worsening or new-onset nightmares, respectively. Multivariate analyses showed that age (OR:1.008; 95% CI 1.001-1.015), females (OR:1.590; 95% CI 1.335-1.900), weight change (decrease: OR:1.772; 95% CI 1.453-2.161; increase: OR:1.468; 95% CI 1.249-1.728), prevalent anxiety (OR:3.414; 95% CI 2.954-3.948), new-onset burnout (OR:1.761; 95% CI 1.489-2.083), family income reduction >30% (OR:1.288; 95% CI 1.069-1.553) and assisting patients with COVID-19 (OR:1.275; 95% CI 1.081-1.506) were independently associated with new-onset or worsening of previous insomnia episodes. CONCLUSIONS: We observed a huge burden of insomnia episodes and other sleep disturbances in health care professionals during the COVID-19 pandemic.