COVID-19 health workers face stress-based trauma and insomnia

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More than a third of medical staff involved in the Covid19 outbreak in China suffered from insomnia, and these sleep-deprived health workers also were more likely to feel depressed, anxious and have stress-based trauma.

The study was by Nanfang Hospital – Southern Medical University, the Renmin Hospital of Wuhan University, the Jingmen City Hospital of Traditional Chinese Medicine and The Chinese University of Hong Kong.

Dr Bin Zhang, a professor at Southern Medical University in Guangzhou, said: “Typically, stress-related insomnia is transient and persists only for a few days, but if the COVID-19 outbreak continues, the insomnia may gradually become chronic insomnia in clinical settings.”

The study, conducted among 1,563 participants, found that health workers with insomnia were also more likely to be suffering from depression during the pandemic. One of the culprits? Uncertainty. “The most important factor was having very strong uncertainty regarding effective disease control among medical staff,” said Zhang. Strong uncertainty was 33% higher for those exhibiting insomnia. According to the report, the authors said health workers were also under “incredible stress in general”. Being in close contact with infected patients who could make them sick was a constant source of stress, coupled with the worry of passing on the disease to family and friends.

Objective: The outbreak of the 2019 novel coronavirus disease (COVID-19) caused not only extraordinary public health concerns but also tremendous psychological distress, particularly among medical staff. We aimed to investigate the prevalence rate of insomnia and confirm the related social psychological factors among medical staff in hospitals during the COVID-19 outbreak.
Method: Medical staff members in China were recruited, including frontline medical workers. The questionnaire, administered through the WeChat program, obtained demographic data and asked self-design questions related to the COVID-19 outbreak, insomnia/depressive/anxiety symptoms, and stress-related symptoms. We used logistic regression analysis to examine the associations between sociodemographic factors and insomnia symptoms.

Result: There were 1,563 participants in our study. Five hundred and sixty-four (36.1%) participants had insomnia symptoms according to the Insomnia Severity Index (ISI) (total score ≥ 8). A multiple binary logistic regression model revealed that insomnia symptoms were associated with the education level of high school or below (OR = 2.69, p = 0.042, 95% CI = 1.0–7.0), occupation of doctor (OR = 0.44, p = 0.007, 95% CI = 0.2–0.8), currently working in an isolation unit (OR = 1.71, p = 0.038, 95% CI = 1.0–2.8), worry about being infected (OR = 2.30, p < 0.001, 95% CI = 1.6–3.4), perceived lack of helpfulness in terms of psychological support from news or social media with regard to COVID-19 (OR = 2.10, p = 0.001, 95% CI = 1.3–3.3), and having very strong uncertainty regarding effective disease control (OR = 3.30, p = 0.013, 95% CI = 1.3–8.5).
Conclusion: Our study found that more than one-third of the medical staff suffered from insomnia symptoms during the COVID-19 outbreak. The related factors included education level, an isolation environment, psychological worries about the COVID-19 outbreak, and occupation of doctor. Interventions for insomnia among medical staff are needed considering the different sociopsychological factors.

Chenxi Zhang, Lulu Yang, Shuai Liu, Simeng Ma, Ying Wang, Zhongxiang Cai, Hui Du, Ruiting Li, Lijun Kang, Meilei Su, Jihui Zhang, Zhongchun Liu, Bin Zhang

Frontiers in Psychiatry abstract

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