Sleep problems among Chinese adolescents and young adults during the coronavirus-2019 pandemic

Abstract

Objective: To assess the prevalence and sociodemographic correlates of insomnia symptoms among Chinese adolescents and young adults affected by the outbreak of coronavirus disease-2019 (COVID-19).

Methods: This cross-sectional study included Chinese adolescents and young adults 12-29 years of age during part of the COVID-19 epidemic period. An online survey was used to collect demographic data, and to assess recognition of COVID-19, insomnia, depression, and anxiety symptoms using the Pittsburgh Sleep Quality Index (PSQI), the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder (GAD-7) questionnaires, respectively. The Social Support Rate Scale was used to assess social support.

Results: Among 11,835 adolescents and young adults included in the study, the prevalence of insomnia symptoms during part of the COVID-19 epidemic period was 23.2%. Binomial logistic regression analysis revealed that female sex and residing in the city were greater risk factors for insomnia symptoms. Depression or anxiety were risk factors for insomnia symptoms; however, social support, both subjective and objective, was protective factors against insomnia symptoms. Furthermore, anxiety and depression symptoms were mediators of social support and insomnia symptoms.

Conclusions: Results of this study revealed a high prevalence of sleep problems among adolescents and young adults during the COVID-19 epidemic, especially senior high school and college students, which were negatively associated with students' projections of trends in COVID-19. The adverse impact of COVID-19 was a risk factor for insomnia symptoms; as such, the government must devote more attention to sleep disorders in this patient population while combating COVID-19.

Keywords: Adolescents; COVID-19; Insomnia; Prevalence; Young adults.

Fig. 1

The incidence of insomnia symptoms in students with different levels of COVID-19 knowledge (N = 11,835).

Fig. 2

The incidence of insomnia symptoms in students with different levels of adverse impact of COVID-19 (N = 11,835).

Fig. 3

The incidence of insomnia symptoms in students with different levels of projections of COVID-19 trend (N = 11,835).

Fig. 4

A shoes model 1 path diagram of the mediation model (X = subjective support; Y= PSQI total score). Path C represent the variance in subjective support associated with PSQI total score. Path C′ represent the association between subjective support and PSQI total score after taking into account PHQ-9 total scores. B shows model 2 path diagram of the mediation model (X = subjective support; Y= PSQI total score). Path C represent the variance in subjective support associated with PSQI total score. Path C′ represent the association between subjective support and PSQI total score after taking into account GAD-7 total scores. Path AB is the mediation effect and is significant at P＜0.05 based on 95% CI from bias-corrected bootstrapping of 5000 samples.

Fig. 5

A shows model 3 path diagram of the mediation model (X = subjective support; Y= PSQI total score). Path C represent the variance in subjective support associated with PSQI total score. Path C′ represent the association between subjective support and PSQI total score after taking into account PHQ-9 total scores. B shows model 4 path diagram of the mediation model (X = subjective support; Y= PSQI total score). Path C represent the variance in objective support associated with PSQI total score. Path C′ represent the association between objective support and PSQI total score after taking into account GAD-7 total scores. Path AB is the mediation effect and is significant at P＜0.05 based on 95% CI from bias-corrected bootstrapping of 5000 samples.