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. 2021 Feb 1;17(2):177-184.
doi: 10.5664/jcsm.8810.

Google Trends reveals increases in internet searches for insomnia during the 2019 coronavirus disease (COVID-19) global pandemic

Kirsi-Marja Zitting  1 , Heidi M Lammers-van der Holst  1 , Robin K Yuan  1 , Wei Wang  1 , Stuart F Quan  1 , Jeanne F Duffy  1
Affiliations

Google Trends reveals increases in internet searches for insomnia during the 2019 coronavirus disease (COVID-19) global pandemic

Kirsi-Marja Zitting et al. J Clin Sleep Med. .

Abstract

Study objectives: The 2019 coronavirus disease (COVID-19) has become a global health and economic crisis. Recent evidence from small samples suggest that it has increased mood and sleep disturbances, including insomnia, around the world. This study aimed to estimate the effect of COVID-19 on insomnia levels worldwide and in the United States during the acute phase of the pandemic.

Methods: We analyzed search query data recorded between January 2004 and May 2020 from Google Trends and Google Keyword Planner for the search term "insomnia".

Results: The number of search queries for insomnia has increased over the past decade and is greater than the number of search queries for other major sleep disorders. The COVID-19 pandemic increased search queries for insomnia both worldwide and in the United States, with the number in the United States increasing by 58% during the first 5 months of 2020 compared with the same months from the previous 3 years. There is a robust diurnal pattern in insomnia search queries in the United States, with the number of queries peaking around 3 am and the overall pattern remaining stable during the pandemic.

Conclusions: These results highlight the impact the COVID-19 pandemic has had on sleep health and the urgent need for making effective interventions accessible. Future studies will be needed to determine whether the increase in insomnia symptoms will persist and lead to higher rates of chronic insomnia in the population.

Keywords: COVID-19; Google Trends; insomnia; sleep; sleep disorder.

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Conflict of interest statement

All authors have seen and approved the manuscript. K.-M.Z. was supported in part by P01 AG009975 and awards from the American Academy of Sleep Medicine Foundation, the President and Fellows of Harvard College, and the William F. Milton Fund of Harvard University. H.M.L.-v.d.H. was supported by National Institutes of Health (NIH) grant R01 AG044416. R.K.Y. was supported by National Institutes of Health (NIH) grant F32 HL143893. J.F.D. and W.W. were supported in part by National Institutes of Health (NIH) grants P01 AG09975 and R01 AG044416. K.M.Z.’s spouse works at Google but did not participate in the writing of this paper. S.F.Q. is a consultant for Jazz Pharmaceuticals, Whispersom, and Best Doctors. He is also the Chair of the Scoring Manual Committee and a member of the Hypopnea Taskforce for the American Academy of Sleep Medicine and receives grant funding from the NIH. The other authors report no conflicts of interest.

Figures

Figure 1
Figure 1. Google search queries for the sleep-related terms between 2004 and 2019.
Google search queries worldwide (A) and in the United States (B) for the search terms “insomnia,” “sleep apnea,” “restless legs,” and “narcolepsy” between 2004 and 2019. There were significantly more search queries for “insomnia” compared to the other 3 sleep disorders worldwide (P < .0001 for all comparisons, log-transformed data) and in the United States (P < .0001 for all comparisons, log-transformed data). There was also a significant increase in search interest for “insomnia” starting from 2009 worldwide (P < .0001 for all comparisons) and from 2011 in the United States (P = .0015 for 2004 vs 2011; P < .0001 for all other comparisons).
Figure 2
Figure 2. Search interest in insomnia and cumulative number of COVID-19 deaths.
Daily search queries for the search term “insomnia” worldwide (A) and in the United States (B) during the first 5 months (January through May 2020) of the COVID-19 pandemic compared with the same 5 months of 2017–2019. There was a significant increase in search interest for “insomnia” in April and May of 2020 compared with the same months in previous years, both worldwide (A) (P < .0001) and in the United States (B) (P < .0001). This increase in search interest for “insomnia” coincides with the increase in the cumulative number of COVID-19–related deaths (logarithmic scale) both worldwide (17 March–22 April; P < .0001) (C) and in the United States (17 March–7 May; P < .0001) (D). COVID-19 = 2019 coronavirus disease.
Figure 3
Figure 3. Daily and weekly pattern in Google search queries for the search term “insomnia” worldwide and in the United States.
There was a significant daily pattern in search interest for “insomnia” both worldwide (A) (P = .0045) and in the United States (B) (P < .0001), with the greatest interest in insomnia observed during the weekend–weekday transition on Sundays and Mondays and the least toward the weekday–weekend transition on Fridays and Saturdays. There was a significant interaction between weeks and day of the week in 2020 worldwide (C) (P = .0437), but not in the United States (D), with a greater number of “insomnia” search queries on weekdays compared with weekends in January and February (weeks 1–8) and fewer search queries on weekdays compared with weekends in April and May (weeks 13–20). Wks = weeks.
Figure 4
Figure 4. Diurnal pattern in Google search queries per hour.
Diurnal pattern in Google search queries per hour for the search term “insomnia” in the United States (black line) and in each of the 50 states (blue lines) (A). There was a significant diurnal pattern in the number of insomnia search queries per hour in 2017–2019 (P < 0.0001), with the greatest interest observed around 3 am. While the number of search queries per hour was significantly higher in 2020 compared with 2017–2019 (P < .0001 for all comparisons, log-transformed data), the overall pattern did not change except for a small delay in peak time in 2020 compared with 2017–2019 (3:06 am in 2017–2019 vs 3:19 am in 2020; P < .0001) (B).
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Comment in

  • Losing sleep during the pandemic.
    Jindal RD. Jindal RD. J Clin Sleep Med. 2021 Feb 1;17(2):115-116. doi: 10.5664/jcsm.9066. J Clin Sleep Med. 2021. PMID: 33289478 Free PMC article.

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