Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct 13;11(1):56.
doi: 10.1186/s13293-020-00333-4.

Sex differences in self-report anxiety and sleep quality during COVID-19 stay-at-home orders

Jeremy A Bigalke  1   2 , Ian M Greenlund  1   2 , Jason R Carter  3   4
Affiliations

Sex differences in self-report anxiety and sleep quality during COVID-19 stay-at-home orders

Jeremy A Bigalke et al. Biol Sex Differ. .

Abstract

Background: COVID-19 and home isolation has impacted quality of life, but the perceived impact on anxiety and sleep remains equivocal. The purpose of this study was to assess the impact of COVID-19 and stay-at-home orders on self-report anxiety and sleep quality, with a focus on sex differences. We hypothesized that the COVID-19 pandemic would be associated with increased anxiety and decreased sleep quality, with stronger associations in women.

Methods: One hundred three participants (61 female, 38 ± 1 years) reported perceived changes in anxiety and sleep quality due to stay-at-home orders during the COVID-19 pandemic and were administered the Spielberger State-Trait Anxiety Inventory (STAI), Pittsburgh Sleep Quality Index (PSQI), and Insomnia Severity Index (ISI). Chi-square and T test analyses were utilized to assess sex differences in reported anxiety and sleep. Analysis of covariance was used to compare the associations between reported impact of COVID-19 and anxiety/sleep parameters.

Results: Women (80.3%) reported higher prevalence of increased general anxiety due to COVID-19 when compared to men (50%; p = 0.001) and elevated STAI state anxiety compared to men (43 ± 1 vs. 38 ± 1 a.u., p = 0.007). Despite these differences in anxiety, the perceived impact of COVID-19 on PSQI was not different between sexes. However, when stratified by perceived changes in anxiety due to COVID-19, participants with higher anxiety responses to COVID-19 had higher ISI compared to those with no perceived changes in anxiety (9 ± 1 vs. 5 ± 1 a.u., p = 0.003). Additionally, participants who reported reduced sleep quality due to COVID-19 reported higher state anxiety (45 ± 1 a.u.) compared to those that perceived no change (36 ± 2 a.u., p = 0.002) or increased (36 ± 2 a.u., p < 0.001) sleep quality.

Conclusion: COVID-19 and state-ordered home isolation was associated with higher anxiety and reduced sleep quality, with a stronger association in women with respect to anxiety.

Keywords: Anxiety; COVID-19; Pandemic; Sex; Sleep quality; Total sleep time.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Chi-square analysis of sex and perceived changes in anxiety due to COVID-19. The proportion of men and women who reported increased versus unchanged/decreased anxiety due to COVID-19 and state-ordered home quarantine
Fig. 2
Fig. 2
Anxiety and sleep parameters stratified by perceived changes in anxiety due to COVID-19. State anxiety and Insomnia Severity Index (ISI) mean covariate adjusted scores in those who reported decreased, unchanged, or increased anxiety due to COVID-19. Decreased anxiety, N = 7; unchanged anxiety, N = 26; increased anxiety, N = 70. *P < 0.01; **P < 0.001. a.u., arbitrary units
Fig. 3
Fig. 3
Anxiety and sleep parameters stratified by perceived changes in sleep quality due to COVID-19. Trait anxiety, state anxiety, Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI) in those who reported decreased, unchanged, or increased sleep quality (SQ) due to COVID-19. Decreased SQ, N = 58; unchanged SQ, N = 28; increased SQ, N = 17. *P < 0.05 vs. groups; **P < 0.001 vs. all groups. a.u., arbitrary units
Fig. 4
Fig. 4
Anxiety and sleep parameters stratified by perceived changes in total sleep time (TST) due to COVID-19. Trait anxiety, state anxiety, Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI) in those who were determined to have decreased, unchanged, or increased TST due to COVID-19. Decreased TST, N = 33; unchanged TST, N = 51; increased TST, N = 19. *P < 0.05 vs. all groups. **P < 0.01 vs. all groups. ***P ≤ 0.001 vs. all groups. a.u., arbitrary units
See this image and copyright information in PMC

References

    1. World Health Organization. Coronavirus Disease (COVID-19) Situation Report 131. World Health Organization; 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/2....
    1. Centers for Disease Control and Prevention . Coronavirus disease 2019 (COVID-19): cases in the U.S.; 2020. Contract No.: May 30. 2020.
    1. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395(10227):912–920. doi: 10.1016/S0140-6736(20)30460-8. - DOI - PMC - PubMed
    1. Xiang YT, Jin Y, Cheung T. Joint international collaboration to combat mental health challenges during the coronavirus disease 2019 pandemic. JAMA Psychiatry. 2020;77(10):989–90. - PubMed
    1. Xiang YT, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020;7(3):228–229. doi: 10.1016/S2215-0366(20)30046-8. - DOI - PMC - PubMed

Publication types

MeSH terms