Factors Associated with Insomnia Symptoms in a Longitudinal Study among New York City Healthcare Workers during the COVID-19 Pandemic

Abstract

Background: Few studies have examined the longer-term psychological impact of COVID-19 in healthcare workers (HCWs).

Purpose: We examined the 10-week trajectory of insomnia symptoms in HCWs during the COVID-19 pandemic.

Methods: HCWs completed a web-based survey at baseline (9 April-11 May 2020) and every 2 weeks for 10 weeks. The main outcome was the severity of insomnia symptoms in the past week. Multivariable-adjusted generalized estimating equation analyses examined factors associated with insomnia symptoms.

Results: n = 230 completed surveys at baseline. n = 155, n = 130, n = 118, n = 95, and n = 89 completed follow-ups at weeks 2, 4, 6, 8, and 10, respectively. Prevalence of insomnia symptoms of at least moderate severity was 72.6% at baseline, and 63.2%, 44.6%, 40.7%, 34.7%, and 39.3% at weeks 2, 4, 6, 8, and 10, respectively. In multivariable analyses, factors significantly associated with increased odds of insomnia symptoms were younger age (OR: 0.98, 95% CI: 0.96-1.00), working in a COVID-facing environment (OR: 1.75, 95% CI: 1.15-2.67) and hours worked (OR: 1.16, 95% CI: 1.06-1.27).

Conclusions: The initial high rates of insomnia symptoms improved as time passed from the peak of local COVID-19 cases but four out of ten HCWs still had moderate-to-severe insomnia symptoms ten weeks after baseline.

Keywords: COVID-19; healthcare worker; insomnia; mental health; sleep.

Figure 1

Prevalence of participants reporting insomnia symptoms of at least moderate severity across the 10-week follow-up period.; ^a Ratings were on a 0–4 scale (none, mild, moderate, severe, very severe) for the following question: “Over the past week, what is the severity of any insomnia symptoms you experienced (e.g., poor quality sleep, difficulty falling asleep or staying asleep, waking up too early, feeling that sleep is not refreshing)?”.