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
. 2022 Dec;38(5):919-926.
doi: 10.1002/smi.3144. Epub 2022 Mar 28.

Longitudinal associations between stress and sleep disturbances during COVID-19

Andrea Ballesio  1 , Andrea Zagaria  1 , Alessandro Musetti  2 , Vittorio Lenzo  3 , Laura Palagini  4 , Maria Catena Quattropani  5 , Elena Vegni  6 , Federica Bonazza  6 , Maria Filosa  7 , Tommaso Manari  2 , Maria Francesca Freda  8 , Emanuela Saita  9 , Gianluca Castelnuovo  9   10 , Giuseppe Plazzi  11   12 , Caterina Lombardo  1 , Christian Franceschini  7
Affiliations

Longitudinal associations between stress and sleep disturbances during COVID-19

Andrea Ballesio et al. Stress Health. 2022 Dec.

Abstract

The psychological consequences of COVID-19 pandemic may include the activation of stress systems, that involve the hypothalamic-pituitary-adrenal axis which influences many physiological functions, including sleep. Despite epidemiological studies evidenced greater prevalence of stress symptoms and sleep disturbances during COVID-19, longitudinal evidence investigating the effects of stress on sleep disturbances during the pandemic is lacking. We collected measures of perceived stress and sleep disturbances during the first wave of COVID-19 (March 2020) and at 8-10 months follow up in a sample of 648 adults (M = 33.52, SD = 12.98 years). Results showed that 39.4% of participants reported moderate to extremely severe stress in March 2020. Prevalence of sleep disturbances was 54.8% in March 2020 and 57.4% at follow-up. Structural equation modelling highlighted that perceived stress in March 2020 significantly predicted sleep disturbances at follow up (β = 0.203; p < 0.001), even after controlling for baseline sleep disturbances. Results remained significant even after controlling for the effects of covariates including age, sex, depression and anxiety symptoms, and referring to psychological services (β = 0.179; p < 0.05). Findings confirm the high prevalence of stress symptoms during the COVID-19 pandemic and provide first longitudinal evidence for the effects of perceived stress on sleep disturbances during the pandemic.

Keywords: COVID-19; HPA axis; arousal; mental health; pandemic; sleep; stress.

PubMed Disclaimer

Conflict of interest statement

The authors do not report any conflict of interest.

References

    1. Antony, M. M. , Bieling, P. J. , Cox, B. J. , Enns, M. W. , & Swinson, R. P. (1998). Psychometric properties of the 42‐item and 21‐item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10(2), 176–181. 10.1037/1040-3590.10.2.176 - DOI
    1. Bacaro, V. , Chiabudini, M. , Buonanno, C. , De Bartolo, P. , Riemann, D. , Mancini, F. , & Baglioni, C. (2020). Insomnia in the Italian population during covid‐19 outbreak: A snapshot on one major risk factor for depression and anxiety. Frontiers in Psychiatry, 11, 579107. 10.3389/fpsyt.2020.579107 - DOI - PMC - PubMed
    1. Bagozzi, P. R. , & Yi, Y. (2012). Specification, evaluation, and interpretation of structural equation models. Academy of Marketing Science, 40, 8–34. 10.1007/s11747-011-0278-x - DOI
    1. Ballesio, A. , Zagaria, A. , Baccini, F. , Micheli, F. , Di Nardo, G. , & Lombardo, C. (2021). A meta‐analysis on sleep quality in inflammatory bowel disease. Sleep Medicine Reviews, 60, 101518. 10.1016/j.smrv.2021.101518 - DOI - PubMed
    1. Beam, C. R. , & Kim, A. J. (2020). Psychological sequelae of social isolation and loneliness might be a larger problem in young adults than older adults. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S58–S60. 10.1037/tra0000774 - DOI - PubMed