Increasing public concern on insomnia during the COVID-19 outbreak in China: An info-demiology study

Abstract

Background: Since December 2019, an unexplained pneumonia has broken out in Wuhan, Hubei Province, China. In order to prevent the rapid spread of this disease, quarantine or lockdown measures were taken by the Chinese government. These measures turned out to be effective in containing the contagious disease. In spite of that, social distancing measures, together with disease itself, would potentially cause certain health risks among the affected population, such as sleep disorder. We herein conducted this web search analysis so as to examine the temporal and spatial changes of public search volume of the mental health topic of "insomnia" during COVID-19 pandemic in China.

Methods: The data sources included Baidu Index (BDI) to analyze related search terms and the official website of the National Health Commission of the People's Republic of China to collect the daily number of newly confirmed COVID-19 cases. Following a descriptive analysis of the overall search situation, Spearman's correlation analysis was used to analyze the relationship between the daily insomnia-related search values and the daily newly confirmed cases. The means of search volume for insomnia-related terms during the COVID-19 outbreak period (January 23rd, 2020 to April 8th, 2020) were compared with those during 2016-2019 using Student's t test. Finally, by analyzing the overall daily mean of insomnia in various provinces, we further evaluated whether there existed regional differences in searching for insomnia during the COVID-19 outbreak period.

Results: During the COVID-19 outbreak period, the number of insomnia-related searches increased significantly, especially the average daily the BDI for the term "1 min to fall asleep immediately". Spearman's correlation analysis showed that 6 out of the 10 insomnia-related keywords were significantly positively related to the daily newly confirmed cases. Compared with the same period in the past four years, a significantly increased search volume was found in 60.0% (6/10) insomnia-related terms during the COVID-19 outbreak period. We also found that Guangdong province had the highest number of searches for insomnia-related during the pandemic.

Conclusions: The surge in the number of confirmed cases during the COVID-19 pandemic has led to an increase in concern and online searches on this topic of insomnia. Further studies are needed to determine whether the search behavior truly reflect the real-time prevalence profile of relevant mental disorders, and further to establish a risk prediction model to determine the prevalence risk of psychopathological disorders, including insomnia, using insomnia-related BDI and other well-established risk factors.

Keywords: Baidu Index; COVID-19; Insomnia; Internet; Web search.

Figure 1

Time series correlation between the number newly confirmed COVID-19 cases and search indexes for insomnia-related terms, including “sleep disorders” (a), “1 min to fall asleep” (b), “insomnia remedies” (c), “falling asleep quickly” (d), “insomnia treatment” (e), and “how insomnia occurs” (f).

Figure 2

Regional distribution of the search indexes of insomnia-related in various provinces and cities of China from January 23rd to April 8th, 2020. AH: Anhui, BJ: Beijing, GZ: Guizhou, GS: Gansu, GD: Guangdong, GX: Guangxi, FJ: Fujian, HL: Heilongjiang, HE: Hebei, HN: Hunan, HI: Hainan, HB: Hubei, HA: Henan, JX: Jiangxi, JS: Jiangsu, JL: Jilin, LN: Liaoning, NM: Inner Mongolia, NX: Ningxia, ZJ: Zhejiang, SD: Shandong, SX: Shanxi, SC: Sichuan, SH: Shanghai, SN: Shaanxi, XJ: Xinjiang, XZ: Tibet, TJ: Tianjing, YN: Yunnan, QH: Qinghai, CQ: Chongqing, MC: Macao, HK: Hongkong, TW: Taiwan.