Impact of the COVID-19 pandemic on change in sleep patterns in an exploratory, cross-sectional online sample of 79 countries

Objectives: To describe changes in sleep patterns during the coronavirus disease 2019 (COVID-19) pandemic, develop profiles according to these patterns, and assess sociodemographic, economic, COVID-19 related, and sleep and mental health factors associated with these profiles. Design, setting, and participants: A 25-minute online survey was distributed worldwide through social media from 5/21/2020 to 7/1/2020. Measurements: Participants reported sociodemographic/economic information, the impact of the pandemic on major life domains, insomnia and depressive symptoms, and changes in sleep midpoint, time-in-bed, total sleep time (TST), sleep efficiency (SE), and nightmare and nap frequency from prior to during the pandemic. Sleep pattern changes were subjected to latent profile analysis. The identified profiles were compared to one another on all aforementioned factors using probit regression analyses. Results: The sample of 991 participants (ages: 18-80 years; 72.5% women; 60.3% residing outside of the United States) reported significantly delayed sleep midpoint, reductions in TST and SE, and increases in nightmares and naps. Over half reported significant insomnia symptoms, and almost two-thirds reported significant depressive symptoms. Latent profile analysis revealed 4 sleep pattern change profiles that were significantly differentiated by pre-pandemic sleep patterns, gender, and various COVID-19-related impacts on daily living such as severity of change in routines, and family stress and discord. Conclusions: In an international online sample, poor sleep and depressive symptoms were widespread, and negative shifts in sleep patterns from pre-pandemic patterns were common. Differences in sleep pattern response to the COVID-19 crisis suggest potential and early targets for behavioral sleep health interventions.