With the demands of the COVID-19 pandemic, sleep deprivation among health care professionals (HCPs) has become a major concern. Are they functioning well enough at work? Do they show signs of stress? Several reviews and surveys have attempted to evaluate and quantify the effects of these unrelenting stressors on the mental and physical health of HCPs treating patients with COVID-19.
An Unprecedented Problem
The impact of the pandemic and subsequent lockdowns on sleep has been universal, according to Michael Grandner, PhD, MTR, CBSM, FAASM, director of the Sleep and Health Research Program and the Behavioral Sleep Medicine Clinic at the University of Arizona College of Medicine in Tucson. “There is not one person anywhere whose sleep has not been affected at all by the pandemic. It’s a foundation of our biology. Paradoxically, everyone’s sleep is affected differently,” he said in an interview.
Lack of sleep among HCPs became a critical problem as frontline clinicians struggled to cope with the personal aspects of COVID-19 while treating those who were sick. A meta-analysis of 53 studies reported a pooled prevalence of poor sleep quality in up to 61% of nurses in general,1 whereas a 2020 survey in China showed that more than one-third of all medical staff experienced symptoms of insomnia associated with the COVID-19 pandemic.
“Health care workers, in particular, have had to work long hours with limited resources and in close proximity to COVID-19 patients during the pandemic,” William D. Killgore, PhD, director of the Social, Cognitive, and Affective Neuroscience (SCAN) Lab in the Department of Psychiatry at the University of Arizona, said in an interview. The SCAN Lab uses advanced technologies to map neurological processes and responses. “As the hospitalization rates continue to surge again, many health care workers are experiencing high levels of stress, anxiety, depression, burnout, and insomnia,” he added.
Many Sleep Domains Affected
Sleep parameters affected include sleep latency, duration, and efficiency. Some study results suggested that insomnia, or difficulty falling asleep or remaining asleep, is reported by more than half of health care workers who worked with patients with COVID-19, Killgore said. “Many health care workers are showing signs of posttraumatic stress, which is often associated with nightmares and disturbed sleep. Unfortunately, sleep is important for the ability to process through emotional experiences, so sleep disruption due to anxiety, long hours, and stress can lead to a vicious circle that maintains sleep problems and the emotional effects of traumatic experiences.”