Indian Journal of Sleep Medicine

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VOLUME 17 , ISSUE 4 ( October-December, 2022 ) > List of Articles

Original Article

Insomnia: An Under-recognized Mental Health Catastrophe during the COVID-19 Era

Amina Mobashir, Vivek Nangia, Shriram Sudhakar Shenoy, Navin Dalal, Rohit R Chandran

Keywords : Cognition, Coronavirus pandemic, Insomnia, Sleep

Citation Information : Mobashir A, Nangia V, Shenoy SS, Dalal N, Chandran RR. Insomnia: An Under-recognized Mental Health Catastrophe during the COVID-19 Era. Indian Sleep Med 2022; 17 (4):93-98.

DOI: 10.5005/jp-journals-10069-0107

License: CC BY-NC 4.0

Published Online: 29-04-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Introduction: The coronavirus pandemic (COVID-19) has affected individuals globally in varied manners. It has also affected the psychosocial well-being, particularly of persons residing in the countries that were worst affected. In India, complete lockdown, social distancing, working from home, and fear of getting infected have caused a vast majority to develop problems related to sleep. We studied the prevalence of insomnia and also identified the potential modifiable risk factors that can address the coronavirus-related sleep pandemic. Materials and methods: We conducted a survey using a questionnaire delivered through the internet. A total of 645 individuals were enrolled in the study. Insomnia severity index was used to calculate the prevalence of clinically significant insomnia. Data were coded and recorded in MS Excel spreadsheet program. SPSS v23 was used for data analysis. Results: We found that 51.3% (n = 331) of our study population had clinically significant insomnia out of which 137 (21.2%) reported new onset symptoms during the lockdown. Statistically significant association were found between insomnia and female gender, age, anxiety, caffeine consumption, alcohol consumption, and sleep–wake patterns. Conclusions: In conclusion, the burden of insomnia is more than those that seek treatment. It has tremendous negative consequences on patient's well-being. During the pandemic, given the current social and economic doldrums, insomnia may very well be the last nail in the coffin for those with pre-existing mental illnesses just trying to stay afloat.

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  1. Española RA, Madrid E. Diccionario de la lengua española. Madrid: Real academia española; 2001 Apr.
  2. Bhattacharya D, Sen MK, Suri JC. Epidemiology of insomnia: A review of the global and Indian scenario. Indian J Sleep Med 2013;8:100. DOI: 10.5005/ijsm-8-3-100.
  3. Kim K, Uchiyama M, Okawa M, et al. An epidemiological study of insomnia among the Japanese general population. Sleep 2000;23(1):41–47. PMID: 10678464.
  4. Morgan K, Clarke D. Risk factors for late-life insomnia in a representative general practice sample. British J Gen Pract 1997;47(416):166–169. PMCID: PMC1312924.
  5. Foley DJ, Monjan A, Simonsick EM, et al. Incidence and remission of insomnia among elderly adults: an epidemiologic study of 6,800 persons over three years. Sleep 1999;22(2):S366–372. PMID: 10394609.
  6. Sher L. COVID-19, anxiety, sleep disturbances and suicide. Sleep Med 2020;70:124. DOI: 10.1016/j.sleep.2020.04.019.
  7. e Cruz MM, Miyazawa M, Gozal D. Putative contributions of circadian clock and sleep in the context of SARS-CoV-2 infection. Eur Respir J 2020;61(4):3–7. DOI: 10.1183/13993003.01023-2020.
  8. Monk TH. Enhancing circadian zeitgebers. Sleep 2010;33(4):421–422. PMCID: PMC2849779.
  9. Sateia MJ. International classification of sleep disorders. Chest 2014;146(5):1387–1394. DOI: 10.1378/chest.14-0970.
  10. Bastien CH, Vallières A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2001;2(4):297–307. PMID: 11438246.
  11. Zhang C, Yang L, Liu S, et al. Survey of insomnia and related social psychological factors among medical staffs involved with the 2019 novel coronavirus disease outbreak. Front Psych 2020;11:1–9. DOI: 10.3389/fpsyt.2020.00306. eCollection 2020.
  12. Morin CM, Belleville G, Bélanger L, et al. The insomnia severity index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep 2011;34(5):601–608. DOI: 10.1093/sleep/34.5.601.
  13. Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep med rev 2002;6(2):97–111. DOI: 10.1053/smrv.2002.0186.
  14. Ford DE, Kamerow DB. Epidemiologic study of sleep disturbances and psychiatric disorders: an opportunity for prevention?. Jama 1989;262(11):1479–1484. PMID: 2769898.
  15. Leger D, Guilleminault C, Dreyfus JP, et al. Prevalence of insomnia in a survey of 12 778 adults in France. J sleep res 2000;9(1):35–42. DOI: 10.1046/j.1365-2869.2000.00178.x.
  16. Soldatos CR. Insomnia in relation to depression and anxiety: Epidemiologic considerations. J Psychosom Research 1994;38:3–8. PMID: 7799249.
  17. Mukku SS, Harbishettar V, Sivakumar PT. Insomnia in elderly: A neglected epidemic. Journal of Geriatric Mental Health 2018;5(2):84–93. DOI: 10.4103/jgmh.jgmh_15_18.
  18. Ohayon MM, Zulley J, Guilleminault C, et al. How age and daytime activities are related to insomnia in the general population: Consequences for older people. J Am Geriatr Soc 2001;49(4):360–366. DOI: 10.1046/j.1532-5415.2001.49077.x.
  19. Yuan Q, Joiner WJ, Sehgal A. A sleep-promoting role for the Drosophila serotonin receptor 1A. Curr Biol 2006;16(11):1051–1062. DOI: 10.1016/j.cub.2006.04.032.
  20. Jiang XL, Zheng XY, Yang J, et al. A systematic review of studies on the prevalence of insomnia in university students. Public health 2015;129(12):1579–1584. PMID: 26298588.
  21. Haile YG, Alemu SM, Habtewold TD. Insomnia and its temporal association with academic performance among university students: A cross-sectional study. BioMed res int 2017;2017:2542367. DOI: 10.1155/2017/2542367.
  22. Lee S, Chan LY, Chau AM, et al. The experience of SARS-related stigma at Amoy Gardens. Social sci med 2005 1;61(9):2038–2046. DOI: 10.1016/j.socscimed.2005.04.010.
  23. Su TP, Lien TC, Yang CY, et al. Prevalence of psychiatric morbidity and psychological adaptation of the nurses in a structured SARS caring unit during outbreak: A prospective and periodic assessment study in Taiwan. J psychiatr res 2007;41(1-2):119–130. doi: 10.1016/j.jpsychires.2005.12.006.
  24. Yoon IY, Kripke DF, Youngstedt SD, et al. Actigraphy suggests age‐related differences in napping and nocturnal sleep. J sleep res 2003;12(2):87–93. DOI: 10.1046/j.1365-2869.2003.00345.x.
  25. Campbell SS, Murphy PJ, Stauble TN. Effects of a nap on nighttime sleep and waking function in older subjects. J Am Geriatr Soc 2005;53(1):48–53. DOI: 10.1111/j.1532-5415.2005.53009.x
  26. Tamaki M, Shirota A, Hayashi M, et al. Restorative effects of a short afternoon nap (<30 min) in the elderly on subjective mood, performance and EEG activity. Sleep res online: SRO 2000;3(3):131–139. PMID: 11382911.
  27. Chaudhary NS, Grandner MA, Jackson NJ, et al. Caffeine consumption, insomnia, and sleep duration: Results from a nationally representative sample. Nutrition 2016;32(11-12):1193–1199. DOI: 10.1016/j.nut.2016.04.005.
  28. Shirlow MJ, Mathers CD. A study of caffeine consumption and symptoms: indigestion, palpitations, tremor, headache and insomnia. Int J Epidemiol 1985;14(2):239–248. DOI: 10.1093/ije/14.2.239.
  29. Calamaro CJ, Mason TB, Ratcliffe SJ. Adolescents living the 24/7 lifestyle: effects of caffeine and technology on sleep duration and daytime functioning. Pediatrics 2009;123(6):e1005–10. DOI: 10.1542/peds.2008-3641.
  30. Karacan I, Thornby JI, Anch AM, et al. Dose‐related sleep disturbances induced by coffee and caffeine. Clin Pharmacol Therapeut 1976;20(6):682–689. DOI: 10.1002/cpt1976206682.
  31. Bonnet MH, Arand DL. Caffeine use as a model of acute and chronic insomnia. Sleep 1992;15(6):526–536. PMID: 1475567.
  32. Zhabenko O, Krentzman AR, Robinson EA, et al. A longitudinal study of drinking and depression as predictors of insomnia in alcohol-dependent individuals. Subst use misuse 2013;48(7):495–505. DOI: 10.3109/10826084.2013.781182.
  33. Shinba T, Murashima YL, Yamamoto KI. Alcohol consumption and insomnia in a sample of Japanese alcoholics. Addiction 1994;89(5):587–591. DOI: 10.1111/j.1360-0443.1994.tb03335.x.
  34. Chang KJ, Son SJ, Lee Y, et al. Perceived sleep quality is associated with depression in a Korean elderly population. Arch Gerontol Geriatr 2014;59(2):468–473. DOI: 10.1016/j.archger.2014.04.007.
  35. Vinson DC, Manning BK, Galliher JM, et al. Alcohol and sleep problems in primary care patients: A report from the AAFP National Research Network. Ann Fam Med 2010;8(6):484–492. PMCID: PMC2975682.
  36. Gellis LA, Park A, Stotsky MT, et al. Associations between sleep hygiene and insomnia severity in college students: Cross-sectional and prospective analyses. Behavior Ther 2014;45(6):806–816. DOI: 10.1016/j.beth.2014.05.002.
  37. Jefferson CD, Drake CL, Scofield HM, et al. Sleep hygiene practices in a population-based sample of insomniacs. Sleep 2005;28(5):611–615. DOI: 10.1093/sleep/28.5.611.
  38. LeBourgeois MK, Giannotti F, Cortesi F, et al. The relationship between reported sleep quality and sleep hygiene in Italian and American adolescents. Pediatrics 2005;115(1):257–265. DOI: 10.1542/peds.2004-0815H.
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