Elsevier

Sleep Medicine

Volume 90, February 2022, Pages 44-52
Sleep Medicine

Original Article
Insomnia and nightmare profiles during the COVID-19 pandemic in Portugal: characterization and associated factors

https://doi.org/10.1016/j.sleep.2021.12.018Get rights and content

Highlights

  • During lockdown, 5 insomnia profiles and 3 nightmare profiles were identified.

  • Profiles varied in severity and over time, being influenced by psychosocial factors.

  • Being a female, young adult and low income increased the odds of having the worst sleep profiles.

  • Fear of SARS-CoV-2 infection is associated with the most severe sleep profiles.

Abstract

Objective/background

To describe and characterize insomnia symptoms and nightmare profiles in Portugal during the first six weeks of a national lockdown due to COVID-19.

Patients/methods

An open cohort study was conducted to collect information of the general population during the first wave of SARS-CoV-2/COVID-19 pandemic in Portugal. We analyzed data from 5011 participants (≥16 years) who answered a weekly questionnaire about their well-being. Two questions about the frequency of insomnia and nightmares about COVID-19 were consecutively applied during six weeks (March–May 2020). Latent class analysis was conducted and different insomnia and nightmare profiles were identified. Associations between individual characteristics and both profiles were estimated using odds ratios (ORs) and 95% confidence intervals (CI).

Results

Five insomnia (No insomnia, Stable-mild, Decreasing-moderate, Stable-severe, Increasing-severe) and three nightmares profiles (Stable-mild, Stable-moderate, Stable-severe) were identified. Being female, younger, perceiving their income as insufficient and feelings of fear towards COVID-19 were associated with higher odds of insomnia (Women: OR = 6.98 95%CI: 4.18–11.64; ≥60 years: OR = 0.30 95%CI: 0.18–0.53; Insufficient income: adjusted OR (aOR) = 8.413 95%CI: 3.93–16.84; Often presenting fear of being infected with SARS-CoV-2 infection: aOR = 9.13 95%CI: 6.36–13.11), and nightmares (Women: OR = 2.60 95%CI: 1.74–3.86; ≥60 years: OR = 0.45 95%CI: 0.28–0.74; Insufficient income: aOR = 2.60 95%CI: 1.20–5.20; Often/almost always presenting fear of being infected with SARS-CoV-2 infection: aOR = 6.62 95%CI: 5.01–8.74). Having a diagnosis of SARS-CoV-2 virus infection was associated with worse patterns of nightmares about the pandemic.

Conclusions

Social and psychological individual factors are important characteristics to consider in the development of therapeutic strategies to support people with sleep problems during the COVID-19 pandemic.

Keywords

COVID-19
SARS-CoV-2
Nightmares
Insomnia symptoms
Portugal
Prospective studies

Cited by (0)

1

Task Force COVID-19 ISPUP – INESC TEC Scientific Committee: Ana Cristina Santos, Ana Isabel Ribeiro, Artur Rocha, Carla Lopes, Daniela Correia, Elisabete Ramos, Gonçalo Gonçalves, Henrique Barros, Joana Araújo, Makram Talih, Margarida Tavares, Milton Severo, Nuno Lunet, Paula Meireles, Raquel Duarte, Raquel Lucas, Rui Camacho, Sílvia Fraga, Sofia Correia, Susana Silva, Teresa Leão.

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