Abstract

IntroductionStressful events, such as the COVID-19 pandemic, can have a detrimental effect on sleep. It is important for practitioners to understand how their patients are affected by events to optimize their care. In this study we evaluated associations of anxiety and daily habits with self-reported sleep disturbance among sleep medicine clinic patients.MethodsBetween June-November 2020, 81 sleep medicine clinic patients (54.8±15.9 y, 44% male, 69% Caucasian) completed an online survey that included PROMIS measures (Sleep Disturbance, Sleep-Related Impairments, Informational Support, Emotional Distress-Anxiety) and Insomnia Severity Index (ISI). Patients were asked about changes in their daily habits (sunlight exposure, caffeine consumption). During the 5-month survey completion time window, the weekly average of positive COVID-19 cases in the Houston area was 2,914. Stepwise linear regression was performed using SAS to determine if self-reported anxiety and informational support predicted PROMIS Sleep Disturbance, PROMIS Sleep-Related Impairments and ISI.ResultsAnxiety had a significant effect on Sleep Disturbance (0.43 ± 0.11, p=0.0001), Sleep-Related Impairments (0.53 ± 0.12, p=0.0001) and ISI (0.28 ± 0.08, p=0.0004). Informational support had a significant inverse effect on Sleep Disturbance (-0.29 ± 0.10, p=0.0063), Sleep-Related Impairments (-0.26 ± 0.11, p=0.01) and ISI (-0.31 ± 0.08, p<0.0001) measures. Decreased sunlight exposure during the pandemic contributed to a significant increase in Sleep Disturbance scores (0.06 ± 0.03, p=0.045). Increased caffeine consumption during the pandemic had significant increase in ISI scores (16.3 ± 7.59, p=0.035).ConclusionHigher levels of anxiety and lower levels of informational support predicted greater insomnia severity, sleep disturbance, and sleep-related impairments in sleep medicine clinic patients during the COVID-19 pandemic. Decreased sunlight exposure and increased caffeine consumption also predicted greater sleep disturbance and insomnia severity, respectively. Addressing anxiety symptoms and access to accurate information during the pandemic is advised when treating sleep medicine clinic patients.Support (if any)This work is supported by National Institutes of Health (NIH) Grant # R01NR018342 (PI: Nowakowski) and by the Department of Veteran Affairs, Veterans Health Administration, Office of Research and Development, and the Center for Innovations in Quality, Effectiveness and Safety (CIN 13–413).

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