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Objectives: This study assessed undergraduates' sleep in Hawaiʻi during the COVID-19 pandemic and whether demographic characteristics, health locus of control, substance use and campus features related to sleep outcomes. Implications are considered for programs to support students' sleep and health during pandemic conditions. Participants: About 1,288 undergraduate students from six universities in Hawai'i. Methods: Surveys assessing sleep, emotional wellbeing, ethnicity, body mass index, locus of health control, and substance use. Results: Students' reported increased sleep time but decreased sleep quality during the pandemic. Sleep disruption related to anxiety, depression, ethnicity, substance use, BMI, health locus of control, class rank, and whether students lived at home. All campuses were associated with disrupted sleep, regardless of size, location, religious affiliation, term structure, or method of instruction. Conclusions: In response to public health crises, such as the COVID-19 pandemic, all Hawaiʻi universities should screen students for sleep disruption, emotional adjustment, social isolation and substance misuse. Programs to promote sleep and behavioral health appear particularly warranted for graduating seniors, Pacific Islanders, students with high BMI, and students who commute to college. [ABSTRACT FROM AUTHOR]

Affiliation is a basic human need, especially during difficult times. To what extent did the need to affiliate limit our capacity to abide by health guidelines, in particular regarding social distancing, during the COVID-19 pandemic? We investigated this issue using questionnaire data from two samples of the French population collected during the first French lockdown (April-May 2020). We found that in men, higher social comparison orientation (sensitivity to the needs of others and inclination to help) and higher perceived threat increased the frequency of reported affiliative activities. At the same time, men's reported affiliative activities were associated with a lower reported intention to abide by lockdown and protective measures and lower levels of reported compliance. This pattern was not found in women. The women in our samples, as has been observed elsewhere, were largely compliant, potentially precluding any effects of affiliative needs. Basic though they may seem, affiliative needs and reported affiliative activities may have played a significant role in the implementation of sanitary guidelines during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

BACKGROUND: Sleep hygiene habits and self-reported sleep quality of those who work from home have yet to be fully understood. As working from home was widely implemented during the COVID-19 pandemic, the period might be a convenient model for studying the measures, as mentioned earlier. OBJECTIVE: This study aimed to assess sleep hygiene habits and self-reported sleep quality in people working from home in March 2020, when the COVID-19 pandemic began. METHOD: This study was designed as a cross-sectional web-based survey. An anonymous questionnaire consisted of sociodemographic variables and questions about personal habits, e.g., exercise activities and caffeine consumption. The outcome measures to assess sleep hygiene and sleep quality were the Sleep Hygiene Index (SHI) before and after the home office (HO) and the Pittsburgh Sleep Quality Index (PSQI). RESULTS: A total of 204 responses were received. The prevalence of significant sleep disturbance (PSQI > 5) was 51 %. The mean PSQI and SHI scores were 6.15±3.385 and 17.67±7.836, respectively. PSQI and SHI showed a significant mutual positive correlation at the level of significance p < 0.001. The total score for SHI was similar before and after working from home (p = 0.982). However, differences were observed in its components. CONCLUSION: The total score on SHI did not change when compared before and during HO. However, working from home was associated with sleep hygiene malpractice in some individual components of SHI. On the other hand, some aspects of sleep hygiene behavior improved during HO. [ABSTRACT FROM AUTHOR]

The aim of the study was to explore the relationships among cyberchondria, fear of COVID-19, health anxiety, obsessions, sleep quality, and negative affect in a national community sample of Turkish participants. A sample of 8,276 volunteers, aged between 18 and 65, were recruited via an online platform. The Perceived Vulnerability about Diseases Questionnaire, Fear of COVID-19 Scale, Cyberchondria Severity Scale, Short Health Anxiety Inventory, Depression Stress Anxiety Scale-21, Obsessive–Compulsive Inventory–Revised, and Pittsburgh Sleep Quality Index were completed by participants. Data were analyzed using mixture structural equation modelling approach. Results revealed that perceived vulnerability to disease was found to be positively related with cyberchondria, poor sleep quality, health anxiety, and obsessive–compulsive symptoms. Negative affect was positively associated with obsessive–compulsive symptoms, fears of COVID-19, cyberchondria severity, and poor sleep quality. Additionally, fear of COVID-19 was positively related to health anxiety. Also, cyberchondria severity was found to be positively associated with poor sleep quality and obsessive–compulsive symptoms. Mixture analysis classified participants into six latent classes: 1) Risk-Aversive Healthy Group, 2) Incautious Healthy Group, 3) Infection Obsessions Group, 4) Health Anxiety Group, 5) Negative Affect Group, and 6) General Psychopathology Group. The national survey data showed that perceived vulnerability to diseases, negative affect, fear of COVID-19, cyberchondria, health anxiety, obsessive–compulsive symptoms, and sleep quality appeared to be at the center of pandemic health anxiety. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 epidemic generated different forms of stress. From this period, there has been a remarkable increase in the quantity of studies on stress conducted by scholars. However, few used bibliometric analyses to focus on overall trends in the field. Purpose: This study sought to understand the current status and trends in stress development during COVID-19, as well as the main research drives and themes in this field. Methods: 2719 publications from the Web of Science(WOS) core repository on stress during COVID-19 were analyzed by utilizing Co-Occurrence (COOC), VOS viewer, and Cite Space bibliometric software. The overall features of research on stress during COVID-19 were concluded by analyzing the quantity of publications, keywords, countries, and institutions. Results: The results indicated that the United States had the largest number of publications and collaborated closely with other countries with each other. University of Toronto was the most prolific institution worldwide. Visualization and analysis demonstrated that the influence of stress during COVID-19 on the work, life, mental and spiritual dimensions is a hot research topic. Among other things, the frequency of each keyword in research on stress during COVID-19 increased from 2021 to 2022, and the researchers expanded their scope and study population; the range of subjects included children, nurses, and college students, as well as studies focusing on different types of stress, and emphasizing the handling of stress. Conclusion: Our findings reveal that the heat of stress research during COVID-19 has declined, and themain research forces come from the United States and China. Additionally, subsequent research should concern more on coping methods with stress, while using more quantitative and qualitative studies in the future. [ABSTRACT FROM AUTHOR]

Introduction: Some of the conditions affected by the COVID-19 pandemic were Temporomandibular Disorders (TMD) and bruxism. The present study compares the effect of the pandemic on TMD and bruxism (sleep and awake) in three time periods: before the pandemic (pre-COV), during the pandemic (during-COV) and after the pandemic subsided (post-COVR). Material and Methods: A total of 587 adult patients (108 in the pre-COV group, 180 in the during-COV group and 252 in the post-COVR group) who arrived for a routine dental treatment between October 2018 and January 2023 were evaluated according to Axis I diagnosis of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Each patient received a DC/TMD Axis I diagnosis as follows: (i) Painful TMD (defined by the presence of at least one of the following - local myalgia, myofascial pain with referral, arthralgia or headache attributed to TMD); (ii) Non painful TMD (defined by the presence of disc displacement with/without reduction, degenerative joint disorders and/or dislocation), (iii) Possible sleep bruxism (SB) and/or (iv) Possible awake bruxism (AB). Statistical methods: Logistic regression analyses were conducted to establish the impact of time and gender on the prospects of painful TMD, non-painful TMD, SB and AB. Results: The odds of subjects to be diagnosed with painful TMD at the post-COVR era were 3.3 times higher compared to the pre-pandemic time period (pre-COV, 95% C.I. 1.438–7.585). The odds of subjects to be diagnosed with non-painful TMD during-COV were 4 times higher compared to the pre-COV era (95% C.I. 1.332–12.542). The odds of subjects to present possible SB at post-COVR were 2.7 times higher compared to pre-pandemic (pre-COV, 95% C.I. 1.258–5.889, p < 0.05) and the odds to present possible AB after the pandemic subsided (post-COVR) were 3.2 times compared to the pre-pandemic period (95% C.I. 1.496–6.949). The odds of female subjects to be diagnosed with either painful or non-painful TMD were 3.7–4.4 times higher, compared to males. Conclusions: Results indicate that with regard to TMD and bruxism the pandemic adverse effects persist also after COVID-19 subsides and the restrictions caused by it are abolished. Apparently, during the pandemic females were affected more seriously by painful and non-painful TMD than males. [ABSTRACT FROM AUTHOR]

Background: The increased stress the world experienced with the coronavirus disease (COVID-19) pandemic affected mental health, disproportionately affecting females. However, how perceived stress in the first year affected menstrual and menopausal symptoms has not yet been investigated. Objectives: This study evaluates the effect that the first year of the COVID-19 pandemic had on female reproductive and mental health. Methods: Residents in British Columbia, Canada, were surveyed online as part of the COVID-19 Rapid Evidence Study of a Provincial Population-Based Cohort for Gender and Sex. A subgroup of participants (n = 4171), who were assigned female sex at birth (age 25–69 years) and were surveyed within the first 6–12 months of the pandemic (August 2020–February 2021), prior to the widespread rollout of vaccines, was retrospectively asked if they noticed changes in their menstrual or menopausal symptoms, and completing validated measures of stress, depression and anxiety. Design: This is a population-based online retrospective survey. Results: We found that 27.8% reported menstrual cycle disturbances and 6.7% reported increased menopause symptoms. Those who scored higher on perceived stress, depression and anxiety scales were more likely to report reproductive cycle disturbances. Free-text responses revealed that reasons for disturbances were perceived to be related to the pandemic. Conclusion: The COVID-19 pandemic has highlighted the need to research female-specific health issues, such as menstruation. Our data indicate that in the first year of the pandemic, almost one-third of the menstruating population reported disturbances in their cycle, which was related to percieved stress, depression and anxiety scores. [ABSTRACT FROM AUTHOR]

Introduction: This systematic review and meta-analysis aims to explore changes in sleep quality and sleep disturbances in the general population from before to during the COVID-19 lockdown. Methods: The protocol was registered in PROSPERO (CRD42021256378) and the PRISMA guidelines were followed. The major databases and gray literature were systematically searched from inception to 28/05/2021 to identify observational studies evaluating sleep changes in the general population during the lockdown with respect to the pre-lockdown period. A random effects meta-analysis was undertaken for studies reporting (a) the means of the Pittsburgh Sleep Quality Index (PSQI) global scores or the means of the sleep onset latency (SOL) times (minutes - min) before and during the lockdown, (b) the percentages of poor sleep quality before and during the lockdown, or (c) the percentages of changes in sleep quality. Subgroup analysis by risk of bias and measurement tool utilized was carried out. A narrative synthesis on sleep efficiency, sleep disturbances, insomnia and sleep medication consumption was also performed. Results: Sixty-three studies were included. A decline in sleep quality, reflected in a pooled increase in the PSQI global scores (standardized mean difference (SMD) = 0.26; 95% CI 0.17-0.34) and in SOL (SMD = 0.38 min; 95% CI 0.30-0.45) were found. The percentage of individuals with poor sleep quality increased during the lockdown (pooled relative risk 1.4; 95% CI 1.24-1.61). Moreover, 57.3% (95% CI 50.01-61.55) of the individuals reported a change in sleep quality; in 37.3% (95% CI 34.27-40.39) of these, it was a worsening. The studies included in the systematic review reported a decrease in sleep efficiency and an increase in sleep disturbances, insomnia, and in sleep medication consumption. Discussion: Timely interventions are warranted in view of the decline in sleep quality and the increase in sleep disturbances uncovered and their potentially negative impact on health. Further research and in particular longitudinal studies using validated instruments examining the long-term impact of the lockdown on sleep variables is needed. [ABSTRACT FROM AUTHOR]

Background: Health-related challenges caused and worsened by the global COVID-19 pandemic have proven broad and multifaceted, particularly for racial/ethnic minority women living with HIV (WLWH). The 2020 pandemic has affected the wellbeing and access to care for WLWH in Southeastern Florida, a region that experienced simultaneous high rates of COVID-19 and HIV. WLWH, over a short- or long-term period, likely utilize different coping mechanisms as they face these challenges. Methods: This analysis compared pandemic-related stress and support endorsed by participants attending an urban clinic in South Florida, from January through May 2021. Participants completed an adapted version of the Pandemic Stress Index (PSI). The items in the PSI assessed emotional distress, stigma, and support, and were dichotomized, as either "stress" or "support". Mann–Whitney U-test assessed differences in distributions of PSI scores (stress and support) comparing long-term survivors (≥ 10 years with an HIV diagnosis) to those more recently diagnosed (< 10 years). Results: The cohort consisted of 63 WLWH, aged 21– 71 (Mean = 42 years± 12.95). The group of WLWH were almost evenly split, with 50.8% having been diagnosed in the last 10 years (short-term survivors). The high-stress group endorsed lower levels of support, compared to the low-stress group. There was a non-significant trend of higher stress scores for short-term survivors, compared to long-term survivors; and, higher support scores for long-term survivors, compared to short-term survivors. Conclusion: Results suggest a trend in long-term survivor WLWH endorsing lower stress and higher support; the contrary was found for their short-term survivor counterparts. Patterns in COVID-19 related stressors and maladaptive behaviors need further exploration to establish suitable interventions that address disparities within groups of WLWH. [ABSTRACT FROM AUTHOR]

Background: Sex-based inequalities in healthcare have been exposed and amplified during the COVID-19 pandemic. However, few studies have reported sex differences in medication utilization and no studies have examined sex differences in prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and opioids utilization. Aim: To compare the utilization patterns of prescribed NSAIDs and opioids between males and females in Manitoba, Canada during the COVID-19 pandemic. Method: A cohort of incident and prevalent users of prescribed NSAIDs and opioids was created. Interrupted times series analysis using autoregressive models were used to evaluate the quarterly change in the prevalent and incident users before and after COVID-19 restrictions were applied (first quarter of 2020). Results: COVID-19 restrictions were associated with a significant decrease in the utilization of prescribed NSAIDs and opioids in all users, followed by a revert to the pre-pandemic trends. Among female prevalent and incident NSAIDs users, there was a significant change in trend after COVID-19 restrictions were introduced (β3 = 0.087 and 0.078, P = 0.023 and 0.028, respectively). However, there was non-significant change in trend among male prevalent and incident NSAIDs and opioids users during the pandemic. Conclusion: In this study, a significant sharp decline in the use of prescribed NSAIDs and opioids was shown in both sexes at the onset of the pandemic. However, a significant upward trend is observed in female NSAIDs users as restrictions began to be lifted. [ABSTRACT FROM AUTHOR]

Background Mental health-related positive and negative aspects of telework are understudied. This study aimed to evaluate anxiety, depression and sleep quality in full-time teleworkers during lockdown imposed by the coronavirus disease 2019 (COVID-19) pandemic and explore potential relationships between these variables, sociodemographic characteristics, quality of life and perceived productivity. Methods A cross-sectional study was conducted on 143 full-time teleworkers. Participants were assessed for anxiety, depression and sleep quality using validated clinical instruments. Results This study found a high prevalence of poor sleep quality (74%, N  = 106). Participants reported anxiety/depressive symptoms with the predominance of anxiety and very high levels of sleep impairment. Better sleep quality was associated with longer sleep duration and better job satisfaction, whereas the use of hypnotic medication and higher depression/anxiety scores seem to point a correlation with sleep impairment. Anxiety/depression positively correlated with worse sleep quality and negatively associated with quality of life. Male sex was negatively associated with perceived productivity. Conclusions A higher prevalence of poor sleep quality was found in comparison with other studies performed during the COVID-19 pandemic as well as high levels of anxiety and depression. These results highlight the relevance of considering the potential negative impact of telework on mental health. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has negatively impacted the well-being of healthcare workers (HCWs). HCWs are highly exposed to shift work and their work schedules have been subject to increasing unpredictability since the start of the pandemic. This review aims to: (1) map the studies providing information about factors associated with sleep characteristics in HCWs working in the context of the COVID-19 pandemic during the first and second waves and (2) examine the state of the evidence base in terms of the availability of information on the influence of atypical work schedules. A literature search was performed in PubMed. Studies containing information about factors (demographic; psychological; occupational; COVID-19-specific; work schedule; lifestyle; medical; or other) associated with various sleep characteristics among HCWs working in the context of the COVID-19 pandemic were included. Particular attention was paid to the availability of information on the role of atypical work schedules on HCW sleep. Fifty-seven articles met the inclusion criteria. Most studies were reports of quantitative cross-sectional surveys using self-report measures. Associations between female sex, frontline HCW status, psychological factors, and poorer sleep were observed. Six studies included a measure of shift work in their analyses, 5 of which reported an association between shift work status and sleep. A wide range of factors were investigated, with female sex, frontline HCW status, and psychological factors repeatedly demonstrating associations with poorer sleep. Sleep was predominantly measured in terms of self-reported sleep quality or insomnia symptoms. Few studies investigated the influence of atypical work schedules on HCW sleep in the context of the COVID-19 pandemic. Research on this topic is lacking in terms of reliable and consistent measurements of sleep outcomes, longitudinal data, and knowledge about the influence of covariates such atypical work schedules, comorbidity, and medical history on HCW sleep. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this study was to investigate the psychosocial and cardiovascular markers in healthcare professionals during the COVID-19 pandemic. Methods: This was a STROBE compliant, blended exploratory study. Residents, staff physicians, nurses, and auxiliary healthcare professionals from both inpatient and outpatient medicine services were recruited using a planned random probability sample. The Maslach Burnout Inventory (MBI), Fuster-BEWAT score (FBS), and socio-demographic factors, as well as sleep quality, were studied. The correlations between burnout severity and cardiovascular risk were examined using multivariable linear regression models adjusted for confounding variables, such as sociodemographic and anthropometric characteristics. Results: The regression analysis with FBS as the outcome showed a negative association between cardiovascular health and emotional exhaustion [Coef.(95%CI): −0.029 (−0.048, −0.01), p = 0.002]. The higher the emotional exhaustion the lower the cardiovascular health. Further, the model showed a positive association between personal accomplishment and cardiovascular health [Coef.(95%CI): 0.045 (0.007, 0.082), p = 0.02]. Emotional exhaustion was significantly positive correlated with REM sleep and light average (Spearman's rank correlation: 0.37 and 0.35, respectively, with P < 0.05). Conclusion: The data from this study show that healthcare practitioners who are with burnout and emotional exhaustion have an elevated cardiovascular risk, however, causality cannot be determined. As an adaptive response to stressful situations, REM sleep increases. The findings of this study may be relevant in creating preventive strategies for burnout and cardiovascular risk reduction or prevention. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT04422418]. [ABSTRACT FROM AUTHOR]

Purpose: To study different mask types' impact on a sinonasal quality of life. Methods: For this observational cross-sectional study, a web-based survey was distributed via social media forums. We used the validated Hebrew version of the Sinonasal Outcome Test–22 followed by a questionnaire developed specifically for the present study, focusing on the time of the COVID-19 pandemic (Mask Sinonasal Outcome Test), and questions regarding general health issues. The participants' mask-wearing routine was also studied. Results: Seventy percent of 351 participants had experienced a change in their breathing during the time of the pandemic. The median total Sinonasal Outcome Test–22 score was 13, and 10% of the participants reported a significantly impaired quality of life. According to multivariate analyses, the only subject-related variables significantly associated with the reduced sinonasal quality of life were female gender, younger age, a background of chronic rhinitis and sinusitis, and the mask-wearing average daily duration. The mask sinonasal outcome test convergent validity was confirmed. Conclusion: The majority of our survey's responders, predominantly female and younger participants, reported reduced sinonasal quality of life in the COVID-19 pandemic period. It can be attributed to mask-wearing, especially for a prolonged time, irrespective of the existing mask type. These findings should encourage medical companies to produce more "airway-minded" personal protection equipment. [ABSTRACT FROM AUTHOR]

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Studies investigating the psychosomatic effects of social isolation in animals have shown that one of the physiologic system that gets disrupted by this environment-affective change is the Endocannabinoid System. As the levels of endocannabinoids change in limbic areas and prefrontal cortex during stressful times, so is the subject more prone to fearful and negative thoughts and aggressive behavior. The interplay of social isolation on the hypothalamic-pituitary-adrenal axis and cannabinoid tone triggers a vicious cycle which further impairs the natural body's homeostatic neuroendocrine levels and provokes a series of risk factors for developing health complications. In this paper, we explore the psychosomatic impact of prolonged quarantine in healthy individuals, and propose management and coping strategies that may improve endocannabinoid tone, such as integration of probiotics, cannabidiol, meditation, and physical exercise interventions with the aim of supporting interpersonal, individual, and professional adherence with COVID-19 emergency public measures whilst minimizing their psycho-physical impact. [ABSTRACT FROM AUTHOR]

Introduction: In late 2019, a new coronavirus disease known as COVID-19 (novel coronavirus disease 2019) was identified. As there is no any drug to treat this pandemic, the healthcare professionals are disproportionately at higher risk. The mental health outcome is expected to be high. Anxiety is expected to have a significant impact on health professionals, especially among those who work without adequate resources for self-protection. Objectives: The objectives of this research was to assess self-reported anxiety symptoms and associated factors among Ethiopian healthcare professionals in the early stages of the pandemic. Methods: We have conducted an online cross-sectional study to collect information from healthcare professionals in Ethiopia during the early stage of the outbreak from April 7, 2020 to May 19, 2020. GAD-7 was used for measurement of anxiety. We have used a cut of point of 10 and above to report anxiety symptoms. We have used Google Forms for online data collection and SPSS-22 for analysis. To determine associated factors for anxiety, a binary logistic regression model was used. Variables with p-value < 0.2 during the bivariable binary logistic regression were exported for further analysis in the multivariable binary logistic regression. Finally, variables with p-value <0.05 were considered as significantly associated with the outcomes. Results: Three hundred and eighty-eight healthcare professionals filled the online questionnaire; Majority (71.1%) were males. Significant number of respondents (78.9%) reported lack of adequate personal protective equipment (PPE) at the work place. The prevalence of anxiety was 26.8%. Being female (AOR: 1.88; 95% C.I:1.11, 3.19), visiting/treating 30–150 patients per day (AOR: 3.44; 95% C.I:1.51, 7.84), those employed at private healthcare institutions (AOR: 2.40; 95% C.I:1.17, 4.90), who do not believe that COVID-19 is preventable (AOR: 2.04; 95% C.I:1.04, 4.03) and those who reported lack of PPE (AOR: 1.98; 95% C.I:1.04, 3.79) were more likely to be anxious. Conclusions: The anxiety prevalence among healthcare professionals in Ethiopia during early stage of COVID-19 pandemic was high. This study shows that lack of preventive equipment, being female, contact with many patients, low self-efficacy and working in private health facilities were risk factors for anxiety. Anxiety prevention among health professionals during COVID-19 pandemic requires a holistic approach including provision of sufficient PPE, improving self-efficacy and addressing problems both at public and private institutions and focusing more on female health professionals. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) has had a global effect on people's lifestyles. Many people have become physically inactive and developed irregular eating patterns, which leads to unhealthier lifestyles and aggravation of lifestyle-related diseases; these in turn increase the severity of COVID-19. Prior to the COVID-19 pandemic, we developed a smartphone application called "Taberhythm" to investigate eating patterns, physical activity, and subjective feelings of happiness. We aimed to compare lifestyle data before and during the first phase of the COVID-19 pandemic to objectively assess lifestyle changes during quarantine. A total of 464 smartphone users (346 women, 35 ± 12 years old, body mass index [BMI] 23.4 ± 4.5) participated in Period A (January 7 to April 28, 2019) and 622 smartphone users (533 women, 32 ± 11 years old, BMI 23.3 ± 4.0) participated in Period B (January 6 to April 26, 2020). Compared with Period A, there was a sharp decline in physical activity during Period B (4642 ± 3513 vs. 3814 ± 3529 steps/day, p<0.001), especially during the final 9 weeks in both periods (4907 ± 3908 vs. 3528 ± 3397 steps/day, p<0.001); however, there were large variations in physical activity among participants. We found a surprising trend during Period B toward increased happiness among women aged 30–50 years, the group most affected by stay-at-home policies that led to working from home and school closure. Moreover, daily eating duration declined in this population. Additionally, there was a positive association of happiness with steps per day in Period B (ρ = 0.38, p = 0.02). Despite the many negative effects of the COVID-19 pandemic, subjective feelings of happiness among middle-aged Japanese women tended to increase, which indicates that some favorable lifestyle changes that could be adopted during quarantine in the ongoing COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: COVID-19 and home isolation has impacted quality of life, but the perceived impact on anxiety and sleep remains equivocal. The purpose of this study was to assess the impact of COVID-19 and stay-at-home orders on self-report anxiety and sleep quality, with a focus on sex differences. We hypothesized that the COVID-19 pandemic would be associated with increased anxiety and decreased sleep quality, with stronger associations in women. Methods: One hundred three participants (61 female, 38 ± 1 years) reported perceived changes in anxiety and sleep quality due to stay-at-home orders during the COVID-19 pandemic and were administered the Spielberger State-Trait Anxiety Inventory (STAI), Pittsburgh Sleep Quality Index (PSQI), and Insomnia Severity Index (ISI). Chi-square and T test analyses were utilized to assess sex differences in reported anxiety and sleep. Analysis of covariance was used to compare the associations between reported impact of COVID-19 and anxiety/sleep parameters. Results: Women (80.3%) reported higher prevalence of increased general anxiety due to COVID-19 when compared to men (50%; p = 0.001) and elevated STAI state anxiety compared to men (43 ± 1 vs. 38 ± 1 a.u., p = 0.007). Despite these differences in anxiety, the perceived impact of COVID-19 on PSQI was not different between sexes. However, when stratified by perceived changes in anxiety due to COVID-19, participants with higher anxiety responses to COVID-19 had higher ISI compared to those with no perceived changes in anxiety (9 ± 1 vs. 5 ± 1 a.u., p = 0.003). Additionally, participants who reported reduced sleep quality due to COVID-19 reported higher state anxiety (45 ± 1 a.u.) compared to those that perceived no change (36 ± 2 a.u., p = 0.002) or increased (36 ± 2 a.u., p < 0.001) sleep quality. Conclusion: COVID-19 and state-ordered home isolation was associated with higher anxiety and reduced sleep quality, with a stronger association in women with respect to anxiety. [ABSTRACT FROM AUTHOR]