在 COVID-19 全国封锁期间，焦虑和抑郁症状与睡眠健康状况不佳有关：对约旦成年人的横断面分析。
Anxiety and depressive symptoms are associated with poor sleep health during a period of COVID-19-induced nationwide lockdown: a cross-sectional analysis of adults in Jordan.
机构信息
Department of Primary Care and Public Health, Cambridge University, Cambridge, UK
Department of Epidemiology, Columbia University Mailman School of Public Health, New York City, New York, USA.
出版信息
BMJ Open. 2020 Dec 22;10(12):e041995. doi: 10.1136/bmjopen-2020-041995.
BACKGROUND
Jordan, a Middle Eastern country, declared a state of national emergency due to COVID-19 and a strict nationwide lockdown on 17 March 2020, banning all travel and movement around the country, potentially impacting mental health. This study sought to investigate the association between mental health (eg, anxiety and depressive symptoms) and sleep health among a sample of Jordanians living through a state of COVID-19-induced nationwide lockdown.
METHODS
Using Facebook, participants (n=1240) in Jordan in March 2020 were recruited and direct to a web-based survey measuring anxiety (items from General Anxiety Disorder 7-item (GAD-7) scale instrument), depressive symptoms (items from Center for Epidemiologic Studies Depression Scale), sleep health (items from the Pittsburgh Sleep Quality Index) and sociodemographic. A modified Poisson regression model with robust error variance. Adjusted prevalence ratios (aPRs) and 95% CIs were estimated to examine how anxiety and depressive symptoms may affect different dimensions of sleep health: (1) poor sleep quality, (2) short sleep duration, (3) encountering sleep problems.
RESULTS
The majority of participants reported having experienced mild (33.8%), moderate (12.9%) or severe (6.3%) levels of anxiety during lockdown, and nearly half of respondents reported depressive symptoms during lockdown. Similarly, over 60% of participants reported having experienced at least one sleep problem in the last week, and nearly half reported having had short sleep duration. Importantly, anxiety was associated with poor sleep health outcomes. For example, corresponding to the dose-response relationship between anxiety and sleep health outcomes, those reporting severe anxiety were the most likely to experience poor sleep quality (aPR =8.95; 95% CI=6.12 to 13.08), short sleep duration (aPR =2.23; 95% CI=1.91 to 2.61) and at least one problem sleep problem (aPR=1.73; 95% CI=1.54 to 1.95). Moreover, depressive symptoms were also associated with poor sleep health outcomes. As compared with scoring in the first quartile, scoring fourth quartile was associated with poor sleep quality (aPR=11.82; 95% CI=6.64 to 21.04), short sleep duration (aPR=1.87; 95% CI=1.58 to 2.22), and experiencing at least one sleep problem (aPR=1.90; 95% CI=1.66 to 2.18).
CONCLUSIONS
Increased levels of anxiety and depressive symptoms can negatively influence sleep health among a sample of Jordanian adults living in a state of COVID-19-induced nationwide lockdown.
背景
由于 COVID-19 疫情，中东国家约旦于 2020 年 3 月 17 日宣布进入全国紧急状态，并实施严格的全国封锁，禁止全国范围内的所有旅行和活动，这可能会对心理健康产生影响。本研究旨在调查 COVID-19 全国封锁期间，约旦样本中精神健康（如焦虑和抑郁症状）与睡眠健康之间的关联。
方法
2020 年 3 月，通过 Facebook 招募了居住在约旦的 1240 名参与者，并要求他们参与一项基于网络的调查，该调查测量了焦虑（来自一般焦虑障碍 7 项量表的项目）、抑郁症状（来自中心流行病学研究抑郁量表的项目）、睡眠健康（来自匹兹堡睡眠质量指数的项目）和社会人口统计学。使用具有稳健误差方差的修正泊松回归模型。为了研究焦虑和抑郁症状可能如何影响睡眠健康的不同方面：（1）睡眠质量差，（2）睡眠持续时间短，（3）出现睡眠问题，我们估计了调整后的患病率比（aPR）和 95%CI。
结果
大多数参与者报告在封锁期间经历了轻度（33.8%）、中度（12.9%）或重度（6.3%）焦虑，近一半的受访者报告在封锁期间有抑郁症状。同样，超过 60%的参与者报告在过去一周至少经历了一次睡眠问题，近一半的人报告睡眠持续时间短。重要的是，焦虑与睡眠健康结果有关。例如，根据焦虑与睡眠健康结果之间的剂量-反应关系，报告严重焦虑的人最有可能经历睡眠质量差（aPR=8.95；95%CI=6.12 至 13.08）、睡眠持续时间短（aPR=2.23；95%CI=1.91 至 2.61）和至少一个睡眠问题（aPR=1.73；95%CI=1.54 至 1.95）。此外，抑郁症状也与睡眠健康结果有关。与得分处于第一四分位数相比，得分处于第四四分位数与睡眠质量差（aPR=11.82；95%CI=6.64 至 21.04）、睡眠持续时间短（aPR=1.87；95%CI=1.58 至 2.22）和至少一个睡眠问题（aPR=1.90；95%CI=1.66 至 2.18）相关。
结论
在 COVID-19 全国封锁期间，焦虑和抑郁症状的增加可能会对居住在约旦的成年人的睡眠健康产生负面影响。
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