Brandão Luiz Eduardo Mateus, Martikainen Teemu, Merikanto Ilona, Holzinger Brigitte, Morin Charles M, Espie Colin A, Bolstad Courtney J, Leger Damien, Chung Frances, Plazzi Giuseppe, Dauvilliers Yves, Matsui Kentaro, De Gennaro Luigi, Sieminski Mariusz, Nadorff Michael R, Chan Ngan Yin, Wing Yun Kwok, Mota-Rolim Sérgio Arthuro, Inoue Yuichi, Partinen Markku, Benedict Christian, Bjorvatn Bjorn, Cedernaes Jonathan
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland.
Nat Sci Sleep. 2021 Oct 6;13:1711-1722. doi: 10.2147/NSS.S327365. eCollection 2021.
Lifestyle and work habits have been drastically altered by restrictions due to the COVID-19 pandemic. Whether the associated changes in sleep timing modulate the risk of suffering from symptoms of insomnia, the most prevalent sleep disorder, is however incompletely understood. Here, we evaluate the association between the early pandemic-associated change in 1) the magnitude of social jetlag (SJL) - ie, the difference between sleep timing on working vs free days - and 2) symptoms of insomnia.
A total of 14,968 anonymous participants (mean age: 40 years; 64% females) responded to a standardized internet-based survey distributed across 14 countries. Using logistic multivariate regression, we examined the association between the degree of social jetlag and symptoms of insomnia, controlling for important confounders like social restriction extension, country specific COVID-19 severity and psychological distress, for example.
In response to the pandemic, participants reported later sleep timing, especially during workdays. Most participants (46%) exhibited a reduction in their SJL, whereas 20% increased it; and 34% reported no change in SJL. Notably, we found that both increased and decreased SJL, as a result of the COVID-19 pandemic, were associated with later sleep midpoint (indicating a later chronotype) as well as more recurrent and moderate-to-severe symptoms of insomnia (about 23-54% higher odds ratio than subjects with unchanged SJL). Primarily those with reduced SJL shifted their bedtimes to a later timepoint, compared with those without changes in SJL.
Our findings offer important insights into how self-reported changes to the stability of sleep/wake timing, as reflected by changes in SJL, can be a critical marker of the risk of experiencing insomnia-related symptoms - even when individuals manage to reduce their social jetlag. These findings emphasize the clinical importance of analyzing sleep-wake regularity.
由于新冠疫情的限制措施，生活方式和工作习惯发生了巨大改变。然而，睡眠时间的相关变化是否会调节患失眠症状（最常见的睡眠障碍）的风险，目前尚不完全清楚。在此，我们评估了疫情早期相关变化与以下两方面的关联：1）社会时差（SJL）的幅度，即工作日与休息日睡眠时间的差异；2）失眠症状。
共有14968名匿名参与者（平均年龄：40岁；64%为女性）回应了一项在14个国家开展的基于网络的标准化调查。我们使用逻辑多元回归分析，研究了社会时差程度与失眠症状之间的关联，并控制了重要的混杂因素，如社会限制延长、各国新冠疫情严重程度以及心理困扰等。
针对疫情，参与者报告称睡眠时间延迟，尤其是在工作日。大多数参与者（46%）的社会时差减小，而20%的参与者社会时差增大；34%的参与者报告社会时差无变化。值得注意的是，我们发现，由于新冠疫情导致的社会时差增大和减小，均与较晚的睡眠中点（表明更晚的生物钟类型）以及更频繁、中度至重度的失眠症状相关（比社会时差无变化的受试者的优势比高约23 - 54%）。与社会时差无变化的人相比，主要是社会时差减小的人将睡眠时间推迟到了更晚的时间点。
我们的研究结果为以下问题提供了重要见解：自我报告的睡眠/觉醒时间稳定性变化（如社会时差的变化所反映）如何成为经历失眠相关症状风险的关键指标——即使个体成功减少了社会时差。这些发现强调了分析睡眠 - 觉醒规律的临床重要性。
