ArticleBMJ open2021
Sleep and daytime problems during the COVID-19 pandemic and effects of coronavirus infection, confinement and financial suffering: a multinational survey using a harmonised questionnaire.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06341374 (Impact of Sleep Disorders on Innate Immunity in COVID-19 Patients. A Cohort Study), which is not on this map. Cited by 36 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Impact of Sleep Disorders on Innate Immunity in COVID-19 Patients. A Cohort Study
Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- An observatory on changes in dreaming during a pandemic: a living systematic review (part 1).Journal of sleep research · 2023Pooled it
- Changes in sleep quality and sleep disturbances in the general population from before to during the COVID-19 lockdown: A systematic review and meta-analysis.Frontiers in psychiatry · 2023Pooled it
- Trial
- Sleep quality and disturbance during the COVID-19 pandemic among people with HIV globally: associations with social determinants of health.AIDS (London, England) · 2026Observational
- SleepJEPA: Learning the latent world of sleep with at-home sleep data to estimate disease risk.medRxiv : the preprint server for health sciences · 2026Article
- Exogenous Melatonin and Sleep Quality: A Scoping Review of Systematic Reviews.Journal of clinical pharmacology · 2026Review
- Trained Immunity in Health and Disease.MedComm · 2025Review
- Pandemic-disordered sleep: longer illness and more fatigue but little SARS-CoV-2 effect.ERJ open research · 2025Article
- Characteristics of sleep disturbance across two waves of the COVID-19 pandemic among nursing staffs.Sleep medicine: X · 2024Article
- Alterations in Circadian Rhythms, Sleep, and Physical Activity in COVID-19: Mechanisms, Interventions, and Lessons for the Future.Molecular neurobiology · 2024Review
- Psychosocial and health stressors during the COVID-19 pandemic and their association with sleep quality.Psychology & health · 2024Article
- Unfolding the role of exercise in the management of sleep disorders.European journal of applied physiology · 2024Review
- Association of COVID-19 preventive behavior and job-related stress with the sleep quality of healthcare workers one year into the COVID-19 outbreak: a Japanese cross-sectional survey.BioPsychoSocial medicine · 2024Article
- Effect of fear of hypoglycaemia on sleep quality of patients with type 2 mellitus diabetes: The mediating role of alexithymia.Heliyon · 2024Article
- Habitual short sleepers with pre-existing medical conditions are at higher risk of Long COVID.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Sleep disorders after COVID-19 in Czech population: Post-lockdown national online survey.Sleep medicine: X · 2023Article
- Article
- The need to promote sleep health in public health agendas across the globe.The Lancet. Public health · 2023Review
- Anxiety, Depression, Emotion Regulation, and Daytime Sleepiness: Are There Links Between These Factors? Network Analysis on an Italian Sample During the Covid-19 Pandemic.Clinical neuropsychiatry · 2023Article
- Effect of the decreased frequency of going out on the association between anxiety and sleep disorder during the COVID-19 pandemic: a mediation analysis.Annals of general psychiatry · 2023Article
Corrections and comments
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Authors and funding
25 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesSleep is important for human health and well-being. No previous study has assessed whether the COVID-19 pandemic impacts sleep and daytime function across the globe.
methodsThis large-scale international survey used a harmonised questionnaire. Fourteen countries participated during the period of May-August 2020. Sleep and daytime problems (poor sleep quality, sleep onset and maintenance problems, nightmares, hypnotic use, fatigue and excessive sleepiness) occurring 'before' and 'during' the pandemic were investigated. In total, 25 484 people participated and 22 151 (86.9%) responded to the key parameters and were included. Effects of COVID-19, confinement and financial suffering were considered. In the fully adjusted logistic regression models, results (weighted and stratified by country) were adjusted for gender, age, marital status, educational level, ethnicity, presence of sleep problems before COVID-19 and severity of the COVID-19 pandemic in each country at the time of the survey.
resultsThe responders were mostly women (64%) with a mean age 41.8 (SD 15.9) years (median 39, range 18-95). Altogether, 3.0% reported having had COVID-19; 42.2% reported having been in confinement; and 55.9% had suffered financially. All sleep and daytime problems worsened during the pandemic by about 10% or more. Also, some participants reported improvements in sleep and daytime function. For example, sleep quality worsened in about 20% of subjects and improved in about 5%. COVID-19 was particularly associated with poor sleep quality, early morning awakening and daytime sleepiness. Confinement was associated with poor sleep quality, problems falling asleep and decreased use of hypnotics. Financial suffering was associated with all sleep and daytime problems, including nightmares and fatigue, even in the fully adjusted logistic regression models.
conclusionsSleep problems, fatigue and excessive sleepiness increased significantly worldwide during the first phase of the COVID-19 pandemic. Problems were associated with confinement and especially with financial suffering.
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Registered trials
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