Abstract

Background: The COVID-19 pandemic has led to significant changes in daily routines and lifestyle
worldwide and mental health issues have emerged as a consequence. We aimed to assess the presence of sleep
disturbances during the lockdown in the general population.
Methods: Cross-sectional, online survey-based study on adults living through the COVID-19 pandemic.
The questionnaire included demographics and specific questions assessing the impact of the pandemic/
lockdown on sleep, daytime functioning and mental health in the general population. Identification of sleep
pattern changes and specific sleep-related symptoms was the primary outcome, and secondary outcomes
involved identifying sleep disturbances for predefined cohorts (participants reporting impact on mental
health, self-isolation, keyworker status, suspected COVID-19 or ongoing COVID-19 symptoms).
Results: In total, 843 participants were included in the analysis. The majority were female (67.4%), middle
aged [52 years (40–63 years)], white (92.2%) and overweight to obese [BMI 29.4 kg/m2 (24.1–35.5 kg/m2)];
69.4% reported a change in their sleep pattern, less than half (44.7%) had refreshing sleep, and 45.6% were
sleepier than before the lockdown; 33.9% had to self-isolate, 65.2% reported an impact on their mental
health and 25.9% were drinking more alcohol during the lockdown. More frequently reported observations
specific to sleep were ‘disrupted sleep’ (42.3%), ‘falling asleep unintentionally’ (35.2%), ‘difficulties
falling’/‘staying asleep’ (30.9% and 30.8%, respectively) and ‘later bedtimes’ (30.0%). Respondents with
suspected COVID-19 had more nightmares and abnormal sleep rhythms. An impact on mental health was
strongly associated with sleep-related alterations.
Conclusions: Sleep disturbances have affected a substantial proportion of the general population during
the COVID-19 pandemic lockdown. These are significantly associated with a self-assessed impact on mental
health, but may also be related to suspected COVID-19 status, changes in habits and self-isolation.