Correlates of insomnia among the adults during COVID19 pandemic: evidence from an online survey in India

Abstract

Background: Psychosocial distresses are often associated with sleep disorders. This is found as a common population level observation during natural calamities or emergency situations like a pandemic. The current study was conducted to determine the magnitude of self-reported insomnia, and to identify its associated factors among the apparently healthy Indian adult population having access to social media during the lockdown period of COVID 19 pandemic.

Methods: A cross-sectional, region-stratified survey was conducted from April 20 - May 19, 2020 in India using online questionnaire comprising Perceived Stress Scale, Generalized Anxiety Disorder Scale, Insomnia Severity Index, variables related to concern, fear and apprehension about COVID19 pandemic, and different socio-clinical variables. The questionnaire was disseminated via different social media platforms and responses from 1081 respondents were included in the analysis.

Results: Moderate clinical insomnia was present in 13.32% (95% confidence interval [CI]: 12.23%-14.50%), and severe clinical insomnia was present in 1.85% (95% CI: 1.08%-3.14%). For higher levels of insomnia mild anxiety was associated with a proportional odds ratio (OR) of 1.83 (95% CI: 1.24-2.71), and moderate and severe anxiety had an OR of 4.01 (95% CI: 2.57-6.25). Factors associated with higher severity of insomnia were middle age group (36-50 years), being a professional, living alone, perceiving COVID as serious disease, urban residence and those having comorbidity. The OR for being concerned for staying indoors was 5.09 (95% CI: 4.09-5.33), whereas the OR for fear of scarcity in availability of masks and sanitizers was 1.48 (95% CI: 1.26-1.75); and the OR for fear of unavailability of essential goods was 3.20 (95% CI: 2.06-4.98).

Conclusions: Psychosocial factors like generalized anxiety, higher age, higher perceived severity, and various concerns related to COVID19 pandemic were identified to be associated with higher degrees of insomnia. Necessary psychosocial interventions, may be required to address the burden of insomnia in a timely and long-term mode.

Keywords: Anxiety; COVID19; Insomnia; Pandemic; Stress.