The relative contribution of COVID-19 infection versus COVID-19 related occupational stressors to insomnia in healthcare workers

Q1 Medicine Sleep Medicine: X Pub Date : 2023-03-02 DOI:10.1016/j.sleepx.2023.100067

Rebecca C. Hendrickson, Catherine A. McCall, Aaron F. Rosser, Kathleen F. Pagulayan, Bernard P. Chang, Ellen D. Sano, Ronald G. Thomas, Murray A. Raskind

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引用次数: 1

Abstract

Objective/Background: Healthcare workers have experienced high rates of psychiatric symptom burden and occupational attrition during the COVID-19 pandemic. Identifying contributory factors can inform prevention and mitigation measures. Here, we explore the potential contributions of occupational stressors vs COVID-19 infection to insomnia symptoms in US healthcare workers.

Patients/Methods: An online self-report survey was collected between September 2020 and July 2022 from N = 594 US healthcare workers, with longitudinal follow-up up to 9 months. Assessments included the Insomnia Severity Index (ISI), the PTSD Checklist for DSM-5 (PCL-5), and a 13-item scale assessing COVID-19 related occupational stressors.

Results

Insomnia was common (45% of participants reported at least moderate and 9.2% reported severe symptoms at one or more timepoint) and significantly associated with difficulty completing work-related tasks, increased likelihood of occupational attrition, and thoughts of suicide or self-harm (all p<.0001). In multivariable regression with age, gender, and family COVID-19 history as covariates, past two-week COVID-related occupational stressors, peak COVID-related occupational stressors, and personal history of COVID-19 infection were all significantly related to past two-week ISI scores (β = 1.7 ± 0.14SE, β = 0.08 ± 0.03, and β = 0.69 ± 0.22 respectively). Although similar results were found for the PCL-5, when ISI and PCL-5 items were separated by factor, COVID-19 infection was significantly related only to the factor consisting of sleep-related items.

Conclusions

Both recent occupational stress and personal history of COVID-19 infection were significantly associated with insomnia in healthcare workers. These results suggest that both addressing occupational stressors and reducing rate of COVID-19 infection are important to protect healthcare workers and the healthcare workforce.

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新冠肺炎感染与新冠肺炎相关职业压力源对医护人员失眠的相对贡献

目的/背景：在新冠肺炎大流行期间，医护人员经历了高比例的精神症状负担和职业消耗。确定促成因素可以为预防和缓解措施提供信息。在这里，我们探讨了职业压力源与新冠肺炎感染对美国医护人员失眠症状的潜在影响。患者/方法：在2020年9月至2022年7月期间，从594名美国医护人员中收集了一项在线自我报告调查，纵向随访长达9个月。评估包括失眠严重程度指数（ISI）、DSM-5创伤后应激障碍检查表（PCL-5）和评估新冠肺炎相关职业压力源的13项量表。结果失眠是常见的（45%的参与者在一个或多个时间点报告了至少中度症状，9.2%的参与者报告了严重症状），并且与难以完成与工作相关的任务、职业消耗的可能性增加以及自杀或自残的想法显著相关（均p＜0.0001），和家庭新冠肺炎史作为协变量，过去两周的新冠肺炎相关职业压力源、峰值新冠肺炎相关性职业压力源和新冠肺炎感染史均与过去两周ISI评分显著相关（分别为β=1.7±0.14SE、β=0.08±0.03和β=0.69±0.22）。尽管PCL-5的结果相似，但当ISI和PCL-5项目按因素分开时，新冠肺炎感染仅与睡眠相关项目组成的因素显著相关。结论医护人员近期职业压力和新冠肺炎感染史均与失眠显著相关。这些结果表明，解决职业压力源和降低新冠肺炎感染率对于保护医护人员和医护人员都很重要。

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