Sleep Disturbance and COVID-19: An Epidemic Inside the Pandemic

occurrence Abstract The COVID-19 pandemic is challenging the world affecting heavily people’s mental health. The psychological consequences of this pandemic include depressive symptoms, anxiety, worry, and loneliness due to home confinement during lockdowns. A good sleep quality is essential to face this stressing condition, nevertheless one of the first complaint reported by the population, soon after the onset of the pandemic in China, was sleep disturbance. A large amount of work has now evidenced that sleep disturbance related to the pandemic affects more than one third of the population of both sexes across all involved countries. Very young people and the elderly are particularly affected by this problem. Anxiety, depression and post-traumatic stress disorder are strictly associated with sleep disturbance. As risk of suicide has increased during the pandemic, insomnia has also been proven to be a cause of suicidal ideation. The strict confinement measures adopted by most countries to tackle the outbreak have also contribute to create a sense of disorientation among people and to change their sleep habits. Poor sleep quality reduces daytime functioning and mental resources. These effects can have dramatic consequences in the general public, but more specifically in health care workers, now facing the most stressful experience right in the center of this catastrophe. In this article we review available evidence on the impact of COVID-19 on people’s quality of sleep and on the occurrence of sleep disturbance in different subsets of the population, analyzing also risk factors determining insomnia and the consequences of this dreadful condition.