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      Profiles of sleep changes during the COVID‐19 pandemic: Demographic, behavioural and psychological factors

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          Summary

          This study aimed to evaluate changes in sleep during the COVID‐19 outbreak, and used data‐driven approaches to identify distinct profiles of changes in sleep‐related behaviours. Demographic, behavioural and psychological factors associated with sleep changes were also investigated. An online population survey assessing sleep and mental health was distributed between 3 April and 24 June 2020. Retrospective questions were used to estimate temporal changes from before to during the outbreak. In 5,525 Canadian respondents (67.1% females, 16–95 years old: Mean ±  SD = 55.6 ± 16.3 years), wake‐up times were significantly delayed relative to pre‐outbreak estimates ( p < .001, η p 2  = 0.04). Occurrences of clinically meaningful sleep difficulties significantly increased from 36.0% before the outbreak to 50.5% during the outbreak (all p < .001, g ≥ 0.27). Three subgroups with distinct profiles of changes in sleep behaviours were identified: “Reduced Time in Bed”, “Delayed Sleep” and “Extended Time in Bed”. The “Reduced Time in Bed” and “Delayed Sleep” subgroups had more adverse sleep outcomes and psychological changes during the outbreak. The emergence of new sleep difficulties was independently associated with female sex, chronic illnesses, being employed, family responsibilities, earlier wake‐up times, higher stress levels, as well as heavier alcohol use and television exposure. The heterogeneity of sleep changes in response to the pandemic highlights the need for tailored interventions to address sleep problems.

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          Most cited references41

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research

            Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
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              Is Open Access

              A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations

              The Coronavirus Disease 2019 (COVID-19) epidemic emerged in Wuhan, China, spread nationwide and then onto half a dozen other countries between December 2019 and early 2020. The implementation of unprecedented strict quarantine measures in China has kept a large number of people in isolation and affected many aspects of people’s lives. It has also triggered a wide variety of psychological problems, such as panic disorder, anxiety and depression. This study is the first nationwide large-scale survey of psychological distress in the general population of China during the COVID-19 epidemic.
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                Author and article information

                Contributors
                Rebecca.Robillard@uottawa.ca
                Journal
                J Sleep Res
                J Sleep Res
                10.1111/(ISSN)1365-2869
                JSR
                Journal of Sleep Research
                John Wiley and Sons Inc. (Hoboken )
                0962-1105
                1365-2869
                17 November 2020
                : e13231
                Affiliations
                [ 1 ] Sleep Research Unit The Royal’s Institute of Mental Health Research Ottawa ON Canada
                [ 2 ] School of Psychology University of Ottawa Ottawa ON Canada
                [ 3 ] Department of Educational & Counselling Psychology McGill University Montréal QC Canada
                [ 4 ] Hôpital en santé mentale Rivières‐des‐Prairies CIUSSS du Nord‐de‐l'Île‐de‐Montréal Montréal QC Canada
                [ 5 ] Culture, Mind and Brain Research Group Division of Social and Transcultural Psychiatry McGill University Montréal QC Canada
                [ 6 ] The Royal Ottawa Mental Health Centre Ottawa ON Canada
                [ 7 ] University of Ottawa Heart Institute Ottawa ON Canada
                [ 8 ] Centre for Addiction and Mental Health Toronto ON Canada
                [ 9 ] Department of Psychiatry University of Toronto Toronto ON Canada
                [ 10 ] Department of Psychiatry University of Ottawa Ottawa ON Canada
                [ 11 ] The Ottawa Hospital Research Institute/University of Ottawa Ottawa ON Canada
                Author notes
                [*] [* ] Correspondence

                Rebecca Robillard, Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Ave, Ottawa, Ontario K1Z 7K4, Canada.

                Email: Rebecca.Robillard@ 123456uottawa.ca

                Author information
                https://orcid.org/0000-0002-1491-997X
                https://orcid.org/0000-0001-5007-2502
                https://orcid.org/0000-0002-1812-9780
                Article
                JSR13231
                10.1111/jsr.13231
                7744844
                33200477
                3afae8bd-a8ce-4346-a221-24e9d3daa400
                © 2020 European Sleep Research Society

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 06 September 2020
                : 11 October 2020
                : 18 October 2020
                Page count
                Figures: 5, Tables: 3, Pages: 12, Words: 17767
                Categories
                Regular Research Paper
                Regular Research Papers
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.5 mode:remove_FC converted:17.12.2020

                chronotype,covid‐19,mental health,pandemic,sleep
                chronotype, covid‐19, mental health, pandemic, sleep

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