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      Editorial: Long-term effects of COVID-19 pandemic on sleep and their relationships with mental health

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          Abstract

          In the 2020–2022 biennium, humankind faced one of the worst public health crises of all time. The SARS-CoV-2 spread posed unprecedented challenges to modern societies, pervasively reshaping the daily life of everyone. The lockdown periods and the subsequent restraining measures deeply impacted the sleep and mental health of the worldwide population (Sousa et al., 2021; AlRasheed et al., 2022), with effects that persisted in the long run (Conte et al., 2021; Salfi et al., 2021). The stressful experience of SARS-CoV-2 infection and hospitalization has been associated with alarming rates of post-traumatic symptoms among COVID-19 survivors (Nagarajan et al., 2022). Moreover, social distancing drove a large-scale transition to a new working approach named remote working, inevitably affecting people's sleep quality and habits (Massar et al., 2021; Salfi et al., 2022). The studies collected in the present Research Topic, each distinct in its focus, converge to offer a holistic understanding of the pandemic impact on sleep, mental wellbeing, and their intricate interplay. Massar et al. study dives into the dynamics of remote work, meticulously tracking the sleep and activity patterns of 225 Singaporean adults across three distinct pandemic phases (from August 2021 to January 2022). The investigation showed a significant shift in sleep routines among remote workers. Bedtime and wake-up time were delayed, and sleep duration increased when people worked from home. However, these changes were coupled with a significant decrease in physical activity—a concern that warrants thoughtful consideration when defining remote working policies in the post-pandemic era. Saalwirth and Leipold delve into the complexities of chronic stress, unveiling its relationship with wellbeing indicators. The study employed a web-based survey to explore sleep quality and psychological symptoms among 480 German adults evaluated during the third COVID-19 infection wave (March–May 2021). The findings indicated that poor sleep quality was linked to heightened psychological symptoms. Notably, the study spotlighted financial worries as the dominant predictor of sleep quality, emotional wellbeing, and life satisfaction, fearing possible long-term implications of the pandemic when considering the triggered economic crisis. The work of Hu et al. adds to a consistent body of research addressing the relationship between sleep and the psychological wellbeing of the younger population during the COVID-19 emergency. Employing a stratified cluster sampling approach, the study highlighted how lower sleep quality was associated with emotional/behavioral symptoms and social adaptation difficulties in a large sample of 6,363 Chinese college students assessed in September–December 2021. Finally, Rapelli et al. case study addressed a timely research topic, proposing the application of Imagery Rehearsal Therapy (IRT) to treat COVID-related nightmares in a woman with a history of SARS-CoV-2 infection and consequent intensive care unit admission. The therapy led to diminished nightmare frequency and intensity, improved sleep quality, and trauma-related positive psychological changes. Overall, the study showed a promising pathway for addressing psychological distress born from severe illness and consequent hospitalization, with large-scale implications for the millions of COVID-19 survivors showing post-traumatic symptoms (Nagarajan et al., 2022). In May 2023, the World Health Organization declares the end of the COVID-19 emergency phase. However, as evidenced by the growing literature in which this Research Topic is inserted, the sequelae of the pandemic period could accompany us for a long time. In this view, several questions remain unsolved and further studies should be performed for understanding the far-reaching impacts of the passed emergency scenario. May remote working represent an ideal approach to tackling the sleep-loss epidemic in our society (Chattu et al., 2018; Wang et al., 2023)? Considering the well-documented bidirectionality between sleep ad psychological disturbances (Alvaro et al., 2013), which is the primary antecedent of the relationship in a pandemic context? May the promotion of healthy sleep habits and the application of sleep interventions mitigate the psychological impact of the SARS-CoV-2 infection? Although the present Research Topic is now closed, we look forward to seeing other special issues like this born in the future. Further studies are necessary to provide a long-range overview of the inextricable relationship between sleep and mental health in the post-pandemic era. Author contributions FS: Writing—original draft, Writing—review and editing. GF: Writing—review and editing. EA: Writing—review and editing. NC: Writing—review and editing.

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          A Systematic Review Assessing Bidirectionality between Sleep Disturbances, Anxiety, and Depression.

          To investigate whether sleep disturbances are bidirectionally related to anxiety and depression, and thus identify potential risk factors for each problem.
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            The Global Problem of Insufficient Sleep and Its Serious Public Health Implications

            Good sleep is necessary for good physical and mental health and a good quality of life. Insufficient sleep is a pervasive and prominent problem in the modern 24-h society. A considerable body of evidence suggests that insufficient sleep causes hosts of adverse medical and mental dysfunctions. An extensive literature search was done in all the major databases for “insufficient sleep” and “public health implications” in this review. Globally, insufficient sleep is prevalent across various age groups, considered to be a public health epidemic that is often unrecognized, under-reported, and that has rather high economic costs. This paper addresses a brief overview on insufficient sleep, causes, and consequences, and how it adds to the existing burden of diseases. Insufficient sleep leads to the derailment of body systems, leading to increased incidences of cardiovascular morbidity, increased chances of diabetes mellitus, obesity, derailment of cognitive functions, vehicular accidents, and increased accidents at workplaces. The increased usage of smart phones and electronic devices is worsening the epidemic. Adolescents with insufficient sleep are likely to be overweight and may suffer from depressive symptoms. The paper concludes by emphasizing sleep quality assessments as an important early risk indicator, thereby reducing the incidence of a wide spectrum of morbidities.
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              Mental Health in COVID-19 Pandemic: A Meta-Review of Prevalence Meta-Analyses

              Background: Mental health burden has been massively reported during the COVID-19 pandemic period. Aiming to summarise these data, we present a meta-review of meta-analyses that evaluated the impact of COVID-19 pandemic on anxiety, depressive and stress symptoms, psychological distress, post-traumatic stress disorder/symptoms (PTSD), and sleep disturbance, reporting its prevalence on general public (GP) and health care workers (HCW). Methods: A search was performed in the PubMed, EMBASE, and the Web of Science. Sleep disturbances, psychological distress, stress, and burnout were grouped as “Psychophysiological stress,” and anxiety, depression, and PTSD were grouped as “Psychopathology.” A random-effects model, calculating the pooled prevalence together with 95% confidence interval was performed for each domain. Subgroup analyses were performed for each population type (GP and HCW) and for each mental health outcome. For anxiety and depression, subgroup analysis for population type was performed. Heterogeneity is reported as I 2 . Publication bias was assessed through visual inspection of the funnel plot, and further tested by Egger's test and trim and fill analyses. Results: A total of 18 meta-analyses were included. The prevalence of psychophysiological stress was 31.99% (CI: 26.88–37.58, I 2 = 99.9%). HCW showed a higher prevalence (37.74%, CI: 33.26–42.45, I 2 = 99.7%) than the GP (20.67%, 15.07–27.66, I 2 = 99.9%). The overall prevalence of insomnia, psychological distress, and stress were, respectively, 32.34% (CI: 25.65–39.84), 28.25% (CI: 18.12–41.20), and 36% (CI: 29.31–43.54). Psychopathology was present at 26.45% (CI: 24.22–28.79, I 2 = 99.9%) of the sample, with similar estimates for population (HCW 26.14%, CI: 23.37–29.12, I 2 = 99.9%; GP: 26.99%, CI: 23.41–30.9, I 2 = 99.9%). The prevalence of anxiety, depression, and PTSD was 27.77% (CI: 24.47–31.32), 26.93% (CI: 23.92–30.17), and 20% (CI: 15.54–24.37), respectively. Similar proportions between populations were found for anxiety (HCW = 27.5%, CI: 23.78–31.55; GP = 28.33%, CI: 22.1–35.5) and depression (HCW = 27.05%, CI: 23.14–31.36; GP = 26.7%, CI: 22.32–31.59). Asymmetry in the funnel plot was found, and a slight increase in the estimate of overall psychopathology (29.08%, CI: 26.42–31.89) was found after the trim and fill analysis. Conclusions: The prevalence of mental health problems ranged from 20 to 36%. HCW presented a higher prevalence of psychophysiological stress than the general population. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=252221 , identifier: CRD42021252221.
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                Author and article information

                Contributors
                URI : http://loop.frontiersin.org/people/1133124/overviewRole: Role:
                URI : http://loop.frontiersin.org/people/953293/overviewRole:
                Role:
                URI : http://loop.frontiersin.org/people/211611/overviewRole:
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                12 September 2023
                2023
                12 September 2023
                : 14
                : 1281604
                Affiliations
                [1] 1Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila , L'Aquila, Italy
                [2] 2Department of Psychology, University of Campania L. Vanvitelli , Caserta, Italy
                [3] 3Center for Health Sciences, SRI International , Menlo Park, CA, United States
                [4] 4Department of General Psychology, University of Padova , Padua, Italy
                Author notes

                Edited and reviewed by: Gianluca Castelnuovo, Catholic University of the Sacred Heart, Italy

                *Correspondence: Federico Salfi Federico.salfi@ 123456univaq.it
                Article
                10.3389/fpsyg.2023.1281604
                10523345
                37771814
                c995fd03-5e0b-42e2-a22f-42b8cbf94b33
                Copyright © 2023 Salfi, Ficca, Alzueta and Cellini.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 22 August 2023
                : 24 August 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 10, Pages: 2, Words: 1472
                Categories
                Psychology
                Editorial
                Custom metadata
                Psychology for Clinical Settings

                Clinical Psychology & Psychiatry
                sleep disturbances,mental health,psychological symptoms,pandemic,covid-19

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