The prevalence of insomnia in different COVID-19 policy phases: Longitudinal evidence from ITA.LI – Italian Lives

Riva, Egidio and Terraneo, Marco and Lucchini, Mario and Gerosa, Tiziano (2022) The prevalence of insomnia in different COVID-19 policy phases: Longitudinal evidence from ITA.LI – Italian Lives. BMC Public Health, 22 (1). ISSN 1471-2458

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Background: This study investigated changes in the prevalence of insomnia in Italy during COVID-19, starting from the first lockdown period (8 March 2020). We hypothesized that lockdown precipitated increased prevalence of insomnia symptoms relative to the pre-pandemic period; b) the gradual relaxation of containment measures – postlockdown period (Phase 2 and Phase 3) – reduced insomnia severity, leading to a relative recovery of pre-pandemic levels; and c) we tested age-related heterogeneity in sleep responses, with an expected higher increase in insomnia in younger and middle-age groups. Methods: Analyses drew on a subsample (N=883) of respondents to ITA.LI – Italian Lives, a recently established panel study on a probability sample of individuals aged 16+living in Italy. To estimate patterns of change in insomnia, we frst ftted a random-efects ordered logistic model on the whole sample. We then added an interaction term between policy phases and the respondent age to test whether the relationship between insomnia and policy phases difered across age groups. Analyses accounted for survey non-response weights. Results: The fraction of respondents reporting moderate (“somewhat”+0.159, S.E. 0.017) or severe (“very much”+0.142, S.E. 0.030) sleep disturbances signifcantly increased during Phase 1. The prevalence of insomnia followed an inverted U-shaped curve across policy phases, with further increases from baseline levels (“somewhat”+0.168, S.E. 0.015; “very much”+0.187, S.E. 0.030) during Phase 2, followed by a relative reduction in Phase 3, although it remained signifcantly higher than in the pre-pandemic period (“somewhat”,+0.084, S.E. 0.016; “very much”,+0.045, S.E. 0.010). There were signifcant age-related diferences in insomnia patterns, as the discrete change from pre-pandemic levels in the probability of not sufering from insomnia was negative and signifcant for the younger age group (−0.269, S.E. 0.060) and for respondents aged 35–54 (−0.163, S.E. 0.039). Conclusion: There is reason to believe that the emergency policy response to the COVID-19 crisis may have had unintended and possibly scarring effects in terms of increased prevalence of insomnia. The hardest hit were young adults and, to a lesser extent, the middle-aged; however, older respondents (55+) remained resilient, and their insomnia trajectory bounced back to pre-pandemic levels.

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