Association of COVID-19 preventive behavior and job-related stress with the sleep quality of healthcare workers one year into the COVID-19 outbreak: a Japanese cross-sectional survey

Muneto Izuhara; Kentaro Matsui; Ryo Okubo; Takuya Yoshiike; Kentaro Nagao; Aoi Kawamura; Ayumi Tsuru; Tomohiro Utsumi; Megumi Hazumi; Yohei Sasaki; Kazuyoshi Takeda; Hirofumi Komaki; Hideki Oi; Yoshiharu Kim; Kenichi Kuriyama; Takeshi Miyama; Kazuyuki Nakagome

doi:10.1186/s13030-024-00304-w

Association of COVID-19 preventive behavior and job-related stress with the sleep quality of healthcare workers one year into the COVID-19 outbreak: a Japanese cross-sectional survey

Biopsychosoc Med. 2024 Mar 6;18(1):8. doi: 10.1186/s13030-024-00304-w.

Authors

Muneto Izuhara^{1

2}, Kentaro Matsui^{1

2}, Ryo Okubo³, Takuya Yoshiike¹, Kentaro Nagao^{1

4}, Aoi Kawamura¹, Ayumi Tsuru^{1

2}, Tomohiro Utsumi¹, Megumi Hazumi^{1

5}, Yohei Sasaki³, Kazuyoshi Takeda³, Hirofumi Komaki³, Hideki Oi³, Yoshiharu Kim⁶, Kenichi Kuriyama⁷, Takeshi Miyama⁸, Kazuyuki Nakagome⁴

Affiliations

¹ Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
² Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
³ Clinical Research & Education Promotion Division, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
⁴ Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
⁵ Department of Public Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
⁶ Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
⁷ Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan. kenichik@ncnp.go.jp.
⁸ Department of Surgery, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.

Abstract

Background: This study aimed to evaluate the association of COVID-19 preventive behavior and job-related stress with sleep quality among healthcare workers (HCWs). We conducted a cross-sectional survey using a questionnaire at the National Center of Neurology and Psychiatry, Tokyo, Japan.

Methods: A total of 586 participants who completed the questionnaire were eligible for the study. The Pittsburgh Sleep Quality Index was used to evaluate sleep quality. We examined the level of engagement between poor sleep and COVID-19-related infection preventive behaviors, such as avoiding closed spaces, crowded places, and close contact (three Cs), a distance of at least one meter from others, wearing a face mask regularly, washing hands regularly, and working remotely, as well as job-related stress in the work environment, exposure to patients, potential risk of infection, fear of infecting others, need for social confinement, and financial instability. We conducted a hierarchical logistic regression analysis to examine the relationship between poor sleep and COVID-19 preventive behavior, job-related stress, and other covariates, including age, sex, and the Kessler Psychological Distress Scale (K6), which was used to measure non-specific psychological distress.

Results: Poor sleep was observed in 223 (38.1%) participants. Adherence to COVID-19 preventive measures was relatively high: 84.1% of participants answered "always" for wearing a face mask regularly and 83.4% for washing hands regularly. In the multivariate logistic regression analysis, stress in the work environment (odds ratio [OR] = 2.09, 95% confidence interval [CI], 1.37-3.20; p < 0.001), financial instability (OR = 1.73, 95% CI, 1.12-2.67; p < 0.05), and low adherence to working remotely (OR = 1.65, 95% CI, 1.06-2.57; p < 0.05) were independently and significantly associated with poor sleep after controlling for the covariates.

Conclusions: One year into the COVID-19 pandemic, the poor sleep rates of HCWs remained high. These results emphasize the need to protect HCWs from work environment stress and financial concerns.

Keywords: Financial instability; Poor sleep; Sleep quality; Work environment stress; Working remotely.

Grants and funding

Reserch Grant 2-1/National Center of Neurology and Psychiatry