Sex differences in self-report anxiety and sleep quality during COVID-19 stay-at-home orders

Biol Sex Differ. 2020 Oct 13;11(1):56. doi: 10.1186/s13293-020-00333-4.

Abstract

Background: COVID-19 and home isolation has impacted quality of life, but the perceived impact on anxiety and sleep remains equivocal. The purpose of this study was to assess the impact of COVID-19 and stay-at-home orders on self-report anxiety and sleep quality, with a focus on sex differences. We hypothesized that the COVID-19 pandemic would be associated with increased anxiety and decreased sleep quality, with stronger associations in women.

Methods: One hundred three participants (61 female, 38 ± 1 years) reported perceived changes in anxiety and sleep quality due to stay-at-home orders during the COVID-19 pandemic and were administered the Spielberger State-Trait Anxiety Inventory (STAI), Pittsburgh Sleep Quality Index (PSQI), and Insomnia Severity Index (ISI). Chi-square and T test analyses were utilized to assess sex differences in reported anxiety and sleep. Analysis of covariance was used to compare the associations between reported impact of COVID-19 and anxiety/sleep parameters.

Results: Women (80.3%) reported higher prevalence of increased general anxiety due to COVID-19 when compared to men (50%; p = 0.001) and elevated STAI state anxiety compared to men (43 ± 1 vs. 38 ± 1 a.u., p = 0.007). Despite these differences in anxiety, the perceived impact of COVID-19 on PSQI was not different between sexes. However, when stratified by perceived changes in anxiety due to COVID-19, participants with higher anxiety responses to COVID-19 had higher ISI compared to those with no perceived changes in anxiety (9 ± 1 vs. 5 ± 1 a.u., p = 0.003). Additionally, participants who reported reduced sleep quality due to COVID-19 reported higher state anxiety (45 ± 1 a.u.) compared to those that perceived no change (36 ± 2 a.u., p = 0.002) or increased (36 ± 2 a.u., p < 0.001) sleep quality.

Conclusion: COVID-19 and state-ordered home isolation was associated with higher anxiety and reduced sleep quality, with a stronger association in women with respect to anxiety.

Keywords: Anxiety; COVID-19; Pandemic; Sex; Sleep quality; Total sleep time.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety Disorders / epidemiology*
  • Anxiety Disorders / etiology
  • Anxiety Disorders / psychology*
  • Betacoronavirus / isolation & purification
  • COVID-19
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / prevention & control
  • Coronavirus Infections / psychology*
  • Coronavirus Infections / transmission
  • Female
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Pandemics / prevention & control
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / prevention & control
  • Pneumonia, Viral / psychology*
  • Pneumonia, Viral / transmission
  • Prevalence
  • Quality of Life
  • Quarantine / psychology*
  • SARS-CoV-2
  • Self Report
  • Sex Factors
  • Sleep Wake Disorders / epidemiology*
  • Sleep Wake Disorders / etiology
  • Sleep Wake Disorders / psychology*
  • Sleep Wake Disorders / virology
  • United States / epidemiology
  • Young Adult