A longitudinal study on the change in sleep across three waves of the COVID-19 outbreaks in Hong Kong

Denise Shuk Ting Cheung; Branda Yee-Man Yu; Simon Ching Lam; Doris Yin Ping Leung; Ka-Fai Chung; Fiona Yan-Yee Ho; Shu-Cheng Chen; Wing-Fai Yeung

doi:10.1007/s41105-023-00486-w

A longitudinal study on the change in sleep across three waves of the COVID-19 outbreaks in Hong Kong

Sleep Biol Rhythms. 2023 Sep 8;22(1):93-102. doi: 10.1007/s41105-023-00486-w. eCollection 2024 Jan.

Authors

Denise Shuk Ting Cheung¹, Branda Yee-Man Yu², Simon Ching Lam³, Doris Yin Ping Leung³, Ka-Fai Chung⁴, Fiona Yan-Yee Ho⁵, Shu-Cheng Chen³, Wing-Fai Yeung^{3

6}

Affiliations

¹ School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong, China.
² Department of Psychology, The University of Hong Kong, Hong Kong SAR, China.
³ School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
⁴ Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
⁵ Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China.
⁶ Research Institute for Smart Ageing, The Hong Kong Polytechic University, Hong Kong, Hong Kong SAR.

PMID: 38476851
PMCID: PMC10899949 (available on 2024-09-08)
DOI: 10.1007/s41105-023-00486-w

Abstract

In the year 2020, Hong Kong experienced four COVID-19 epidemic waves. The present study aimed to examine the transition of sleep disturbances and explore its associated factors across the later three epidemic waves. Among the 1138 respondents who participated in an online survey at the second wave (T1, April 2020), 338 and 378 participants also completed a follow-up at the third (T2, August 2020) and fourth waves (T3, December 2020), respectively. Participants completed the Insomnia Severity Index and an investigator-designed questionnaire regarding potential factors associated with sleep change such as perceived risk of being infected, economic stress, and confidence in the government and health care professional. Sample of this study were mainly female (67.7%), married (50.3%), young adults (54.2%) with tertiary education (81.6%). Maintaining normal sleep was the most prevalent trajectory of sleep of all three waves (50.5%), followed by persistent insomnia (17.2%) and remitted insomnia (9.0%). Besides female, older-age and lower education level, the results showed that increment in worry about family being infected (adjusted risk ratio, RR = 1.28), perceived interference of daily lives (adjusted RR = 1.19), and economic distress (adjusted RR = 1.24) were significantly associated with the development of clinical insomnia during the three epidemic waves. These factors were also associated with worsening of other sleep parameters. Insomnia being persistent across the three waves of COVID-19 outbreaks was common. Increasing economic distress, daily interference, and worry about family members being infected were associated with an increasing risk of clinical insomnia across the three COVID-19 outbreaks.

Supplementary information: The online version contains supplementary material available at 10.1007/s41105-023-00486-w.

Keywords: Epidemic; Insomnia; Pandemic; Sleep disturbance; Trajectory.

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