Insomnia in Healthcare Workers Worsened During the Pandemic

Daniela Ovadia

December 08, 2021

Healthcare workers who don't sleep well are twice as likely to report symptoms of depression than their better-rested colleagues, according to a recent study on the association between quality of sleep and psychological distress of healthcare workers in New York City during the pandemic.

The study, conducted by a group of researchers from Columbia University and recently published in the Journal of Affective Disorders, also showed that those with sleep disturbances are 50% more likely to report psychological distress and 70% more likely to report anxiety.

This constellation of troubles could worsen the crisis caused by the pandemic, which is already taking a toll on healthcare workers, according to lead researcher Marwah Abdalla, MD, assistant professor of medicine at Columbia University Medical Center in New York City.

"Right now, a large percentage of healthcare workers are leaving their jobs because of the stress, producing a shortage of healthcare workers nationally," said Abdalla. "With fewer workers on the job, the remaining staff must work more and longer shifts, exacerbating their sleep problems and stress."

The Columbia group conducted a series of surveys to assess sleep habits and psychological symptoms experienced by their colleagues during the pandemic's first peak in New York City. The data showed that over 70% of healthcare workers reported at least moderate insomnia. Although that number decreased as COVID case counts went down, nearly four in 10 still suffered from insomnia 10 weeks after the first survey, when the first COVID wave was over and work schedules had returned to somewhat normal levels.

"We know that lack of sleep degrades quality of care for our patients and can increase medical errors, but it may also trigger symptoms of depression and anxiety," said Abdalla.

After a subsequent in-depth study and a follow-up period, the researchers found that healthcare workers who reported poor sleep also reported higher levels of stress, anxiety, and depression than healthcare workers who slept better.

Italians Worse Off Than European Counterparts

The situation in Italy is no different. A recent study showed that Italian physicians have experienced more stress-induced issues than some of their colleagues in other European countries.

"There are no specific studies on sleep disturbances among Italian physicians, but many colleagues have turned to our Center to resolve severe insomnia symptoms that have worsened over the course of the last 2 years," said Luigi Ferini Strambi, MD, head physician at the Sleep Disorders Center of San Raffaele Hospital in Milan.

"Early intervention is imperative; this way, we can prevent these kinds of problems from interfering with the focus needed to handle emergency situations," he added.

It's hardly news that healthcare workers have been under immense stress during the COVID-19 pandemic; poor sleep quality is an age-old problem for physicians, at least in Italy. A 2015 survey of 2,000 newly minted physicians, conducted by the National Association for Hospital Aides and Assistants, showed that when physicians were not feeling well, they most often attributed their malaise to insomnia. This was particularly true for those who worked in hospitals.

Countermeasures and Wake-up Calls

Although stress, anxiety, and depression can arise in well-rested individuals, "sleep is essential to mental health," said Abdalla. "While we don't know from this study if psychological distress itself caused poor sleep or if poor sleep resulted in psychological distress among these healthcare workers, improving sleep can reduce psychological problems and vice versa, and this is especially important for physicians."

Recommended interventions range from cognitive-behavioral therapy for insomnia to increasing the amount of time spent resting during breaks and installing nap pods in workplaces — especially in hospitals — for staff to use during long shifts.

"When overwhelmed by work, lying down for just 20 or 30 minutes will help," Abdalla and her colleagues write.

"Previous research has shown that sleep trouble increases your risk for chronic conditions, such as heart disease, diabetes, dementia, and cancer," said Abdalla. "If you have trouble sleeping, let this be a wake-up call."

This article originally appeared on Univadis from Medscape.

Follow Medscape on Facebook, Twitter, Instagram, and YouTube


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.