![]() ![]() Such estimates clearly exceed base rates reported in most epidemiological studies conducted under normal circumstances (ie, pre-pandemic) and using similar criteria. Surveys conducted in several countries since the beginning of the pandemic, as well as meta-analyses, ,, ], have reported very high and variable rates of insomnia (20–35%), anxiety (20–45%), and depression (25–50%) in the general population, with rates even higher among health-care workers, ,, ] and patients with COVID-19. Combined with mandatory confinement in many countries around the world, these multiple stressors have had major impacts on sleep and mental health. Stress has been ubiquitous due to health concerns, social isolation, financial hardship, home-schooling, and uncertainty about the future. In addition to the estimated 4.1 million deaths caused by this virus thus far (July 20, 2021), the pandemic has caused unprecedented changes in social, work, travel, and leisure activities. The COVID-19 pandemic is one of the most significant health challenges of our time. ![]() These associations remained significant after controlling for age, sex, and psychological symptoms. Risks of insomnia were higher among participants who reported having had COVID-19, who reported greater financial burden, were in confinement for a period of four to five weeks, and living alone or with more than five people in same household. Proportions of insomnia cases were significantly higher among participants who completed the survey earlier in the first wave of the pandemic relative to those who completed it later. Rates of insomnia symptoms (>40%) and insomnia disorder (>25%) were significantly higher in women, younger age groups, and in residents of Brazil, Canada, Norway, Poland, USA, and United Kingdom compared to residents from Asian countries (China and Japan, 8% for disorder and 22%–25% for symptoms) (all Ps < 0.01). Clinical insomnia symptoms were reported by 36.7% (95% CI, 36.0–37.4) of respondents and 17.4% (95% CI, 16.9–17.9) met criteria for a probable insomnia disorder. ![]()
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