| Objectives:The purpose of this study was to investigate the sleep status of Chinese community residents in the early stage of the novel coronavirus(COVID-19)epidemic and the intervention effect of one-week online cognitive behavioral therapy for insomnia(CBTI)on situational insomnia of community residents.Study 1 explored the changes of sleep quality and related factors of Chinese community residents after the outbreak of the COVID-19.Based on the findings of study 1,in study 2,one-week online CBTI was used to conduct an interventional study on community patients with situational insomnia,to explore the intervention effect and whether it can prevent the transformation of situational insomnia into chronic insomnia,and the factors affecting the effectiveness of CBTI intervention were further analyzed.Methods:The first study was a cross-sectional survey.Under the guidance of the Chinese Sleep Research Society,online sleep health questionnaire was conducted through the Toutiao APP to investigate the sleep status and related factors of Chinese community residents before and during the epidemic,and the Pittsburgh Sleep Quality Index(PSQI)was used to assess the sleep quality.The poor sleep group was included with PSQI>7,and PSQI≤7 were included in the good sleep group.Changes in sleep patterns between the two groups and risk factors related to poor sleep were analyzed before and after the epidemic.The second is a longitudinal intervention study.Community patients with situational insomnia were given the one-week digital CBTI intervention after COVID-19 outbreak.The participants were divided into the complete treatment group(the participants completed all 7 modules of the CBTI course),and the incomplete treatment group(the participants completed 0-6 modules of the CBTI course).Online assessment was conducted at baseline,post-intervention and 3 months after intervention,respectively.Insomnia Severity Index(ISI)>8 after three months with symptoms lasting for three months was considered as the criteria for chronic insomnia.The evaluation indicators included:transition rate of chronic insomnia,Insomnia Severity Index(ISI),Pre-sleep Arousal Scale(PSAS),and Hospital Anxiety and Depression Scale(HADS).Repeated measure analysis of variance andχ2test were used to compare the differences before and after intervention,and survival analysis Cox regression model was used to analyze the factors affecting the effectiveness of CBTI intervention.Results:1.30.0%of the participants reported suffering poor sleep quality(PSQI>7)after the COVID-19 outbteak.Logistic regression analysis found that factors associated with poor sleep were poor health status,fear of infection,and prolonged exposure to epidemic information etc(all p<0.001),as well as suspected and confirmed cases in the same community(P=0.002,P=0.007 respectively)2.A total of 194 subjects were included in the longitudinal intervention study(the complete treatment group n=75 and the incomplete treatment group n=119).There were significant differences in group × time effect(p=0.024)between the two groups in the ISI total score.There were significant differences in group × time effect(p=0.013)between the two groups in the PSAS-somatic score.And the transition rate from situational insomnia to chronic insomnia was significantly lower in the complete treatment group compared than in the incomplete treatment group(27.5%vs 48.5%,p=0.023).Baseline depressive symptoms(HR=0.55,P=0.004,95%CI:0.36-0.82)and baseline anxiety symptoms(HR=0.50,P=0.001,95%CI:0.33-0.75)had significant negative effects on insomnia recovery.Conclusions:Our study revealed a high incidence of poor sleep among community residents after the COVID-19 outbreak.The anxiety related to the epidemic and the wrong sleep cognition and behavior pattern will affect the sleep quality of residents.One-week online CBTI can improve the symptoms of situational insomnia,and decrease the transition rate of chronic insomnia from situational insomnia during the COVID-19,which has important practical significance and clinical value for improving the insomnia caused by the epidemic and reducing the adverse effects of insomnia. |
PDF Full Text Request