Effect of Confinement on Anxiety Symptoms and Sleep Quality during the COVID-19 Pandemic

Caren Alvarado-Aravena, Karem Arriaza, Matías Castillo-Aguilar, Karen Flores, Alexies Dagnino-Subiabre, Claudia Estrada-Goic, Cristian Núñez-Espinosa, Caren Alvarado-Aravena, Karem Arriaza, Matías Castillo-Aguilar, Karen Flores, Alexies Dagnino-Subiabre, Claudia Estrada-Goic, Cristian Núñez-Espinosa

Abstract

Confinement during the COVID-19 pandemic has significantly impacted lifestyles worldwide. The aim of this study was to evaluate the effect of confinement on anxiety symptoms and sleep quality in people living in extreme southern latitudes. The Beck Anxiety Inventory (BAI) and the Pittsburgh Sleep Quality Index (PSQI) were administered to 617 people, 74.2% of whom were women. The sample was grouped according to confinement: the zone of confinement (CZ) (46.5%) and the zone of partial confinement (PZ) (53.5%). In addition, the sample was further categorized into four age subgroups (18-25 years; 26-40 years; 41-50 years; over 50 years). Higher levels of anxiety and worse sleep quality were found in the CZ group than in the PZ group. Women had higher levels of anxiety and worse sleep quality than men. A significant bidirectional relationship between anxiety and sleep quality was observed, even after controlling for sex. This study demonstrated that women and young adults were more vulnerable to the effects of confinement on anxiety symptoms and sleep quality in populations at southern latitudes.

Keywords: COVID-19; anxiety; confinement; mental health; sleep quality.

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Scatter plot of PSQI and BAI with superimposed weighted local regression lines (LOESS); box plots indicate the distributions of these scores for the CZ and PZ groups. The size of the points represents the number of observations at each point.
Figure 2
Figure 2
Model 2P (left) and Model 2B (right) explain significant and substantial proportions of the variance (R2 = 0.39, F(5, 611) = 78.92, p < 0.001, adjusted R2 = 0.39).

References

    1. World Health Organization . Coronavirus Disease 2019 (COVID-19): Situation Report, 94. World Health Organization; Geneva, Switzerland: 2020.
    1. Perea Tinajero G., Bąk A. To Lock or Not to Lock? Mexico Case. Hist. Philos. Life Sci. 2021;43:1–5.
    1. Sher L. COVID-19, Anxiety, Sleep Disturbances and Suicide. Sleep Med. 2020;70:124. doi: 10.1016/j.sleep.2020.04.019.
    1. Kolahchi Z., Domenico M.D., Uddin L.Q., Cauda V., Grossmann I., Lacasa L., Grancini G., Mahmoudi M., Rezaei N. Coronavirus Disease-COVID-19. Springer; Berlin/Heidelberg, Germany: 2021. Correction to: COVID-19 and Its Global Economic Impact; p. C1.
    1. Trógolo M.A., Moretti L.S., Medrano L.A. A Nationwide Cross-Sectional Study of Workers’ Mental Health During the COVID-19 Pandemic: Impact of Changes in Working Conditions, Financial Hardships, Psychological Detachment from Work and Work-Family Interface. BMC Psychol. 2022;10:73. doi: 10.1186/s40359-022-00783-y.
    1. World Health Organization . Depression and Other Common Mental Disorders: Global Health Estimates. World Health Organization; Geneva, Switzerland: 2017.
    1. Talevi D., Socci V., Carai M., Carnaghi G., Faleri S., Trebbi E., Bernardo A.D., Capelli F., Pacitti F. Mental Health Outcomes of the CoViD-19 Pandemic. Riv. Psichiatr. 2020;55:137–144.
    1. Wang C., Pan R., Wan X., Tan Y., Xu L., Ho C.S., Ho R.C. Immediate Psychological Responses and Associated Factors During the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic Among the General Population in China. Int. J. Environ. Res. Public Health. 2020;17:1729. doi: 10.3390/ijerph17051729.
    1. Shah S.M.A., Mohammad D., Qureshi M.F.H., Abbas M.Z., Aleem S. Prevalence, Psychological Responses and Associated Correlates of Depression, Anxiety and Stress in a Global Population, During the Coronavirus Disease (COVID-19) Pandemic. Community Ment. Health J. 2021;57:101–110. doi: 10.1007/s10597-020-00728-y.
    1. Steinmetz L.C.L., Florio M.A.D., Leyes C.A., Fong S.B., Rigalli A., Godoy J.C. Levels and Predictors of Depression, Anxiety, and Suicidal Risk During COVID-19 Pandemic in Argentina: The Impacts of Quarantine Extensions on Mental Health State. Psychol. Health Med. 2022;27:13–29. doi: 10.1080/13548506.2020.1867318.
    1. Tollos I., Theodorakopoulou A., Christodoulou G.N. Stress and Pathophysiological Mechanisms for the Development of Psychosomatic Disease. Psychiatrike. 2021;32:148–156. doi: 10.22365/jpsych.2021.023.
    1. McMakin D.L., Alfano C.A. Sleep and Anxiety in Late Childhood and Early Adolescence. Curr. Opin. Psychiatry. 2015;28:483. doi: 10.1097/YCO.0000000000000204.
    1. Gould C.E., Spira A.P., Liou-Johnson V., Cassidy-Eagle E., Kawai M., Mashal N., O’Hara R., Beaudreau S.A. Association of Anxiety Symptom Clusters with Sleep Quality and Daytime Sleepiness. J. Gerontol. Ser. B. 2018;73:413–420. doi: 10.1093/geronb/gbx020.
    1. Maya R., Paola E. Bachelor’s Thesis. Benemérita Universidad Autónoma de Puebla; Puebla, Mexico: 2021. Efecto de La Ansiedad En El Ciclo Sueño-Vigilia.
    1. Irwin M.R., Opp M.R. Sleep Health: Reciprocal Regulation of Sleep and Innate Immunity. Neuropsychopharmacology. 2017;42:129–155. doi: 10.1038/npp.2016.148.
    1. Besedovsky L., Lange T., Haack M. The Sleep-Immune Crosstalk in Health and Disease. Physiol. Rev. 2019;99:1325–1380. doi: 10.1152/physrev.00010.2018.
    1. McKay D., Yang H., Elhai J., Asmundson G.J. Anxiety Regarding Contracting COVID-19 Related to Interoceptive Anxiety Sensations: The Moderating Role of Disgust Propensity and Sensitivity. J. Anxiety Disord. 2020;73:102233. doi: 10.1016/j.janxdis.2020.102233.
    1. Cohen S., Doyle W.J., Alper C.M., Janicki-Deverts D., Turner R.B. Sleep Habits and Susceptibility to the Common Cold. Arch. Intern. Med. 2009;169:62–67. doi: 10.1001/archinternmed.2008.505.
    1. Besedovsky L., Born J. Sleep, Don’t Sneeze: Longer Sleep Reduces the Risk of Catching a Cold. Sleep. 2015;38:1341–1342. doi: 10.5665/sleep.4958.
    1. Prather A.A., Janicki-Deverts D., Hall M.H., Cohen S. Behaviorally Assessed Sleep and Susceptibility to the Common Cold. Sleep. 2015;38:1353–1359. doi: 10.5665/sleep.4968.
    1. Lin Y.N., Liu Z.R., Li S.Q., Li C.X., Zhang L., Li N., Sun X.W., Li H.P., Zhou J.P., Li Q.Y. Burden of Sleep Disturbance During COVID-19 Pandemic: A Systematic Review. Nat. Sci. Sleep. 2021;13:933. doi: 10.2147/NSS.S312037.
    1. Idrissi A.J., Lamkaddem A., Benouajjit A., El Bouaazzaoui M.B., El Houari F., Alami M., Labyad S., Chahidi A., Benjelloun M., Rabhi S., et al. Sleep Quality and Mental Health in the Context of COVID-19 Pandemic and Lockdown in Morocco. Sleep Med. 2020;74:248–253. doi: 10.1016/j.sleep.2020.07.045.
    1. Pieh C., Budimir S., Probst T. The Effect of Age, Gender, Income, Work, and Physical Activity on Mental Health During Coronavirus Disease (COVID-19) Lockdown in Austria. J. Psychosom. Res. 2020;136:110186. doi: 10.1016/j.jpsychores.2020.110186.
    1. Kasper S., Wehr T.A., Bartko J.J., Gaist P.A., Rosenthal N.E. Epidemiological Findings of Seasonal Changes in Mood and Behavior: A Telephone Survey of Montgomery County, Maryland. Arch. Gen. Psychiatry. 1989;46:823–833.
    1. Goikolea J., Miralles G., Cabré A.B., Vieta E., Bulbena A. Adaptación Española Del Cuestionario de Evaluación de Perfil Estacional (Seasonal Pattern Assessment Questionnaire, SPAQ) En Las Versiones de Adultos e Infanto-Juvenil. Actas Españolas De Psiquiatr. 2003;31:192–198.
    1. De Rudder B. Grundriss Einer Meteorobiologie Des Menschen: Wetter-Und Jahreszeiteneinflüsse. Springer; Berlin/Heidelberg, Germany: 2013.
    1. Rosen L.N., Targum S.D., Terman M., Bryant M.J., Hoffman H., Kasper S.F., Hamovit J.R., Docherty J.P., Welch B., Rosenthal N.E. Prevalence of Seasonal Affective Disorder at Four Latitudes. Psychiatry Res. 1990;31:131–144. doi: 10.1016/0165-1781(90)90116-M.
    1. Ozaki N., Ono Y., Ito A., Rosenthal N.E. Prevalence of Seasonal Difficulties in Mood and Behavior Among Japanese Civil Servants. Am. J. Psychiatry. 1995;152:1225–1227.
    1. Sakamoto K., Kamo T., Nakadaira S., Tamura A., Takahashi K. A Nationwide Survey of Seasonal Affective Disorder at 53 Outpatient University Clinics in Japan. Acta Psychiatr. Scand. 1993;87:258–265. doi: 10.1111/j.1600-0447.1993.tb03368.x.
    1. Alvarado-Aravena C., Estrada-Goic C., Núñez-Espinosa C. Sintomatología Depresiva y Calidad de Vida En Estudiantes de Medicina En Alta Latitud Sur. Rev. Médica De Chile. 2021;149:357–365. doi: 10.4067/s0034-98872021000300357.
    1. Gobierno de Chile Instructivo Para Permisos de Desplazamiento, Actualizado al 09 de Julio de 2020. Plan de Acción Coronavirus COVID-19. [(accessed on 15 August 2022)]. Available online: .
    1. Sanz J., Navarro M.E. Propiedades Psicométricas de Una Versión Española Del Inventario de Ansiedad de Beck (BAI) En Estudiantes Universitarios. Ansiedad Y Estrés. 2003;9:59–84.
    1. Starosta A., LA B. Encyclopedia of Clinical Neuropsychology. Springer; Berlin/Heidelberg, Germany: 2017. Beck Anxiety Inventory.
    1. Jiménez-Genchi A., Monteverde-Maldonado E., Nenclares-Portocarrero A., Esquivel-Adame G., Vega-Pacheco A. de la Confiabilidad y análisis Factorial de La Versión En Español Del íNdice de Calidad de Sueño de Pittsburgh En Pacientes Psiquiátricos. Gac. Médica De México. 2008;144:491–496.
    1. R Core Team . R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing; Vienna, Austria: 2021.
    1. RStudio Team . RStudio: Integrated Development Environment for R. RStudio; PBC; Boston, MA, USA: 2021.
    1. Rizopoulos D. Ltm: An r Package for Latent Variable Modelling and Item Response Theory Analyses. J. Stat. Softw. 2006;17:1–25. doi: 10.18637/jss.v017.i05.
    1. Suso-Ribera C., Martín-Brufau R. How Much Support Is There for the Recommendations Made to the General Population During Confinement? A Study During the First Three Days of the Covid–19 Quarantine in Spain. Int. J. Environ. Res. Public Health. 2020;17:4382. doi: 10.3390/ijerph17124382.
    1. Canet-Juric L., Andrés M.L., Del Valle M., López-Morales H., Poó F., Galli J.I., Yerro M., Urquijo S. A Longitudinal Study on the Emotional Impact Cause by the COVID-19 Pandemic Quarantine on General Population. Front. Psychol. 2020;11:2431. doi: 10.3389/fpsyg.2020.565688.
    1. Gismero-González E., Bermejo-Toro L., Cagigal V., Roldán A., Martínez-Beltrán M.J., Halty L. Emotional Impact of COVID-19 Lockdown Among the Spanish Population. Front. Psychol. 2020;11:616978. doi: 10.3389/fpsyg.2020.616978.
    1. Cheikh Ismail L., Mohamad M.N., Bataineh M.F., Ajab A., Al-Marzouqi A.M., Jarrar A.H., Abu Jamous D.O., Ali H.I., Al Sabbah H., Hasan H., et al. Impact of the Coronavirus Pandemic (COVID-19) Lockdown on Mental Health and Well-Being in the United Arab Emirates. Front. Psychiatry. 2021;12:265. doi: 10.3389/fpsyt.2021.633230.
    1. Saunders R., Buckman J.E., Fonagy P., Fancourt D. Understanding Different Trajectories of Mental Health Across the General Population During the COVID-19 Pandemic. Psychol. Med. 2021:1–9. doi: 10.1017/S0033291721000957.
    1. Li S.H., Graham B.M. Why Are Women so Vulnerable to Anxiety, Trauma-Related and Stress-Related Disorders? The Potential Role of Sex Hormones. Lancet Psychiatry. 2017;4:73–82. doi: 10.1016/S2215-0366(16)30358-3.
    1. Dagnino-Subiabre A. Resilience to Stress and Social Touch. Curr. Opin. Behav. Sci. 2022;43:75–79. doi: 10.1016/j.cobeha.2021.08.011.
    1. Campos J.A.D.B., Martins B.G., Campos L.A., Marôco J., Saadiq R.A., Ruano R. Early Psychological Impact of the COVID-19 Pandemic in Brazil: A National Survey. J. Clin. Med. 2020;9:2976. doi: 10.3390/jcm9092976.
    1. Alexander J.L., Dennerstein L., Kotz K., Richardson G. Women, Anxiety and Mood: A Review of Nomenclature, Comorbidity and Epidemiology. Expert Rev. Neurother. 2007;7:S45–S58. doi: 10.1586/14737175.7.11s.S45.
    1. Hodes G.E., Epperson C.N. Sex Differences in Vulnerability and Resilience to Stress Across the Life Span. Biol. Psychiatry. 2019;86:421–432. doi: 10.1016/j.biopsych.2019.04.028.
    1. Prater K.E., Hosanagar A., Klumpp H., Angstadt M., Phan K.L. Aberrant Amygdala–Frontal Cortex Connectivity During Perception of Fearful Faces and at Rest in Generalized Social Anxiety Disorder. Depress. Anxiety. 2013;30:234–241. doi: 10.1002/da.22014.
    1. Chini M., Hanganu-Opatz I.L. Prefrontal Cortex Development in Health and Disease: Lessons from Rodents and Humans. Trends Neurosci. 2021;44:227–240. doi: 10.1016/j.tins.2020.10.017.
    1. Mena F.J., De Paz V., Avilés M., Orantes L. Educabilidad y Salud Mental de Universitarios Salvadoreños Durante La Pandemia Por Covid-19. Cienc. Y Educ. 2021;5:19–38. doi: 10.22206/cyed.2021.v5i3.pp19-38.
    1. Oliver N., Barber X., Roomp K., Roomp K. The Covid19 Impact Survey: Assessing the Pulse of the COVID-19 Pandemic in Spain via 24 Questions. arXiv. 20202004.01014 2020
    1. ElHafeez S.A., Cruz M.M.E., Gouda S., Nofal M., Fayed A., Ghazy R.M., Mekky J. Sleep Quality and Anxiety Among Egyptian Population During Covid-19 Pandemic. Sleep Sci. 2022;15:8. doi: 10.5935/1984-0063.20210020.
    1. Drager L.F., Pachito D.V., Morihisa R., Carvalho P., Lobao A., Poyares D. Sleep Quality in the Brazilian General Population: A Cross-Sectional Study. Sleep Epidemiol. 2022;2:100020. doi: 10.1016/j.sleepe.2022.100020.

Source: PubMed

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