Fig 1.
Proportion of participants reporting Covid-19 pandemic-related effects.
78% (18/23) of the participants reported that they felt an increase in stress and anxiety due to the pandemic; 52% (12/23) reported experiencing a harder time getting to sleep, 43% (10/23) felt that they were not getting enough sleep and 70% (16/21) reported suffering from more than one of the six effects listed, namely ‘sleep disorder’, ‘vivid dream/ nightmares’, ‘no fixed sleep schedule’, ‘not enough sleep’, ‘hard to get to sleep’ and ‘stress and anxiety’.
Fig 2.
State Trait Anxiety Inventory (STAI) and BDI scores differ pre- and mid-pandemic.
A). STAI scores increased from pre- to mid-pandemic, (t (21) = -3.077, p = 0.006), with individuals being 4 times more likely to be anxious during mid-pandemic than during pre-pandemic (OR = 4.08, 95% CI: 1.11–15.02, Z = 2.12, p = 0.034). B) BDI scores increased from pre- to mid-pandemic (Z = -2.702, p = 0.007).
Fig 3.
Association of differences in BDI scores between mid-pandemic and pre-pandemic with differences in STAI scores.
Increasing relative anxiety scores (higher mid-pandemic scores relative to pre-pandemic scores) are associated with increases in depression scores (R2 = 0.632, β = 0.765, p < 0.001).
Table 1.
Regression analysis of differences between mid- and pre-pandemic depression symptoms (BDI) (as outcome) and anxiety (STAI).
Fig 4.
Association of the differences in PROMIS scores mid-pandemic versus pre-pandemic with differences in STAI and BDI scores.
Increases in sleep disturbance scores during the pandemic are positively associated with increases in (A) anxiety scores (R2 = 0.258, β = 0.508, p = 0.045) and (B) BDI scores (R2 = 0.305, β = 0.552, p = 0.022).
Fig 5.
Average behavioral survey scores (STAI, BDI, PROMIS) in individuals reporting less sleep during pandemic.
Individuals reporting that they spent less time sleeping during the pandemic compared to pre-pandemic reported significantly higher STAI (t(14) = -2.186, p = 0.046), and BDI (t(13) = -3.168, p = 0.007) scores during mid-pandemic relative to pre-pandemic. There was no significant change in PROMIS scores (t(12) = -0.800, p = 0.439).
Table 2.
Regression analysis of differences between mid- and pre-pandemic sleep disturbance (PROMIS) (as outcome) and anxiety (STAI) and depression (BDI).
Fig 6.
Association of mid-pandemic changes in PROMIS scores relative to pre-pandemic with changes in percentages of REM and deep sleep on free (non-work) days.
A) Increasing PROMIS scores during pandemic are associated with decreases in the amount of REM sleep received during the pandemic relative to pre-pandemic (R2 = 0.269, β = -0.518, p = 0.033). B) Increasing PROMIS scores during pandemic are associated with decreases in the amount of deep sleep received during the pandemic relative to pre-pandemic (R2 = 0.248, β = -0.498, p = 0.035).
Table 3.
Average values for sleep parameters measured by Fitbit on free days (median (IQR)).
Table 4.
Regression analysis of differences between mid- and pre-pandemic sleep disturbance (PROMIS) (as outcome) and Fitbit sleep measures (REM and deep sleep).