Half of the Population May Be Experiencing Clinically Significant Sleep Difficulties During the Pandemic

man can't sleep
man can’t sleep
This study aimed to evaluate changes in sleep during the COVID-19 outbreak, and used data-driven approaches to identify distinct profiles of changes in sleep-related behaviors. Demographic, behavioral and psychological factors associated with sleep changes were also investigated.

The global pandemic due to the novel coronavirus 2019 (COVID-19) has caused highly heterogenous alterations of sleep patterns. These findings, from an online survey, were published in the Journal of Sleep Research.

Researchers from the University of Ottawa in Canada recruited individuals (N=5525) aged 16 years or older online between April 3 and June 24, 2020 to participate in a study of sleep patterns. Respondents were assessed by multiple sleep instruments, for demographics, health status, and socioeconomic characteristics.

Participants were aged mean 55.6±16.3 years and 67.1% were women who responded a median 62 (interquartile range [IQR], 12) days after the pandemic was declared.

After controlling for age, sex, and the time since the pandemic began, individuals reported waking 28 minutes later than usual (F[1,5.274], 209.4; hp2, 0.04; P <.001) and a significant proportion of participants indicated they were experiencing clinically significant sleep difficulties (50.5%; Cohen’s g ³.27; P <.001).

With a cluster analysis, 3 subgroups among 3 clusters of sleep patterns were identified. The subgroups and clusters differed by time. Some individuals had an altered bedtime (F[2,5,256], 2209.2; hp2, 0.46; P <.001), wake-up time (F[2,5,256], 2609.7; hp2, 0.48; P <.001), or overall time spent in bed (F[2,5,256], 1699.2; hp2, 0.39; P <.001).

Some individuals who were experiencing an alteration of the time spent in bed kept the same bedtime but had a significantly later wake-up time (hp2, 0.02; P <.001) lengthening their overall time in bed (hp2, 0.03; P =.001; subgroup n=3515). Others in this cluster had a later bedtime (hp2, 0.15; P <.001) and wake-up time (hp2, 0.21; P <.001) causing a pattern of delayed sleep (hp2, 0.02; P <.001; subgroup n=1059).

Individuals with altered bedtimes (hp2, 0.03; P <.001) and wake-up times (hp2, 0.02; P =.001) spent significantly less time in bed (hp2, 0.08; P <.001; subgroup n=686).

Those who reported new-onset sleep difficulties had significantly more problems initiating sleep (c2, 159.3; P <.001), maintaining sleep (c2, 82.2; P <.001), and waking early (c2, 226.4; P <.001).

The emergence of sleep difficulties was significantly associated with gender (P <.001), Pittsburgh Sleep Quality Index score (P <.001), Cohen’s Perceived Stress Scale score (P <.001), family responsibilities (P =.001), television watching (P =.024), wake-up time (P =.028), current chronic illness (P =.030), drinking ³7 alcoholic beverages per week (P =.031), and employment status (P =.047).

This study was limited by the retrospective reporting of prior sleep difficulties, which may have been over or under stated.

These results indicated that more than half of individuals may be at risk for pandemic-related sleep difficulties and highlighted the need for increased public awareness and access to large-scale sleep interventions.


Robillard R, Dion K, Pennestri MH, et al. Profiles of sleep changes during the COVID-19 pandemic: Demographic, behavioural and psychological factors. J Sleep Res. 2020;e13231. doi:10.1111/jsr.13231