Based on Google Trends’ search queries for the term “insomnia,” there was an increase in difficulty sleeping, both in the United States and globally, during the acute phase (April and May 2020) of the COVID-19 pandemic, compared to the same months in the 3 previous years. Results of the study were published in the Journal of Clinical Sleep Medicine.
The researchers examined how many search queries, according to Google Trends reports’ relative popularity 0 to 100 (most popular) rating, users around the globe conducted of the term “insomnia” between January 1, 2004 (the earliest data available) and May 31, 2020. They also obtained the monthly search query data for the search terms: “insomnia,” “sleep apnea,” “restless legs,” and “narcolepsy” (solely in English) from January 1, 2014 through December 31, 2019; the daily search query data for “insomnia” between January 1, 2020, and May 31, 2020; and the daily and weekly search query data for the term “insomnia” between January 1, 2017, and May 31, 2020.
The study authors normalized the daily data to the weekly data and rescaled it to the original 0 to 100 and excluded data from the first week of each year to make the data comparable across the whole time period. Google Trends data on the search term “cancer” from January 1 to May 31, 2020 was used as a control.
Using Google’s Keyword Planner, the researchers obtained the monthly search query data for January 2017 to May 2020 for “insomnia” for the overall United States and each individual state and calculated the absolute number of insomnia search queries per hour by combining the Google Ads Keyword Planner data with Google Trends data and found the number of search queries per capita using United States Census Bureau data. The researchers also were able to obtain the hourly and weekly search query data on “insomnia” between January 1, 2017 and May 31, 2020, from each state using the pytrends script for Python.
The impact of COVID-19 on “insomnia” searches was evaluated by correlating the number of COVID-19 related deaths to the number of daily “insomnia” search queries from January 1, 2020 through May 2020 in the US and worldwide.
Through their statistical analyses of the data, the researchers made the following findings:
- The absolute number of “insomnia” search queries increased by 58% in January through May 2020 over the same months in 2017-2019 in the US (P <.0001) and were also substantially higher worldwide in those months of 2020 compared with the same months in the previous years. While “insomnia” search queries worldwide decreased from January to May in the previous years and from the number seen in January 2020 to the number seen in March 2020 (P <.0001), the numbers seen in April, May, and January 2020 did not have significant difference. Both globally and in the US, “insomnia” search queries decreased from February to March (P =.0075 worldwide, P<.0001 in the US) and increased from March to April (P <.0001 both locations) and remained steady from April to May.
- There was a significant positive correlation between the number of “insomnia” search queries and the cumulative number of COVID-19 deaths in March, April, and May worldwide (March 17 – April 22, P <.0001) and in the US (March 17 – May 7, P <.0001).
- “Insomnia” search queries peaked on Sundays and Mondays and plummeted from Friday to Saturday, which the researchers attributed to work-to-weekend-to-work transitions, in January through May 2020 both globally (P =.0045) and in the US (P <.0001).
- In the US (P <.0001), “insomnia” search queries peaked around 3 AM in each of the 50 states, decreased in the later morning, were the lowest in the afternoon and early evening and then rose again later in the evening. States peaked at slightly different times, based on the random variability the researchers noticed in the peak phase (P <.0001). These diurnal patterns only varied by a small change in the peak time (3:06 AM to 3:19 AM) from the 2017-2019 period to 2020.
- Globally, Google search queries for “insomnia” are significantly higher than searches for “sleep apnea,” “restless legs syndrome,” and “narcolepsy” (P <.0001), and queries for “insomnia” substantially increased from 2004 to 2009 and have remained high in from 2010-2019 (P <.0001). In the US, “insomnia” search queries have been higher than queries for all other major sleep disorders over the entire 16-year period (P <.0001) and rapid growth occurred from 2004 to 2011 (P =.0015).
Limitations of the study included the existence of alternative reasons for which the search terms could have been used, as well as the possible bias toward younger people who are more digitally connected. Another limitation was the exclusion of non-English search terms, which may limit the generalizability of the results in countries where English is not a major language and the sole use of Google Trends data, which excludes countries where Google is not the dominant search engine.
“The COVID-19 outbreak led to a significant increase in the number of insomnia search queries between April and May 2020 both worldwide and in the United States, suggesting it may have been a consequence of the pandemic’s negative impact on mental health and wellbeing on a global scale,” the researchers said.
Disclosures: Several study authors declared affiliations with the industry. Please see the original reference for a full list of authors’ disclosures.
Zitting KM, Lammers-van der Holst HM, Yuan RK, Wang W, Quan SF, Duffy JF. Google Trends reveal increases in internet searches for insomnia during the COVID-19 global pandemic. J Clin Sleep Med. Published online September 25, 2020. doi:10.5664/jcsm.8810