COVID-19 medical staff in China found to experience insomnia and high stress levels
A new study has recently revealed that medical staff in China, especially those working during the height of the COVID-19 outbreak, had greater instances of insomnia and symptoms of anxiety, depression and traumatic response. The study also found that nurses were particularly susceptible to insomnia and anxiety than doctors due to increased patient contact and thus, a greater traumatic response.
The negative psychological effects amongst medical staff working on the frontline of the COVID-19 pandemic have been significant: medical staff must be equipped with full-body protective equipment under negative pressure for over 12 hours at a time, including double-layer protective equipment, double-face masks, double-layer gloves, isolation caps, foot covers, and protective glasses; and cannot eat, drink, or use the bathroom during working hours.
“Many of them are dehydrated due to excessive sweating, and some develop cystitis and a rash,” said Dr. Bin Zhang, a professor at Southern Medical University in Guangzhou, China. Medical staff working in the quarantine area also have to maintain close contact with infected patients, and avoid being infected or spreading infection themselves, “Under these dangerous conditions, medical staff become mentally and physically exhausted, and therefore experience an increased risk of insomnia due to high stress.”
Zhang and colleagues surveyed about 1,560 medical personnel who worked with critically ill COVID-19 patients through social media platform WeChat. The results of questionnaires showed that 36.1% of the participants reported insomnia symptoms and around 87.1% of these participants reported symptoms of depression, compared to just 31% of the non-insomnia group. Similar differences between the two groups were reported for symptoms of anxiety and stress-induced trauma.
The statistics were nevertheless consistent with those reported during the 2002-2003 SARS-CoV outbreaks – the novel coronavirus, SARS-CoV-2, is a close relative of the virus that caused these outbreaks and shares many similar features.
In addition, the study found that being a doctor was a protective factor against insomnia. This may be because doctors typically have a less disrupted circadian cycle and tend to have less contact with patients. The researchers said, “Doctors often work in the daytime, so that they can get good sleep at night, while nurses may have to work the whole night with frequent night shifts. Nurses are more likely to have circadian rhythm dysfunctions induced by irregular and frequent night shifts.” Nurses also have more contact time with patients.
The researchers note that the relative levels of education and the sex balance between the doctors and nurses may also have been contributing factors to insomnia. A greater number of nurses in the study were female, and previous studies have shown that females are more susceptible to insomnia.
According to Dr. Zhang, “The most important factor was having very strong uncertainty regarding effective disease control among medical staff.”
The researchers therefore hope to develop interventions to support medical staff with insomnia and related mental health issues; they also suggest that cognitive behavioural therapy for insomnia may help hospital administrations become generally more attentive to mental health risk factors in their line of work.
