Prevalence of insomnia and its association with quality of life among Macau residents shortly after the summer 2022 COVID-19 outbreak: A network analysis perspective

Pan Chen, Ling Zhang, Sha Sha, Mei Ieng Lam, Ka In Lok, Ines Hang Iao Chow, Tong Leong Si, Zhaohui Su, Teris Cheung, Yuan Feng, Todd Jackson, Yu Tao Xiang

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Background: The latest wave of the coronavirus disease 2019 (COVID-19) pandemic in Macau began on 18 June 2022 and was more serious than previous waves. Ensuing disruption from the wave is likely to have had a variety of negative mental health consequences for Macau residents including increased risk for insomnia. This study investigated the prevalence and correlates of insomnia among Macau residents during this wave as well as its association with quality of life (QoL) from a network analysis perspective. Methods: A cross-sectional study was conducted between 26 July and 9 September 2022. Univariate and multivariate analyses explored correlates of insomnia. Analysis of covariance (ANCOVA) examined the relationship between insomnia and QoL. Network analysis assessed the structure of insomnia including “Expected influence” to identify central symptoms in the network, and the flow function to identify specific symptoms that were directly associated with QoL. Network stability was examined using a case-dropping bootstrap procedure. Results: A total of 1,008 Macau residents were included in this study. The overall prevalence of insomnia was 49.0% (n = 494; 95% CI = 45.9–52.1%). A binary logistic regression analysis indicated people with insomnia were more likely to report depression (OR = 1.237; P < 0.001) and anxiety symptoms (OR = 1.119; P < 0.001), as well as being quarantined during the COVID-19 pandemic (OR = 1.172; P = 0.034). An ANCOVA found people with insomnia had lower QoL (F(1,1,008) = 17.45, P < 0.001). “Sleep maintenance” (ISI2), “Distress caused by the sleep difficulties” (ISI7) and “Interference with daytime functioning” (ISI5) were the most central symptoms in the insomnia network model, while “Sleep dissatisfaction” (ISI4), “Interference with daytime functioning” (ISI5), and “Distress caused by the sleep difficulties” (ISI7) had the strongest negative associations with QoL. Conclusion: The high prevalence of insomnia among Macau residents during the COVID-19 pandemic warrants attention. Being quarantined during the pandemic and having psychiatric problems were correlates of insomnia. Future research should target central symptoms and symptoms linked to QoL observed in our network models to improve insomnia and QoL.

Original languageEnglish
Article number1113122
JournalFrontiers in Psychiatry
Volume14
DOIs
Publication statusPublished - 2023
Externally publishedYes

Keywords

  • COVID-19 outbreak
  • insomnia
  • network analysis
  • prevalence
  • quality of life

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