Follow-up Study on the Sleep Status of Anti-Epidemic Staff: A Study Based on Wearable Sleep Trackers.

Abstract

Objective: This study aimed to compare sleep architecture, as estimated by a wearable pulse oximeter, between healthcare staff who worked in designated hospitals during the COVID-19 pandemic in Wuhan and a control group, and across a one-year follow-up, and identify factors associated with insomnia risk in this population.

Methods: Thirty healthcare professionals who worked in Wuhan during the initial COVID-19 outbreak in 2020 and 28 healthy control healthcare professionals who did not participate in epidemic control were recruited. All participants underwent one night of overnight sleep monitoring with a ring-shaped medical pulse oximeter. Psychological health conditions were assessed using the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), Perceived Stress Scale (PSS-10), Insomnia Severity Index (ISI), and Self-reporting Questionnaire (SRQ-20). A one-year follow-up, including repeat one-night sleep monitoring, was conducted for 28 of the anti-epidemic staff.

Results: Twenty-eight anti-epidemic staff and 28 controls completed the study. The difference in total sleep time (TST) among the healthcare staff at the post-deployment assessment, the 1-year follow-up, and the control group was statistically significant (F=9.942, p<0.001). TST of the anti-epidemic group at the post-deployment assessment was significantly longer than that at the 1-year follow-up and that of the control group. A non-significant trend toward a relative decrease in the proportion of deep sleep was observed in the anti-epidemic group after 1 year (F=2.456, p=0.092). In an exploratory analysis, this trend appeared to be driven by a numerical decrease in deep sleep and a numerical increase in light sleep at the follow-up. In a logistic regression model, higher SRQ-20 score and older age were independently associated with increased risk of insomnia, while higher BMI and higher PHQ-9 score showed inverse associations.

Conclusion: In this exploratory study, stress exposure may have a sustained impact on the sleep of healthcare staff. SRQ-20 score, age, BMI, and PHQ-9 score were independently associated with insomnia in this cohort. The application of wearable pulse oximeters may serve as a convenient tool for large-scale sleep health screening, but sleep architecture findings derived from these devices require confirmation by polysomnography and should be interpreted with caution.