The questioner was completed by 622 persons and 620 responses were validated (331 students and 289 workers). The majority of the respondents were female (N = 464) and 4 out of 5 were young adults aged between 18 and 35 years. Regarding the level of education, 57.1% of the respondents have an academic degree (bachelor, master, doctoral). Regarding marital status 65.8% were in a relationship (cohabitating couple, married), the rest of them were not in a relationship (single, divorced, widowed). All demographic, socio-economic characteristics, as well as any underlying conditions are presented in Table 1.
Table 1
Sample demographics (N = 620)
Lot Characteristics | Answers - Lot (N) – 620 people / % |
Demographics Characteristics |
Occupational status | Student – 331 (53.4%) Employees − 289 (46.6%) |
Gender | Male – 156 (25.2%) Female – 464 (74.8%) |
Age | 18 to 24 years – 374 (60.3%) 25 to 34 years – 137 (22.1%) 35 to 44 years – 44 (7.1%) 45 to 54 years – 35 (5.6%) 55 years and over – 30 (4.9%) |
Marital status | No relationship 212 (34.2%) | Divorced – 11 (1.8%) Widowed – 3 (0.5%) Single – 198 (31.9%) |
In a relationship 408 (65.8%) | Cohabitating couple – 293 (47.3%) Married – 115 (18.5%) |
Living location | Urban – 569 (91.8%) Rural – 51 (8.2%) |
Do you take care of an older person? | Yes – 585 (94.4%) No – 46 (7.4%) |
Pet owner | Yes – 250 (40.3%) No – 370 (59.7%) |
Socioeconomic status |
Level of education | High school graduation | 266 (42.9%) |
Academic degree | Bachelor’s Degree Certificate 229 (36.9%) Master's Degree Certificate 117 (18.9%) Doctoral Degree Certificate and Postdoctoral studies 8 (1.3%) |
Household size and composition | Living alone 99 (15.8%) |
Living with somebody else 558 (90%) | Partner – 249 (47.8%) Children – 82 (15.7%) Parents – 236 (45.3%) Grandparents – 36 (6.9%) Siblings– 92 (17.7%) Friends/ Flat mates – 41 (7.9%) Others – 7 (1.3%) |
Family/personal income N = 586 (36 respondents chose not to respond) | 0-€ 99 / person – 20 (3.4%) € 100-€ 199 / person – 54 (9.2%) € 200-€ 399 / person – 104 (17.7%) € 400-€ 799 / person – 216 (36.9%) € 800-€ 1599 / person – 136 (23.2%) € 1600 or more / person – 56 (9.6%) |
Number of hours of weekly work | Under 10 hours / week – 119 (19.2%) 10 to 20 hours / week – 66 (10.6%) 20 to 40 hours / week – 204 (32.9%) 40 to 60 hours / week – 195 (31.5%) Over 60 hours / week – 36 (5.8%) |
Underlying health conditions (somatic and psychiatric) |
Do you have any comorbidities? | Yes – 62 (10%) No – 558 (90%) |
Have you ever been diagnosed with any psychiatric disorders? | Yes – 35 (5.6%) No – 585 (94.4%) |
If so, please mention the diagnosis and treatment followed. N = 35 (diagnosis) N = 15(treatment) | Major depressive disorder – 18 (51.4%) General anxiety disorder– 13 (37.1%) Mixed anxiety depressive disorder – 3 (8.6%) Obsessive-compulsive disorder – 4 (11.4) Bipolar affective disorder – 2 (5.7) Borderline personality disorder– 1 (2.9%) Insomnia − 1 (2.9%) | Antipsychotics 4 (26.7%) Antidepressants 11 (73.3%) Benzodiazepine 6 (40%) |
Regarding COVID-19 disease, 16% tested positive for SARS-Cov2, of which 65% had a mild form. A great number of individuals had close people detected with COVID-19 and 7.1% had close people who died of COVID-19 (Table 2).
Table 2
COVID-19 status | Answers - Lot (N) – 620 people / % |
Were you infected with SARS-Cov-2 (confirmed by a test)? | Yes, I am positive now – 28 (4.5%) Yes, I was infected last month – 39 (6.3%) Yes, I was infected in the last 6 months – 27 (4.4%) Yes, I was infected more than 6 months ago – 5 (0.8%) No – 520 (84%) |
If the answer to the previous question is "yes", what was /is the severity of symptoms? N = 100 | Asymptomatic – 10 (10%) Few symptoms – 65 (65%) Moderate symptoms – 25 (25%) Severe symptoms – 0 (0%) |
Has someone close to you been infected with SARS-Cov-2? | Yes – 439 (70.8%) No – 181 (29.2%) |
Has someone close to you died of COVID-19 infection? | Yes – 44 (7.1%) No – 576 (92.9%) |
Using the predefined cut-offs of the AIS scoring system to screen for sleep disturbances, we found that every second participant in the survey (374, 60.32%) had impaired sleep quality. With scores between 6 and 10, more than one third of the respondents (n = 242, 39.03%) screened positive for mild sleep problems, while 132 (21.29%) of them screened positive for insomnia (score ≥ 11).
In the student population, sleep induction was more affected comparing to employees’ group (p = 0.013, df = 3, Phi = 0.132, moderate association). Also, the perception of physical and mental functioning during the day (p < 0.001, df = 3, Phi = 0.206, strong association) and sleepiness during daytime (p < 0.001, df = 3, Phi = 0.189, strong association) are more prevalent among students. In contrast, awakenings during the night are more prevalent among employees (p < 0.001, df = 3, Phi = 0.185, strong association) and the final awakening also was found to be earlier than desired (p = 0.002, df = 3, Phi = 0.155, strong association). Overall, the AIS results are not significantly different between students and employees (p = 0.140, df = 1).
Women reported more frequently by impairment of total sleep duration (p = 0.032, df = 3, Phi = 0.119, moderate correlation); and overall poorer quality of sleep regardless of the total duration of sleep (p = 0.042, df = 3, Phi = 0.115, moderate correlation). Furthermore, AIS scores were significantly higher for women, (Mean Differences-1,027: women’s mean score = 6.39, men’ s mean score = 5.37), p = 0.007, Levene's test = 0.001. The frequency of awakenings during night increase with age (p < 0.001, df = 6, Phi = 0.248, strong correlation), as well as awakenings earlier than the desired time (p = 0.004, df = 6, Phi = 0.202, strong corelation). Drowsiness during the day is more prevalent at younger ages (p < 0.001, df = 6, Phi = 0.251, large association).
Single people (divorced, widowed, single) experienced more often awakenings during the night compared to those who are married or in a relationship (p < 0.001, df = 12, Phi = 0.369, strong association). On the other hand, married people have a tendency to wake up in the morning before the setting time more often (p = 0.040, df = 12, Phi = 0.184, strong association).
There are no significant differences between respondents from urban areas or countryside related to AIS scale scores (p = 0.084, df = 1).
Taking care of an older person is associated with delay in falling asleep (p = 0.037, df = 3, Phi = 0.117, moderate association) and waking before the desired time (p = 0.003, df = 3, Phi = 0.173, strong association). Participants who care for older people have more often clinically significant scores on AIS scale (p = 0.024, df = 3, Phi = 0.091, weak association).
Pet owners have a shorter duration of fall asleep (p = 0.036, df = 3, Phi = 0.117, moderate association) however, they experience more sleepiness during the day (p = 0.028, df = 3, Phi = 0.121, moderate association). However, in terms of AIS total score there are no differences between pet owners and those who do not own pets.
Lower educational levels associate higher levels of dysfunctionality during the day (p < 0.001, df = 2, Phi = 0.199, strong association). Nonetheless, AIS total score is not it is not statistically significant influenced by educational level.
Regarding household size and his composition, participants who live with their partners had a shorter time to fall asleep (p = 0.008, df = 3, Phi = 0.150, strong association) and daytime sleepiness was associated less often in this group (p = 0.019, df = 3, Phi = 0.139, moderate association). At the same time, the perception of functioning during the day was better for the participants who live with their partner (p = 0.022, df = 3, Phi = 0.136, moderate association). Altogether, participants who live with partner had normal scores at AIS test, lower than 5 (p = 0.024, df = 1, Phi = 0.099, week association) which also, at quantitative statistical test was equivalent with lower values (p = 0.017, Mean Rank for the participants who live with their partner = 244.63, and the mean rank for the participants who don`t = 275.99).
Studied participants that are living with their children experienced more frequently awakenings during the night (p = 0.018, df = 2, Phi = 0.116, moderate association), but they did not experience daytime sleepiness (p = 0.001, df = 1, Phi = 0.146, moderate association) and had a good functioning during the day (p = 0.001, df = 3, Phi = 0.176, strong association). In contrast, those who live with their parents experienced less frequently awakenings during the night (p = 0.047, df = 2, Phi = 0.108, moderate association), but still they associated sleepiness during the day more often (p = 0.022, df = 3, Phi = 0.136, moderate association). Living with grandparents was associated with a longer time to fall asleep (p < 0.001, df = 3, Phi = 0.211, strong association) and worse quality of sleep (p = 0.020, df = 3, Phi = 0.138, moderate association). A worse quality of sleep was observed also in the participants who live with a roommate (p = 0.027, df = 3, Phi = 0.133, moderate association), who also declared a worse state of wellbeing during the day (p = 0.023, df = 3, Phi = 0.135, moderate association).
Low- and middle-income participants have longer times until they fall asleep (p = 0.046, df = 15, Phi = 0.217, strong association). Higher income participants present slowness during the day more frequently (p = 0.014, df = 15, Phi = 0.224, strong association). Despite these particularities, no difference in AIS total score was associated with monthly income (p = 0.233). In relation to weekly working hours, people who work more feel more often that sleep duration is not enough (p = 0.050, df = 12, Phi = 0.181, strong association).
Participants with comorbidities do not exhibit clinically significant scores (over 6) on the AIS more frequently than participants without comorbidities, with the exception of psychiatric disorders, like depression, anxiety, bipolar affective disorder, which are associated in the studied group with awakening during the night (p = 0.001, df = 3, Phi = 0.206, strong association), awakening before desired time (p = 0.029, df = 3, Phi = 0.146, moderate association) and unsatisfactory total duration and quality of sleep (p = 0.035, df = 3, Phi = 0.118, moderate association; p = 0.003, df = 3, Phi = 0.150, strong association). Additionally, participants with mental disorders presented more frequently the next day consequences of insomnia: less wellbeing (p < 0.001), worse functioning (p < 0.001) and sleepiness (p = 0.010) during the daytime. After all, participants with mental disorders associated higher scores on AIS (p < 0.001, df = 1, Phi = 0.165, strong association).
Regarding COVID-19 status, there were no significant differences between participants in the study who were infected with SARS-CoV2 and those who were not, and there was no difference on insomnia scale in relation to the time interval elapsed since infection with SARS-CoV2 or the severity of associated symptoms of the infection. Moreover, infection or death due to COVID-19 of loved ones is not a risk factor for sleep disturbances in the studied group.