BMJ Mental Health (Oct 2024)

Changes in sleep patterns in people with a history of depression during the COVID-19 pandemic: a natural experiment

  • Ian B Hickie,
  • Joanne S Carpenter,
  • Jacob J Crouse,
  • Enda M Byrne,
  • Sarah E Medland,
  • Lucia Colodro-Conde,
  • Richard Parker,
  • Naomi R Wray,
  • Penelope Lind,
  • Brittany L Mitchell,
  • Mirim Shin,
  • Emiliana Tonini

DOI
https://doi.org/10.1136/bmjment-2024-301067
Journal volume & issue
Vol. 27, no. 1

Abstract

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Background The COVID-19 pandemic, while a major stressor, increased flexibility in sleep–wake schedules.Objectives To investigate the impact of the pandemic on sleep patterns in people with a history of depression and identify sociodemographic, clinical or genetic predictors of those impacts.Methods 6453 adults from the Australian Genetics of Depression Study (45±15 years; 75% women) completed surveys before (2016–2018) and during the pandemic (2020–2021). Participants were assigned to ‘short sleep’ (<6 hours), ‘optimal sleep’ (6–8 hours) or ‘long sleep’ (>8 hours). We focused on those having prepandemic ‘optimal sleep’.Findings Pre pandemic, the majority (70%, n=4514) reported optimal sleep, decreasing to 49% (n=3189) during the pandemic. Of these, 57% maintained optimal sleep, while 16% (n=725) shifted to ‘short sleep’ and 27% (n=1225) to ‘long sleep’. In group comparisons ‘optimal-to-short sleep’ group had worse prepandemic mental health and increased insomnia (p’s<0.001), along with an elevated depression genetic score (p=0.002). The ‘optimal-to-long sleep’ group were slightly younger and had higher distress (p’s<0.05), a greater propensity to being evening types (p<0.001) and an elevated depression genetic score (p=0.04). Multivariate predictors for ‘optimal-to-short sleep’ included reported stressful life events, psychological or somatic distress and insomnia severity (false discovery rate-corrected p values<0.004), while no significant predictors were identified for ‘optimal-to-long sleep’.Conclusion and implications The COVID-19 pandemic, a natural experiment, elicited significant shifts in sleep patterns among people with a history of depression, revealing associations with diverse prepandemic demographic and clinical characteristics. Understanding these dynamics may inform the selection of interventions for people with depression facing major challenges.