The relative contribution of COVID-19 infection versus COVID-19 related occupational stressors to insomnia in healthcare workers

Rebecca C. Hendrickson; Catherine A. McCall; Aaron F. Rosser; Kathleen F. Pagulayan; Bernard P. Chang; Ellen D. Sano; Ronald G. Thomas; Murray A. Raskind

Sleep Medicine: X (Dec 2023)

The relative contribution of COVID-19 infection versus COVID-19 related occupational stressors to insomnia in healthcare workers

Rebecca C. Hendrickson,
Catherine A. McCall,
Aaron F. Rosser,
Kathleen F. Pagulayan,
Bernard P. Chang,
Ellen D. Sano,
Ronald G. Thomas,
Murray A. Raskind

Affiliations

Rebecca C. Hendrickson: Corresponding author. 1660 S Columbian Way, S116 MIRECC, Seattle, WA, 98108, USA.; VISN 20 Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, 1660 S. Columbian Way, S116 MIRECC, Seattle, WA, 98108, USA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356560 Room BB1644, Seattle, WA, 98195-6560, USA; VA Puget Sound Healthcare System, Seattle Division, Mental Health Service, 1660 S. Columbian Way, S116 MIRECC, Seattle, WA, 98108, USA
Catherine A. McCall: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356560 Room BB1644, Seattle, WA, 98195-6560, USA; VA Puget Sound Healthcare System, Department of Pulmonary, Critical Care, and Sleep Medicine, 1660 S. Columbian way, S111 PULM, Seattle, WA, 98108, USA
Aaron F. Rosser: VISN 20 Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, 1660 S. Columbian Way, S116 MIRECC, Seattle, WA, 98108, USA; VA Puget Sound Healthcare System, Seattle Division, Mental Health Service, 1660 S. Columbian Way, S116 MIRECC, Seattle, WA, 98108, USA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356560 Room BB1644, Seattle, WA, 98195-6560, USA
Kathleen F. Pagulayan: VISN 20 Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, 1660 S. Columbian Way, S116 MIRECC, Seattle, WA, 98108, USA; Department of Rehabilitation Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356490, Seattle, WA, 98195-6560, USA
Bernard P. Chang: Department of Emergency Medicine, Columbia University Irving Medical Center, 630 West 168th Street, New York, NY, 10032, USA
Ellen D. Sano: Department of Emergency Medicine, Columbia University Irving Medical Center, 630 West 168th Street, New York, NY, 10032, USA
Ronald G. Thomas: Department of Biostatistics, University of California, 9500 Gilman Drive, La Jolla, CA, 92093, USA
Murray A. Raskind: VISN 20 Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, 1660 S. Columbian Way, S116 MIRECC, Seattle, WA, 98108, USA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356560 Room BB1644, Seattle, WA, 98195-6560, USA

Journal volume & issue: Vol. 5
p. 100067

Abstract

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Objective/Background: Healthcare workers have experienced high rates of psychiatric symptom burden and occupational attrition during the COVID-19 pandemic. Identifying contributory factors can inform prevention and mitigation measures. Here, we explore the potential contributions of occupational stressors vs COVID-19 infection to insomnia symptoms in US healthcare workers.Patients/Methods: An online self-report survey was collected between September 2020 and July 2022 from N = 594 US healthcare workers, with longitudinal follow-up up to 9 months. Assessments included the Insomnia Severity Index (ISI), the PTSD Checklist for DSM-5 (PCL-5), and a 13-item scale assessing COVID-19 related occupational stressors. Results: Insomnia was common (45% of participants reported at least moderate and 9.2% reported severe symptoms at one or more timepoint) and significantly associated with difficulty completing work-related tasks, increased likelihood of occupational attrition, and thoughts of suicide or self-harm (all p<.0001). In multivariable regression with age, gender, and family COVID-19 history as covariates, past two-week COVID-related occupational stressors, peak COVID-related occupational stressors, and personal history of COVID-19 infection were all significantly related to past two-week ISI scores (β = 1.7 ± 0.14SE, β = 0.08 ± 0.03, and β = 0.69 ± 0.22 respectively). Although similar results were found for the PCL-5, when ISI and PCL-5 items were separated by factor, COVID-19 infection was significantly related only to the factor consisting of sleep-related items. Conclusions: Both recent occupational stress and personal history of COVID-19 infection were significantly associated with insomnia in healthcare workers. These results suggest that both addressing occupational stressors and reducing rate of COVID-19 infection are important to protect healthcare workers and the healthcare workforce.

Published in Sleep Medicine: X

ISSN: 2590-1427 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine
Website: https://www.journals.elsevier.com/sleep-medicine-x

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