This study aims to investigate the mediating role of fear of death in the relationship between intolerance of uncertainty and sleep quality in earthquake survivors. Participants were 190 voluntary earthquake survivors (nmen = 64, nwomen = 123, three of them not specified) aged between 18 and 64 years. Data collection tools were the Multidimensional Mortality Awareness Measure, Intolerance of Uncertainty Scale, Basic Scale on Insomnia Complaints/Quality of Sleep, and sociodemographic information form. Data were analyzed via correlation and mediation analyses. Significant positive correlations were found between intolerance of uncertainty and poor sleep quality, intolerance of uncertainty and fear of death, and fear of death and poor sleep quality. Fear of death had no mediating role in the relationship between intolerance of uncertainty and sleep quality. Given that intolerance of uncertainty and fear of death are related to sleep quality, it is critical to consider these variables in sleep quality intervention programs for earthquake survivors.

The present study aimed to understand the experiences of intern nurses returning to clinical practice after a year-long distance education during the pandemic.

The study was conducted using the qualitative content analysis method. The participants were 32 intern nurses. The data included specific narratives on the experience of intern nurses returning from distance education to clinical practice during the pandemic. Data were collected through a total of four focus group interviews. Data analysis was conducted using an inductive qualitative analysis approach.

The content analysis identified three main categories. The category 'Feelings during Clinical Practice' included the subcategories 'fear', 'uncertainty' and 'intolerance'. The category 'Challenges during Clinical Practice' included the subcategories 'sleep problems', 'alienation from clinical placement', 'lack of knowledge and experience', 'hospital staff', 'difficulty reaching nurse educator' and 'lack of protective equipment'. The category 'Suggestions for Clinical Practice' included the subcategories 'psychological support', 'case discussion and academic counselling' and 'protective equipment support'.

The study revealed that intern nurses faced various challenges in clinical settings following their year-long distance education. The results may help nurse educators understand the experiences of intern nurses returning to clinical practice after a year-long distance education and determine the teaching strategies to be followed in specific situations like pandemics in the future.

Klinefelter syndrome (KS) is the most common sex chromosomal aneuploidy in males (47,XXY karyotype in 80-90% of cases), primarily characterized by hypergonadotropic hypogonadism and infertility. It encompasses a broad phenotypic spectrum, leading to variability in neurocognitive and psychosocial outcomes among affected individuals. Despite the recognized correlation between KS and various neuropsychiatric conditions, studies investigating potential sleep disorders, particularly in pediatric subjects, are lacking. This study aimed to investigate the presence of sleep-related behaviors potentially suggestive of a sleep disorder in a cohort of pediatric patients with KS, in comparison with a group of healthy male age-matched controls. During the period from January to December 2023, a validated sleep questionnaire (Sleep Disturbance Scale for Children: SDSC) was administered to the primary caregivers of 80 children with KS: 40 of preschool age (3-5 years) and 40 of school age (6-16 years). Data were compared with a control group of 180 healthy age-matched male children: 90 of preschool age (3-5 years) and 90 of school age (6-16 years). Among preschoolers, the proportion of subjects with pathological non-restorative sleep T-scores was significantly higher in the KS group compared to controls (p = 0.03). In both KS and control groups, school-aged subjects had higher questionnaire scores compared to preschoolers. The school age KS group had significantly higher mean total T-scores and mean T-scores for disorders of initiating and maintaining sleep (DIMS), disorders of arousal (DA), and disorders of excessive somnolence (DOES) compared to controls (p < 0.01 for all). The KS group also showed significantly higher percentages of children with clinically relevant T-scores for DIMS, DA, DOES, sleep hyperhidrosis, and total T-scores.

Our study indicates that sleep disorders are more prevalent in children with KS than in the general population, especially in the school age group. Screening for sleep issues in the clinical setting using tools like the SDSC is warranted, and should start from age 6 for children with KS. Further research is needed to better understand the origins of these disturbances, the role of comorbidities, and their long-term effects to improve diagnosis and treatment strategies for these patients.

• Neurocognitive and psychosocial disorders can be observed in individuals with KS. • Sleep disorders may be associated with various neuropsychiatric conditions; however, they have not been sufficiently explored in individuals with KS, particularly in pediatric populations.

• Sleep-related problems are more common in children with KS compared to the general population, especially in the school age group with regard to DIMS, DA, and DOES factors. • Starting from 6 years of age, the SDSC might be a promising early diagnostic tool for sleep disorders in children with KS.

The COVID-19 pandemic has created unprecedented levels of stress and anxiety, which has a profound effect on sleep quality. However, limited data are available on the sleep quality of medical residents who work directly with patients infected with SARS-CoV-2. As sleep is a crucial brain state, our goal is to know the sleep quality of these medical residents.

This study evaluated sleep quality among medical residents caring for patients with COVID-19 at Hospital São Paulo, São Paulo, Brazil. It used a validated questionnaire and assessed sleep habits and sociodemographic variables. The study focused on sleep latency, bedtime changes, early awakening, and discouragement.

A total of 150 resident physicians participated, 93 females and 57 males. We observed poor sleep quality in 72.7%, discouragement complaints in 91.33%, what was moderate or intense in 52.0%. Discouragement was associated with sleep fragmentation and awakening early in the morning; sleeping pill users had a greater sleep latency (P < .00001). Poor sleep quality was linked to changes in bedtime and use of sleeping medications during social isolation in 2020 (P = .037 and P < .001, respectively).

During the COVID-19 pandemic, more than two-thirds of resident physicians experienced poor sleep quality. They changed their bedtime, increased sleep latency, the use of hypnotics, feelings of discouragement, fragmented sleep, and early awakening in the morning. These findings should serve as a wake-up call for everyone, especially those in administrative roles. They are a matter of concern for medical residents, chief residents, supervising physicians, medical directors, and faculties. Maximās grātiās vōbīs agimus.

dos Santos FTAR, Bizari Fernandes do Prado L, Bizari Coin de Carvalho L, do Prado GF. The impact of the COVID-19 pandemic on the quality of sleep of medical residents in a tertiary care hospital. J Clin Sleep Med. 2025;21(1):17-22.

Burnout syndrome is a global burden characterized by exhaustion, work detachment, and a sense of ineffectiveness. It affects millions of individuals worldwide, with a particularly high prevalence among medical students. Factors such as demanding education, exposure to suffering, and the COVID-19 pandemic have contributed to elevated stress levels. Addressing this issue is crucial due to its impact on well-being and health-care quality.

This cross-sectional survey study assessed fear of COVID-19 and burnout levels among medical student interns in hospitals in Guadalajara, Jalisco. The study used validated scales and collected data from September 2021 to September 2022. A snowball sampling method was employed and a minimum sample size of 198 participants was calculated.

This study included 311 medical students (62.1% female and 37.9% male with a mean age of 23.51 ± 2.21 years). The majority were in their second semester of internship (60.5%) and from public hospitals (89.1%). Most students believed that the COVID-19 pandemic affected the quality of their internship (82.6%). Female students had higher personal burnout scores, while male students had higher work-related burnout scores. The mean score for fear of COVID-19 was 13.71 ± 6.28, with higher scores among women (p = 0.004) and those from public hospitals (p = 0.009). A positive weak correlation was found between COVID-19 scores and burnout subscales.

Our study emphasizes the significant impact of various factors on burnout levels among medical students and health-care professionals during the COVID-19 pandemic. Prolonged exposure to COVID-19 patients, reduced staffing, and increased workload contributed to burnout, affecting well-being and quality of care. Targeted interventions and resilience-building strategies are needed to mitigate burnout and promote well-being in health-care settings.

The COVID-19 pandemic put a significant strain on communities, social resources, and personal relationships, disproportionately impacting Black and low-income communities in the United States. Community cohesion and social support are positively associated with numerous health outcomes and preventive health measures, yet were strained during the pandemic due to COVID mitigation measures. This study examined the relationships between social cohesion, social support, mental health, and COVID-19 vaccination to understand whether community cohesion and social support were associated with increased likelihood of receiving a COVID-19 vaccination. Data are from a cross-sectional survey of 537 Black Chicagoans that was disseminated between September 2021 and March 2022. Structural equation modeling was used to test associations between community cohesion, social support, loneliness, anxiety, stress, and having received a COVID-19 vaccination. Results demonstrated that social support mediated associations between community cohesion and loneliness, anxiety, and stress, but was not associated with COVID-19 vaccination. These results demonstrate the importance of community cohesion and social support on mental health and suggest there are other potential pathways that may link community cohesion and vaccination.

The aim of this study was to examine the mediating effect of e-health literacy levels on the relationship between individuals' awareness of COVID-19 and dispositional hope during the COVID-19 pandemic. The research was conducted with a mixed-methods design. Quantitative data were collected for the study online using Google Forms and qualitative data were collected online with an interview technique. In this framework, the qualitative data were obtained from a total of 15 people who had been diagnosed with COVID-19. These participants were selected using the snowball sampling method. A personal information form, e-Health Literacy Scale, Coronavirus Awareness Scale, Dispositional Hope Scale, and semistructured interview form were utilized in the course of the research. As a result of, it was determined that there were significant relationships between coronavirus awareness and both e-health literacy and dispositional hope, as well as between e-health literacy and dispositional hope. The measurement model was found to have good fit values. Testing the structural equation model, it was determined that e-health literacy had a full mediating role between coronavirus awareness and dispositional hope. In addition, this study showed that people who had COVID-19 had increased awareness of COVID-19 after contracting the disease.

Improper use of social media during the COVID-19 outbreak, leading to fear and misunderstanding, can contribute to psychological disorders in vulnerable populations. This descriptive and analytical cross-sectional study was conducted in 2023 on 511 medical students of Babol University of Medical Sciences. Data were collected using demographic, psychological distress, fear and misunderstanding questionnaires related to COVID-19 and social media dependency. A total of 511 medical students, with an average age of Mean and S.D; 23.57 ± 3.03 participated in the study. The average psychological distress score was 23.82 ± 7.73 (out of 54), the average score of social media dependency was 17.53 ± 3.09 (out of 30), for the fear of COVID-19 was12.63 ± 2.56 (out of 35), and for the misperception of COVID-19 was 0.53 ± 0.09 (out of 18). Path analysis results) showed that direct path from improper use of social media to psychological distress is significant (P < 0.001, B = 0.19) but this relationship is not significant through fear and misperception related to COVID-19. Improper use of social media, identified as the strongest predictor, can directly increase psychological distress in medical students, without mediation through fear and misperception related to COVID-19. These findings should be taken into consideration when designing and evaluating interventions aimed at promoting mental health and fostering appropriate use of social media among students during disease outbreaks.

During the COVID-19 pandemic, the extensive lockdown measures implemented for disease mitigation triggered a surge in round-the-clock social media use, giving rise to widespread concerns regarding its impact on sleep health. This meta-analysis examined the association between social media use and sleep disturbance during the pandemic, along with potential moderators. The dataset included 43 independent samples comprising 68,247 residents of 21 countries across 7 world regions. The three-level mixed-effects meta-analysis revealed a weak, positive overall effect size (r = 0.1296, 95% confidence interval: 0.0764-0.1828, k = 90). The magnitude of the effect size varied by the type of social media use: compulsive use exhibited a moderately strong effect size, whereas information-focused use showed marginal significance. The effect size was more pronounced in countries imposing stricter (vs. less strict) lockdown measures. Lockdown status also moderated this association, with a marginally significant effect size observed during lockdowns but a significant effect size after lockdowns. For demographics, samples involving emerging adults demonstrated moderately strong effect sizes, whereas those involving the general population had modest effect sizes. Notably, the interaction between the type of social media use and lockdown status was significant. Specifically, the positive association with information-focused use was significant only during lockdowns, whereas that with general use was significant after, but not during, lockdowns. However, compulsive use showed a moderately strong effect size both during and after lockdowns. These findings underscored the importance of considering multiple factors-such as the type of social media use, context, and demographics-when studying social media use and sleep health.

This study aims to assess the status and related factors among healthcare workers (HCWs) in designated quarantine-hospital-site (DQHS) based on the model of health ecology.

The cross-sectional study was conducted from April to May, 2022, which included 351 valid samples. We measured sleep quality using the Pittsburgh Sleep Quality Index, which encompasses seven dimensions: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. Each dimension is scored individually, contributing to an overall sleep quality score. Factors associated with the sleep quality of HCWs in DQHS were divided into individual, behavioral, interpersonal and social dimensions. Hierarchical linear regressions were conducted to identify the potential factors associated with sleep quality among HCWs in DQHS.

HCWs in DQHS had a statistically higher sleep quality than the Chinese national norm. HCWs who were female, afraid of Coronavirus disease, had more negative emotions, frequently worked overtime, were married, and had a higher income were more likely to experience worse sleep quality (p < 0.05), while those who worked between 51 and 70 h weekly, treated over 10 patients daily, and engaged in more health behaviors may have better sleep quality (p < 0.05).

This study revealed a worrying level of sleep quality among HCWs in DQHS. The government, hospital managers, and families should collaborate to ensure the sleep quality of HCWs in DQHS.

The Coronavirus Disease 2019 (COVID-19) pandemic and the containment measures for COVID-19 have affected sleep quality in the population. This study explored sleep-related research from a bibliometric perspective to provide an overview of the research outputs in this field.

Original and review articles were retrieved from the Web of Science Core Collection (WOSCC) database from December 2019 to 7 Aug 2023. R package "bibliometrix" was used to summarize the number of articles of authors, institutions, and countries; count the citations of the articles, and generate a Three-Fields Plot. VOSviewer software was applied to visualize the collaboration network among authors and institutions, and to conduct a co-occurrence analysis of keywords.

A total of 4,499 articles on COVID-19 and sleep, and 25,883 articles on non-COVID-19 and sleep were included. Sleep related articles were mainly published by authors from China, the USA, and Italy. For COVID-19 and sleep research, Huazhong University of Science was the most productive institution. The Psychiatry Research was the most influential journal across the different subject categories of this field. "Mental health", "anxiety", and "depression" were the most common keywords, while "sleep quality" and "quality of life" were the likely topic areas in terms of future research directions.

Our findings provide a comprehensive perspective for researchers to understand the wider landscape of both COVID-19 and non-COVID-19 sleep-related research area.

The COVID-19 pandemic posed an unprecedented challenge to public well-being, necessitating an examination of its health impact. This review discusses the relationship between pandemic-induced stressors and individual sleep patterns and quality. The pandemic stressors include lockdown or physical distancing measures, direct virus exposure, and the dissemination of misinformation and disinformation. The pandemic led to delayed sleep-wake cycles, except for healthcare professionals, and worsened sleep quality. The prevalence of insomnia was higher for women due to pre-existing conditions and susceptibility stressors such as lockdown stress and family responsibilities. Healthcare professionals, who experienced worsened work conditions during the pandemic, reported higher rates of insomnia and sleep difficulties due to infection anxiety and post-traumatic stress from direct virus exposure. For the general population, stress stemmed from social isolation under lockdown and overwhelming false information available online, resulting in sleep problems. Taken together, the findings highlight the importance of promoting social interactions, providing psychological support services, and caution in navigating health information. In summary, this review underscores the need for individual- and group-centered approaches in ongoing research and interventions to address pandemic-related stress and sleep issues during COVID-19.

The COVID-19 pandemic has placed an unprecedented burden on nurses who have been at the forefront of patient care. The continuous exposure to suffering, death, and overwhelming demands has the potential to lead to compassion fatigue, a state of emotional, physical, and cognitive exhaustion.

The study aimed to explore and understand the phenomenon of compassion fatigue in nurses as the effect of the COVID-19 pandemic.

A constructivist grounded theory design was used.

The research data were collected from 20 nurses who had been employed in pandemic clinics in Turkey for a minimum of 6 months. Data were collected using a two-step approach: purposeful sample selection followed by theoretical sample selection. Individual interviews were conducted via an online platform with participants who consented to participate in the study from January 16th to April 28th, 2022. The collected data underwent initial, focused, and theoretical coding for analysis. The research findings were reported following the Consolidated Criteria for Reporting Qualitative Research guidelines.

Ethical approval for the study was received from Non-Interventional Clinical Research Ethics Committee. The study was conducted following the Declaration of Helsinki.

The study identified a core category, namely the desire to provide the best care, which was accompanied by five main categories: causes, symptoms, consequences, coping methods, and the benefits of coping methods.

During the pandemic process, nurses have experienced compassion fatigue due to various factors and have seen its symptoms. Nurses have developed various coping mechanisms individually. However, they have not indicated any institutional-level support. It has become necessary to plan nurse-centered comprehensive interventions that will reduce compassion fatigue.

The extensive use of various electronic games and communication devices, particularly among children and adolescents, has raised concerns, particularly during the COVID-19 pandemic. This study investigated the link between screen time and internalizing disorders, such as anxiety and depression, among individuals aged ≤18 during the global COVID-19 pandemic.

This systematic review aims to summarize scientific publications from 2019 to early 2022 by searching databases, including the Cochrane Library, PubMed, Web of Science, Scopus, and PsycINFO, to identify suitable studies. In each paper, we searched the following keywords and their synonyms: screen, child, high school, middle school, and psychiatric disorders. The quality of the selected papers was evaluated using a checklist recommended by the National Institutes of Health (NIH) for observational cohort studies.

Out of 986 reports identified, we included 12 papers with 14,483 participants. The study revealed a negative correlation between screen time (TV, computer, video games, and mobile phones) and behavioral outcomes. Smartphones were the most frequently used devices, with video games being more prevalent among older participants for education, communication, and entertainment purposes. The prevalence of depression ranged between 10% and 25%. Furthermore, anxiety and depression were identified as predictors of increased screen usage. Some results displayed variation based on the type of screen exposure, the questionnaires used, and the age of the participants.

The findings imply an indirect association between increased screen time and depression and anxiety. It is crucial to consider limitations on screen time exposure and parental supervision as measures to prevent certain mental disorders.

Mandatory deployment-related quarantining added further constraints on soldiers during the pandemic. Contrary to overwhelming research documenting an adverse impact of quarantining on mental health, no adverse short-term mental health effects of pre-deployment quarantining for German soldiers were identified. Therefore, we are interested in a potentially delayed onset, the impact of an additional post-deployment quarantine, and quarantine-associated risk and resilience factors predicting mental health post-deployment.

In a prospective research design, 928 German soldiers enrolled in the study at the in-processing of pre-deployment quarantine between February 2021 and March 2022. Every German military service member undergoing pre-deployment quarantine could participate. The soldiers were between 18 and 64 years old; 87.5% identified as male and 12.5% as female. Self-reported mental health (Mini-SCL), perceived social support (FSozU-K22), and perceived unit cohesion were assessed three to five times: at the beginning and the end of pre-deployment quarantine (Nt1 = 928, Nt2 = 907), if still mandatory-at the beginning and the end of post-deployment quarantine (Nt3 = 143 and Nt4 = 132), and 3 months post-deployment, on average 7 to 8 months later than pre-deployment quarantine (Nt5 = 308). The analyzed quarantine-associated risk and resilience factors were informedness about COVID-19, infection risk, quarantine benefit, clarity of quarantine protocol, need for intimacy/bonding, norms, stigma, practicality, financial disadvantages, boredom, and health-promoting leadership.

Despite four different mental health trajectories identified, repeated measures ANOVAs revealed a significant improvement in mental health post-deployment (F[2,265] = 21.54, p < 0.001), a small decrease in social support (F[2,266] = 16.85, p < 0.001), and no significant changes in unit cohesion (F[2,264] = 0.482, p = 0.618) 3 months post-deployment. Using stepwise regression, 24% of variance in mental health symptomatology post-deployment is predicted pre-deployment by a clear quarantine protocol, unit cohesion, intimacy/bonding, and social support (F[4,263] = 22.23, p < 0.001). In total, 30% of mental health at the end of post-deployment quarantine is predicted by stigma and a clear quarantine protocol (F[2,99] = 22.22, p < 0.001).

Although no overall adverse impact of quarantining on mental health was found, it is recommended to address perceived stigma and clearly communicate the quarantine protocol, and to further follow up on the perceived decrease in social support.

The ability of the public to remain psychologically resilient in the face of public health emergencies and disasters (such as the COVID-19 pandemic) is a key factor in the effectiveness of a national response to such events. Community resilience and social capital are often perceived as beneficial and ensuring that a community is socially and psychologically resilient may aid emergency response and recovery. This review presents a synthesis of literature which answers the following research questions: How are community resilience and social capital quantified in research?; What is the impact of community resilience on mental wellbeing?; What is the impact of infectious disease outbreaks, disasters and emergencies on community resilience and social capital?; and, What types of interventions enhance community resilience and social capital?A scoping review procedure was followed. Searches were run across Medline, PsycInfo, and EMBASE, with search terms covering both community resilience and social capital, public health emergencies, and mental health. 26 papers met the inclusion criteria.The majority of retained papers originated in the USA, used a survey methodology to collect data, and involved a natural disaster. There was no common method for measuring community resilience or social capital. The association between community resilience and social capital with mental health was regarded as positive in most cases. However, we found that community resilience, and social capital, were initially negatively impacted by public health emergencies and enhanced by social group activities.Several key recommendations are proposed based on the outcomes from the review, which include: the need for a standardised and validated approach to measuring both community resilience and social capital; that there should be enhanced effort to improve preparedness to public health emergencies in communities by gauging current levels of community resilience and social capital; that community resilience and social capital should be bolstered if areas are at risk of disasters or public health emergencies; the need to ensure that suitable short-term support is provided to communities with high resilience in the immediate aftermath of a public health emergency or disaster; the importance of conducting robust evaluation of community resilience initiatives deployed during the COVID-19 pandemic.

The purpose of the current study was to clarify the effects of illness perceptions, coping styles, and social support on psychological distress of individuals with coronavirus disease 2019 (COVID-19) isolating at home. A cross-sectional study was performed in a state hospital in Turkey with 112 individuals with confirmed cases of COVID-19. Data were collected online using self-report scales between June 8, 2020, and December 25, 2020. Regression models were used to determine predictors of psychological distress. Significant predictors were cognitive and emotional illness representations, self-blame, and positive reinterpretation coping methods. Health care providers should consider individuals' illness perceptions and coping methods and their effect on psychological distress when providing in-home and follow-up care. [Journal of Psychosocial Nursing and Mental Health Services, 61(12), 27-36.].

Drawing on conservation of resources (COR) theory, we aimed to investigate whether leisure crafting reduces emotional exhaustion by improving sleep quality and strengthening psychological detachment from the coronavirus disease 2019 (COVID-19) pandemic. We posited that sleep quality and psychological detachment from the COVID-19 pandemic mediate the negative relationship between leisure crafting and emotional exhaustion. We carried out a two-wave longitudinal study among a group of individuals (N = 216) from Wuhan, China. We measured leisure crafting, sleep quality, and psychological detachment from the COVID-19 pandemic at Time 1 and emotional exhaustion two months later at Time 2. We discovered that leisure crafting reduced emotional exhaustion at home by improving sleep quality and increasing psychological detachment from the COVID-19 pandemic. At the end of this article, we discuss theoretical and practical implications, research limitations, and directions for future research.

Objectives: To explore the impacts of psychological character strengths, self-efficacy, and the number of confirmed COVID-19 cases on residential satisfaction at the initial stage of the COVID-19 pandemic in China. Methods: To achieve the study aim, we collected data from 281 observations from Xiangyang City, China, via an online survey. Data were analyzed using linear regression. Results: Character strengths and the number of confirmed COVID-19 cases significantly impacted residential satisfaction. While self-efficacy did not directly impact residential satisfaction, it moderated the relationship between the number of confirmed COVID-19 cases and residential satisfaction. The control variables of social trust and shared value positively impacted residential satisfaction, and their influence on residential satisfaction was higher than that of character strengths. The sociodemographic variables of marriage, age, educational attainment, and housing area per capita also impacted residential satisfaction significantly. However, strong ties and weak ties became insignificant variables due to social distancing strategies. Conclusion: The study findings offer insights for local governments to enhance residential satisfaction in the community to avoid social panic during unpredictable threats or future pandemics.

Sleep is an essential determinant of health and quality of life. This study aimed to evaluate sleep disorders and symptomatic dry eye (DE) occurrence. This study was a cross-sectional survey of 1393 participants in China. The insomnia severity index (ISI) Questionnaire was used to evaluate sleep quality, and the ocular surface disease index (OSDI) questionnaire was used to assess DE symptoms. Subjects were divided into 2 groups based on subjects with and without symptomatic DE. The patients who had DE (10.48 ± 7.27) had substantially lower ISI scores compared to those without DE (3.57 ± 5.10) (P = .003). Furthermore, each ISI item and total ISI score was significantly correlated with OSDI dry eye severity and total OSDI dry eye score. Higher prevalence of insomnia was found in participants with symptomatic DE, and insomnia correlated significantly with DE symptoms. The present results suggest that clinicians and healthcare workers need to remember that DE and insomnia are highly co-existing health issues.

This study aimed to examine the association between sleep quality, depression, anxiety and stress levels, and the frequency of temporomandibular disorders in a sample of Turkish dental students during the COVID-19 pandemic.

The current cross-sectional study was conducted with 699 dental university students during the COVID-19 pandemic. Fonseca Anamnestic Index (FAI), Pittsburgh Sleep Quality Index (PSQI), and Depression Anxiety Stress Scale-21 (DASS-21) were used in the present study.

The incidence of temporomandibular joint disorders in the present study was found to be 77.5%. Female students' FAI scores were found to be statistically significantly higher than males (p < 0.05). Additionally, higher depression and anxiety and stress levels caused increased PSQI and FAI scores.

During the COVID-19 pandemic, increased temporomandibular joint disorders were observed with increased impaired sleep quality and higher depression, anxiety and stress levels among dental university students.

The COVID-19 (SARS-CoV-2) pandemic has jeopardized humanity worldwide and has considerably altered the healthy lifestyle behaviors of societies. This study examined the possible mediating role of sleep quality in the relationship between orthorexia nervosa and fear of COVID-19 among Turkish adults. This study used an observational and descriptive design. It was carried out online with 1,130 participants across Turkey between April and August 2021. The data were collected using a questionnaire, the Fear of COVID-19 Scale (FC-19S), the Pittsburgh Sleep Quality Index (PSQI), and Orthorexia Nervosa-R (ON-R). The participants had an ON-R mean score of 3.08 ± 0.90 and a mean PSQI score of 8.03 ± 2.80. Likewise, their mean FC-19S score was 18.24 ± 6.55. There was a significant positive correlation between the FC-19S and the PSQI (r = 0.208; p = 0.000) as well as a significant negative correlation between the ON-R and the PSQI (r = - 0.145; p = 0.000). In addition, the results of the process model analysis supported our hypotheses that the PSQI was a predictor of ON-R and that its direct and indirect effects were moderated by FC19S and the PSQI. A one-unit increase in FC-19S scores causes an average 1% increase on the ON-R scale, while it generates an 8% increase on the PSQI. It was determined that the PSQI total score caused an average of 6% increase in the ON-R scale score. The findings of this study showed that sleep quality has a mediating role in the relationship between orthorexia nervosa and fear of COVID-19 experienced by Turkish adults during the pandemic. For this reason, governments need to take the necessary precautions concerning this subject when creating action plans for possible global crisis situations that may adversely affect public health in the future.

To explore the association between social capital and health-related quality of life (HRQoL) and to determine whether depression mediates the association among Chinese older adults in the context of the COVID-19 pandemic.

A descriptive cross-sectional research design.

The Geriatric Depression Scale-15, Social Capital Questionnaire and 12-item Short-Form Health Survey were used to investigate 1201 older adults selected from Jinan, Shandong Province, China, using a multistage stratified cluster random sampling method.

Pearson's correlation analysis revealed a significant positive correlation between social capital and HRQoL (r = 0.269, p < 0.01). Multivariate linear regression analyses demonstrated that social capital was significantly negatively associated with depression (β = -0.072, p < 0.001) and that depression was associated with HRQoL (β = -1.031, p < 0.001). The mediation analyses showed that depression mediated the association between social capital and HRQoL, and the indirect effect size was 0.073 (95% confidence interval: 0.050, 0.100).

The comparative investigation of the scientific research materials and systematization of the latest data on the epidemiological state, pathogenetic mechanisms, clinical manifestations, risk factors, and psychopathological consequences of the impact of the COVID-19 pandemic on the mental health of the population is needed for the further targeted development of treatment and rehabilitation measures.

The COVID-19 pandemic has been increasingly viewed through the lens of serious global mental health issues. This article analyzes the results of original research and publications data on the etiopathogenesis, neuropsychiatric features, and risk factors of mental disorders associated with the pandemic. The study was carried out within the scope of the scientific research work of the Department of General, Children's Forensic Psychiatry, and Narcology of the Shupyk National Healthcare University of Ukraine. Its title was "Development of a multimodal system of restorative therapy and medical and psychological rehabilitation of patients with COVID-19, based on the study of leading pathogenetic mechanisms" (state registration number 0121U114707).

Despite the recent rapid increase in the number of sources in the literature devoted to the consequences of the COVID-19 pandemic, several questions remain unresolved. This especially applies to disorders in the mental sphere, concerning clinical phenomenology, features of emotional and cognitive disturbances, personal response, levels of social functioning and the quality of life of patients who have suffered from COVID-19. The data obtained can serve as the basis for the further development of a multimodal model of hierarchical structural-functional pathogenetic links of mental disorders, as well as a target-oriented system of restorative therapy and medical-psychological rehabilitation of patients who have suffered from COVID-19.

China's aging population, mobile population, low-income families, and other vulnerable groups congregate in dilapidated urban communities serving as public health spaces. As a result, managing public sports spaces in aging urban areas is a significant public health project in China, an essential strategy for raising residents' quality of life, and a significant effort to support the active aging of the older adult.

The study used mathematical and statistical techniques, questionnaires, and logical deduction to conduct a public health study on the participation mechanism of social capital in the governance of public sports spaces in dilapidated urban communities. It chose 11 old Changsha, Hunan Province, communities as the research objects.

Personal social capital was found to boost the availability of public sports spaces in older populations through social connections. Collective social capital improves the availability of public sports spaces in aging populations through social trust and stabilizes the order of public sports spaces in aging communities through social involvement.

To improve the governance efficiency of public sports spaces in aging urban communities, the study aims to actively mobilize and accumulate social capital through cultivating the public spirit, reshaping the concept of sports governance, appropriately decentralizing and empowering, strengthening sports governance structures, enhancing communication and collaboration, and building sports governance. This is essential for China to fully implement the policies of active aging, a healthy China, and creating a community for global public health.

As the focal point of epidemic prevention and control, the mental health of COVID-19 patients cannot be ignored. Online Mindfulness-Based Stress Reduction (MBSR) allows for the provision of conveniently accessible, effective and low-cost interventions on a large scale. We aim to evaluate the effectiveness of an online MBSR intervention in alleviating anxiety and depression among asymptomatic/mild patients limited by COVID-19-related restrictions.

Fifty-eight patients treated in Sanya Fangcang hospital were randomly allocated to either to the experimental group (n = 29) following daily, for 5 days, an online-based mindfulness intervention or to the control group (n = 29). Patients from both groups underwent online questionnaires including assessment of anxiety and depression status at pre- and post-tests using Self-rating Anxiety Scale and Self-Rating Depression Scale.

After the online-based MBSR program, the anxiety and depression scores of the patients in the MBSR group decreased significantly in comparison to the scores of those in the control group (respectively η² = 0.175, η² = 0.215, p < 0.001). And the proportion of severe anxiety and depression patients in the MBSR group decreased to 0% which lower than the control group, and the proportion of light anxiety and depression patients was significantly more than that in the control group after the MBSR intervention.

The online-based MBSR intervention appears to be an effective way of alleviating anxiety and depression symptoms among COVID-19 patients with associated quarantine in Fangcang hospital. Given the seriousness of mental health threat that could be posed by this ongoing pandemic, our study provides a new idea and method for cost-effective and time-efficient interventions in the future of epidemic prevention and control.

During the COVID-19 pandemic in China, the silent management (Lockdown) policy has caused severe sleep problems for university students. Long-term isolation may further deteriorate sleep quality, and it requires practical interventions. Today in mental and sleep health, interventions based on Buddhist, Taoist and Confucian ethics have been proven effective in reducing cognition and sleep disorders. However, such interventions also have limitations. They tend to focus on peace of mind or some technical means with the main direction of symptom improvement but neglect the mundane activities of daily life.

We conducted an innovative tranquil sitting intervention program based on the Chinese Confucian value of the "tranquility and reverence" method, integrating various intervention techniques traditionally recognized as effective for achieving more lasting mental health and sleep quality. This study aims to assess the effectiveness and feasibility of a tranquil sitting intervention in improving sleep problems in isolated university students. Using a randomized control trial (RCT), the participants in the intervention program (n = 35) practiced the tranquil sitting intervention program for ten weeks. They had their PSQI scores measured at the pre-experimental, post-test, and 1-month follow-up time points and compared to the control group (n = 35).

The participants who received the tranquil sitting intervention had significantly better sleep quality than the control group, with moderate to large effect sizes in the middle and late stages. The instructor may challenge the intervention group at the beginning of the tranquil sitting technique. However, the improvement in sleep quality was significant after fully mastering the method.

The intervention program in this study emphasized the importance of "tranquility" and showed the same sleep improvement as in other traditional interventions. In conclusion, this intervention is a feasible and promising new approach to improving sleep quality among youths.

The study aim was to investigate the prevalence of behavioral symptoms and burnout in healthcare workers in an intensive neurological rehabilitation unit in Messina, Italy, during the first COVID-19 lockdown in Italy.

Forty-seven healthcare workers (including neurologists, physiatrists, nurses and rehabilitation therapists) were enrolled in this cross-sectional study from February 2020 to June 2020. Participants were administered the following psychometric tests to investigate burnout and related symptoms: the Maslach Burnout Inventory, which measures emotional exhaustion, depersonalization and reduced personal accomplishment; the Zung Self-Rating Depression Scale (SDS); the Pre-Sleep Arousal Scale (PSAS); the Dyadic Adjustment Scale; and the Buss-Perry Aggression Questionnaire (BPAQ).

We found several correlations between test scores and burnout subdimensions. Emotional exhaustion was correlated with SDS (r = 0.67), PSAS-Cognitive (r = 0.67) and PSAS-Somatic (r = 0.70) scores, and moderately correlated with all BPAQ dimensions (r = 0.42). Depersonalization was moderately correlated with SDS (r = 0.54), PSAS-Cognitive (r = 0.53) and PSAS-Somatic (r = 0.50) scores.

During the first COVID-19 lockdown in Italy, healthcare workers were more exposed to physical and mental exhaustion and burnout. Research evaluating organizational and system-level interventions to promote psychological well-being at work for healthcare workers are needed.

Objective: This study aims to investigate the connection between social capital and sleep duration among older adults in Ghana, as limited research has been conducted to explore this relationship. Methods: This study utilized Wave 2 data from a sample of Ghanaian older adults from the World Health Organization Study on Global AGEing and Adult Health (SAGE). Self-reported data on social capital and sleep duration were compiled. Using ordered logistic regression, the relationship between social capital and sleep duration was examined. Results: Older adults who did not participate in social activities showed the strongest association with the risk of short sleep (p < 0.05). Our study found that older adults who sleep for shorter periods tend to report better sleep quality. There was no correlation between medium and long sleep durations and social capital. Conclusion: This study underscores the importance of more research to truly understand the complex connections between older adults' social participation, sleep, and health. It also has important implications for the promotion of good sleep in aging populations.

Research on the impact of the COVID-19 pandemic among college students around the world has primarily focused on their mental health symptoms and COVID-specific worry. However, contextually specific understanding of outbreak impacts is key to inform directed public health messaging and programming to improve wellbeing and coping. The current study aimed to identify the main psychosocial problems college students experienced during the first 6 months of the COVID-19 pandemic in Monterrey, Mexico. Participants were 606 college students (71% female) enrolled in a private university. Participants described COVID-related problems in an open-ended prompt as part of a longitudinal online survey: initially in May 2020, and then every 2 weeks for 3 months. Thematic analyses were conducted within a longitudinal inductive qualitative approach to rank responses by frequency across themes. Five major categories emerged. At baseline, over 75% of participants noted the outbreak negatively impacted their daily activities and responsibilities, 73% their mental health, 50% their physical health, 35% their interpersonal relationships, and 22% their economic situation. Concerns remained relatively stable throughout the follow-up period, with interpersonal and economic concerns becoming more prevalent as the pandemic progressed. Problems identified in this study can inform preventative measures for future health crises, including tailoring public health messaging and expanding access to contextually sensitive mental and behavioral health programming.

Although several studies have described the impact of the COVID-19 pandemic, particularly on sleep quality, there are few studies that, in the same time period and using the same assessment tools, compare sleep quality and mental health status between nurses and the general population. Thus, the aim of this study was to (a) examine whether there were differences between nurses and the general population regarding sleep quality and mental health status during the COVID-19 pandemic and (b) identify which factors may explain sleep quality during the COVID-19 pandemic. To do that, we carried out a cross-sectional study in Portugal. Data were collected using an online survey platform during the first COVID-19 wave, from April to August 2020. Nurses presented poorer sleep quality than the general population, as well as higher anxiety levels. Irritability and worries about the future were two of the factors that might explain those differences. Thus, we can conclude that irritability and worries about the future are dimensions of anxiety that were associated with poor sleep quality during the COVID-19 pandemic. Thus, it would be important to adopt regular anxiety and sleep assessments, particularly for nurses, and to implement strategies to reduce this problem.

Health regulations to constrain the progress of the pandemic such as lockdowns, curfews, and quarantines made radical alterations in every aspect of individuals' lives, causing significant impact on their mental health and well-being. The current study aimed to examine whether there are significant differences in participants' sociodemographic variables in reported cases of depression, anxiety, and stress among women who lived in Kuwait during the curfew and lockdown caused by COVID-19 pandemic. This study used a cross-sectional method. A nonrandom sample of 596 participants was recruited. The current study found that women at higher risk of reporting more incidents of depression, anxiety, and stress during the lockdown and curfew were from the older age group above 50 years old, hold higher educational certificates, and own private businesses. High rates of reported depression and anxiety were detected significantly among Kuwaiti women. The findings of this study reveal the significant impact of an uncomfortable and distressful environment during the COVID-19 pandemic, which may negatively affected individuals' mental health and generated diverse forms of psychosocial illness.

Sleep is inexorably linked to both physiological and psychological wellbeing. Restrictions imposed to control the COVID-19 pandemic likely impacted upon daily and weekly routines, which can have a negative impact on a range of factors including sleep quality, and/or quantity and general wellbeing. The aim of this study was to investigate the effect of COVID-19 related restrictions on sleep patterns and psychological wellbeing of healthcare students. A survey was delivered to healthcare students across three faculties at a single institution. Participants completed questionnaires on the effect of COVID-19 restrictions on course delivery and clinical placements, its effect on sleep-wake times, sleep quality, sleep hygiene, psychological wellbeing, their current sleep knowledge and sleep education in their current course. Using the Pittsburgh Sleep Quality Index (PSQI), over 75% of participants were found to have poor sleep quality. Changes in sleep habits and sleep behaviours during COVID-19 restrictions were associated with poorer sleep quality, and this poor sleep quality was associated with poor psychological wellbeing, particularly, motivation, stress and fatigue. Increases in negative sleep hygiene behaviours were associated with a statistically significant increase in PSQI global score. Positive emotions were positively correlated with PSQI (r = 0.22-0.24, p < .001), negative emotions were negatively correlated with PSQI (r = -0.22 - -0.31, p < .001). Also, a self-perceived lack of sleep education was identified. This study illustrates the negative association between self-reported poor sleep behaviour and poor sleep quality during COVID-19 restrictions on university student mental health and wellbeing. Additionally, there is a self-perceived lack of sleep education with little to no time spent educating students in their current degree. Hence, appropriate sleep education may improve sleep behaviours and subsequent sleep quality, which may prove to be a protective factor against poor mental health in the face of unexpected changes to routines.

COVID-19 has become a major source of stress for people around the world. Stressful life events play a role in the pathogenesis of sleep disorders such as insomnia which is considered a risk factor for anxiety and depression. Emotion regulation is an important factor linked with sleep and mental health problems. Therefore, the main goal of the present study was to examine whether insomnia could constitute a mediation mechanism that explains the relationship between emotion regulation strategies (rumination, reappraisal, suppression) and stress-induced mental health outcomes during the COVID-19 pandemic.

The cross-sectional study was conducted among young (M±SD 24.8±2.24) individuals (N = 281, 85.4% women) during the time of the third wave of infections in Poland. Data were collected by means of selfreport questionnaires, including the Emotion Regulation Questionnaire; Cognitive Emotion Regulation Questionnaire; Athens Insomnia Scale; Depression, Anxiety and Stress Scale. The direct and indirect effects of emotion regulation strategies on depression, anxiety, and stress were calculated using a bootstrap estimation technique.

All analyzed indirect effects were significant. The results show that insomnia mediates the relationships between all 3 emotion regulation strategies and stress, anxiety and depression.

The presented results shed the light on the role of insomnia on the relationships between emotion regulation strategies and emotional states experienced during the COVID-19 pandemic. Additionally, the present study suggests that educational and therapeutic interventions aimed at improving emotion regulation might be useful for improving symptoms of insomnia and, through it, symptoms of affective disorders. Int J Occup Med Environ Health. 2023;36(1):151-59.

In this study, we explored whether satisfaction with government management, perception of risk, and gratitude influenced public anxiety during the COVID-19 pandemic in China. Using a cross-sectional, anonymous and confidential online survey, a nationwide sample of Chinese adults (N = 876) was targeted between March 25-March 30, 2020, a period in which newly confirmed cases significantly declined in China. The anxiety level was decreased as compared to that assessed during the peak period. Multiple parallel mediation modeling demonstrated that risk perception and gratitude partially mediated the relationship between satisfaction with government management and public anxiety. Increasing satisfaction and gratitude, as well as reducing risk perception contribute to the public's mental health. The results may shed light on the positive factors for psychological well-being during the COVID-19 pandemic and may aid potential strategies for the policy maker, the public, and the clinic to regulate negative emotions or future emerging infectious diseases.

The outbreak of the 2019 coronavirus disease (COVID-19) has significant effects on stress, emotion and sleep in the general public. The aim of this study was to explore the relationship between perceived stress and emotional symptoms during the first wave of the COVID-19 pandemic in China and to further determine whether insomnia could serve as a mediator in this relationship. A total of 1178 ordinary citizens living in mainland China conducted anonymous online surveys. The 10-item Perceived Stress Scale, the Insomnia Severity Index, the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder scale were used to estimate perceived stress, insomnia, depression and anxiety symptoms, respectively. Of the 1171 valid respondents from 132 cities in China, 46.6 % and 33.0 % showed symptoms of depression and anxiety, respectively. Perceived stress and insomnia independently predicted the prevalence of emotional symptoms and were positively correlated with the severity of these emotional symptoms. The mediation analyses further revealed a partial mediation effect of insomnia on the relationship between perceived stress and emotional symptoms during the first wave of the COVID-19 outbreak in China. Our findings can be used to formulate early psychological interventions to improve the mental health of vulnerable groups, specifically those with insomnia, during the COVID-19 pandemic.

This study aimed to determine the mediating role of psychological distress and domestic violence in the association of fear of COVID-19 with marital satisfaction and sexual quality of life (QoL) among Iranian women of reproductive age.

A cross-sectional study comprising 324 married women was conducted. Online convenience sampling was used to collect data. SPSS PROCESS macro was used for the mediation analysis. The direct and indirect effects of the fear of COVID-19 on sexual QoL and marital satisfaction were estimated comprising a 95% CI using 5000 bootstrap samples. Pairwise comparisons between the mediators were calculated by Hayes' macros.

A positive/negative or suspected history of COVID-19 infection had marginally significant relationship with marital satisfaction (p=0.049). The total effect of fear of COVID-19 on sexual QoL was significant (b=-1.31, SE=0.20, p<0.001). Fear of COVID-19 had no significant direct effect on sexual QoL (b=-0.22, SE=0.19, p=0.24) but it had an indirect effect on sexual QoL via mediation of psychological distress (b=-0.34, SE=0.09, 95% CI: -0.53 to -0.19) and domestic violence (b=-0.75, SE=0.18, 95% CI: -1.12 to -0.40). The total effect of fear of COVID-19 on marital satisfaction was significant (b=-1.91, SE=0.32, p<0.001). Fear of COVID-19 had no significant direct effect (b=0.20, SE=0.25, p=0.42) on marital satisfaction but it had an indirect effect on marital satisfaction via mediation of psychological distress (b=-0.59, SE=0.13, 95% CI: -0.86 to -0.36) and domestic violence (b=-1.51, SE=0.29, 95% CI: -2.08 to -0.92).

The fear of COVID-19 during the pandemic indirectly decreased women's marital satisfaction and sexual QoL via increased psychological distress and domestic violence. Consequently, in critical situations such as the COVID-19 pandemic, improving couples' psychological health and reducing domestic violence are likely to improve women's sexual QoL and marital satisfaction.

The study was carried out one year after the establishment of the pandemic state in the European Union (EU), the situation at the end of the next wave of the COVID-19 pandemic in Poland. The survey was conducted on a representative sample of Polish people using Computer Assisted Web Interviewing (CAWI), considering several demographic categories, such as sex, age, place of residence, education, and monthly income. The survey's main objective was to find out whether the respondents feel fear related to pandemics and living in a pandemic, and if so, what the psychological and physiological symptoms of this fear are. Half of the respondents (50.2%) declared that they felt fear about what their life would look like after the pandemic, and every tenth person (10.1%) marked the highest level of fear on the scale. The respondents felt the psychological symptoms of the pandemic much more often than they felt the physical ones. The most common psychological symptoms were fear of the future (38.5% of them gave "often" and "very often" responses, together), despondency (29.2% of them gave "often" and "very often" responses), and mental tension (28.9% of them gave "often" and "very often" responses). A detailed analysis of data from representative studies showed that the responses in a pandemic are strongly determined by demographic categories, mainly sex and age, and they differ depending on the social group to which a person belongs.

Background: Professional commitment is an important factor in employee performance. COVID-19 outbreak has seriously affected the nurses working conditions. Numerous factors can affect nurses' professional commitment in this situation.Aim: To explore the nurses' lived experiences, attitudes, views and perceptions toward professional commitment and factors affecting it in the Covid-19 crisis.Method, Setting and Participants: This qualitative study was conducted using phenomenological approach and content analysis method. Twenty-five nurses were interviewed using semi structured in-depth interviews. Conventional content analysis was used to analyze collected data.Ethical considerations: Ethical approval was obtained from the Ethics Committee of Qazvin University of Medical Sciences.Results: Five themes were extracted as follows: "Collaborative empathetic commitment", "Loyal commitment", "Sacrificial commitment", "Commitment with doubt and concern" and "humanistic commitment".Discussion and Conclusion: The Covid-19 crisis has caused major changes in nurses' working conditions, which have also affected the concept of professional commitment to the nursing profession and revealed new concepts. Identifying internal and external factors that can enhance nurses' commitment to the profession in critical situations such as the Covid-19 outback is of particular importance.

This study examined the impact of Japan's state of emergency on trends in diabetes care during the coronavirus disease 2019 (COVID-19) pandemic.

A descriptive and retrospective study.

Showa University Hospital, Japan.

Patients with diabetes who received medical treatment from 2018 to 2020. Determinants of interest: Number of patients with diabetes visiting the hospital per week. To examine the impact of the Japan's state of emergency, the number of hospital visitations by patients with diabetes was summarized from 28 weeks of data for each year, from calendar week 8 to calender week 35.

Compared with the mean of 2018 and 2019, no significant difference was found between the three periods (before, during, and after the state of emergency). However, the numbers of patients from both inside and outside Tokyo increased at 7 weeks after the state of emergency was lifted.

A significant increase in the numbers of patients with diabetes was seen compared with the same period in 2018 and 2019, suggesting that the state of emergency may have hindered diabetes care. Therefore, patients with diabetes should receive continuous follow-up regarding their diabetes care, keeping a close eye on relvent measurements.

The number of citations to a paper represents the weight of that work in a particular area of interest. Several highly cited papers are listed in the bibliometric analysis. This study aimed to identify and analyze the 100 most cited papers in insomnia research that might appeal to researchers and clinicians.

We reviewed the Web of Science (WOS) Core Collection database to identify articles from 1985 to 24 March 2022. The R bibliometric package was used to further analyze citation counts, authors, year of publication, source journal, geographical origin, subject, article type, and level of evidence. Word co-occurrence in 100 articles was visualized using VOS viewer software.

A total of 44,654 manuscripts were searched on the Web of Science. Between 2001 and 2021, the top 100 influential manuscripts were published, with a total citation frequency of 38,463. The top countries and institutions contributing to the field were the U.S. and Duke University. Morin C.M. was the most productive author, ranking first in citations. Sleep had the highest number of manuscripts published in the top 100 (n = 31), followed by Sleep Medicine Reviews (n = 9). The most cited manuscript (Bastien et al., Sleep Medicine, 2001; 3,384 citations) reported clinical validation of the Insomnia Severity Index (ISI) as a brief screening indicator for insomnia and as an outcome indicator for treatment studies. Co-occurrence analyses suggest that psychiatric disorders combined with insomnia and cognitive behavioral therapy remain future research trends.

This study provides a detailed list of the most cited articles on insomnia. The analysis provides researchers and clinicians with a detailed overview of the most cited papers on insomnia over the past two decades. Notably, COVID-19, anxiety, depression, CBT, and sleep microstructure are potential areas of focus for future research.

Introduction: Healthcare professionals (HCPs) appear to be at increased risk for negative psychological outcomes [e.g. depression, anxiety, post-traumatic stress disorder (PTSD), moral distress] and associated impacts on functioning throughout the COVID-19 pandemic. HCPs working on designated COVID-19 units may be further impacted than their colleagues not on these units given added demands of patient care and risk of contracting COVID-19. Little is known, however, about the mental health and functioning of specific professional groups beyond nurses and physicians, including respiratory therapists (RTs), over the course of the pandemic. Accordingly, the purpose of the present study was to characterize the mental health and functioning of Canadian RTs and compare profiles between RTs working on and off designated COVID-19 units.Methods: Canadian RTs completed an online survey between February and June 2021, including demographic information (e.g. age, sex, gender,) and measures of depression, anxiety, stress, PTSD, moral distress and functional impairment. Descriptive statistics, correlation analyses and between-groups comparisons were conducted to characterize RTs and compare profiles between those on and off COVID-19 units.Results: Two hundred and eighteen (N = 218) RTs participated in this study. The estimated response rate was relatively low (6.2%) Approximately half of the sample endorsed clinically relevant symptoms of depression (52%), anxiety (51%) and stress (54%) and one in three (33%) screened positively for potential PTSD. All symptoms correlated positively with functional impairment (p's < .05). RTs working on COVID-19 units reported significantly greater patient-related moral distress compared to those not on these units (p < .05).Conclusion: Moral distress and symptoms of depression, anxiety, stress and PTSD were prevalent among Canadian RTs and were associated with functional impacts. These results must be interpreted with caution given a low response rate, yet raise concern regarding the long-term impacts of pandemic service among RTs.