Pre-Existing Depression, Anxiety Linked With Increased Risk of Insomnia After COVID-19 Infection


Participants of a recent study who had pre-existing depression or anxiety were significantly more likely to develop insomnia.

Individuals who had a COVID-19 infection with none or mild symptoms have an increased risk of experiencing insomnia, according to data published in the journal Frontiers in Public Health.1 The link was significantly stronger in those with pre-existing chronic conditions, including depression and anxiety.

Individual in bed with insomnia / Graphicroyalty -

Individual in bed with insomnia / Graphicroyalty -

Long COVID, which encompasses over 200 different symptoms, has emerged as a serious public health issue. Insomnia is 1 of the most common of these symptoms reported, with a prevalence ranging from 5.4% to 66.76%. Although previous research has been done examining sleep issues among patients who recovered from COVID-19, there remains a lack of data.1

Key Takeaways

  • A cross-sectional study involving 1056 adults in Vietnam showed that the prevalence of insomnia among recovered COVID-19 patients was high, with 76.1% experiencing insomnia and 22.8% having severe insomnia.
  • Pre-existing depression or anxiety, other chronic conditions, and higher education levels were identified as risk factors for developing insomnia after COVID-19 infection.
  • Participants reported worse sleep quality, shorter sleep duration, increased difficulty falling asleep, and more awakenings at night after their COVID-19 infection.

“As a sleep researcher, I received many questions and complaints from relatives, friends, and colleagues about their sleep disturbances after recovering from COVID-19,” Huong T. X. Hoang, lead author on the study, said in a release.2 “I found that the majority of papers focused on hospitalized patients. The environment of their treatment and quarantine would differ greatly from those with milder symptoms.”

A team of investigators conducted a cross-sectional study to assess the prevalence of insomnia and identify associations with depression and anxiety among recovered COVID-19 patients who were not hospitalized. Data was gathered from an online survey of adults who recovered from COVID-19 within 6 months of their initial infection.

The study cohort included 1056 adults from the general population in Vietnam. The participants answered questions related to COVID-19 severity and sociodemographic characteristics, such as age, sex, marital and employment status, education level, occupation, and pre-existing chronic conditions. The Insomnia Severity Index was also used to measure insomnia severity among the participants, and the Depression, Anxiety, and Stress Scale was used to measure mental health.

Investigators found that the prevalence of insomnia was 76.1% among the participants, of which 22.8% was severe insomnia. One-third of participants said they had worse sleep quality, shorter sleep duration, and that it was harder for them to fall asleep. Half of the participants also said that they had more awaken nights after their COVID-19 infection.

READ MORE: BIPOC Experience More Negative Effects After COVID-19 Infection

Participants who had pre-existing depression or anxiety were significantly more likely to develop insomnia. Additionally, having other pre-existing chronic conditions and having a higher level of education were also risk factors for insomnia. COVID-19 symptoms and disease duration were not significantly associated with insomnia.

Study limitations include the cross-sectional nature of the study, recall and selection bias due to data being collected online, and that some sleep parameters, vaccination status, and physical COVID-19 symptoms were not measured. The authors noted that collecting data via electronic invitation and convenience sampling was the most efficient and feasible strategy at the time the study was conducted.

“If you experience insomnia after COVID-19, don’t think that is normal,” said Hoang.2 “If insomnia does not bother you much, you can take some simple actions, such as: taking a warm shower before bedtime, shutting your phone down at least one hour before going to bed, doing 30 minutes of exercise per day, and avoiding caffeine after 4pm. In case insomnia really troubles you, you can try some over-the-counter sleep aids. If they don’t help, go to see a sleep therapist.”

READ MORE: COVID-19 Resource Center

1. Hoang HTX, Yeung WF, Truong QTM, et al. Sleep quality among non-hospitalized COVID-19 survivors: a national cross-sectional study. Front. Public Health. 11:1281012. doi: 10.3389/fpubh.2023.1281012
2. Mild COVID-19 infections make insomnia more likely, especially in people with anxiety or depression. News Release. Frontiers. February 5, 2024. Accessed February 5, 2024.
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