Sleep disturbances among women in a Subarctic region: a nationwide study

Funding Information: Approval for the study was granted by the Icelandic Bioethics Committee (nr. VSNb2017110046/03.01) Publisher Copyright: © 2022 Sleep Research Society. Published by Oxford University Press on behalf of the Sleep Research Society.STUDY OBJECTIVES: To date, few studies have assessed sleep problems among women residing in Subarctic regions. Therefore, the aim of this large-scale population-based study was to assess the prevalence of severe sleep problems and associated factors among Icelandic women, living at 63-66°N. METHODS: Participants were 29 681 women (18-69 years old) who took part in the Icelandic Stress-And-Gene-Analysis study in 2018-2019. Background information, health-related behavior, and mental health symptoms were assessed with an online questionnaire. The Pittsburgh Sleep Quality Index (PSQI) was used to assess severe sleep problems during the past month. Adjusting for age, marital status, number of children, education, personal income, work schedule, region, and response period, we used modified Poisson log-linear models to obtain prevalence ratios (PRs) with 95% confidence intervals (CIs). RESULTS: Overall, 24.2% of women reported severe sleep problems (PSQI >10). Women responding in the winter presented with an overall higher prevalence of severe sleep problems, compared to those responding in the summer (PR 1.21; 95% CI, 1.15 to 1.28). Severe sleep problems were more prevalent among young and late-midlife women, those who were single, had children, socio-economic challenges, worked shifts, and flexible hours. Furthermore, obesity, suboptimal health behaviors, excessive screen time, and mental health problems were associated with severe sleep problems. CONCLUSION: Severe sleep problems are more common among women in Subarctic regions than elsewhere, particularly during winter. These findings motivate the development of preventive strategies and interventions for women in the Subarctic who suffer from sleep problems.Peer reviewe

Acute COVID-19 severity and mental health morbidity trajectories in patient populations of six nations: an observational study

Background Long-term mental and physical health consequences of COVID-19 (long COVID) are a persistent public health concern. Little is still known about the long-term mental health of non-hospitalised patients with COVID-19 with varying illness severities. Our aim was to assess the prevalence of adverse mental health symptoms among individuals diagnosed with COVID-19 in the general population by acute infection severity up to 16 months after diagnosis. Methods This observational follow-up study included seven prospectively planned cohorts across six countries (Denmark, Estonia, Iceland, Norway, Sweden, and the UK). Participants were recruited from March 27, 2020, to Aug 13, 2021. Individuals aged 18 years or older were eligible to participate. In a cross-sectional analysis, we contrasted symptom prevalence of depression, anxiety, COVID-19-related distress, and poor sleep quality (screened with validated mental health instruments) among individuals with and without a diagnosis of COVID-19 at entry, 0–16 months from diagnosis. In a cohort analysis, we further used repeated measures to estimate the change in mental health symptoms before and after COVID-19 diagnosis. Findings The analytical cohort consisted of 247 249 individuals, 9979 (4·0%) of whom were diagnosed with COVID-19 during the study period. Mean follow-up was 5·65 months (SD 4·26). Participants diagnosed with COVID-19 presented overall with a higher prevalence of symptoms of depression (prevalence ratio [PR] 1·18 [95% CI 1·03–1·36]) and poorer sleep quality (1·13 [1·03–1·24]) but not symptoms of anxiety (0·97 [0·91–1·03]) or COVID-19-related distress (1·05 [0·93–1·20]) compared with individuals without a COVID-19 diagnosis. Although the prevalence of depression and COVID-19-related distress attenuated with time, individuals diagnosed with COVID-19 but never bedridden due to their illness were consistently at lower risk of depression (PR 0·83 [95% CI 0·75–0·91]) and anxiety (0·77 [0·63–0·94]) than those not diagnosed with COVID-19, whereas patients who were bedridden for more than 7 days were persistently at higher risk of symptoms of depression (PR 1·61 [95% CI 1·27–2·05]) and anxiety (1·43 [1·26–1·63]) than those not diagnosed throughout the study period. Interpretation Severe acute COVID-19 illness—indicated by extended time bedridden—is associated with long-term mental morbidity among recovering individuals in the general population. These findings call for increased vigilance of adverse mental health development among patients with a severe acute disease phase of COVID-19.Funding Nordforsk, Horizon2020, Wellcome Trust, and Estonian Research Council

Sleep Disturbances among Females and Associated Risk Factors: A Nationwide Cohort Study in Iceland

Bakgrunnur: Faraldsfræðilegar lýðgrundaðar ferilrannsóknir hafa sýnt að tíðni skerta svefngæða eru á bilinu 27–52% meðal kvenna víðsvegar um heiminn. Engar faraldsfræðilegar rannsóknir hafa verið framkvæmdar til að meta svefngæði hjá íslenskum konum til þessa. Markmið þessarar rannsóknar er því að meta algengi skerta svefngæða hjá íslenskum konum og tengsl þess við bakgrunnsbreytur og aðra áhættuþætti. Aðferð: Þátttakendur voru samtals 31.811 íslenskar konur (18–69 ára) sem tóku þátt í lýðgrundaðri ferilrannsókn sem heitir Áfallasaga kvenna á árunum 2018–2019. Upplýsingum um bakgrunn, heilsufarslega þætti og skjátíma var safnað með rafrænum sjálfsmatsspurningalista. Svefngæði vorum metin með Pittsburg Sleep Quality Index (PSQI). Poission-aðhvarfsgreining var notuð til að reikna áhættuhlutföll (ÁH) með 95% öryggisbili (ÖB). Leiðrétt var fyrir aldri, menntun, líkamsþyngdarstuðli, áfengisneyslu og reykingum þegar það átti við. Niðurstöður: Í heildina greindu 65,6% kvenna frá skertum svefngæðum (>5 stig á PSQI) síðasta mánuðinn. Samband aldurs og svefngæða var U-laga þar sem yngstu og elstu þátttakendurnir greindu frekar frá skertum svefngæðum. Niðurstöðurnar gáfu til kynna að það að búa á Norðurlandi (leiðrétt ÁH = 1.06 [95% ÖB (1.03–1.09)]), lágt menntunarstig (leiðrétt ÁH = 1.32 [95% ÖB (1.29–1.34)]), lágar tekjur (leiðrétt ÁH = 1.46 [95% ÖB (1.42–1.50)]), að vera einhleyp (leiðrétt ÁH = 1.16 [95% ÖB (1.15–1.18)]) og eiga fimm börn eða fleiri (leiðrétt ÁH = 1.11 [95% ÖB (1.06–1.15)]) tengist aukinni hættu á skertum svefngæðum. Ennfremur tengdust óvirkni á vinnumarkaði (leiðrétt ÁH = 1.38 [95% ÖB (1.36–1.40)]) og vaktavinna (leiðrétt ÁH = 1.21 [95% ÖB (1.18–1.24)]) skertum svefngæðum. Þeir heilsufarslegu þættir sem tengdust skertum svefngæðum voru undirvikt (leiðrétt ÁH = 1.17 [95% ÖB (1.09–1.25)]), offita (leiðrétt ÁH = 1.23 [95% ÖB (1.21–1.25)]), reykingar (leiðrétt ÁH = 1.37 [95% ÖB (1.34–1.40)] fyrir daglegar reykingar) og óhófleg áfengisneysla, sérstaklega einu sinni eða oftar í viku (leiðrétt ÁH = 1.25 [95% ÖB (1.21–1.29)]). Að auki tengdust þrjár klukkustundir eða meira af daglegum tómstundatengdum skjátíma skertum svefngæðum, en áhættan á skertum svefngæðum jókst með aukinni skjánotkun. Ályktanir: Niðurstöður rannsóknarinnar gefa til kynna að algengi skerta svefngæða sé hærra hjá íslenskum konum en annarsstaðar. Jafnframt tengist búseta á Norðurlandi, lág félagshagfræðileg staða og slæm heilsutengd hegðun skertum svefngæðum. Þessar niðurstöður gætu nýst við skipulagninu forvarna og til að bera kennsl á konur sem þurfa á íhlutun að halda til að bæta svefn sinn.Background: International population-based studies have found the prevalence of poor sleep quality among adult females to range from 27% to 52%. However, no epidemiological population-based study has assessed this among Icelandic females. Therefore, the aim of this study is to assess the prevalence of poor sleep quality among the Icelandic female population and associated risk factors. Method: Participants consisted of 31,811 Icelandic females (18–69 yrs. old) who took part in the nationwide Stress and Gene Analysis (SAGA) cohort study in 2018–2019. Information on background characteristics, health-related behavior, and screen-time was assessed with a self-report questionnaire. Past month sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Poisson log-linear models were used to obtain relative risks (RRs) with 95% confidence intervals (CIs). Adjustments were made for age, education, BMI, alcohol consumption, and smoking, when relevant. Results: Overall, 65.6% of females were experiencing poor sleep quality (PSQI score > 5) in the past month. The relationship between age and sleep quality was U-shaped, with poor sleep quality being more common among the youngest and oldest participants. In addition, residing in North Iceland (adjusted relative risk [aRR] = 1.06 [95% CI (1.03–1.09)]), low education level (aRR = 1.32 [95% CI (1.29–1.34)]), low income (aRR = 1.46 [95% CI (1.42–1.50)]), not being in a relationship (RR = 1.16 [95% CI (1.15–1.18)]), and having five or more children (aRR = 1.11 [95% CI (1.06–1.15)]) was associated with poor sleep quality. Furthermore, being inactive in the workforce (aRR = 1.38 [95% CI (1.36–1.40)]) and working shifts, compared to regular hours (aRR = 1.21 [95% CI (1.18–1.24)]) was associated with poor sleep quality. Health-related factors associated with poor sleep quality included being underweight (aRR = 1.17 [95% CI (1.09–1.25)]), obese (aRR = 1.23 [95% CI (1.21–1.25)]), smoking (aRR = 1.37 [95% CI (1.34–1.40)] for daily smoking), and binge drinking, particularly once or more a week (aRR = 1.25 [95% CI (1.21–1.29)]). In addition, more than three hours of daily leisure-based screen-time was associated with poor sleep quality, with the risk of poor sleep quality increasing as a function of time spent in front of screens. Conclusion: Our results indicate that the prevalence of poor sleep quality in the Icelandic female population is higher than elsewhere. In addition, residing in North Iceland, low socioeconomic status, shift work, and adverse health-related behavior were associated with poor sleep quality. These findings could be valuable in the development of preventive strategies and identifying females who could benefit from interventions to improve sleep

Psychometric properties of the Satisfaction with life scale (SWLS) in a sample of individuals over the age of 40 years old from the Icelandic population

Background: The psychometric properties of different language versions of the Satisfaction with Life Scale (SWLS) has been shown to be good to excellent in general populations and clinical samples. The current study estimated the psychometric properties of the Icelandic version of the SWLS as well as general life satisfaction for a large, population based sample of Icelandic individuals over the age of 40. The current study is part of the largest scientific study to date conducted in Iceland, which evaluates the value of screening for a precursor of myeloma in Icelanders over the age of 40. Methods: All Icelandic individuals born preceding the year of 1976 (i.e., 40 years or older) were offered participation in a study screening for monoclonal gammopathy of undetermined significance (MGUS), which is a precursor to multiple myeloma. Individuals that provided informed consent were 78,581 and about half of those individuals completed at least one of the five self-report measures used in the current study. Results: The mean score on the SWLS was relatively high with females scoring slightly higher than males in most age groups. The relationship between satisfaction with life and age followed a nonlinear, slightly U-shaped curve, in which life satisfaction decreased until late middle age and then increased again. The SWLS had good internal consistency and construct validity in the current sample. Conclusions: The results of the current study were in accordance with previous studies into satisfaction with life. On average, the Icelandic population over the age of 40 reported being satisfied with their lives. Additionally, females reported being slightly more satisfied with their lives than males, and the relationship between life satisfaction and age was nonlinear and slightly U-shaped. Results from the current study indicate that the psychometric properties of the Icelandic version of the SWLS are good, and therefore, the Icelandic version of the scale is a reliable and valid measure of life satisfaction

Elevated symptoms of depression and anxiety among family members and friends of critically ill COVID-19 patients – an observational study of five cohorts across four countries

Background: Little is known regarding the mental health impact of having a significant person (family member and/or close friend) with COVID-19 of different severity.Methods: The study included five prospective cohorts from four countries (Iceland, Norway, Sweden, and the UK) with self-reported data on COVID-19 and symptoms of depression and anxiety during March 2020–March 2022. We calculated prevalence ratios (PR) of depression and anxiety in relation to having a significant person with COVID-19 and performed a longitudinal analysis in the Swedish cohort to describe temporal patterns.Findings: 162,237 and 168,783 individuals were included in the analysis of depression and anxiety, respectively, of whom 24,718 and 27,003 reported a significant person with COVID-19. Overall, the PR was 1.07 (95% CI: 1.05–1.10) for depression and 1.08 (95% CI: 1.03–1.13) for anxiety in relation to having a significant person with COVID-19. The respective PRs for depression and anxiety were 1.15 (95% CI: 1.08–1.23) and 1.24 (95% CI: 1.14–1.34) if the patient was hospitalized, 1.42 (95% CI: 1.27–1.57) and 1.45 (95% CI: 1.31–1.60) if the patient was ICU-admitted, and 1.34 (95% CI: 1.22–1.46) and 1.36 (95% CI: 1.22–1.51) if the patient died. Individuals with a significant person with hospitalized, ICU-admitted, or fatal COVID-19 showed elevated prevalence of depression and anxiety during the entire year after the COVID-19 diagnosis.Interpretation: Family members and close friends of critically ill COVID-19 patients show persistently elevated prevalence of depressive and anxiety symptoms

Cohort Profile: COVIDMENT: COVID-19 cohorts on mental health across six nations

Key features • COVIDMENT [www.covidment.is] is a NordForsk-funded research collaboration across six nations, with the overarching aim to significantly advance current knowledge on mental morbidity trajectories associated with the coronavirus disease 2019 (COVID-19) in the general population and in specific risk groups. • From March 2020 through August 2021, 392 817 individuals have been recruited to the seven COVIDMENT cohorts: the Danish Blood Donor Study (N ¼ 71 562), the Estonian Biobank COVID-19 and Mental Health Data Collection cohorts (N ¼ 13 329 and N ¼ 86 116, respectively), the Icelandic COVID-19 National Resilience Cohort (N ¼ 22 849), the Norwegian BRY.DEG2020 (N ¼ 19 343), the Norwegian Mother, Father and Child Cohort Study (N ¼ 132 486), the Scottish Generation Scotland/CovidLife (N ¼ 18 518) and the Swedish Omtanke2020 (N ¼ 28 614). Semi-harmonized questionnaire data have been collected across all COVIDMENT cohorts with longitudinal data available, e.g. through linkage to the national registers. • The average age of participants ranged from 31.8 to 58.5 years across cohorts. The prevalence of depressive symptoms above cut-off point varied considerably across cohorts (4.2–20.8%). The prevalence of depressive symptoms was highest at COVID-19 incidence of 30 cases per week per 100 000 persons, i.e. 14.3% [95% confidence interval (CI): 9.4–21.8%], which was 61.0% (95% CI: 34.0–94.1%) higher than the prevalence at COVID-19 incidence of 0 cases per week per 100 000 persons (P ¼ 1.1 x 10 ^( 6)).