BACKGROUND: During the pandemic, healthcare workers on social media are sharing their challenges, including sleep disturbances, however no study has evaluated sleep in US frontline healthcare workers during the COVID-19 pandemic .
OBJECTIVE: To assess sleep among US frontline healthcare workers with validated measures on social media .
METHODS: A self-selection survey was distributed on Facebook, Twitter, and Instagram for 16 days (August 31-September 15 , 2020) targeting healthcare workers (HCW) who were clinically active during the pandemic . Study participants completed the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and reported demographic/career information . Poor sleep quality was defined as PSQI> 5 . Moderate-to-severe insomnia was defined as an ISI> 14 . The mini-Z was used to measure burnout . Multivariate logistic regression tested associations between demographics, career characteristics, and sleep outcomes .
RESULTS: Nine-hundred and sixty-three surveys were completed . Participants were predominantly white (92.8 %), female (73.4 %), aged 30-49 (71.9 %), and physicians (64.4 %). Mean sleep duration was 6.1 (SD 1.2) hours . Nearly 90% reported poor sleep (PSQI). One third (33.0 %) reported moderate or severe insomnia . Many (60 %) experienced sleep disruptions due to device usage or had bad dreams at least once per week (45 %). Over 50% reported burnout . In multivariable logistic regressions, non-physician (OR 2.4; CI : 1.7 , 3.4), caring for COVID-19 patients (OR 1.8; CI 1.2 , 2.8), Hispanic ethnicity (OR 2.2; CI : 1.4 , 3.5), being female (OR 1.6; CI 1.1 , 2.4), and having a sleep disorder (OR 4.3; CI 2.7,6.9) were associated with increased odds of insomnia . In open-ended comments (n=310), poor sleep mapped to four categories: children and family, work demands, personal health, and pandemic-related sleep disturbances .
CONCLUSIONS: During the COVID-19 pandemic , 90% of US frontline healthcare workers surveyed on social media reported poor sleep, over one-third reported insomnia, and over half reported burnout . Many also reported sleep disruptions due to device usage and nightmares . Sleep interventions for frontline healthcare workers are urgently needed.