THE EFFECT OF COVID-19 OUTBREAK AND VACCINATION ON SLEEP QUALITY, SLEEP CHRONOTYPE (MORNINGNESS-EVENINGNESS), DEPRESSION, ANXIETY AND STRESS; A CROSS-SECTIONAL STUDY AMONG ISFAHANI RESIDENTS

Abstract

Background. Havebeen reports suggesting physical or psychological complications associated with for anti-COVID-19 vaccination. We aimed to investigate the effect of COVID-19 infection and vaccination on sleep quality, chronotype, depression, anxiety, and stress among Isfahani population. Materials and methods. 2000 adult residents (aged >= 18 years) were enrolled between January 10 to Sep-tember 10, 2022. The participants completed three questionnaires: the Pittsburgh Sleep Quality Index Questionnaire, the Reduced Morningness-Eveningness Questionnaire, and the Depression, Anxiety and Stress Scale-21 items, in addition to demographics (age and gender), history of COVID-19 (severity and management), and vaccination. The questionnaire scores were calculated and compared between the groups with and without COVID-19 infection, based on vaccination status and disease severity using IBM SPSS Statistics (version 25). Results. The mean age of participants was 33.04 +/- 10.52 years; and most were female (61.65). A history of COVID-19 was positive in 926 individuals (186 with inpatient and 740 with outpatient management), and negative in the remaining participants (N=1074). Patients with COVID-19 had a greater Pittsburgh Sleep Quality Index score (P=0.024) with significant difference based on the severity of COVID-19 (P<0.001). Anxiety severity was different between patients with and without COVID-19 (P=0.001). Among all participants, 144 were unvaccinated for COVID-19, 191 had received one dose, and 1665 had completed immunization (two doses). Those who received two doses had a lower mean score on the Reduced Morningness-Eveningness Questionnaire, compared to unvaccinated and one-dose participants, and lower mean depression and anxiety scores, compared to the one-dose group (P<0.05). Chronotype and severity of depression and anxiety differed significantly by vaccination status (P<0.001). Conclusion. COVID-19 infection and vaccination may affect sleep quality and anxiety levels. Therefore, strategies for managing sleep hygiene and improving sleep quality during COVID-19 rehabilitation are recommended, along with raising physicians' awareness for the proper diagnosis and treatment of these complications.with raising physicians' awareness for the proper diagnosis and treatment of these complications.