The COVID-19 pandemic has induced significant impairments, including sleep disturbances. The present study aimed to explore the impact of fear in relation to stress on sleep disorders among Italian adults and older participants in the second phase of the EPICOVID19 web-based survey (January-February 2021). Sleep disturbances during the pandemic were evaluated using the Jenkins Sleep Scale, perceived stress through the 10-item Perceived Stress Scale and fear of contagion and about economic and job situation with four ad hoc items. The strength of the pathways between stress, sleep disturbances and fear was explored using structural equation modelling, hypothesising that stress was related to sleep disturbances and that fear was associated with both stress and sleep problems. Out of 41,473 participants (74.7% women; mean age 49.7 ± 13.1 years), 8.1% reported sleep disturbances and were more frequently women, employed in a work category at risk of infection or unemployed, and showed higher deprivation scores. Considering an a priori hypotheses model defining sleep and stress scores as endogenous variables and fear as an exogenous variable, we found that fear was associated with sleep problems and stress, and stress was associated with sleep problems; almost half of the total impact of fear on sleep quality was mediated by stress. The impact of stress on sleep quality was more evident in the younger age group, among individuals with a lower socioeconomic status and healthcare workers. Fear related to COVID-19 seem to be associated with sleep disturbances directly and indirectly through stress.

中文翻译：

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COVID-19 大流行期间的睡眠障碍：基于网络的 EPICOVID19 研究第二阶段的结果

COVID-19 大流行造成了严重的损害，包括睡眠障碍。本研究旨在探讨 EPICOVID19 网络调查第二阶段（2021 年 1 月至 2 月）中与压力相关的恐惧对意大利成年人和老年参与者睡眠障碍的影响。使用詹金斯睡眠量表评估大流行期间的睡眠障碍，通过 10 项感知压力量表评估感知压力，并使用四个临时项目评估对传染和经济和工作状况的恐惧。使用结构方程模型探讨了压力、睡眠障碍和恐惧之间路径的强度，假设压力与睡眠障碍有关，而恐惧与压力和睡眠问题相关。在 41,473 名参与者中（74.7% 为女性；平均年龄 49.7 ± 13.1 岁），8.1% 的人报告睡眠障碍，其中女性更为常见，从事有感染风险或失业的工作类别，并表现出较高的剥夺得分。考虑到先验假设模型将睡眠和压力评分定义为内生变量，将恐惧定义为外生变量，我们发现恐惧与睡眠问题和压力相关，而压力与睡眠问题相关；恐惧对睡眠质量的总影响几乎有一半是由压力介导的。压力对睡眠质量的影响在较年轻的年龄组、社会经济地位较低的人和医护人员中更为明显。与 COVID-19 相关的恐惧似乎通过压力直接或间接与睡眠障碍相关。