COVID-19 and Sleep in Medical Staff: Reflections, Clinical Evidences, and Perspectives

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Reflections from the COVID Pandemic (A Iranzo and M Rosenfeld, Section Editors)

COVID-19 and Sleep in Medical Staff: Reflections, Clinical Evidences, and Perspectives Luigi Ferini-Strambi, MD, PhD1,2,* Marco Zucconi, MD2 Francesca Casoni, MD2 Maria Salsone, MD2,3 Address 1 Vita-Salute San Raffaele University, Milan, Italy *,2 Sleep Disorders Center, Division of Neuroscience, IRCCS San Raffaele Hospital, Milan, Italy Email: [email protected] 3 Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy

* Springer Science+Business Media, LLC, part of Springer Nature 2020

This article is part of the Topical Collection on Reflections from the COVID Pandemic Keywords COVID-19 pandemic I Sleep quality I Actigraphy I Healthcare workers/medical staff

Abstract Purpose of the review There is evidence that, before the coronavirus pandemic 2019 (COVID-19), healthcare workers did not experience good sleep quality with relevant consequences on health. By contrast, little is known about the sleep quality of medical staff during the COVID-19 pandemic. In this review, we aimed to contribute with a review of the literature, sharing our clinical experience supported by actigraphic evaluation and by proposing future strategies. Recent findings Sleep disorders, in particular insomnia, have been commonly reported in frontline medical workers, in hospitals during the COVID-19 pandemic and are often accompanied by depressive and anxiety symptoms. Sleep quality, however, has been mainly assessed by the use of self-reported measures, thus limiting clinical usefulness. Summary Poor sleep quality among the medical staff is prevalent, and our experience supports that this has increased during the COVID-19 pandemic. A longitudinal investigation assessing whether and for how long sleep remains altered in medical staff could be of interest to evaluate the temporal effect of the pandemic on health.

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Curr Treat Options Neurol

(2020) 22:29

The state of the art In the weeks of May 2020, during which this report was written, the COVID-19 pandemic in Lombardia, Italy, was subsiding and likely entering a novel phase. Starting February 20, the day on which the first case of SARSCov-2 infection-related severe acute respiratory syndrome (COVID-19) was diagnosed in an Italian citizen in Codogno, the pandemic has had severe and profound effects on all aspects of our life including mental and physical health. Considering the clinical relevance that good sleep quality has on our health even perhaps importantly among healthcare workers, we would like to contribute with an accurate review of the literature, sharing our clinical experience and proposing future strategies. The COVID-19 pandemic raises some fundamental questions: (1) what was the impact of COVID-19 infection on the sleep quality of medical staff, and (2) what are the effects of impaired sleep on the mental and physical health of medical staff? Although the COVID19 pandemic is described as changing the world, in some cases, it has li