Sleep in a pandemic: Implications of COVID-19 for sleep through the lens of the 3P model of insomnia.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has fundamentally altered daily life across the globe, and the stress associated with these changes is likely to impact sleep. Sleep is critical for physical and mental health; thus, understanding the factors that may contribute to poor sleep during the pandemic represents a first step in identifying behavioral health targets for intervention efforts during and after the pandemic. This review first summarizes the developing research on sleep during the pandemic. The impact of the pandemic on sleep is then examined through the lens of the 3P model of insomnia by proposing pandemic-specific predisposing, precipitating, and perpetuating factors. The potential consequences of sleep disturbance on physical and mental health conditions most relevant to the pandemic are also reviewed. Finally, recommendations for reducing or eliminating pandemic-specific perpetuating factors are detailed, highlighting the potential utility of behavioral sleep medicine interventions in the integration of behavioral health responses and public health initiatives during and after the pandemic. Public Significance Statement This article reviews the developing literature on the effects of the pandemic on sleep and highlights potential features of the pandemic that may predispose, precipitate, and perpetuate sleep disturbance. Sleep disturbance may contribute to poor physical and mental health outcomes during the pandemic, and interventions for healthy sleep should be integrated into behavioral and public health responses to the pandemic.