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dc.contributor.authorUdeh-Momoh, Chinedu T,en_US
dc.contributor.authorWatermeyer, Tamlynen_US
dc.contributor.authorSindi, Shireenen_US
dc.contributor.authorGiannakopoulou, Partheniaen_US
dc.contributor.authorRobb, Catherine E.en_US
dc.contributor.authorAhmadi-Abhari, Saraen_US
dc.contributor.authorZheng, Bangen_US
dc.contributor.authorWaheed, Aminaen_US
dc.contributor.authorMcKeand, Jamesen_US
dc.contributor.authorSalman, Daviden_US
dc.contributor.authorBeaney, Thomasen_US
dc.contributor.authorde Jager Loots, Celeste A.en_US
dc.contributor.authorPrice, Gerainten_US
dc.contributor.authorAtchison, Christinaen_US
dc.contributor.authorCar, Josipen_US
dc.contributor.authorMajeed, Azeemen_US
dc.contributor.authorMcGregor, Alison H.en_US
dc.contributor.authorKivipelto, Miiaen_US
dc.contributor.authorWard, Helenen_US
dc.contributor.authorMiddleton, Lefkos T.en_US
dc.identifier.citationUdeh-Momoh, C. T., Watermeyer, T., Sindi, S., Giannakopoulou, P., Robb, C. E., Ahmadi-Abhari, S., Zheng, B., Waheed, A., McKeand, J., Salman, D., Beaney, T., de Jager Loots, C. A., Price, G., Atchison, C., Car, J., Majeed, A., McGregor, A. H., Kivipelto, M., Ward, H. & Middleton, L. T. (2021). Health, lifestyle, and psycho-social determinants of poor sleep quality during the early phase of the COVID-19 pandemic : a focus on UK older adults deemed clinically extremely vulnerable. Frontiers in Public Health, 9, 753964-.
dc.description.abstractBackground: Several studies have assessed the impact of COVID-19-related lockdowns on sleep quality across global populations. However, no study to date has specifically assessed at-risk populations, particularly those at highest risk of complications from coronavirus infection deemed "clinically-extremely-vulnerable-(COVID-19CEV)" (as defined by Public Health England). Methods: In this cross-sectional study, we surveyed 5,558 adults aged ≥50 years (of whom 523 met criteria for COVID-19CEV) during the first pandemic wave that resulted in a nationwide-lockdown (April-June 2020) with assessments of sleep quality (an adapted sleep scale that captured multiple sleep indices before and during the lockdown), health/medical, lifestyle, psychosocial and socio-demographic factors. We examined associations between these variables and sleep quality; and explored interactions of COVID-19CEV status with significant predictors of poor sleep, to identify potential moderating factors. Results: Thirty-seven percent of participants reported poor sleep quality which was associated with younger age, female sex and multimorbidity. Significant associations with poor sleep included health/medical factors: COVID-19CEV status, higher BMI, arthritis, pulmonary disease, and mental health disorders; and the following lifestyle and psychosocial factors: living alone, higher alcohol consumption, an unhealthy diet and higher depressive and anxiety symptoms. Moderators of the negative relationship between COVID-19CEV status and good sleep quality were marital status, loneliness, anxiety and diet. Within this subgroup, less anxious and less lonely males, as well as females with healthier diets, reported better sleep. Conclusions: Sleep quality in older adults was compromised during the sudden unprecedented nation-wide lockdown due to distinct modifiable factors. An important contribution of our study is the assessment of a "clinically-extremely-vulnerable" population and the sex differences identified within this group. Male and female older adults deemed COVID-19CEV may benefit from targeted mental health and dietary interventions, respectively. This work extends the available evidence on the notable impact of lack of social interactions during the COVID-19 pandemic on sleep, and provides recommendations toward areas for future work, including research into vulnerability factors impacting sleep disruption and COVID-19-related complications. Study results may inform tailored interventions targeted at modifiable risk factors to promote optimal sleep; additionally, providing empirical data to support health policy development in this area.en_US
dc.relation.ispartofFrontiers in Public Healthen_US
dc.rights© 2021 Udeh-Momoh, Watermeyer, Sindi, Giannakopoulou, Robb, Ahmadi-Abhari, Zheng, Waheed, McKeand, Salman, Beaney, de Jager Loots, Price, Atchison, Car, Majeed, McGregor, Kivipelto, Ward and Middleton. This is an openaccess article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.en_US
dc.titleHealth, lifestyle, and psycho-social determinants of poor sleep quality during the early phase of the COVID-19 pandemic : a focus on UK older adults deemed clinically extremely vulnerableen_US
dc.typeJournal Articleen
dc.contributor.schoolLee Kong Chian School of Medicine (LKCMedicine)en_US
dc.contributor.researchCentre for Population Health Sciencesen_US
dc.description.versionPublished versionen_US
dc.subject.keywordsSleep Qualityen_US
dc.subject.keywordsCOVID-19 Lockdownen_US
dc.description.acknowledgementThis study was sponsored by Imperial College London and partly funded by the Imperial College Healthcare Trust, NIHR Biomedical Research Centre.en_US
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