{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:02:10Z","timestamp":1782842530067,"version":"3.54.5"},"reference-count":42,"publisher":"JMIR Publications Inc.","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>During the COVID-19 pandemic, health care workers are sharing their challenges, including sleep disturbances, on social media; however, no study has evaluated sleep in predominantly US frontline health care workers during the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to assess sleep among a sample of predominantly US frontline health care workers during the COVID-19 pandemic using validated measures through a survey distributed on social media.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A self-selection survey was distributed on Facebook, Twitter, and Instagram for 16 days (August 31 to September 15, 2020), targeting health care workers who were clinically active during the COVID-19 pandemic. Study participants completed the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI), and they reported their demographic and career information. Poor sleep quality was defined as a PSQI score \u22655. Moderate-to-severe insomnia was defined as an ISI score &gt;14. The Mini-Z Burnout Survey was used to measure burnout. Multivariate logistic regression tested associations between demographics, career characteristics, and sleep outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 963 surveys were completed. Participants were predominantly White (894\/963, 92.8%), female (707\/963, 73.4%), aged 30-49 years (692\/963, 71.9%), and physicians (620\/963, 64.4%). Mean sleep duration was 6.1 hours (SD 1.2). Nearly 96% (920\/963, 95.5%) of participants reported poor sleep (PSQI). One-third (288\/963, 30%) reported moderate or severe insomnia. Many participants (554\/910, 60.9%) experienced sleep disruptions due to device use or had nightmares at least once per week (420\/929, 45.2%). Over 50% (525\/932, 56.3%) reported burnout. In multivariable logistic regressions, nonphysician (odds ratio [OR] 2.4, 95% CI 1.7-3.4), caring for patients with COVID-19 (OR 1.8, 95% CI 1.2-2.8), Hispanic ethnicity (OR 2.2, 95% CI 1.4-3.5), female sex (OR 1.6, 95% CI 1.1-2.4), and having a sleep disorder (OR 4.3, 95% CI 2.7-6.9) were associated with increased odds of insomnia. In open-ended comments (n=310), poor sleep was mapped to four categories: children and family, work demands, personal health, and pandemic-related sleep disturbances.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>During the COVID-19 pandemic, nearly all the frontline health care workers surveyed on social media reported poor sleep, over one-third reported insomnia, and over half reported burnout. Many also reported sleep disruptions due to device use and nightmares. Sleep interventions for frontline health care workers are urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/27331","type":"journal-article","created":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T19:28:33Z","timestamp":1618601313000},"page":"e27331","source":"Crossref","is-referenced-by-count":51,"title":["Sleep Disturbances in Frontline Health Care Workers During the COVID-19 Pandemic: Social Media Survey Study"],"prefix":"10.2196","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8964-9188","authenticated-orcid":false,"given":"Nancy H","family":"Stewart","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7952-6563","authenticated-orcid":false,"given":"Anya","family":"Koza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5733-4704","authenticated-orcid":false,"given":"Serena","family":"Dhaon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1289-7674","authenticated-orcid":false,"given":"Christiana","family":"Shoushtari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5218-5615","authenticated-orcid":false,"given":"Maylyn","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7172-5303","authenticated-orcid":false,"given":"Vineet M","family":"Arora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2021,5,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2020.05.035"},{"key":"ref2","unstructured":"CampbellLWeed and seven Benadryl: the wild lengths COVID docs are taking to get sleepDaily Beast202101032021-01-03https:\/\/www.thedailybeast.com\/weed-and-seven-benadryl-and-other-wild-lengths-covid-docs-are-taking-to-get-sleep"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.8808"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.17269\/s41997-020-00376-5"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.28111"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39469.763218.be"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2020.05.026"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1186\/s12992-020-00620-0"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.8624"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-020-02135-9"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2020.08.013"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.07.008"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1097\/00001888-200405000-00007"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa041404"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201504-0767ST"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2020.06.007"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"195","DOI":"10.4135\/9780857020055.n11","author":"Fricker, R","year":"2008","journal-title":"The SAGE Handbook of Online Research Methods"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(89)90047-4"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/34.5.601"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-016-3720-4"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1002\/smi.1002"},{"key":"ref24","unstructured":"R.E.S.T. 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