{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:40:39Z","timestamp":1762508439945,"version":"build-2065373602"},"reference-count":61,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,3,28]],"date-time":"2021-03-28T00:00:00Z","timestamp":1616889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Objective: The aim of this study was to evaluate sleep and awakening quality (SQ and AQ) during COVID-19 in a large and diversified population in order to identify significant associations and risks in terms of demography, health and health-related behaviors, sleep variables, mental health, and attitudes. Methods\/Results:Online surveys were used for data collection, received from 5479 individuals from the general population, sleep disorder patients, and COVID-involved (medical doctors (MDs) and nurses) and COVID-affected professionals (teachers, psychologists, and dentists). SQ and AQ were worse in adults, females, and high-education subjects. Feeling worse, having economic problems, depression, anxiety, irritability, and a high Calamity Experience Check List (CECL) score during COVID were significantly associated with poor SQ and AQ. Shorter sleep duration, increased latency, poor nutrition, low physical activity, increased mobile and social network use, more negative and less positive attitudes and behaviors were associated with poor AQ. Conclusions: The SQ logistic regression showed gender, morbidities, CECL, and awakenings as relevant, whereas, for AQ, relevant variables further included age and physical activity. Aiming to have a high stress compliance, each individual should sleep well, have important control of their mood, practice positive behaviors while dismissing negative behaviors and attitudes, practice exercise, have adequate nutrition, and beware of technologies and dependences.<\/jats:p>","DOI":"10.3390\/ijerph18073506","type":"journal-article","created":{"date-parts":[[2021,3,28]],"date-time":"2021-03-28T22:09:01Z","timestamp":1616969341000},"page":"3506","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Sleep and Awakening Quality during COVID-19 Confinement: Complexity and Relevance for Health and Behavior"],"prefix":"10.3390","volume":"18","author":[{"given":"Teresa","family":"Paiva","sequence":"first","affiliation":[{"name":"Sleep Medicine Center\u2014CENC, 1070-068 Lisbon, Portugal"},{"name":"Instituto de Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-026 Lisbon, Portugal"},{"name":"Comprehensive Health Research Center (CHRC), Nova Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6585-3993","authenticated-orcid":false,"given":"C\u00e1tia","family":"Reis","sequence":"additional","affiliation":[{"name":"Sleep Medicine Center\u2014CENC, 1070-068 Lisbon, Portugal"},{"name":"Instituto de Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-026 Lisbon, Portugal"},{"name":"Faculdade de Medicina de Lisboa, Instituto de Medicina Molecular Jo\u00e3o Lobo Antunes (IMM), 1649-028 Lisbon, Portugal"},{"name":"Cat\u00f3lica Research Centre for Psychological Family and Social Wellbeing (CRC-W), Catholic University, 1649-023 Lisbon, Portugal"}]},{"given":"Am\u00e9lia","family":"Feliciano","sequence":"additional","affiliation":[{"name":"Sleep Medicine Center\u2014CENC, 1070-068 Lisbon, Portugal"},{"name":"Comprehensive Health Research Center (CHRC), Nova Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"},{"name":"Cl\u00ednica Lus\u00edadas de Almada\/Parque das Na\u00e7\u00f5es-Lisboa 2810-500, 1990-095 Almada, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8100-8589","authenticated-orcid":false,"given":"Hugo","family":"Canas-Simi\u00e3o","sequence":"additional","affiliation":[{"name":"Sleep Medicine Center\u2014CENC, 1070-068 Lisbon, Portugal"},{"name":"Comprehensive Health Research Center (CHRC), Nova Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"},{"name":"Psychiatry and Mental Health Department\u2014Centro Hospitalar de Lisboa Ocidental (CHLO), 1349-019 Lisbon, Portugal"}]},{"given":"Maria Augusta","family":"Machado","sequence":"additional","affiliation":[{"name":"Departamento de Medicina, Servi\u00e7o de Pneumologia, Centro Hospitalar P\u00f3voa de Varzim\/Vila do Conde, 4490-421 P\u00f3voa do Varzim, 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Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-026 Lisbon, Portugal"},{"name":"Faculty Human Kynetics, Universidade de Lisboa, 1495-751 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8170-3119","authenticated-orcid":false,"given":"Maria Raquel","family":"Silva","sequence":"additional","affiliation":[{"name":"Comprehensive Health Research Center (CHRC), Nova Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"},{"name":"Faculty of Health Sciences\/Higher School of Health, University Fernando Pessoa\/Funda\u00e7\u00e3o Fernando Pessoa, 4200-150 Porto, Portugal"}]},{"given":"L\u00facia","family":"Ramiro","sequence":"additional","affiliation":[{"name":"Instituto de Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-026 Lisbon, Portugal"},{"name":"Escola Secund\u00e1ria Poeta Al Berto, 7520-902 Sines, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0494-6771","authenticated-orcid":false,"given":"Susana","family":"Gaspar","sequence":"additional","affiliation":[{"name":"Instituto de Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-026 Lisbon, Portugal"},{"name":"Escola Superior de Sa\u00fade Atl\u00e2ntica, Universidade Atl\u00e2ntica, 2730-036 Barcarena, Portugal"}]},{"given":"Carla","family":"Bentes","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina de Lisboa, Instituto de Medicina Molecular Jo\u00e3o Lobo Antunes (IMM), 1649-028 Lisbon, Portugal"},{"name":"Department of Neurology, CHULN\u2014Centro Hospitalar Universit\u00e1rio Lisboa Norte, 1649-028 Lisbon, Portugal"},{"name":"Neurology and Dental Medicine, Hospital da Luz, 1500-065 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9245-256X","authenticated-orcid":false,"given":"Francisco","family":"Sampaio","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences\/Higher School of Health, University Fernando Pessoa\/Funda\u00e7\u00e3o Fernando Pessoa, 4200-150 Porto, Portugal"},{"name":"Innovation &amp; Development in Nursing research group, CINTESIS\u2014Center for Health Technology and Services Research, 4200-450 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1174-0744","authenticated-orcid":false,"given":"Lara","family":"Pinho","sequence":"additional","affiliation":[{"name":"Comprehensive Health Research Center (CHRC), Nova Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"},{"name":"Nursing Department, Escola Superior de Enfermagem S. Jo\u00e3o de Deus (ESESJD), University \u00c9vora, 7000-811 \u00c9vora, Portugal"}]},{"given":"Concei\u00e7\u00e3o","family":"Pereira","sequence":"additional","affiliation":[{"name":"Instituto de Sono e Medicina Dent\u00e1ria (ISMD), 9000-098 Funchal, Portugal"}]},{"given":"Alexandra","family":"Carreiro","sequence":"additional","affiliation":[{"name":"Unidade do Sono, Hospital do Divino Esp\u00edrito Santo de Ponta Delgada, 9500-370 Ponta Delgada, Portugal"}]},{"given":"Susana","family":"Moreira","sequence":"additional","affiliation":[{"name":"Pneumologia, Hospital dos Lus\u00edadas, 1500-458 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8610-194X","authenticated-orcid":false,"given":"Isabel","family":"Luzeiro","sequence":"additional","affiliation":[{"name":"Centro Medicina Sono e Servi\u00e7o Neurologia e Neurofisiologia, Hospital CUF Coimbra, 3000-600 Coimbra, Portugal"},{"name":"Servi\u00e7o Neurologia e Neurofisiologia, Hospital CUF Coimbra, 3000-600 Coimbra, Portugal"},{"name":"Escola Superior de Tecnologia da Sa\u00fade de Coimbra, 3046-854 Coimbra, Portugal"}]},{"given":"Joana","family":"Pimentel","sequence":"additional","affiliation":[{"name":"Sleep Medicine Center\u2014CENC, 1070-068 Lisbon, Portugal"},{"name":"Pneumologia, Hospital de Vila Franca de Xira, 2600-009 Vila Franca de Xira, Portugal"}]},{"given":"Gabriela","family":"Videira","sequence":"additional","affiliation":[{"name":"Neurology and Dental Medicine, Hospital da Luz, 1500-065 Lisbon, Portugal"}]},{"given":"J\u00falio","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Orisclinic\u2014Centro Integrado de Medicina Dent\u00e1ria de Coimbra, 3030 Coimbra, Portugal"}]},{"given":"Ana","family":"Bernarda","sequence":"additional","affiliation":[{"name":"Linde Sa\u00fade\u2014Homecare, Linde Sa\u00fade, 1800-217 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7937-7342","authenticated-orcid":false,"given":"Joana","family":"Vaz Castro","sequence":"additional","affiliation":[{"name":"Sleep Medicine Center\u2014CENC, 1070-068 Lisbon, Portugal"},{"name":"Comprehensive Health Research Center (CHRC), Nova Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3372-8316","authenticated-orcid":false,"given":"Sofia","family":"Rebocho","sequence":"additional","affiliation":[{"name":"Sleep Medicine Center\u2014CENC, 1070-068 Lisbon, Portugal"}]},{"given":"Katie","family":"Almondes","sequence":"additional","affiliation":[{"name":"UFRN\u2014AMBSONO Sleep Clinic, Department Psychology, Federal University Rio Grande do Norte, Natal 59030-180, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1894-4870","authenticated-orcid":false,"given":"Helena","family":"Canh\u00e3o","sequence":"additional","affiliation":[{"name":"Comprehensive Health Research Center (CHRC), Nova Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"}]},{"given":"Margarida Gaspar","family":"Matos","sequence":"additional","affiliation":[{"name":"Instituto de Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-026 Lisbon, Portugal"},{"name":"Faculty Human Kynetics, Universidade de Lisboa, 1495-751 Lisboa, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"654","DOI":"10.17269\/s41997-020-00382-7","article-title":"Sleep and circadian rhythm in response to the COVID-19 pandemic","volume":"111","author":"Morin","year":"2020","journal-title":"Canad. J. Public Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.bbi.2020.03.025","article-title":"Using psychoneuroimmunity against COVID-19","volume":"87","author":"Kim","year":"2020","journal-title":"Brain Behav. Immun."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.smrv.2015.01.009","article-title":"The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis","volume":"25","author":"Mollayeva","year":"2016","journal-title":"Sleep Med. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/0895-4356(88)90138-2","article-title":"A scale for the estimation of sleep problems in clinical research","volume":"41","author":"Jenkins","year":"1988","journal-title":"J. Clin. Epidemiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.sleep.2004.07.006","article-title":"Psychometric properties of the Medical Outcomes Study Sleep measure","volume":"6","author":"Hays","year":"2005","journal-title":"Sleep Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S1389-9457(00)00065-4","article-title":"Validation of the Insomnia Severity Index as an outcome measure for insomnia research","volume":"2","author":"Bastien","year":"2001","journal-title":"Sleep Med."},{"key":"ref_7","unstructured":"Paiva, T., and Penzel, T. (2011). Centro de Medicina do Sono: Manual Pr\u00e1tico, Lidel."},{"key":"ref_8","first-page":"169","article-title":"Erste klinische Erfahrungen mit einem neuen schlafansto\u00dfenden Benzodiazepin, Cinolazepam, mittels eines Selbstbeurteilungsbogens f\u00fcr Schlaf-und Aufwachqualit\u00e4t (SSA)","volume":"1","author":"Saletu","year":"1987","journal-title":"Neuropsychiatrie"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.biopsycho.2013.05.014","article-title":"In search of objective components for sleep quality indexing in normal sleep","volume":"94","author":"Rosipal","year":"2013","journal-title":"Biol. Psychol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.sleh.2016.11.006","article-title":"National Sleep Foundation\u2019s sleep quality recommendations: First report","volume":"3","author":"Ohayon","year":"2017","journal-title":"Sleep Health"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Trakada, A., Nikolaidis, P.T., Andrade, M., Puccinelli, P.J., Economou, N.T., Steiropoulos, P., Knechtle, B., and Trakada, G. (2020). Sleep During \u201cLockdown\u201d in the COVID-19 Pandemic. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17239094"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Zhou, Y., Yang, Y., Shi, T., Song, Y., Zhou, Y., Zhang, Z., Guo, Y., Li, X., Liu, Y., and Xu, G. (2020). Prevalence and Demographic Correlates of Poor Sleep Quality Among Frontline Health Professionals in Liaoning Province, China During the COVID-19 Outbreak. Front. Psychiatry, 11, Available online: https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2020.00520\/full.","DOI":"10.3389\/fpsyt.2020.00520"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Franceschini, C., Musetti, A., Zenesini, C., Palagini, L., Scarpelli, S., Quattropani, M.C., Lenzo, V., Freda, M.F., Lemmo, D., and Vegni, E. (2020). Poor Sleep Quality and Its Consequences on Mental Health During the COVID-19 Lockdown in Italy. Front. Psychol., 11, Available online: https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2020.574475\/full?&utm_source=Email_to_authors_&utm_medium=Email&utm_content=T1_11.5e1_author&utm_campaign=Email_publication&field=&journalName=Frontiers_in_Psychology&id=574475.","DOI":"10.3389\/fpsyg.2020.574475"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.sleep.2020.05.011","article-title":"The enemy who sealed the world: Effects quarantine due to the COVID-19 on sleep quality, anxiety, and psychological distress in the Italian population","volume":"75","author":"Casagrande","year":"2020","journal-title":"Sleep Med."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Wang, X., Lei, S.M., Le, S., Yang, Y., Zhang, B., Yao, W., Gao, Z., and Cheng, S. (2020). Bidirectional Influence of the COVID-19 Pandemic Lockdowns on Health Behaviors and Quality of Life among Chinese Adults. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17155575"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"114463","DOI":"10.1016\/j.bcp.2021.114463","article-title":"Sleep during COVID-19 lockdown: A cross-cultural study investigating job system relevance","volume":"10","author":"Florea","year":"2021","journal-title":"Biochem. Pharmacol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"217","DOI":"10.5935\/1984-0063.20180036","article-title":"Sleep duration, lifestyles and chronic diseases: A cross-sectional population-based study","volume":"11","author":"Reis","year":"2018","journal-title":"Sleep Sci."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Xiao, H., Zhang, Y., Kong, D., Li, S., and Yang, N. (2020). Social Capital and Sleep Quality in Individuals Who Self-Isolated for 14 Days During the Coronavirus Disease 2019 (COVID-19) Outbreak in January 2020 in China. Med. Sci. Monit., 26, Available online: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7177038\/.","DOI":"10.12659\/MSM.923921"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"112954","DOI":"10.1016\/j.psychres.2020.112954","article-title":"Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: A web-based cross-sectional survey","volume":"288","author":"Huang","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.sleep.2020.07.045","article-title":"Sleep quality and mental health in the context of COVID-19 pandemic and lockdown in Morocco","volume":"74","author":"Idrissi","year":"2020","journal-title":"Sleep Med."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Marelli, S., Castelnuovo, A., Somma, A., Castronovo, V., Mombelli, S., Bottoni, D., Leitner, C., Fossati, A., and Ferini-Strambi, L. (2020). Impact of COVID-19 lockdown on sleep quality in university students and administration staff. J. Neurol., Available online: https:\/\/link.springer.com\/article\/10.1007\/s00415-020-10056-6.","DOI":"10.1007\/s00415-020-10056-6"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1038\/s41398-020-00913-3","article-title":"Psychological health, sleep quality, and coping styles to stress facing the COVID-19 in Wuhan, China","volume":"10","author":"Fu","year":"2020","journal-title":"Transl. Psychiatry"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/s13293-020-00333-4","article-title":"Sex differences in self-report anxiety and sleep quality during COVID-19 stay-at-home orders","volume":"11","author":"Bigalke","year":"2020","journal-title":"Biol. Sex. Differ."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.sleep.2020.06.034","article-title":"Prevalence and associated factors of poor sleep quality among Chinese returning workers during the COVID-19 pandemic","volume":"73","author":"Yang","year":"2020","journal-title":"Sleep Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jocn.2020.07.073","article-title":"The anxiety levels, quality of sleep and life and problem-solving skills in healthcare workers employed in COVID-19 services","volume":"80","author":"Korkmaz","year":"2020","journal-title":"J. Clin Neurosci"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.sleep.2020.09.021","article-title":"The mediation role of sleep quality in the association between the incidence of unhealthy movement behaviors during the COVID-19 quarantine and mental health","volume":"76","author":"Werneck","year":"2020","journal-title":"Sleep Med."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Wang, W., Song, W., Xia, Z., He, Y., Tang, L., Hou, J., and Lei, S. (2020). Sleep Disturbance and Psychological Profiles of Medical Staff and Non-Medical Staff During the Early Outbreak of COVID-19 in Hubei Province, China. Front. Psychiatry, 11, Available online: https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2020.00733\/full.","DOI":"10.3389\/fpsyt.2020.00733"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"370","DOI":"10.4103\/psychiatry.IndianJPsychiatry_523_20","article-title":"Changes in sleep pattern and sleep quality during COVID-19 lockdown","volume":"62","author":"Gupta","year":"2020","journal-title":"Indian J. Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.jcbs.2020.07.001","article-title":"Mediators of the association between COVID-19-related stressors and parents\u2019 psychological flexibility and inflexibility: The roles of perceived sleep quality and energy","volume":"17","author":"Peltz","year":"2020","journal-title":"J. Contextual. Behav. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Ingram, J., Maciejewski, G., and Hand, C.J. (2020). Changes in Diet, Sleep, and Physical Activity Are Associated With Differences in Negative Mood during COVID-19 Lockdown. Front. Psychol., 11.","DOI":"10.3389\/fpsyg.2020.588604"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Targa, A.D.S., Ben\u00edtez, I.D., Moncus\u00ed-Moix, A., Arguimbau, M., de Batlle, J., Dalmases, M., and Barb\u00e9, F. (2020). Decrease in sleep quality during COVID-19 outbreak. Sleep Breath, Available online: https:\/\/link.springer.com\/article\/10.1007\/s11325-020-02202-1.","DOI":"10.21203\/rs.3.rs-82381\/v1"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"110371","DOI":"10.1016\/j.paid.2020.110371","article-title":"COVID-19 related loneliness and sleep problems in older adults: Worries and resilience as potential moderators","volume":"168","author":"Grossman","year":"2021","journal-title":"Pers. Individ. Dif."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.2147\/NSS.S280892","article-title":"Influence of Confinement by COVID-19 on the Quality of Sleep and the Interests of University Students","volume":"12","year":"2020","journal-title":"Nat. Sci. Sleep"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Jahrami, H., BaHammam, A.S., AlGahtani, H., Ebrahim, A., Faris, M., AlEid, K., Saif, Z., Haji, E., Dhahi, A., and Marzooq, H. (2020). The examination of sleep quality for frontline healthcare workers during the outbreak of COVID-19. Sleep Breath.","DOI":"10.1007\/s11325-020-02135-9"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Stojanov, J., Malobabic, M., Stanojevic, G., Stevic, M., Milosevic, V., and Stojanov, A. (2020). Quality of sleep and health-related quality of life among health care professionals treating patients with coronavirus disease-19. Int. J. Soc. Psychiatry, 002076402094280. Available online: https:\/\/journals.sagepub.com\/doi\/full\/10.1177\/0020764020942800.","DOI":"10.1177\/0020764020942800"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.sleep.2020.05.023","article-title":"The evaluation of sleep disturbances for Chinese frontline medical workers under the outbreak of COVID-19","volume":"72","author":"Qi","year":"2020","journal-title":"Sleep Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1186\/s12967-020-02465-y","article-title":"Does Sars-Cov-2 threaten our dreams? Effect of quarantine on sleep quality and body mass index","volume":"18","author":"Barrea","year":"2020","journal-title":"J. Transl. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.sleep.2020.09.029","article-title":"Sleep quality during the COVID-19 pandemic: Not one size fits all","volume":"76","author":"Kocevska","year":"2020","journal-title":"Sleep Med."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Ohayon, M.M. (2004). Prevalence and Risk Factors of Morning Headaches in the General Population. Arch. Intern. Med., 164\u2013197.","DOI":"10.1001\/archinte.164.1.97"},{"key":"ref_40","first-page":"654","article-title":"D\u00e9finitions et \u00e9pid\u00e9miologie de L\u2019hypersomnolence. La plainte \u201csomnolence excessive\u201d concerne un quart de la population","volume":"66","author":"Ohayon","year":"2016","journal-title":"La Revue Du Prat."},{"key":"ref_41","unstructured":"Greg\u00f3rio, M.J., Santos, C.T., Ferreira, S., and Gra\u00e7a, P. (2012). Alimenta\u00e7\u00e3o Inteligente\u2014Coma Melhor, Poupe Mais, Dire\u00e7\u00e3o-Geral da Sa\u00fade."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/BF03173600","article-title":"Anxiety, depression, and peer relationships during adolescence: Results from the Portuguese national MG health behaviour in school-aged children survey","volume":"18","author":"Barrett","year":"2003","journal-title":"Eur. J. Psychol. Educ."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e13206","DOI":"10.1111\/jsr.13206","article-title":"ICOSS-collaboration group. Sleep and circadian problems during the coronavirus disease 2019 (COVID-19) pandemic: The International COVID-19 Sleep Study (ICOSS)","volume":"30","author":"Partinen","year":"2021","journal-title":"J Sleep Res."},{"key":"ref_44","unstructured":"Quah Stella, R. (2017). Measurement and Valuation of Health for Economic Evaluation. International Encyclopedia of Public Health, Academic Press. [2nd ed.]."},{"key":"ref_45","first-page":"308","article-title":"Errors in sleep duration perception in insomniac patient","volume":"25","author":"Mestre","year":"2016","journal-title":"J. Sleep Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e5172","DOI":"10.7717\/peerj.5172","article-title":"Exercise can improve sleep quality: A systematic review and meta-analysis","volume":"6","author":"Banno","year":"2018","journal-title":"PeerJ"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"4855","DOI":"10.1038\/s41598-020-61627-6","article-title":"The relationship between subjective sleep quality and cognitive performance in healthy young adults: Evidence from three empirical studies","volume":"10","author":"Zavecz","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_48","first-page":"1","article-title":"Resilience and the Role of Depressed and Anxious Mood in the Relationship between Perceived Social Isolation and Perceived Sleep Quality During the COVID-19 Pandemic","volume":"7","author":"DeAngelis","year":"2021","journal-title":"Int. J. Behav. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1038\/s41398-020-00982-4","article-title":"Resilience, COVID-19-related stress, anxiety and depression during the pandemic in a large population enriched for healthcare providers","volume":"10","author":"Barzilay","year":"2020","journal-title":"Transl. Psychiatry"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Putilov, A.A. (2017). Age-related changes in the association of sleep satisfaction with sleep quality and sleep\u2013wake pattern. Sleep Biol. Rhythms., Available online: https:\/\/link.springer.com\/article\/10.1007\/s41105-017-0140-8.","DOI":"10.1007\/s41105-017-0140-8"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"138","DOI":"10.3121\/cmr.2016.1338","article-title":"Exploring Gender Difference in Sleep Quality of Young Adults: Findings from a Large Population Study","volume":"14","author":"Fatima","year":"2016","journal-title":"Clin. Med. Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"43690","DOI":"10.1038\/srep43690","article-title":"Gender and Regional Differences in Sleep Quality and Insomnia: A General Population-based Study in Hunan Province of China","volume":"7","author":"Tang","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1089\/jwh.2014.4816","article-title":"Exploring Sex and Gender Differences in Sleep Health: A Society for Women\u2019s Health Research Report","volume":"23","author":"Mallampalli","year":"2014","journal-title":"J. Womens Health"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"104853","DOI":"10.1016\/j.appet.2020.104853","article-title":"Obesity, eating behavior and physical activity during COVID-19 lockdown: A study of UK adults","volume":"156","author":"Robinson","year":"2021","journal-title":"Appetite"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"105002","DOI":"10.1016\/j.appet.2020.105002","article-title":"Eating behavior and food purchases during the COVID-19 lockdown: A cross-sectional study among adults in the Netherlands","volume":"157","author":"Poelman","year":"2021","journal-title":"Appetite"},{"key":"ref_56","first-page":"1364387","article-title":"Interrelationship between Sleep and Exercise: A Systematic Review","volume":"2017","author":"Dolezal","year":"2017","journal-title":"Adv. Prev Med."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Culnan, E., Reid, K.J., Zee, P.C., Crowley, S.J., and Baron, K.G. (2021). Meal timing relative to DLMO: Associations with BMI and body fat. Sleep Health., 17, Available online: https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S2352721821000012.","DOI":"10.1016\/j.sleh.2021.01.001"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Azlan, A.A., Hamzah, M.R., Sern, T.J., Ayub, S.H., and Mohamad, E. (2020). Public knowledge, attitudes and practices towards COVID-19: A cross-sectional study in Malaysia. PLoS ONE, 15.","DOI":"10.1101\/2020.04.29.20085563"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Li, J., Yang, A., Dou, K., Wang, L., Zhang, M., and Lin, X. (2020). Chinese public\u2019s knowledge, perceived severity, and perceived controllability of COVID-19 and their associations with emotional and behavioural reactions, social participation, and precautionary behaviour: A national survey. BMC Public Health, 20.","DOI":"10.1186\/s12889-020-09695-1"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1080\/07420528.2020.1775241","article-title":"Is disruption of sleep quality a consequence of severe Covid-19 infection? A case-series examination","volume":"37","author":"Vitale","year":"2020","journal-title":"Chronobiol. Int."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Trimmel, K., Eder, H.G., B\u00f6ck, M., Stefanic-Kejik, A., Kl\u00f6sch, G., and Seidel, S. (2021). The (mis)perception of sleep: Factors influencing the discrepancy between self-reported and objective sleep parameters. J. Clin. Sleep Med., 33393901. Available online: https:\/\/jcsm.aasm.org\/doi\/10.5664\/jcsm.9086.","DOI":"10.5664\/jcsm.9086"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/7\/3506\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:25:26Z","timestamp":1760361926000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/7\/3506"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,28]]},"references-count":61,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["ijerph18073506"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18073506","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2021,3,28]]}}}