Poor sleep quality during COVID-19 pandemic restrictions associated with reduced psychological wellbeing in healthcare students

Sleep is inexorably linked to both physiological and psychological wellbeing. Restrictions imposed to control the COVID-19 pandemic likely impacted upon daily and weekly routines, which can have a negative impact on a range of factors including sleep quality, and/or quantity and general wellbeing. The aim of this study was to investigate the effect of COVID-19 related restrictions on sleep patterns and psychological wellbeing of healthcare students. A survey was delivered to healthcare students across three faculties at a single institution. Participants completed questionnaires on the effect of COVID-19 restrictions on course delivery and clinical placements, its effect on sleep-wake times, sleep quality, sleep hygiene, psychological wellbeing, their current sleep knowledge and sleep education in their current course. Using the Pittsburgh Sleep Quality Index (PSQI), over 75% of participants were found to have poor sleep quality. Changes in sleep habits and sleep behaviours during COVID-19 restrictions were associated with poorer sleep quality, and this poor sleep quality was associated with poor psychological wellbeing, particularly, motivation, stress and fatigue. Increases in negative sleep hygiene behaviours were associated with a statistically significant increase in PSQI global score. Positive emotions were positively correlated with PSQI (r = 0.22-0.24, p < .001), negative emotions were negatively correlated with PSQI (r = -0.22 - -0.31, p < .001). Also, a self-perceived lack of sleep education was identified. This study illustrates the negative association between self-reported poor sleep behaviour and poor sleep quality during COVID-19 restrictions on university student mental health and wellbeing. Additionally, there is a self-perceived lack of sleep education with little to no time spent educating students in their current degree. Hence, appropriate sleep education may improve sleep behaviours and subsequent sleep quality, which may prove to be a protective factor against poor mental health in the face of unexpected changes to routines.