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Title: Sleep and mood disturbances during the COVID-19 outbreak in an urban Chinese population in Hong Kong : a longitudinal study of the second and third waves of the outbreak
Authors: Lam, CS
Cheung, DST
Cheung, T 
Lam, SC
Chung, KF
Yeung, WF 
Issue Date: Aug-2021
Source: International journal of environmental research and public health, Aug. 2021, v. 18, no. 16, 8444
Abstract: In response to the worsening situation of the COVID pandemic, this follow-up study aimed to assess the impact of the “third wave” of the outbreak on sleep and mood disturbances among Hong Kong citizens. A total of 339 respondents included in our last study during the second wave (4–11 August 2020) joined this survey (response rate = 51.1%). The questionnaire collected data on sleep conditions, mood, stress, and risk perception. The sleep quality and mood status were assessed using the Insomnia Severity Index (ISI), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9. The weighted prevalence of insomnia, anxiety, and depression was 33.6%, 15.3%, and 22.0%, respectively. Compared with the last survey, five out of six sleep parameters significantly worsened despite the lack of difference in the ISI score. The GAD-7 score was significantly lower. Old-aged adults were less likely to maintain good sleep quality compared with middle-aged adults (adjusted OR = 4.03, 95% CI: 1.04–15.73). Respondents without psychiatric disorder were more likely to be anxiety-free across the two time points (adjusted OR = 7.12, 95% CI: 1.33–38.03). One-third of Hong Kong people reported poor sleeping quality in the third wave of the COVID-19 outbreak. Policy-makers need to propose a contingent plan to allocate mental health resources to vulnerable subpopulations.
Keywords: Cohort
Mental health
Publisher: Molecular Diversity Preservation International (MDPI)
Journal: International journal of environmental research and public health 
ISSN: 1661-7827
EISSN: 1660-4601
DOI: 10.3390/ijerph18168444
Rights: © 2021 by the authors.Licensee MDPI, Basel, Switzerland.This article is an open access articledistributed under the terms andconditions of the Creative CommonsAttribution (CC BY) license (
The following publication Lam, C.S.; Yu, B.Y.-M.;Cheung, D.S.T.; Cheung, T.; Lam, S.C.;Chung, K.-F.; Ho, F.Y.-Y.; Yeung,W.-F.Sleep and Mood Disturbances duringthe COVID-19 Outbreak in an UrbanChinese Population in Hong Kong: ALongitudinal Study of the Second andThird Waves of the Outbreak. Int. J.Environ. Res. Public Health 2021, 18,8444 is available at
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