Association between quarantine and sleep disturbance in Hong Kong adults: The mediating role of COVID-19 mental impact and distress

Abstract

<p><strong>Background:</strong> COVID-19 quarantine has been associated with increased sleep problems and prolonged psychological responses to the pandemic could mediate this relationship. The present study attempted to examine the mediating role of COVID-19 mental impact and distress between quarantine and sleep disturbance.</p><p><strong>Methods:</strong> The present study recruited 438 adults (109 with quarantine experience) in Hong Kong <em>via</em> an online survey between August and October 2021. The respondents completed a self-report questionnaire on quarantine, Mental Impact and Distress Scale: COVID-19 (MIDc), and Pittsburgh Sleep Quality Index (PSQI). The MIDc was treated as a latent mediator and continuous PSQI factor and poor sleep quality (PSQI score > 5) were the study outcomes. We evaluated the direct and indirect effects of quarantine on sleep disturbance <em>via</em> MIDc using structural equation modeling. Analyses were adjusted for gender, age, education level, knowing confirmed COVID-19 cases, COVID-19 frontline work, and primary income source of the family.</p><p><strong>Results:</strong> More than half (62.8%) of the sample reported poor sleep quality. Quarantine was associated with significantly higher levels of MIDc and sleep disturbance (Cohen <em>d</em> = 0.23 – 0.43, <em>p</em> < 0.05). In the structural equation model, the MIDc mediated the relationship between quarantine and sleep disturbance (<em>αβ</em> = 0.152, 95% CI = 0.071 to 0.235). Quarantine significantly increased the proportion of poor sleep quality by 10.7% (95% CI = 0.050 to 0.171) indirectly <em>via</em> MIDc.</p><p><strong>Conclusions:</strong> The results provide empirical support to the mediating role of the MIDc as psychological responses in the relationship between quarantine and sleep disturbance.</p>