Clinical and psychological aspects of insomnia associated with COVID-19 pandemic

Background. In addition to clinical, epidemiological, and political aspects, the pandemic situation has a clinical and psychological aspect, as long as the measures taken to counteract infection inevitably cause unusual living conditions for a large number of people. Stress experience is accompanied by changes in autonomic regulation and, as a result, a number of somatic shifts. Stress markers include sleep disorders, changes in appetite, gastrointestinal disorders, headaches, chest pain, dyspnea, body pain, dizziness, numbness, fluctuations in blood pressure, sleep disorders, panic attacks, depressive and suicidal tendencies.

Objective. We suggested that resilience is the predictor of successful resolution of existential crisis from the point of view of maintaining mental and somatic health, as well as gaining experience of deep self-improvement, strengthening of personality and potential for coping with life difficulties. Resilience includes coping at all levels of functioning — physical, psychological, social and existential. The latter defines the perception of reality itself as a challenge of complexity that requires coping, and regulates resilience at all other levels. The indicator of sleep quality was used as an empirical criterion to evaluate coping with stress. It is both an indicator and an antistress resource for physical functioning. The hypothesis of the study was the assumption that psychological content of resilience differs in subjects with moderate severity insomnia and with no sleep disturbances during pandemic period.

Design and methods. To evaluate this hypothesis during the period of self-isolation in connection with the COVID-19 pandemic (April-May 2020), an empirical study was carried out on a randomized sample of 93 subjects using clinical and psychological scales.

Results. This research resulted in the identification of differences in psychological content of resilience which reflect clinical and psychological characteristics in subjects with moderate severity insomnia and with normal sleep during the pandemic. The psychological content of resilience in respondents without sleep disturbances during the pandemic can be considered as complex and mature mechanisms of personality self regulation that allow of maintaining mental and somatic health, efficiency, ability to develop. Identified features can be used as psychotherapeutic targets in patients at different stages of exposure to stress factors.

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