A hidden epidemic during COVID-19: Sleep disturbance and alcohol use among healthcare workers

BACKGROUND: The COVID-19 pandemic has led to significant mental health issues among healthcare workers (HCW), including depression, anxiety, and post traumatic stress disorder. Emerging studies are now showing that HCWs are facing additional mental health challenges such as insomnia and alcohol use disorder that also require urgent attention. The current study thus aimed to evaluate the prevalence and factors related to sleep disturbance and alcohol use in Australian HCWs. METHODS: In January 2023, 211 Australian hospital HCWs completed an online cross-sectional survey that included a modified version of the Coronavirus Health and Impact Survey, a single item measure of sleep disturbance, a single item measure of alcohol use, and a demographic measure. Missing data were imputed and analysed using adjusted multivariate regressions and relative weight analysis to determine key predictors of outcomes. RESULTS: Results show that 172 (81.5%) participants experienced sleep disturbance affecting their personal or occupational life, with 49 (23.2%) at very or extremely high levels. With alcohol use, 73 (34.6%) reported monthly intake, 58 (27.5%) reported weekly intake and 8 (3.8%) reported daily intake. Sleep disturbance was significantly associated with poor pre-covid mental health (p < 0.001, R(2)=17.66%), time spent outdoors (p < 0.01, R(2)=4.2%), poor physical health (p < 0.05, R(2)=4.9%), COVID infection worries (p < 0.05, R(2)=3.9%), and providing direct care to COVID patients (p < 0.05, R(2)=3.1%). Alcohol use was higher in physicians compared to nurses (p < 0.01, R(2)=3.1%) and associated with direct care of COVID patients (p < 0.05, R(2)=2.4%) and relationship stress (p < 0.05, R(2)=1.9%). CONCLUSIONS: These findings are the first to investigate sleep disturbance and alcohol use in Australian HCWs and shows that these challenges pose a significant risk for this cohort. Findings highlight at risk groups and potential treatment targets to address these outcomes. KEY MESSAGES: • Sleep disturbance and alcohol use are increasingly becoming a growing concern for HCWs, indicating an urgent need for interventions and supports to prevent long term consequences. • Findings highlight 4 risk and 1 protective factor for sleep disturbance and 3 risk factors for alcohol use that can be targeted in interventions and supports for HCWs.