{"doi":"10.1016/j.sleepx.2023.100067","title":"The relative contribution of COVID-19 infection versus COVID-19 related occupational stressors to insomnia in healthcare workers","abstract":"Objective/Background: Healthcare workers have experienced high rates of psychiatric symptom burden and occupational attrition during the COVID-19 pandemic. Identifying contributory factors can inform prevention and mitigation measures. Here, we explore the potential contributions of occupational stressors vs COVID-19 infection to insomnia symptoms in US healthcare workers.Patients/Methods: An online self-report survey was collected between September 2020 and July 2022 from N = 594 US healthcare workers, with longitudinal follow-up up to 9 months. Assessments included the Insomnia Severity Index (ISI), the PTSD Checklist for DSM-5 (PCL-5), and a 13-item scale assessing COVID-19 related occupational stressors. Results: Insomnia was common (45% of participants reported at least moderate and 9.2% reported severe symptoms at one or more timepoint) and significantly associated with difficulty completing work-related tasks, increased likelihood of occupational attrition, and thoughts of suicide or self-harm (all p<.0001). In multivariable regression with age, gender, and family COVID-19 history as covariates, past two-week COVID-related occupational stressors, peak COVID-related occupational stressors, and personal history of COVID-19 infection were all significantly related to past two-week ISI scores (β = 1.7 ± 0.14SE, β = 0.08 ± 0.03, and β = 0.69 ± 0.22 respectively). Although similar results were found for the PCL-5, when ISI and PCL-5 items were separated by factor, COVID-19 infection was significantly related only to the factor consisting of sleep-related items. Conclusions: Both recent occupational stress and personal history of COVID-19 infection were significantly associated with insomnia in healthcare workers. These results suggest that both addressing occupational stressors and reducing rate of COVID-19 infection are important to protect healthcare workers and the healthcare workforce.","journal":"Sleep Medicine X","year":2023,"id":387916,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9079,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":562024,"name":"Catherine McCall","orcid":"0000-0002-3697-1496","position":1,"is_corresponding":false},{"id":1011007,"name":"Aaron F. Rosser","orcid":null,"position":2,"is_corresponding":false},{"id":967427,"name":"Kathleen F. Pagulayan","orcid":"0000-0002-8010-1631","position":3,"is_corresponding":false},{"id":106979,"name":"Bernard Chang","orcid":"0000-0001-8800-7140","position":4,"is_corresponding":false},{"id":562023,"name":"Ellen Sano","orcid":"0000-0002-2202-448X","position":5,"is_corresponding":false},{"id":226053,"name":"Ronald G. Thomas","orcid":"0000-0003-1686-4965","position":6,"is_corresponding":false},{"id":323140,"name":"Murray A. Raskind","orcid":"0000-0001-9763-2423","position":7,"is_corresponding":false},{"id":373522,"name":"Rebecca C. Hendrickson","orcid":"0000-0003-2377-823X","position":0,"is_corresponding":true}],"reference_count":16,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:18:13.977537Z","pmid":"36923965","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}