Global Study Unpacks How Resilience Can Mitigate the Impact of the Pandemic on Sleep and Mental Health Problems

Since its emergence in 2019, the COVID-19 pandemic has directly elevated stress and anxiety levels across the globe, leaving many wondering how to cope with the feeling of uncertain times. 

Early in 2020, Mustafa al'Absi, PhD, a professor in the Department of Family Medicine and Biobehavioral Health and principal investigator for the Stress and Resilience Laboratories (SRRL) and the Duluth Global Health Research Institute (DGHRI) at the University of Minnesota Medical School, launched an international study titled, Stress and Resilience in the Face of COVID-19, with partners around the globe to monitor how people were responding to the pandemic in real-time. The survey was translated into eight languages – Spanish, French, Arabic, Chinese, Russian, Italian, German and Bulgarian. 

Seven months after the survey circulated, the team’s novel findings were published in the International Journal of Behavioral Medicine titled, Resilience and the Role of Depressed and Anxious Mood in the Relationship Between Perceived Social Isolation and Perceived Sleep Quality During the COVID‑19 Pandemic. With participation from over 6,000 people across 1,000 countries in all corners of the globe, the study is among the first to examine the role of resilience in moderating the relationships among feelings of isolation, depression, stress, anxious mood and sleep quality during this period of social isolation.

“The immediate question that we wanted to address was the shared experiences of social isolation during this crisis and its impact on sleep and other functions,” Dr. al’Absi said. “We focused on these domains because sleep, isolation and the ability to cope with problems can, directly and indirectly, impact health and contribute to multiple diseases, above all during this vulnerable time.” 

With uncertainty and fear about the spread of COVID-19, resilience – or the ability to recover from stress – is one factor that Dr. al'Absi suggests may buffer the impact of pandemic-related isolation on negative moods and sleep. Those who have decreased resilience can be especially at-risk for depressed and anxious moods and sleep impairments with their associated consequences, such as impaired immune functioning. “We know that working from home, confronting various sets of new issues and being anxious about the news can all directly affect sleep,” Dr. al’Absi explained. 

Global Reactions

With much of the globe under stay-at-home orders during the pandemic's height, the team reported a typical analysis of the quarantine’s direct outcomes. The results showed that isolation across the world was associated with significant reductions in sleep time, with depressed and anxious mood playing a larger role in contributing to the impact of social isolation on sleep quality. 

Preliminary discussions have also shed light on the long-term effects of the pandemic as a continuous stressor. “I was talking to a group the other day about Post-Traumatic Stress Disorder (PTSD) and heard about emerging results showing that 20% of the population have experienced significant symptoms, making them potentially diagnosable for PTSD during this period – a huge escalation when compared to 4% prevalence of such disorder before the pandemic,” Dr. al’Absi said. “If you can just imagine how many people have lost loved ones over this and those who directly experienced the threat of COVID-19 and hospitalization, there’s a lot of pain and suffering being felt everywhere.”

In confronting such a crisis, the study responses, focusing on Minnesota, further demonstrated that those who exhibited high resilience levels could buffer the effects of anxiety on their overall sleep quality, due to higher levels of virtual social capital among their internal networks. These findings on the influence of resilience provide a promising area for targeted interventions. 

Cognitive resilience, meaning how people see problems and how they deal with them, can generate long-lasting, positive results for the individual. “It’s easy to say, ‘forget about that,’ or ‘don’t worry about this,’ but that isn’t enough,” Dr. al’Absi said. “The goal should be to work on developing and using skills to manage the worry or address its source if it is within our capacity to do so – that’s where cognitive resilience comes into play.”

Building Resilience

The journey to resilience is not easy, but it can be achieved by taking a road less traveled. On an individual level, the way people interpret bad events and adversities helps them become more dispositioned to be optimistic about the future. While many aspects are out of one’s control, Dr. al’Absi says it’s essential to focus on the things that can be controlled. “No matter how bad the moment or the day is, remember it’s going to pass,” Dr. al’Absi said. “With this frame of mind, the more skilled and resourceful you are in solving problems, the better off you will be when dealing with stressful life events or even huge health threats.”

Dr. al’Absi recommends a few simple ideas on how people can build resilience to cope with stress and overcome challenges: 

  • Learn cognitive skills to modify your thoughts about what is going on around you. Remember, stress is not only what happens around you, but it is also what you think about these events.

  • Take an hour of your time to pause, do something different, exercise or practice slow breathing to focus on “the here and now” to clear your mind.

  • Organize your day, identifying blocks of time for breaks.

  • Communicate virtually with friends and family or reach out to someone you haven’t talked to in a while. 

  • Don’t occupy your time with news media coverage or too many sad movies. 

  • Remember that things will come to pass – nothing stays still. This all will be history. 

“We need to pay attention to psychological health during circumstances requiring social distancing, and we need to minimize feelings of loneliness by virtually improving interaction and support safety,” Dr. al’Absi said. “Resilience-enhancement programs are direly needed to prevent the short- and long-term consequences of these trying times.”

Future of Study 

The team will continue its ongoing analysis of the study through multiple projects. Currently, the SRRL team is collecting data on the interaction between COVID-19-related stress and addiction problems, such as smoking, marijuana and alcohol use. In the next phase of their analysis, the team will also address questions related to impact in rural versus urban populations, regional challenges and the role of socioeconomic status and poverty, while identifying ways by which the mental health impact of COVID-19 can be mitigated. 

The global survey will remain open. The SRRL team is dedicated to capturing the various global surveillance data during the COVID-19 pandemic for the future scientific community.

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