Frontline medical staff treating Covid-19 patients in China and who are experiencing insomnia face long-term health risks, researchers warn. More than a third of medical staff who responded to the coronavirus pandemic during its peak in China, and who took part in the research survey, suffered from sleeplessness , according to the study, published in Frontiers in Psychiatry . The health care workers who regularly lost good sleep were also more likely to feel depressed, anxious and have stress-based trauma, according to the paper. “Typically, stress-related insomnia is transient and persists for only a few days,” said Dr Bin Zhang, a professor at Southern Medical University in Guangzhou, China, and co-author of the paper. “But if the Covid-19 outbreak continues, the insomnia may gradually become chronic insomnia,” he added. The research was conducted between January 29 and February 3 during the peak of the epidemic in China. To date, more than 83,800 Covid-19 cases have been confirmed in China, with more than 4,630 deaths. Researchers used the social media platform WeChat to gather answers from 1,563 participants in the medical field. More than 36 per cent of respondents had insomnia symptoms, which was in line with previous research conducted on the psychological effects of the 2002 Sars outbreak . Those with insomnia during the Covid-19 outbreak experienced significantly higher levels of depression than the non-insomnia group – 87.1 per cent versus 31 per cent – with similar results for anxiety and trauma. The team identified certain factors connected to the insomnia. “The most important factor was having very strong uncertainty regarding effective disease control among medical staff ,” Zhang said. Staff with less education were also more prone to the sleep disorder. The risk of insomnia among medical staff with a high school education or below was 2.69 times higher than those with a doctoral degree. Researchers said health care workers were under incredible stress because of being in close contact with infected patients who could pass on the disease to them , making them worried about infecting their own family and friends. They also worked under stressful conditions wearing a full array of personal protective equipment (PPE) for more than 12 hours at a time, often without being able to take a break because they risked infection by removing the PPE. “Under these dangerous conditions, medical staff become mentally and physically exhausted, and therefore experience an increased risk of insomnia due to high stress,” researchers concluded. The authors recommended several strategies to overcome sleep disorders, including stress relief to overcome negative thoughts, and cognitive behavioural therapy for insomnia, which includes sleep hygiene education, relaxation therapy, stimulation control and sleep restriction. Cognitive therapy focuses on eliminating psychological distress, while cognitive behavioural therapy also targets the elimination of negative behaviour. The investigators also suggested health officials screen medical staff based on the risk factors their research identified. “A longitudinal study to track the changes of insomnia symptoms is needed among medical staff, especially when the death of medical staff during Covid-19 will be officially announced and updated,” Zhang said.