Decrease in Social Zeitgebers Is Associated With Worsened Delayed Sleep-Wake Phase Disorder: Findings During the...

Area of Science:

• Sleep Medicine
• Chronobiology
• Psychiatry

Background:

• Sleep-wake rhythm disruptions were noted in the general population during the COVID-19 pandemic.
• The impact of the pandemic on patients with Delayed Sleep-Wake Phase Disorder (DSWPD) remained unstudied.
• This study retrospectively analyzed DSWPD symptom changes before and during the pandemic.

Purpose of the Study:

• To examine changes in DSWPD symptoms in outpatients during the COVID-19 pandemic.
• To identify factors associated with the exacerbation of sleep-wake rhythms in DSWPD patients.
• To understand the pandemic's specific impact on individuals with DSWPD.

Main Methods:

• Retrospective study of outpatients with DSWPD (aged ≥16) from January to September 2020.
• Defined decreased social zeitgebers as ≥50% reduction in commuting frequency.
• Assessed DSWPD severity using Clinical Global Impressions-Severity (CGI-S) scores pre- and during the pandemic; analyzed worsened, unchanged, and improved groups using logistic regression.

Main Results:

• Sixty DSWPD patients were included; unemployment/non-attendance correlated with pre-pandemic severity.
• During the pandemic, 27 patients worsened, 28 remained unchanged, and 5 improved.
• Decreased social zeitgebers (OR=6.67) and comorbid mood disorders (OR=8.88) were independently associated with worsened DSWPD symptoms.

Conclusions:

• DSWPD symptoms generally worsened during the COVID-19 pandemic.
• The findings highlight the critical role of social zeitgebers in managing DSWPD.
• External motivation and social engagement are crucial for effective DSWPD treatment.