Sleep and mood disturbances during the covid-19 outbreak in an urban chinese population in hong kong: A longitudinal study of the second and third waves of the outbreak

Chun Sing Lam, Branda Yee Man Yu, Denise Shuk Ting Cheung, Teris Cheung, Simon Ching Lam, Ka Fai Chung, Fiona Yan Yee Ho, Wing Fai Yeung

Research output: Journal article publicationJournal articleAcademic researchpeer-review


In response to the worsening situation of the COVID pandemic, this follow-up study aimed to assess the impact of the “third wave” of the outbreak on sleep and mood disturbances among Hong Kong citizens. A total of 339 respondents included in our last study during the second wave (4–11 August 2020) joined this survey (response rate = 51.1%). The questionnaire collected data on sleep conditions, mood, stress, and risk perception. The sleep quality and mood status were assessed using the Insomnia Severity Index (ISI), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9. The weighted prevalence of insomnia, anxiety, and depression was 33.6%, 15.3%, and 22.0%, respectively. Compared with the last survey, five out of six sleep parameters significantly worsened despite the lack of difference in the ISI score. The GAD-7 score was significantly lower. Old-aged adults were less likely to maintain good sleep quality compared with middle-aged adults (adjusted OR = 4.03, 95% CI: 1.04–15.73). Respondents without psychiatric disorder were more likely to be anxiety-free across the two time points (adjusted OR = 7.12, 95% CI: 1.33–38.03). One-third of Hong Kong people reported poor sleeping quality in the third wave of the COVID-19 outbreak. Policy-makers need to propose a contingent plan to allocate mental health resources to vulnerable subpopulations.

Original languageEnglish
Article number8444
JournalInternational Journal of Environmental Research and Public Health
Issue number16
Publication statusPublished - 2 Aug 2021


  • Cohort
  • Insomnia
  • Mental health
  • Pandemic
  • Web-based

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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