Impact of mandatory institutional quarantine on sleep quality: A cross sectional Tunisian study

Abstract Background Given the COVID-19 pandemic, Tunisian authorities have imposed quarantine in dedicated centers mainly for travelers coming from countries with highest coronavirus infection rates. Such restrictive measures may have a detrimental impact on people's mental health and can thus affect sleep. We aimed in this study to assess the impact of mandatory institutional quarantine on sleep quality in Tunisia and to determine factors associated with clinical insomnia. Methods Data were collected through a cross sectional study conducted from April to November 2020 among individuals who were in quarantine for 14 days including at least a week in a Tunisian quarantine center. Sleep quality was assessed using the Insomnia Severity Index. Factors associated with clinical insomnia were assessed using bivariate and multivariate analysis. Results In the present study, 506 participants were included with a mean age of 37.6±13.6 years. Majority (66.4%) were men. Nearly one fifth (19.2%) of surveyed individuals had symptoms of clinical insomnia. In multivariate analysis, we found that being a woman, spending longer time on covid-19 news per day, having experienced stigma during the quarantine period, financial difficulties due to the coronavirus pandemic and dissatisfaction by the accommodation conditions of the quarantine facility were independently associated with clinical insomnia. Conclusions Nearly one fifth of participants had clinical insomnia during the quarantine period. Providing a good sleep environment, educating sleep healthy behavior and giving adequate psychological support to quarantined individuals in quarantine centers is necessary. Key messages Among surveyed participants, 19.2% had symptoms of clinical insomnia. Providing a good sleep environment in quarantine centers and providing mental health support to quarantined individuals is essential.