Depression, anxiety and stress associated with insomnia in Peruvian military cadets during a pandemic

Authors

Keywords:

depression, anxiety, stress, insomnia, military personnel, Peru.

Abstract

Introduction: Cadets are still young trainees, and they were also exposed to the pandemic, generating possible alterations in their mental health.
Objective: To determine whether depression, anxiety and stress were associated with insomnia in Peruvian military cadets during the pandemic.
Methods: Analytical cross-sectional study, which through a survey inquired about 3 mental health pathologies (DASS-21 scale) and insomnia (Insomnia Severity Index scale, in Spanish), the results of both were crossed and adjusted.
Results: Of the 752 cadets, insomnia was associated with moderate or higher levels of anxiety (p-value< 0.001) or even severe levels of anxiety (p-value< 0.001); in both cases it was also associated with sex (p-value< 0.014) and having more age range (p-values< 0.013); all these associations were adjusted for having suffered from COVID-19, levels of depression and stress (p-values> 0.05).
Conclusions: Insomnia was associated with having anxiety at moderate or higher levels or even at severe levels. It was also associated with gender (females were the most affected) and with cadets being older.

Downloads

Download data is not yet available.

References

1. Lesser IA, Nienhuis CP. The Impact of COVID-19 on Physical Activity Behavior and Well-Being of Canadians. International Journal of Environmental Research and Public Health. 2020; 17(11):3899. DOI: 10.3390/ijerph17113899

2. Rasheed R, Rizwan A, Javed H, Sharif F, Zaidi A. Socio-economic and environmental impacts of COVID-19 pandemic in Pakistan-an integrated analysis. Environ Sci Pollut Res Int. 2021; 28(16):19926-43. DOI: 10.1007/s11356-020-12070-7

3. Kunzler AM, Röthke N, Günthner L, Stoffers-Winterling J, Tüscher O, Coenen M, et al. Mental burden and its risk and protective factors during the early phase of the SARS-CoV-2 pandemic: systematic review and meta-analyses. Globalization and Health. 2021; 17(1):1-29. DOI: 10.1186/s12992-021-00670-y

4. Bareeqa SB, Ahmed SI, Samar SS, Yasin W, Zehra S, Monese GM, et al. Prevalence of depression, anxiety and stress in china during COVID-19 pandemic: A systematic review with meta-analysis. Int J Psychiatry Med. 2021; 56(4):210-27. DOI: 10.1177/0091217420978005

5. Cénat JM, Blais-Rochette C, Kokou-Kpolou CK, Noorishad PG, Mukunzi JN, McIntee SE, et al. Prevalence of symptoms of depression, anxiety, insomnia, posttraumatic stress disorder, and psychological distress among populations affected by the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Res. 2021; 295:113599. DOI: 10.1016/j.psychres.2020.113599

6. Auriemma V, Iannaccone C. COVID-19 Pandemic: Socio-Economic Consequences of Social Distancing Measures in Italy. Frontiers in Sociology. 2020; 5:575791. DOI: 10.3389/fsoc.2020.575791

7. Pinilla J, Barber P, Vallejo-torres L, Rodríguez-mireles S, López-valcárcel BG, Serra-majem L. The Economic Impact of the SARS-COV-2 (COVID-19) Pandemic in Spain. International Journal of Environmental Research and Public Health. 2021; 18(9):4708. DOI: 10.3390/ijerph18094708

8. Rodríguez S, Valle A, Piñeiro I, González-Suárez R, Díaz FM, Vieites T. COVID-19 Lockdown: Key Factors in Citizens' Stress. Front Psychol. 2021; 12:2238. DOI: 10.3389/fpsyg.2021.666891

9. López-Morales H, del Valle MV, Canet-Juric L, Andrés ML, Galli JI, Poó F, et al. Mental health of pregnant women during the COVID-19 pandemic: A longitudinal study. Psychiatry Res. 2021; 295:113567. DOI: 10.1016/j.psychres.2020.113567

10. Hill ML, Nichter B, Na PJ, Norman SB, Morland LA, Krystal JH, et al. Mental health impact of the COVID-19 pandemic in U.S. military veterans: a population-based, prospective cohort study. Psychol Med. 2023; 53(3):945-56. DOI: 10.1017/S0033291721002361

11. Lázaro-Pérez C, Martínez-López JÁ, Gómez-Galán J, Fernández-Martínez MDM. COVID-19 Pandemic and Death Anxiety in Security Forces in Spain. International Journal of Environmental Research and Public Health. 2020; 17(21):7760. DOI: 10.3390/ijerph17217760

12. Battaglino J. Políticos y militares en los gobiernos de la nueva izquierda sudamericana. Política y gobierno. 2015 [acceso: 20/10/2022]; 22(1):03-43. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1665-20372015000100001&lng=es&nrm=iso&tlng=es

13. Sudom KA, Lee JEC. Well-being of Canadian Armed Forces members during the COVID-19 pandemic: the influence of positive health behaviours. Health Promot Chronic Dis Prev Can. 2022; 42(3):113-21. DOI: 10.24095/hpcdp.42.3.05

14. Valladares-Garrido MJ, Picón-Reátegui CK, Zila-Velasque JP, Grados-Espinoza P. Prevalence and Factors Associated with Insomnia in Military Personnel: A Retrospective Study during the Second COVID-19 Epidemic Wave in Peru. Healthcare. 2022; 10(7):1199. DOI: 10.3390/healthcare10071199

15. Han RH, Schmidt MN, Waits WM, Bell AKC, Miller TL. Planning for Mental Health Needs During COVID-19. Curr Psychiatry Rep. 2020; 22(12):66. DOI: 10.1007/s11920-020-01189-6

16. Fuentes Guevara DG, Seminario Moran DJ, Vilca Muñoz JJ. La somnolencia diurna excesiva y el rendimiento académico de los cadetes de cuarto año de La Escuela Militar de Chorrillos "Coronel Francisco Bolognesi" [Tesis para optar el Título Profesional de Licenciado en Ciencias Militares con Mención en Administración]. Perú, Lima: Escuela Militar de Chorrillos "Coronel Francisco Bolognesi"; 2016. [acceso: 01/03/2023]. Disponible en: https://repositorio.escuelamilitar.edu.pe/handle/EMCH/797

17. Bastien CH, Vallières A, Morin CM. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med. 2001; 2(4):297-307. DOI: 10.1016/s1389-9457(00)00065-4

18. Antúnez Z, Vinet E v. Escalas de Depresión, Ansiedad y Estrés (DASS - 21): Validación de la Versión abreviada en Estudiantes Universitarios Chilenos. Terapia psicológica. 2012; 30(3):49-55. DOI: 10.4067/S0718-48082012000300005

19. Organización Panamericana de la Salud. La OMS subraya la urgencia de transformar la salud mental y los cuidados conexos - OPS/OMS. Organización Panamericana de la Salud. Noticias. 2022 [acceso: 01/03/2023]. Disponible en: https://www.paho.org/es/noticias/17-6-2022-oms-subraya-urgencia-transformar-salud-mental-cuidados-conexos

20. David J, Huarcaya-Victoria J, Almenara Irigoyen G, Médico psiquiatra P. Consideraciones sobre la salud mental en la pandemia de COVID-19. Rev Perú Med Exp Salud Pública. 2020; 37(2):327-34. DOI: 10.17843/rpmesp.2020.372.5419

21. Armas-Elguera F, Talavera JE, Cárdenas MM, de la Cruz-Vargas JA. Trastornos del sueño y ansiedad de estudiantes de Medicina del primer y último año en Lima, Perú. FEM: Revista de la Fundación Educación Médica. 2021; 24(3):133-8. DOI: 10.33588/fem.243.1125

22. De Azevedo Barros MB, Guimarães Lima M, Carvalho Malta D, Landmann Szwarcwald C, Cruz Soares de Azevedo R, Romero D, et al. Relato de tristeza/depressão, nervosismo/ansiedade e problemas de sono na população adulta brasileira durante a pandemia de COVID-19. Epidemiologia e Serviços de Saúde. 2020; 29(4):e2020427. DOI: 10.1590/S1679-49742020000400018

23. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020; 3(3):e203976-e203976. DOI: 10.1001/jamanetworkopen.2020.3976

24. McCarthy E, DeViva JC, Na PJ, Pietrzak RH. New-onset and exacerbated insomnia symptoms during the COVID-19 pandemic in US military veterans: A nationally representative, prospective cohort study. J Sleep Res. 2022; 31(1):e13450. DOI: 10.1111/jsr.13450

25. Morin CM, Bjorvatn B, Chung F, Holzinger B, Partinen M, Penzel T, et al. Insomnia, anxiety, and depression during the COVID-19 pandemic: an international collaborative study. Sleep Med. 2021; 87:38-45. DOI: 10.1016/j.sleep.2021.07.035

26. Meaklim H, Saunders WJ, Byrne ML, Junge MF, Varma P, Finck WA, et al. Insomnia is a key risk factor for persistent anxiety and depressive symptoms: A 12-month longitudinal cohort study during the COVID-19 pandemic. J Affect Disord. 2023; 322:52-62. DOI: 10.1016/j.jad.2022.11.021

27. Mejia C, Coronel L, Meza-Roque G, Chacon J, Gallardo G, Ramirez M. Factores asociados al miedo por la información recibida durante la pandemia en policías y militares peruanos. Revista Cubana de Medicina Militar. 2023 [acceso: 15/05/2023]; 52(1):e02302109. Disponible en: https://revmedmilitar.sld.cu/index.php/mil/article/view/2109

28. Medina-Ortiz O, Araque-Castellanos F, Ruiz-Domínguez LC, Riaño-Garzón M, Bermudez V, Medina-Ortiz O, et al. Trastornos del sueño a consecuencia de la pandemia por COVID-19. Rev Perú Med Exp Salud Pública. 2020; 37(4):755-61. DOI: 10.17843/rpmesp.2020.374.6360

29. Lin L, Wang J, Ou-yang X, Miao Q, Chen R, Liang F, et al. The immediate impact of the 2019 novel coronavirus (COVID-19) outbreak on subjective sleep status. Sleep Med. 2021; 77:348-54. DOI: 10.1016/j.sleep.2020.05.018

30. Li SH, Graham BM. Why are women so vulnerable to anxiety, trauma-related and stress-related disorders? The potential role of sex hormones. Lancet Psychiatry. 2017; 4(1):73-82. DOI: 10.1016/S2215-0366(16)30358-3

31. Zhang B, Wing YK. Sex Differences in Insomnia: A Meta-Analysis. Sleep. 2006; 29(1):85-93. DOI: 10.1093/sleep/29.1.85

32. Sowers MF, Zheng H, Kravitz HM, Matthews K, Bromberger JT, Gold EB, et al. Sex Steroid Hormone Profiles are Related to Sleep Measures from Polysomnography and the Pittsburgh Sleep Quality Index. Sleep. 2008 [acceso: 06/11/2022]; 31(10):1339. Disponible en: https://pubmed.ncbi.nlm.nih.gov/18853931/

33. Moreno-Tamayo K, Ramírez-García E, Sánchez-García S. Trastornos del sueño en personas mayores. ¿Cómo duermen las personas mayores de la Ciudad de México? Aportación original. 2021 [acceso: 06/11/2022]; 59(6):1-9. Disponible en: https://docs.bvsalud.org/biblioref/2022/02/1357567/4145-28351-1-pb-06-12.pdf

34. Scarpelli S, Alfonsi V, Mangiaruga A, Musetti A, Quattropani MC, Lenzo V, et al. Pandemic nightmares: Effects on dream activity of the COVID-19 lockdown in Italy. J Sleep Res. 2021; 30(5):e13300. DOI: 10.1111/jsr.13300

35. Ballot O, Daviaux Y, Sanz-Arigita EJ, Ivers H, Micoulaud-Franchi JA, Bioulac S, et al. Emotion coping strategies and dysfunctional sleep-related beliefs are associated with objective sleep problems in young adults with insomnia. Sleep Med. 2021; 88:180-6. DOI: 10.1016/j.sleep.2021.10.014

36. Greenwood BN, Foley TE, Day HEW, Burhans D, Brooks L, Campeau S, et al. Wheel running alters serotonin (5-HT) transporter, 5-HT1A, 5-HT1B, and alpha1b-adrenergic receptor mRNA in the rat raphe nuclei. Biol Psychiatry. 2005; 57(5):559-68. DOI: 10.1016/j.biopsych.2004.11.025

37. Lipinska G, Lewis R, Roden L, Scheuermaier K, Gomez-Olive X, Rae D, et al. The Interrelationship of Insomnia Symptoms, Physical Activity and Sedentary Behaviour on Symptoms of Depression and Anxiety Before and During the COVID-19 Pandemic Lockdown. Sleep Med. 2022; 100: S98. DOI: 10.1016/j.sleep.2022.05.273

38. Stanton R, Reaburn P. Exercise and the treatment of depression: a review of the exercise program variables. J Sci Med Sport. 2014; 17(2):177-82. DOI: 10.1016/j.jsams.2013.03.010

39. Ramírez LA, Pérez-Padilla EA, García-Oscos F, Salgado H, Atzori M, Pineda JC, et al. Nueva teoría sobre la depresión: un equilibrio del ánimo entre el sistema nervioso y el inmunológico, con regulación de la serotonina-quinurenina y el eje hipotálamo-hipófiso-suprarrenal. Biomédica. 2018; 38(3):437-50. DOI: 10.7705/biomedica.v38i3.3688

Downloads

Published

2023-08-21

How to Cite

1.
Mejia CR, Farfan-Zapata O, Casimiro-Porras M, Mendoza-Cairampoma DE, Armada J, Gallardo -Zarate G, et al. Depression, anxiety and stress associated with insomnia in Peruvian military cadets during a pandemic. Rev Cubana Med Milit [Internet]. 2023 Aug. 21 [cited 2025 May 10];52(3):e02303125. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/3125

Issue

Vol. 52 No. 3 (2023): July - september

Section

Research Article

License

Authors who have publications with this Journal accept the following terms:

  • The authors will retain their copyright and guarantee the Journal the right of first publication of their work, which will simultaneously be subject to the Creative Commons Attribution License. The content presented here can be shared, copied and redistributed in any medium or format; Can be adapted, remixed, transformed or created from the material, using the following terms: Attribution (giving appropriate credit to the work, providing a link to the license, and indicating if changes have been made); non-commercial (you cannot use the material for commercial purposes) and share-alike (if you remix, transform or create new material from this work, you can distribute your contribution as long as you use the same license as the original work).
  • The authors may adopt other non-exclusive license agreements for the distribution of the published version of the work (for example: depositing it in an institutional electronic archive or publishing it in a monographic volume) as long as the initial publication in this Journal is indicated.
  • Authors are allowed and recommended to disseminate their work through the Internet (e.g., in institutional electronic archives or on their website) before and during the submission process, which can produce interesting exchanges and increase citations. of the published work.