Presentation from the Maltepe University International Student Congress 2021(MUISC2021) for medical students.

1. INSOMNIA DURING THE
COVID-19 PANDEMIC IN THE
REPUBLIC OF NORTH
MACEDONIA
Igor Radenkov
Nina Gavrilova
Natasha Mladenoska
Medical faculty, University “ Ss. Cyril and Methodius”
- Skopje

2. Introduction
• The COVID-19 pandemic, since it’s beginning in late 2019 has
caused massive mortality and morbidity globally.
• The outbreak has had a massive effect on the global economy
with millions losing their jobs worldwide and suffering
financial losses.
• COVID-related news has become the leading subject in news
reporting, leading to a widespread state of fear.

3. Introduction
• Insomnia is defined an inability to fall and/or stay asleep.
• It can be acute(short-term),lasting from one night to a few
weeks or chronic(long-term) insomnia, lasting for at least 3
nights a week for 3 months or more.
Risk factors:
Stress
Chronic pain
Female gender
Advanced age
Night-shift work
Lifestyle factors
Anxiety and
depression

4. Aim of our study
Our aim in this study was
investigate the prevalence of
insomnia during the
COVID19
pandemic in our country and
it’s correlations with various
socioeconomic factors.
• Much research has been
conducted on the effect on
the COVID-19 outbreak and
it’s repercussions on
• the prevalence of insomnia,
depression and anxiety
disorders in the global
population

5. Study design
Timeline
27th of March to the 3rd of April 2021
Method
Google Forms questionnaire
Questions
- general information about the participant
-exposure to SARS-CoV-2
- past medical history
- effect of the virus on various aspects of the participants life

6. Study design
Distribution
Through the smartphone applications Viber
and Messenger
Sampling method
Snowball sampling
Inclusion criteria:
- literacy
- willing consent
- owning a smartphone with an Internet connection
-installed Viber and Messenger applications

7. Study design
A score of ≥ 8 indicates the presence of insomnia

8. Statistical analysis
• First, descriptive analysis
were performed.
• Then two groups were
created: an insomnia
group and a non-
insomnia(control) group.
• Lastly, multiple binary
logistic regression was
performed.

9. Results
• N= 195 participants
• Sixty-three participants(36.2%) met the criteria for
insomnia according to the Insomnia Severity Index(ISI).
Presence of insomnia n(%)
No clinically significant insomnia 132(67.7%)
All types of insomnia 63(32.3%)
Subthreshold insomnia 41(21%)
Clinical insomnia(moderately severe) 20(10.3%)
Clinical insomnia(severe) 2(1%)

10. Results

11. Results

12. Results

13. Results

14. Results
Multiple binary logistic regression

15. Limitations
 Lack of participants over the age of 65 years.
 Self-reported study.
 The ISI used as the only measuring tool for
presence of insomnia.
 The majority of the participants being from
Skopje.

16. Discussion
 Economic aspect
 Loss of income during
the pandemic was
significantly correlated
with insomnia
prevalence.
 In a relatively weak
economy like that of
North Macedonia, every
loss of income is
significant and it can
contribute to increase of
stress.

17. Discussion
 Workplace aspect
 Numerous studies have
linked increased
workload with higher
amounts of stress and
insomnia, especially in
acute increase of
workload over a short
period of time.
 Especially prevalent
among manual labour
workers in North
Macedonia during the
pandemic.

18. Discussion
 Social aspect
 Consistency with other
studies which showed that
concern about family
members and friends
during the pandemic
showed correlation with
presence of insomnia.
 Constant worry creates a
state of elevated stress
hormones which impacts
the normal sleep cycle.

19. Discussion
 Social aspect
 Significant correlation
between not having a
partner during the
pandemic and insomnia.
 The COVID lockdowns
that were used to
contain the spread of the
virus, impacted normal
life immensely, leading
to more social isolation
and loneliness among
the population.

20. Conclusion
 Our study found that almost one-third of the
population suffered insomnia symptoms since the
beginning of the COVID-19 pandemic in the Republic
of North Macedonia.
 The related risk factors included the loss of a job,
lowering of the total household income and exposure
to the virus of a friend or relative of the participant.
 These results prompt effective interventions conducted
in a timely manner in the treatment of insomnia in the
high-risk groups identified- the individuals suffering
financial losses during the COVID-19 pandemic,
overworked individuals and individuals with little
social contact.