Page 76 - IJPS-9-1

International Journal of
Population Studies COVID-19, economic crisis, insomnia, and stress

1. Introduction Insomnia Scale-18 scale [Hallit et al., 2019] and 47.1%
using the Athens Insomnia Scale [Al Karaki et al., 2020]).
The novel coronavirus has rapidly impacted the world with
deleterious consequences on mental health, particularly in PTSS is likely to occur “after exposure to a potentially
countries with financial hardships and preexisting mental traumatic event that is beyond a typical stressor; events
health conditions induced by war or socioeconomic that may lead to it include, but are not limited to, violent
difficulties (Abou Hassan et al., 2023; Sacre et al., 2022; personal assaults, natural or human-caused disasters,
Salameh et al., 2020; the United Nations Office for the accidents, combat, and other forms of violence.” The
Coordination of Humanitarian Affairs, 2022). Lebanon, previous reports among the Lebanese population shed
a Middle Eastern developing country, falls within this light on the prevalence of PTSD among adolescents,
category (El Khoury-Malhame et al., 2023; Farran, 2021). adult victims of cluster munitions, and habitants of South
It has been shattered by local and regional religious, Lebanon who have endured years-long conflicts and
political, and social conflicts, including a 15-year-long civil multiple traumatic events (Fares et al., 2017; Farhood
war, political instability, military tensions at the borders et al., 2016; Shaar, 2013). Furthermore, studies have found
(Farran, 2021), and the inflow of Syrian refugees since the a close interaction between PTSD and sleep patterns. Sleep
declaration of the war in Syria in 2012 (the United Nations disturbances have often been identified as core symptoms
High Commissioner for Refugees, 2023). All these factors, of PTSD; they increase psychiatric comorbidity, including
combined with corruption and mismanagement of substance use disorder, and decrease quality of life in PTSD

resources,havecrippled Lebanon’s economy and resulted in (Richards et al., 2020). Additional research published
both a downgrade by the World Bank from a high-income during COVID-19 pandemic supported this hypothesis
to upper-middle-income country and an unprecedented and pinpointed perceived stress as a critical factor in sleep
socioeconomic crisis, with massive demonstrations, outcomes (Wu et al., 2021; Wu et al., 2020).
strikes, and temporary bank closures (Arezki et al., 2018; While several studies have assessed the impact of the
Harake & Abou Hamde, 2019). current pandemic on PTSS occurrence (Liu et al., 2020;
Since the first positive case of coronavirus disease Rossi et al., 2020) and quality of sleep (Huang & Zhao,
2019 (COVID-19) was reported in Lebanon on February 2020; Rossi et al., 2020; Voitsidis et al., 2020) in the general
21, 2020, the government implemented several measures population worldwide, none, to our knowledge, has
to curb the spread of the disease, including a sanitary evaluated the combined association of the economy and
lockdown on March 15, 2020 (Rossi et al., 2020). Such COVID-19 on PSTD and insomnia. Such an assessment
actions further deepened the currently collapsing economy, would identify the predictors for the co-occurrence of
and households started experiencing more job losses, these disorders and is essential information for mental-
long-term unemployment, salary cuts, and mortgage health providers when establishing appropriate rescue
payment difficulties (Abou Hassan et al., 2023; Bizri plans and care. Therefore, the objective of this study was
et al., 2021; Farran, 2021). In this economic and sanitary to evaluate the association of COVID-19 and economy-
double hit, Lebanese people may have been exposed to related factors on PTSS and sleep in a sample of the general
death and suffered from severe illnesses due to COVID-19 Lebanese population.
infection, especially in an exhausted and overwhelmed
healthcare system (Fleifel & Abi Farraj, 2022; Zahreddine 2. Data and methods
et al., 2022). The economic crisis made things much 2.1. Study design and sampling
more complicated due to the medications and medical
supply shortages (mainly oxygen and ventilators) and the An online cross-sectional survey was conducted between
inability to subsist in scarce resources (Bizri et al., 2021; May 10, and 20, 2020, and 502 participants were recruited
Koweyes et al., 2021). Thus, Lebanese experienced various through snowball sampling due to the government-
mental adverse outcomes, including increased stress and mandated sanitary lockdown. A questionnaire, which
irritability, uncertainty, nightmares, emotional distress, required 15 – 20 min to be completed, was created on
hypervigilance, sadness, anxiety, isolation, and grief Google Forms and shared with participants on social
(El Khoury-Malhame et al., 2023; Sacre et al., 2022; Salameh media platforms and WhatsApp groups. All individuals
et al., 2020; Younes et al., 2022), which may trigger post- over 18 years of age with access to the internet were eligible
traumatic stress symptoms (PTSS) or disorders (PTSD) to participate.
(American Psychiatric Association, 2015; Hawryluck et al., 2.2. Sample size
2004; Sprang & Silman, 2013) as well as sleep difficulties
that are already highly prevalent among the Lebanese The minimum sample size was calculated using the
population (estimated to be 17.9% using the Lebanese G-Power software, version 3.0.10. The calculated effect

Volume 9 Issue 1 (2023) 70 https://doi.org/10.36922/ijps.440