Italy was the first western hotspot of the COVID-19 pandemic. In order to contain the spread of the virus, the Italian Government imposed home confinement to the entire population for almost two months. The present study is the first large-scale longitudinal report of the sleep and mental health changes during the prolonged lockdown due to the COVID-19 outbreak. We focused on the gendered vulnerability in a sample of the Italian population since cross-sectional research identified women to be more at-risk than men during this unprecedented situation.

A total of 2701 individuals (mean age ± standard deviation, 32.37 ± 11.62; range, 18–82) participated in a web-based longitudinal survey consisting of two measurements. Participants were first-time recruited on social networks and via telephone messages through a snowball sampling and tested during the third week of the lockdown period. Subsequently, a follow-up evaluation was carried out during the seventh week of restraining measures. The survey assessed sleep quality, insomnia and depression symptoms, perceived stress, and anxiety, using the following questionnaires: the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, the Beck Depression Inventory-second edition, the 10-item Perceived Stress Scale, and the State-Anxiety Inventory.

Female gender showed the worst condition for all the examined dimensions in both the assessments. Nevertheless, at the follow-up women reported a reduction in insomnia and depression severity symptoms, perceived stress, and anxiety. On the other hand, male participants showed a worsening of sleep quality, insomnia symptoms, and perceived stress. Consequently, the gender prevalence gap of clinical conditions such as insomnia and depression was largely reduced under lockdown.

Our investigation pointed to a different time course of sleep and mental health between genders during the home confinement period. Women seemed to show greater long-term resilience during the lockdown. Meanwhile, the male gender emerges as the most vulnerable category to the extension of the restraining measures. Our results suggest that there is no “weaker gender” after a prolonged lockdown. Indeed, the Italian population transversely presented signs of psychological suffering and significant sleep disturbances after the protracted and stressful lockdown period due to the COVID-19 pandemic.

意大利是COVID-19大流行的第一个西方热点。为了遏制该病毒的传播，意大利政府对整个居民实施了将近两个月的家禁。本研究是因COVID-19爆发而长期锁定期间睡眠和心理健康变化的第一份大规模纵向报告。由于横断面研究发现，在这种前所未有的情况下，女性比男性更容易受到威胁，因此我们关注了意大利人口中的性别脆弱性。

共有2701人（平均年龄±标准差，32.37±11.62；范围18-82）参加了基于网络的纵向调查，其中包括两次测量。参与者是在社交网络上首次招募的，并通过电话信息通过滚雪球采样，并在锁定期的第三周进行了测试。随后，在限制措施的第七周进行了随访评估。该调查使用以下调查表评估了睡眠质量，失眠和抑郁症状，感知的压力和焦虑：匹兹堡睡眠质量指数，失眠严重性指数，贝克抑郁量表（第二版），十项感知压力量表和国家焦虑量表。

在两次评估中，所有检查维度的女性性别状况最差。不过，在随访中，妇女报告失眠和抑郁严重程度症状，感觉到的压力和焦虑有所减轻。另一方面，男性参与者表现出睡眠质量恶化，失眠症状和感觉到的压力。因此，在锁定状态下，失眠和抑郁等临床状况的性别患病率大大降低了。

我们的调查指出，在分娩期间，男女在睡眠和心理健康上的时间过程有所不同。在封锁期间，妇女似乎表现出更大的长期复原力。同时，男性成为限制措施扩展最脆弱的类别。我们的结果表明，长时间的锁定后没有“较弱的性别”。的确，由于COVID-19大流行，在旷日持久的压力性禁闭期之后，意大利人口横向呈现出心理痛苦和严重睡眠障碍的迹象。