Healthcare workers who are on the front line of COVID-19 and are also undergoing shift schedules face long work hours with few pauses, experience desynchronization of circadian rhythm, and an imbalance between work hours effort and reward in saving lives, resulting in an impact on work capacity, aggravated by the lack of personal protective equipment (PPE), few resources and precarious infrastructure, fear of contracting the virus and contaminating family members. Some consequences are sleep deprivation, chronic insomnia, stress-related sleep disorders, and post-traumatic stress disorder. These sleep alterations critically affect mental health, precipitating or perpetuating anxiety, stress, and depression, resulting in the inability to regulate positive and negative emotions. Pre-existing sleep disorders are an important risk factor for the development and maintenance of PSTD when individuals are exposed to an important stressor such as a COVID-19 pandemic. At the same time, how an individual regulates the emotion associated with worries during daytime functioning impacts nighttime sleep, precipitating and perpetuating difficulties in sleeping. All of these changes in sleep and emotional regulation also alter the immune system. Sleep deprivation is commonly associated with chronic inflammatory diseases, due to the desynchronizations in circadian rhythms, causing possible psychophysiological disorders and impaired neuroimmune-endocrine homeostasis. From this perspective, we clarify in this article how sleep disorders affect the immune system and emotional regulation, explaining their phenomenological and neurobiological mechanisms, and discussing elements of cognitive and behavioral coping for health professionals to adopt and manage a healthier sleep pattern in the COVID-19 outbreak.

中文翻译：

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睡眠剥夺对医护人员情绪调节和免疫系统的影响作为 COVID 19 的危险因素：拉丁美洲睡眠心理学协会工作组的实用建议

处于 COVID-19 前线且实行轮班制的医护人员面临着长时间工作、几乎没有停顿、昼夜节律不同步以及工作时间努力与拯救生命的回报之间不平衡，从而影响由于缺乏个人防护装备（PPE）、资源匮乏和基础设施不稳定以及担心感染病毒和污染家庭成员，工作能力进一步恶化。一些后果是睡眠不足、慢性失眠、压力相关的睡眠障碍和创伤后应激障碍。这些睡眠改变严重影响心理健康，引发或持续焦虑、压力和抑郁，导致无法调节积极和消极情绪。当个体暴露于重要的压力源（例如 COVID-19 大流行）时，先前存在的睡眠障碍是发生和维持 PSTD 的重要危险因素。与此同时，个人如何调节白天功能中与忧虑相关的情绪会影响夜间睡眠，从而导致和延续睡眠困难。所有这些睡眠和情绪调节的变化也会改变免疫系统。由于昼夜节律不同步，睡眠不足通常与慢性炎症性疾病有关，导致可能的心理生理障碍和神经免疫内分泌稳态受损。从这个角度来看，我们在本文中阐明了睡眠障碍如何影响免疫系统和情绪调节，解释其现象学和神经生物学机制，并讨论卫生专业人员在新冠肺炎疫情中采取和管理更健康的睡眠模式的认知和行为应对要素。 19日爆发。