Trajectories and predictors of sleep quality during and after the pandemic in five European populations

Objectives: This paper investigates the trajectory and potential predictors of sleep quality across 13 waves of data on 5 European populations from April 2020-September 2024. Methods: Data are based on the ongoing COME-HERE survey, a comprehensive longitudinal study designed to capture the socioeconomic, health, and psychological impacts of the COVID-19 pandemic across multiple European countries, including 8063 participants and over 60,000 observations drawn from representative samples in France, Germany, Italy, Spain, and Sweden. Results: Our findings reveal an upward trend in average sleep quality over time, with fluctuations that align with major COVID-19 waves, suggesting pandemic-related disruptions to typical seasonal sleep patterns. Through multivariate regression analysis, female gender, income, employment, physical activity, mental health, and social interactions are key predictors of sleep quality, with financial security and mental health showing particularly strong associations. Importantly, our results hold across diverse groups (by country, gender, age, and education) and remain consistent from the height of the pandemic through to the postpandemic period, supporting the enduring influence of mental health, socioeconomic, and lifestyle factors on sleep quality. Conclusions: Our study highlights the complex interplay between social determinants, mental health, and lifestyles in shaping sleep quality in the general population, regardless of geographic context and the potential impact of major public health emergencies such as the recent COVID-19 pandemic. These findings further emphasize the need for greater attention to sleep health in both clinical and public health settings.