Anxiety’s correlation with sleepiness and memory among security officers during the COVID-19 pandemic

1 Introduction

The general public is currently exposed to a wide range of mental illnesses, including anxiety, which affects approximately 20% of individuals over the age of 60 [1]. Anxiety disorders are ranked as the tenth most prevalent cause of disability by the World Health Organization due to their high incidence, chronicity, and comorbidity. Various factors such as emotional stress, the untimely death of a loved one, and other social and personal variables contribute to the development of anxiety disorders [2].

Anxiety induced by workplace stress, family issues, job discontent, and loneliness can lead to reduced performance and functioning in the workplace [3–5]. The COVID-19 pandemic, in particular, has resulted in a global increase in psycho-emotionally chaotic conditions, including anxiety, melancholy, stress, sleepiness difficulties, and terror [6]. The uncommon SARS-CoV-2 virus responsible for COVID-19 has had a significant impact on people’s physical and mental health [7].

During the pandemic healthcare personnel including security officers have experienced anxiety more frequently than the general population and noticeable signs of anxiety such as restlessness, impatience, and forgetfulness, have been observed [1, 8]. During the COVID-19 pandemic, elderly security officers faced a unique set of challenges. They were at an increased risk of severe COVID-19 symptoms, given their age, yet had to continue working in public spaces, intensifying concerns for their health. The physical demands of enforcing pandemic-related rules and handling potential conflicts added to their stress. Furthermore, the pandemic’s general anxiety and uncertainty, coupled with the isolation resulting from the need to minimize exposure, likely took a toll on their mental health. The need to adapt to new technology and surveillance tools, coupled with potential economic instability, posed additional challenges. Inadequate training for pandemic-related challenges might have further disadvantaged them. These challenges were compounded by the notable prevalence of depression among guardians of psychiatric patients during the pandemic, emphasizing the importance of providing mental health support and resources to this specific population, particularly in times ofcrisis [9].

These issues often go undiagnosed, especially in security officers who face continuous surveillance and physically and emotionally taxing job requirements. Poor memory has been shown to negatively impact the performance of security personnel, particularly older workers with more demanding jobs, regardless of socio-demographic characteristics or personality traits. In recent years, there has been a growing interest in the intricate relationship between sleepiness and memory processes, particularly in the context of aging. Sleep, a fundamental physiological phenomenon, plays a vital role in memory consolidation and the maintenance of cognitive functions. This dynamic interplay between sleep and memory has garnered substantial attention from researchers seeking to unravel the mechanisms through which sleep, including its circadian rhythms, influences episodic memory, especially among olderadults [10, 11].

The COVID-19 pandemic has brought about a profound impact on mental health worldwide, with anxiety emerging as a prominent concern. Recent studies states that diverse array of variables might influence anxiety levels among this group, including workload, personal protective equipment availability, and exposure to COVID-19 patients [12, 13].

The sleep-related challenges have emerged in the wake of the pandemic and the observed increase in sleep disturbances has implications for individuals’ overall well-being, as adequate sleep is integral to physical and mental health. However, existing research has primarily focused on medical professionals directly involved in treating COVID-19 patients, rather than those who were exposed to them on a daily basis, such as security officers [14]. A study conducted on security officers during the COVID-19 pandemic revealed a high prevalence of severe physical and mental illnesses, including anxiety [15].

Due to the pandemic, security officers have been assigned to COVID-19 wards and intensive care units in addition to their regular duties. This exposes them to constant vigilance, the use of personal protective equipment (PPE), and the sight of deceased individuals, further exacerbating burnout and anxiety [16]. These circumstances can have physical and psychological consequences, contributing to mental illness, forgetfulness, and insomnia [17]. Individuals with anxiety disorders often experience severe cognitive, emotional, and sleep problems. Anxiety is etiologically linked to insomnia, which is a core contributor to sleep disturbances [18].

Research suggests that sleep disturbances, particularly among the working population, are significant symptoms of generalized anxiety disorder (GAD) [19, 20]. Anxiety disorders also affect memory function through the hippocampus and prefrontal cortex [21, 22]. While some studies indicate no significant negative impact on memory performance [23, 24], others demonstrate plausible connections between anxiety and cognitive functions. Diverse memory bias patterns have been observed in various anxiety disorders, including pathological anxiety and the anticipation of potential threats, which can influence memory function [21, 25]. Furthermore, maintaining a balanced sleep-wake cycle is essential for optimal cognitive functioning. Several studies suggest a link between anxiety, poor sleep quality, and memory impairment [26]. Poor sleeping habits can negatively affect attention, focus, memory, and the performance of daily tasks, leading to agitation, nervousness, depression, and mood instability [22]. Additionally, research indicates a strong correlation between cognitive functioning and sleep deprivation, suggesting that inadequate sleep may impact memory [27]. As no prior studies have examined the correlation between sleep duration with memory and anxiety specifically among security officers, the present study aims to provide insights into the prevalence of anxiety disorders and explore the correlations between anxiety symptoms, sleep, and memory during the COVID-19 pandemic.

2 Method

3 Results

The samples’ average age was 65.2 years, and there were 33, (92%) men which was more than women (3, 8%) in the samples. Approximately 61.4% of the participants were between the ages of 60 and 65, and 38.6% were between the ages of 66 and 70. The GAD-7 scale scores revealed that the samples were distributed as mild-19%, moderate-38.2%, and severe-42.8%. The ESS revealed that 2.8% of the study samples had daytime sleepiness that was less than normal, 14.8% had normal daytime sleepiness, 20.1% had mild excessive sleepiness, 24.1% had moderate excessive sleepiness, and 38.7% had severe excessive daily symptoms.

The assumption of normal distribution required for conducting Pearson correlations and to ensure the validity of our analysis, we performed normality tests on the data. The Shapiro-Wilk normality test was conducted to evaluate the distribution of our data, and the results indicated that our data met the necessary conditions for accurate correlation analysis. This suggests that our data exhibited a normal distribution, which is a fundamental assumption for conducting valid correlation analyses.In addition to the present study’s aim, we also found a statistically significant positive link between age and anxiety with a correlation of 0.91 (P < 0.05) (Tables 1 and 2).

A total of 36 of the 42 participants (85.71%) experienced moderate to severe anxiety, and these 36 individuals also had sleep disorders assessed using the Epworth Sleepiness Scale (ESS) and reduced memory performance as assessed by Everyday Memory Questionnaire-Revised (EMQ-R). Anxiety and sleepiness had a correlation of 0.8, while anxiety and memory had a connection of 0.87 with a positive EMQ-R relationship. Moreover, there was a statistically significant association between sleepiness and memory, with a positive correlation of 0.73.

The objective of this study was to determine the prevalence of anxiety among security officers and explore the correlations between anxiety symptoms, sleepiness, and memory during the COVID-19 pandemic. Among security officers aged 60 to 70 (mean age 65.6), we found that 20% experienced mild anxiety, 28.2% experienced moderate anxiety, and 42.8% experienced severe anxiety. In terms of gender distribution, 61.4% of participants aged 60 to 65 were male while 38.6% of participants aged 66 to 70 were male, with a higher proportion of male participants in both age groups. In contrast, a study examining the Generalized Anxiety Disorder Questionnaire among individuals fewer than 60 revealed gender disparities in anxiety symptoms [31].

Compared to other professions, security officers face increased exposure to work-related personal dangers, which heightens their vulnerability to anxiety and emotional disturbances [12]. The combination of excessive stress, poor pay, and potentially life-threatening job requirements contributes to job dissatisfaction among security officers [32]. Previous research by Hallford et al. [33] established a strong correlation between the incidence of generalized anxiety disorder (GAD) and the likelihood of old security officers experiencing falls and violent attacks at work [33, 34]. Studies conducted by Yunus et al. and Jaime et al. have shown that anxiety symptoms can negatively impact sleepiness quality, particularly among older individuals [35, 36].

Our study revealed a significant association between anxiety and sleepiness among security officers, with a higher prevalence of moderate to severe excessive daytime symptoms in those with anxiety symptoms. Insomnia is considered one of the primary symptoms of GAD, with around 60 to 70 percent of individuals with GAD experiencing sleepiness disturbances [19]. Furthermore, our findings using the EMQ-R indicated that security officers are more likely to experience memory issues compared to the general population, as reflected by higher scores. Memory impairment often begins as a minor problem and worsens with increased stress levels, making it an early indicator of cognitive decline [37].

Early diagnosis and treatment of anxiety symptoms are crucial to prevent further issues in affected individuals. Recent research has demonstrated a strong association between cognitive decline, anxiety, and sleepiness problems among older individuals. Timely identification and management of these issues may reduce the risk of further cognitive decline. For future research, we recommend conducting large-scale studies with diverse samples, including both younger and older female security officers. Such studies can provide a better understanding of anxiety’s impact on sleepiness and memory in security officers, as well as explore other factors like job characteristics and personality traits. Additionally, we encourage the use of multicenter studies with cross-sectional designs and large sample sizes to assess various treatment protocols and their long-term effectiveness.

5 Conclusion

The key takeaway from our study is that among senior security officers, there is a substantial prevalence of anxiety accompanied by notable insomnia and memory problems. Our findings indicate a clear relationship between sleepiness disturbances, memory issues, and the most prevalent anxiety symptoms. These results emphasize the importance of incorporating mental health assessments and addressing anxiety in the effective treatment of geriatric patients. Healthcare professionals should prioritize the identification and management of anxiety-related concerns to promote overall well-being and cognitive health in this population.

Ethics considerations

The Saveetha Medical College & Hospital Institutional Ethics Committee approved this phase of human population research proposal with approval number 004/06/2021/IEC/SMCH after it complied with all applicable laws and regulations. The research adhered to the Helsinki Declaration’s ethical guidelines. All the participants recruited for the study were adults, participation was anonymous, no invasive methods were employed, and no participant deception took place.

Informed consent

Following an in-depth description of the methodology, participants from the private hospital were recruited. The intervention methods were presented in detail to the participants in their native language, and a complete information sheet was provided to the individuals, who volunteered for this study. The written and signed informed consent was collected and the records were kept confidentially.

Reporting guidelines

The EQUATOR Network for Reporting Guidelines-STROBE Statement for observational studies with cross-sectional research was followed for reporting the current study.