# Association Between Depression, Anxiety, Quality of Life and Burnout Syndrome with Symptoms of Insomnia in Healthcare Professionals in Montenegro During the COVID-19 Pandemic

## TL;DR

This study found that healthcare workers in Montenegro during the pandemic experienced high rates of insomnia linked to mental health issues and burnout.

## Contribution

The study specifically examines the interplay between insomnia, mental health, and burnout in Montenegrin healthcare professionals during the pandemic.

## Key findings

- Insomnia symptoms were more common in female participants and associated with alcohol, smoking, and sedative use.
- Healthcare professionals with insomnia reported lower quality of life and higher stress, anxiety, and depression.
- Burnout was significantly linked to emotional exhaustion but not to depersonalization or personal achievement.

## Abstract

Background: The COVID-19 pandemic significantly impacted the mental health and well-being of healthcare professionals worldwide. This study investigated the association between mental health factors, burnout syndrome, quality of life, and insomnia symptoms in healthcare professionals during the COVID-19 pandemic in Montenegro. Methods: A cross-sectional study was conducted between July and October 2021 among 299 healthcare professionals at the Clinical Center of Montenegro. Participants completed standardized questionnaires, including the Maslach Burnout Inventory (MBI-HSS), Athens Insomnia Scale (AIS), depression, anxiety, and stress scale (DASS-21), and EQ-5D health-related quality of life questionnaire. Results: Insomnia was reported in 65.0% of female and 35.0% of male participants, with a mean age of 38.57 ± 11.57 years. Insomnia symptoms were more common among those reporting alcohol consumption (p = 0.007), smoking (p = 0.006), and sedative use (p = 0.038). A higher workload (p = 0.017), previous COVID-19 infection (p = 0.001), and quarantine (p = 0.008) were linked to insomnia. Healthcare professionals with insomnia reported lower quality of life across all EQ-5D dimensions (p < 0.001) and higher levels of stress, anxiety, and depression (p < 0.001). Burnout was significantly associated with emotional exhaustion (p < 0.001), while depersonalization and personal achievement showed no significant differences. Conclusions: This study highlights a significant relationship between burnout, mental health issues, and insomnia during the COVID-19 pandemic. Addressing these factors through targeted interventions and workplace policies is essential for improving healthcare professionals’ well-being and ensuring the healthcare system’s sustainability.