Stay-at-home circumstances do not produce sleep disorders: An international survey during the COVID-19 pandemic

Stop (to Work) and Go (to Recover) During Mandatory Work From Home: A Three-Wave Study

During the COVID-19 pandemic, many workers have been forced to work from home. In this situation, the boundaries between work and private life have become particularly blurred, and recovering from work was even more difficult than in traditional times, with negative consequences for workers' health. Among the psychological experiences that might underlie the recovery process, mastery played a crucial role as people sought new stimuli and challenging situations. However, there are few articles that have explored the role of this specific recovery experience, its antecedents, and the health consequences under conditions of work from home. Therefore, in this multiwave study, we aimed to investigate the role of mastery as a mediator between supervisor support and insomnia problems. The study was conducted during the COVID-19 pandemic in Italy and had a three-wave design. A convenience sample of 130 employees (67% women) completed an online questionnaire. Hypotheses were tested using a three-wave autoregressive cross-lagged panel model. According to the results, supervisor support at Time 1 was positively related to mastery at Time 2, which in turn showed a negative association with insomnia at Time 3. The results demonstrated that mastery experiences have played a crucial role during COVID-19 mandatory work from home, which points to some potential implications for workers' health in the adoption of teleworking beyond the emergency situation.

Children's Sleep and Mental Health During the COVID-19 Pandemic

PURPOSE OF REVIEW

The COVID-19 pandemic and protracted home confinement required adjustments to schedules and routines generating concern about children's sleep. This review describes general considerations regarding children's sleep, changes and disturbances in their sleep during the pandemic, and the association of sleep measures with health and psychological outcomes in general and in the context of the pandemic.

RECENT FINDINGS

A number of studies found an increase in the duration of children's sleep with later bedtimes and waketimes for some children. The research also documented sleep disturbances and associations between children's sleep and psychological outcomes. The extent to which increased sleep duration and changed sleep behaviors translated into improved sleep quality and/or a change in sleep disturbances remains unclear. This review suggests the importance of considering children's sleep in other mass trauma situations including, for example, natural and man-made disasters, as well as pandemics.

Effects of the COVID-19 pandemic on screen time and sleep in early adolescents

OBJECTIVE

During the COVID-19 pandemic, adolescents and families have turned to online activities and social platforms more than ever to maintain well-being, connect remotely with friends and family, and online schooling. However, excessive screen use can have negative effects on health (e.g., sleep). This study examined changes in sleep habits and recreational screen time (social media, video gaming), and their relationship, before and across the first year of the pandemic in adolescents in the Adolescent Brain Cognitive Development (ABCD) Study.

METHOD

Mixed-effect models were used to examine associations between self-reported sleep and screen time using longitudinal data of 5,027 adolescents in the ABCD Study, assessed before the pandemic (10-13 years) and across six time points between May 2020 and March 2021 (pandemic).

RESULTS

Time in bed varied, being higher during May-August 2020 relative to pre-pandemic, partially related to the school summer break, before declining in October 2020 to levels lower than pre-pandemic. Screen time steeply increased and remained high across all pandemic time points relative to pre-pandemic. Higher social media use and video gaming were associated with shorter time in bed, later bedtimes, and longer sleep onset latency.

CONCLUSIONS

Sleep behavior and screen time changed during the pandemic in early adolescents. More screen time was associated with poorer sleep behavior, before and during the pandemic. While recreational screen usage is an integral component of adolescent's activities, especially during the pandemic, excessive use can have negative effects on essential health behaviors, highlighting the need to promote balanced screen usage. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Poor Sleep Quality and Working From Home Influence the Prevalence of Leisure Time Physical Inactivity During the COVID-19 Pandemic: COVID-Inconfidentes Study

OBJECTIVE

The aim of the study is to explore possible associations according to quality of sleep and work from home (WFH) with physical inactivity (PI) during the COVID-19 pandemic.

METHODS

This is a cross-sectional study in two Brazilian cities (>18 years), by probability sampling. Leisure-time physical activity was self-reported and classified according to guidelines. Sleep was by applying the Pittsburgh Sleep Quality Index. Work from home was classified as: total WFH or no WFH.

RESULTS

A total of 1750 adults were analyzed, 69.1% were physically inactive, 51.9% had poor sleep quality, and 79.8% were not in WFH. PI was associated with poor sleep quality and non-WFH. Compared with those who reported WFH and good sleep quality, those who reported non-WFH and poor sleep quality had 4 times the prevalence of PI.

CONCLUSIONS

Poor sleep quality, and not WFH, is associated with leisure PI. These factors combined increase the probability of PI.

Sleep Debt Mediates the Relationship between Work-Related Social Factors, Presenteeism, and Well-Being in Japanese Workers

Sleep debt is associated with presenteeism and mental health; however, the association of sleep debt with presenteeism and well-being in the context of work-related social factors (commuting time, workdays, and working hours) has not been fully elucidated. This study aimed to examine whether work-related social factors are associated with presenteeism and well-being via sleep debt. The participant group comprised 872 full-time and 526 part-time workers (mean age: 44.65 ± 12.37 and 48.47 ± 12.93 years, respectively). For both the full-time and part-time workers, increased sleep debt was significantly associated with presenteeism (β = -0.171; β = -0.160) and low well-being (β = -0.135; β = -0.153). Notably, commuting time was significantly associated with increased sleep debt in full-time workers (β = 0.09). In contrast, the number of workdays was significantly associated with increased sleep debt in part-time workers (β = -0.102). Working hours were not significantly associated with sleep debt for both full- and part-time workers. These results reveal that sleep debt might lead to various risks among workers, elucidating the work-related social factors related to sleep debt. They also highlight the importance of considering work-related social factors when addressing sleep debt.

Sleep Deprivation and Insomnia in Adolescence: Implications for Mental Health

Sleep changes significantly throughout the human lifespan. Physiological modifications in sleep regulation, in common with many mammals (especially in the circadian rhythms), predispose adolescents to sleep loss until early adulthood. Adolescents are one-sixth of all human beings and are at high risk for mental diseases (particularly mood disorders) and self-injury. This has been attributed to the incredible number of changes occurring in a limited time window that encompasses rapid biological and psychosocial modifications, which predispose teens to at-risk behaviors. Adolescents’ sleep patterns have been investigated as a biunivocal cause for potential damaging conditions, in which insufficient sleep may be both a cause and a consequence of mental health problems. The recent COVID-19 pandemic in particular has made a detrimental contribution to many adolescents’ mental health and sleep quality. In this review, we aim to summarize the knowledge in the field and to explore implications for adolescents’ (and future adults’) mental and physical health, as well as to outline potential strategies of prevention.

Changes in work/sleep patterns due to the COVID-19 pandemic are associated with psychological distress among Japanese workers

Objectives

The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted working life quality. This study investigated whether changes in work/sleep patterns due to the pandemic are related to poor psychological status among Japanese workers during the third wave of the COVID-19 pandemic (December 2020). We hypothesized that workers who experienced drastic changes in working hours and sleep duration would be at an increased risk of psychological distress.

Methods

A cross-sectional self-administered Internet survey was conducted that included questions regarding socio-demographics, lifestyle, health, and occupational background and conditions. Multivariable logistic regression models were utilized to examine the association between psychological distress and a combination of changes in working hours and sleep duration.

Results

Among 25,762 workers, decreased work hours and decreased sleep duration presented 2.59 times higher odds of psychological distress (95% confidence interval [CI] = 2.05–3.28) compared to those who had no changes in work hours combined with unchanged sleep duration (reference group). Increased work hours and decreased sleep duration were associated with 1.98 times higher odds of psychological distress (95% CI = 1.64–2.39).

Conclusion

Our observations confirmed that decreased sleep duration could be a key factor for psychological distress, irrespective of working hours. Interestingly, workers with a combination of decreased work hours and sleep duration posed the highest risk of psychological distress. Decreased work hours accompanied by financial difficulties in the early stage of the pandemic may have caused decreased sleep duration, resulting in a high prevalence of psychological distress. Our study underlined the importance of sleep management in maintaining workers’ mental health, moreover, the need to consider situations and conditions of other daily tasks, such as work hours, for better sleep management.

Lifestyle of Families with Children Aged 4-8 Years before and during Lockdown Due to COVID-19 Pandemic in Poland

The aim of the study was to evaluate the lifestyle changes of families with children aged 4-8 years during lockdown compared to the time before the COVID-19 pandemic. The study was conducted among 1098 parents during the first lockdown in Poland. An originally developed questionnaire was used as the research tool. The Wilcoxon test was used to determine the frequency of differences in the lifestyle of parents and children before the pandemic and during lockdown. Differences were found in the frequency of healthy habits in the periods under investigation, both in the lifestyle of parents and children. A moderately healthy lifestyle was predominant among families with children aged 4-8 years during lockdown. The families' lifestyle significantly changed in relation to the time before the pandemic. There is a need for lifestyle education for families with children to prevent the development of bad habits during and after the pandemic and isolation time.

Psychological Research on Sleep Problems and Adjustment of Working Hours during Teleworking in the COVID-19 Pandemic: An Exploratory Study

Mandatory home isolation caused by COVID-19 in professional contexts led to a situation that required work activities to be converted into a remote modality. The literature on this topic is very recent, given the pandemic and the uncertainty of virtual and face-to-face work modalities. This study aimed to examine the effects of adults' prolonged exposure to screens on sleep quality, the type of devices used according to age and gender, periods of access to such devices and the impact on performance in the context of telework due to COVID-19. Specifically, the study analyzed the differences in the use of devices and in the time spent using them during and after teleworking between genders and age groups. A total of 127 Portuguese participants answered the Pittsburgh Sleep Quality Index and a questionnaire that we specifically developed to characterize teleworking habits. The results showed differences between men and women regarding the use of devices and its impact on sleep quality, as well as differences in terms of age. These results are discussed in terms of how the current work context may affect performance, sleep, gender differences and the adverse effects of exposure to screens during and after work hours.

The prevalence of insomnia in different COVID-19 policy phases: Longitudinal evidence from ITA.LI - Italian Lives

BACKGROUND

This study investigated changes in the prevalence of insomnia in Italy during COVID-19, starting from the first lockdown period (8 March 2020). We hypothesized that lockdown precipitated increased prevalence of insomnia symptoms relative to the pre-pandemic period; b) the gradual relaxation of containment measures - post-lockdown period (Phase 2 and Phase 3) - reduced insomnia severity, leading to a relative recovery of pre-pandemic levels; and c) we tested age-related heterogeneity in sleep responses, with an expected higher increase in insomnia in younger and middle-age groups.

METHODS

Analyses drew on a subsample (N = 883) of respondents to ITA.LI - Italian Lives, a recently established panel study on a probability sample of individuals aged 16 + living in Italy. To estimate patterns of change in insomnia, we first fitted a random-effects ordered logistic model on the whole sample. We then added an interaction term between policy phases and the respondent age to test whether the relationship between insomnia and policy phases differed across age groups. Analyses accounted for survey non-response weights.

RESULTS

The fraction of respondents reporting moderate ("somewhat" + 0.159, S.E. 0.017) or severe ("very much" + 0.142, S.E. 0.030) sleep disturbances significantly increased during Phase 1. The prevalence of insomnia followed an inverted U-shaped curve across policy phases, with further increases from baseline levels ("somewhat" + 0.168, S.E. 0.015; "very much" + 0.187, S.E. 0.030) during Phase 2, followed by a relative reduction in Phase 3, although it remained significantly higher than in the pre-pandemic period ("somewhat", + 0.084, S.E. 0.016; "very much", + 0.045, S.E. 0.010). There were significant age-related differences in insomnia patterns, as the discrete change from pre-pandemic levels in the probability of not suffering from insomnia was negative and significant for the younger age group (- 0.269, S.E. 0.060) and for respondents aged 35-54 (- 0.163, S.E. 0.039).

CONCLUSION

There is reason to believe that the emergency policy response to the COVID-19 crisis may have had unintended and possibly scarring effects in terms of increased prevalence of insomnia. The hardest hit were young adults and, to a lesser extent, the middle-aged; however, older respondents (55 +) remained resilient, and their insomnia trajectory bounced back to pre-pandemic levels.

Associations between longitudinal changes in sleep disturbance and depressive and anxiety symptoms during the COVID-19 virus pandemic among older women with and without breast cancer in the thinking and living with breast cancer study

PURPOSE

Several studies have reported sleep disturbances during the COVID-19 virus pandemic. Little data exist about the impact of the pandemic on sleep and mental health among older women with breast cancer. We sought to examine whether women with and without breast cancer who experienced new sleep problems during the pandemic had worsening depression and anxiety.

METHODS

Breast cancer survivors aged ≥60 years with a history of nonmetastatic breast cancer (n = 242) and frequency-matched noncancer controls (n = 158) active in a longitudinal cohort study completed a COVID-19 virus pandemic survey from May to September 2020 (response rate 83%). Incident sleep disturbance was measured using the restless sleep item from the Center for Epidemiological Studies-Depression Scale (CES-D). CES-D score (minus the sleep item) captured depressive symptoms; the State-Anxiety subscale of the State Trait Anxiety Inventory measured anxiety symptoms. Multivariable linear regression models examined how the development of sleep disturbance affected changes in depressive or anxiety symptoms from the most recent prepandemic survey to the pandemic survey, controlling for covariates.

RESULTS

The prevalence of sleep disturbance during the pandemic was 22.3%, with incident sleep disturbance in 10% and 13.5% of survivors and controls, respectively. Depressive and anxiety symptoms significantly increased during the pandemic among women with incident sleep disturbance (vs. no disturbance) (β = 8.16, p < 0.01 and β = 6.14, p < 0.01, respectively), but there were no survivor-control differences in the effect.

CONCLUSION

Development of sleep disturbances during the COVID-19 virus pandemic may negatively affect older women's mental health, but breast cancer survivors diagnosed with the nonmetastatic disease had similar experiences as women without cancer.

Changes in Canadian Adolescent Time Use and Movement Guidelines During the Early COVID-19 Outbreak: A Longitudinal Prospective Natural Experiment Design

BACKGROUND

Comprehensive, prospective, longitudinal data are lacking on the effects of the COVID-19 outbreak on adolescents' movement behaviors (moderate to vigorous physical activity [MVPA], sleep, recreational screen use, and strengthening exercises). The purpose was to compare movement behavior changes among adolescents affected by the pandemic with controls.

METHODS

Survey data from 10,659 students at 82 Canadian secondary schools (aged 12-19 y) during the 2018-2019 and 2019-2020 school years were analyzed. One-year change in time spent in movement behaviors and likelihood of meeting Canadian 24-hour movement guidelines was compared between preoutbreak controls (October 2019-March 2020) and early outbreak respondents (May-July 2020) after controlling for sociodemographic factors.

RESULTS

Compared with controls, the early outbreak group reported a greater decrease in time spent in MVPA and greater increases in time spent in sleep and recreational screen use. The early outbreak group was less likely to meet MVPA and recreational screen time guidelines but more likely to meet guidelines for strengthening exercises and sleep duration.

CONCLUSIONS

Findings for MVPA and screen time changes were in the same direction as retrospective reports from children and youth samples. Sleep adherence may have improved due to no longer having to commute to school. Strengthening exercises may represent physical activity that is easier to do in the home with minimal equipment leading to improved adherence during restrictions.

Postpartum sleep health in a multiethnic cohort of women during the COVID-19 pandemic in New York City

OBJECTIVE/DESIGN

Cross-sectional study to examine the determinants of sleep health among postpartum women during the COVID-19 pandemic in New York City (NYC).

SETTING/PARTICIPANTS

A subset of participants recruited as part of the COVID-19 Mother Baby Outcomes (COMBO) cohort at Columbia University (N = 62 non-Hispanic White, N = 17 African American, N = 107 Hispanic).

MEASUREMENTS

Data on maternal sleep, COVID-19 infection during pregnancy, sociodemographic, behavioral, and psychological factors were collected via questionnaire at 4 months postpartum. Self-reported subjective sleep quality, latency, duration, efficiency, disturbances, and daytime dysfunction were examined as categorical variables (Pittsburgh Sleep Quality Index [PSQI]). Associations between sleep variables and COVID-19 status, time of the pandemic, sociodemographic, behavioral, and psychological factors were estimated via independent multivariable regressions.

RESULTS

Mothers who delivered between May-December 2020, who delivered after the NYC COVID-19 peak, experienced worse sleep latency, disturbances and global sleep health compared to those who delivered March-April 2020, the peak of the pandemic. Maternal depression, stress and COVID-19-related post-traumatic stress were associated with all sleep domains except for sleep efficiency. Maternal perception of infant's sleep as a problem was associated with worse global PSQI score, subjective sleep quality, duration, and efficiency. Compared to non-Hispanic White, Hispanic mothers reported worse global PSQI scores, sleep latency, duration and efficiency, but less daytime dysfunction.

CONCLUSIONS

These findings provide crucial information about sociodemographic, behavioral, and psychological factors contributing to sleep health in the postpartum period.

Changes in Frequency and Patterns of Marital Sexual Activity During COVID-19: Evidence From Longitudinal Data Prior to, During and After Lockdown in Singapore

BACKGROUND

The literature suggests that the pandemic has affected sexual activity and sexual desire around the world, potentially due to increased levels of stress, movement restrictions under lockdown conditions, and changes in relationship quality.

AIM

To investigate changes in frequency and patterns of marital sexual activity and the role of potential factors underlying these changes, during and after COVID-19 lockdown.

METHODS

This longitudinal study followed 409 heterosexual married female participants who completed a baseline survey in April-July 2018 and biweekly online surveys over the next 14 weeks; an online survey in May 2020 during the lockdown in Singapore; and an online survey in June 2020 after the lockdown was lifted. Participants were recruited in 2018 using street intercept and screened for inclusion and exclusion criteria. Logistic fixed-effects models were used to test for changes in frequency and patterns of marital sexual activity and assess underlying factors. Pseudo-design-based sample weights were applied.

OUTCOMES

The 2018 in-person baseline survey collected information on demographic characteristics and ideal frequency of marital sex, while follow-up online questionnaires in May-June 2020 included items on exact dates of marital sexual activity of previous weeks; stress and fatigue levels; both spouses' stay-at-home statuses during lockdown; and marital satisfaction.

RESULTS

409 heterosexual married women were included in this study. Compared to pre-pandemic levels, the proportion of participants not having marital sex within a week remained stable while weekly sexual frequency increased, with more evenly distributed sexual activity on weekdays and weekends. Stress, fatigue, and marital satisfaction levels predicted probability of non-activity and sexual frequency.

CLINICAL TRANSLATION

The increase in weekly sexual frequency has implications for sexual and reproductive health, including sexual satisfaction and prevalence of infertility and low birth weight associated with waiting time to pregnancy.

STRENGTHS & LIMITATIONS

The longitudinal nature of the dataset provides unique insights into differences in frequency of marital sexual activity during compared to before the pandemic. Unlike previous studies, detailed data on exact dates of sexual activity allow for detection of differences in sexual activity by day of the week. However, dates of sexual activity were recorded retrospectively and may contain recall errors. Data were collected only from wives and hence dates of marital sexual activities were not cross-validated with husbands.

CONCLUSION

Results point to more active and flexible marital sex lives during the pandemic, with effects that persisted after the lockdown ended. Tan PL. Changes in Frequency and Patterns of Marital Sexual Activity During COVID-19: Evidence From Longitudinal Data Prior to, During and After Lockdown in Singapore. J Sex Med 2022;19:188-200.

Changes in sleep patterns of college students in Israel during COVID-19 lockdown, a sleep diaries study

To prevent and reduce the spread of COVID-19, governments around the world apply social restrictions and lockdowns. Such lockdowns significantly alter daily routine and habits. A growing body of research indicates that lockdowns affect sleep and circadian rhythms. The current study further explores this effect using sleep logs for a relatively long duration including lockdown and post-lockdown periods in Israel. For two consecutive months, both during lockdown and during post-lockdown periods, from March 13th, 2020 to May 12th, 2020, Israeli students were asked to fill out daily sleep logs in which they report their sleep and wake times. The participants were also asked to fill out the Morningness–Eveningness Questionnaire (MEQ) in the beginning of the study. Data show increase in sleep duration and a delayed midsleep point during lockdown, compared to post-lockdown periods, both on workdays and on weekends. An interaction between chronotype and lockdown was also observed; morning types sleep more both during lockdown and during post-lockdown periods. Interestingly, the midsleep point of late chronotypes is later during both workdays and weekends even during lockdown when social constrains on sleep time are in part removed. Overall, the current results based on detailed and relatively long-term sleep logs analysis confirm previous work using limited measures, such as one-time questionnaires. A lockdown period affects sleep–wake behavior: during lockdown people sleep duration is increased and their sleep onset is delayed. Nevertheless, the circadian preference of individuals is conserved across conditions.

Social Isolation and Sleep: Manifestation During COVID-19 Quarantines

Although researchers have investigated the impact of social isolation on well-being, the recent quarantines due to COVID-19 resulted in a social isolation environment that was unique to any examined in the past. Because sleep is one of the endogenous drives that impacts short and long-term health and well-being, it is important to consider how social isolation during the COVID-19 government-mandated quarantines affected sleep and sleep habits. A number of researchers have addressed this question during the last 2 years by examining several concepts related to possible changes in sleep during the quarantines. To best understand these recent results, the current mini review provides a background on the pre-pandemic literature on the effects of social isolation and loneliness with a focus on sleep and then summarizes the recent literature on sleep and sleep habits. In general, sleep was negatively impacted for many people during the pandemics but not all. One group that seemed to benefit from the pandemic in terms of sleep patterns, were younger people who could more easily adapt their sleep times to match their internal chronobiology. Given the potential broad impact of sleep on health and well-being, better understanding how social isolation impacts sleep is an important consideration for individuals, work organizations, and governments.

Impact of COVID-19 pandemic lockdown on movement behaviours of children and adolescents: a systematic review

INTRODUCTION

Several studies have examined how the lockdown restrictions enforced to halt the spread of COVID-19 have affected children and adolescents' movement behaviours, but there is a need to synthesise these findings. Therefore, we conducted this systematic review to examine the impact of COVID-19 lockdown on children and adolescents' movement behaviours.

METHODS

We searched eight databases and grey literature for relevant studies of all study designs; and conducted a narrative analysis of the results following synthesis without meta-analysis guidelines. We used appropriate tools to assess the risk of bias in quantitative and qualitative studies. We compared changes in physical activity, screen time and sleep duration and quality from before to during the COVID-19 lockdown.

RESULTS

This review included 71 studies reporting data from 35 countries and territories, mostly from high-income economies. A majority of the studies used a cross-sectional design and had fair to poor-quality ratings. Most studies reported reduced physical activity, increased screen time and longer sleep hours among children and adolescents. Children and adolescents facing strict lockdowns saw a larger decline in physical activity and a sharper increase in screen time than those under mild restrictions.

CONCLUSION

COVID-19-related lockdowns were detrimental to children and adolescents' movement behaviours, with stricter lockdowns tending to have a bigger impact. Children and adolescents under COVID-19 restrictions are likely to be less active, spend more time on screen, and sleep longer hours than before the lockdown. More studies from low-income and middle-income countries could provide a clearer picture of the impact.

PROSPERO REGISTRATION NUMBER

CRD42021245924.

Subjective sleep quality before and during the COVID-19 pandemic in a Brazilian rural population

OBJECTIVES

Prior studies have examined sleep during the coronavirus disease 2019 (COVID-19) pandemic, but have few compared sleep measured both during and prior to COVID. We examined the impact of the COVID-19 pandemic on subjective sleep quality in general and separately by gender and age (<50 vs. ≥50 years). Further, we compared sleep quality between those who did and did not follow quarantine orders.

METHODS

This sample is from the Baependi Heart Study, a family-based cohort of adults in South-eastern Brazil. Longitudinal data were from 417 individuals who completed the Pittsburgh Sleep Quality Index (PSQI) twice: between January 2010 and September 2014 (pre-COVID) and during the COVID-19 stay-at-home order March-June, 2020. Cross-sectional analysis included 800 participants.

RESULTS

Mean (±SD) PSQI scores were significantly higher during than before COVID-19 (5.7 ± 3.8 vs. 5.0 ± 3.3, p < .01). This increase was significant among women and among adults ≥50 years but not in men or younger adults. The significant increase in PSQI was only observed in those who quarantined during COVID-19 (5.9 ±3.7 vs. 5.2 ±3.4, p < .01) and not those who did not quarantine (5.0 ± 3.7 vs. 4.5 ± 3, p = .12). In cross-sectional analyses, individuals who quarantined had higher PSQI scores than nonquarantined individuals (6.1 ± 3.9 vs. 5.0 ± 3.5, p < .01). The quarantine status-dependent differences were significant for women (6.4 ± 4 vs. 5.2 ± 3.7, p < .01) and older adults (6.6 ± 0.1 vs. 5.5 ± 3.3, p = .04). Differences by quarantine status were attenuated after adjusting for age and gender.

CONCLUSIONS

Subjective sleep quality declined during the COVID-19 pandemic, particularly among women, older adults, and those compliant to quarantine orders.

Exploring the impact of COVID-19 on the movement behaviors of children and youth: A scoping review of evidence after the first year

PURPOSE

The objective of this scoping review was to summarize systematically the available literature investigating the relationships between the coronavirus disease 2019 (COVID-19) pandemic and movement behaviors (physical activity, sedentary behavior, and sleep) of school-aged children (aged 5-11 years) and youth (aged 12-17 years) in the first year of the COVID-19 outbreak.

METHODS

Searches for published literature were conducted across 6 databases on 2 separate search dates (November 25, 2020, and January 27, 2021). Results were screened and extracted by 2 reviewers (DCP and KR) independently, using Covidence. Basic numeric analysis and content analysis were undertaken to present thematically the findings of included studies according to the associated impact on each movement behavior.

RESULTS

A total of 1486 records were extracted from database searches; of those, 150 met inclusion criteria and were included for analysis. Of 150 articles, 110 were empirical studies examining physical activity (n = 77), sedentary behavior/screen time (n = 58), and sleep (n = 55). Results consistently reported declines in physical-activity time, increases in screen time and total sedentary behavior, shifts to later bed and wake times, and increases in sleep duration. The reported impacts on movement behaviors were greater for youth than for children.

CONCLUSION

The COVID-19 pandemic is related to changes in the quantity and nature of physical activity, sedentary behavior, and sleep among children and youth. There is an urgent need for policy makers, practitioners, and researchers to develop solutions for attenuating adverse changes in physical activity and screen time among children and youth.

The impact of lockdown on sleep patterns of children and adolescents with ADHD

STUDY OBJECTIVES

The current study examined the impact of home confinement (lockdown) because of the COVID-19 pandemic on the sleep patterns of children and adolescents with attention-deficit hyperactivity disorder (ADHD).

METHODS

Nine hundred ninety-two parents of children and adolescents with ADHD filled out an anonymous online survey through the ADHD family association website. The survey investigated the sleep patterns and disturbances (using a modified version of the Sleep Disturbance Scale for Children) and screen exposure time before and during lockdown.

RESULTS

During lockdown, 59.3% of children and 69.4% of adolescents with ADHD reported a change of bedtime, with a significant increase in patients with ADHD who went to sleep at 11 pm or later. Sleep duration, in contrast, resulted in 2 opposing processes with more children and adolescents sleeping either less than 6 hours/night or 10-11 hours/night. Among children and adolescents, respectively, 19.9% and 22% slept less than they did before lockdown, whereas 21.4% and 27.4% slept for more hours. Bedtime delay and decreased sleep duration were associated with an increase in screen time exposure. Moreover, patients with ADHD reported an increase in sleep disturbances when compared to their previous condition, mainly including difficulties falling asleep, anxiety at bedtime, night awakenings, nightmares, and daytime sleepiness.

CONCLUSIONS

Lockdown impacted sleep-wake rhythms by strengthening the maladaptive sleep patterns reported in usual-life conditions in children and adolescents with ADHD.

CITATION

Bruni O, Giallonardo M, Sacco R, Ferri R, Melegari MG. The impact of lockdown on sleep patterns of children and adolescents with ADHD. J Clin Sleep Med. 2021;17(9):1759-1765.

Pre-pandemic sleep behavior and adolescents' stress during Covid-19: a prospective longitudinal study

OBJECTIVE

To prospectively document changes in adolescents' sleep before versus during the COVID-19 pandemic, and to examine their impact on adolescents' perceived stress.

METHODS

Sixty-two typically developing adolescents participated in the study before (Time 1: January 15 to March 13, 2020) and during (Time 2: May 15 to June 30, 2020) the COVID-19 pandemic in Canada. At Time 1, each participant's sleep pattern was assessed in the home environment using actigraphy and sleep logs for seven consecutive nights. Adolescents completed a battery of questionnaires in which they reported on their sleep schedule, duration, and quality, as well as their activities at bedtime, their daytime sleepiness, and their social/emotional behavior. The participants' parents provided demographic information. At Time 2, each participant completed a sleep log, the same battery of questionnaires regarding sleep, and the Perceived Stress Scale.

RESULTS

(1) Adolescents' reported sleep was of longer duration and on a delayed schedule during the COVID-19 pandemic compared to pre-pandemic. (2) A larger proportion of adolescents reported meeting or exceeding the recommended amount of sleep during the COVID-19 pandemic compared to pre-pandemic sleep. (3) "Social jet lag" disappeared during the COVID-19 pandemic. (4) A shorter reported sleep duration and higher level of arousal at bedtime at Time 1 were significant predictors of adolescents' perceived stress at Time 2-during the COVID-19 pandemic. (5) A higher levels of arousal at bedtime and lower reported sleep quality at Time 2 were concurrently associated with higher levels of perceived stress among adolescents, even when we controlled for the levels of pre-pandemic emotional or behavioral issues, sleep duration, or sleep quality.

CONCLUSION

Sleep duration and cognitive-emotional arousal, which are both modifiable behaviors, were associated with adolescents' perceived stress during the COVID-19 pandemic. These behaviors could be useful targets for preventive interventions aiming to reduce adolescents' stress in the face of stressogenic situations, such as the COVID-19 pandemic.

Evening-types show highest increase of sleep and mental health problems during the COVID-19 pandemic - Multinational study on 19,267 adults

Study Objectives

Individual circadian type is a ubiquitous trait defining sleep, with eveningness often associated with poorer sleep and mental health than morningness. However, it is unknown whether COVID-19 pandemic has differentially affected sleep and mental health depending on the circadian type. Here, the differences in sleep and mental health between circadian types are examined globally before and during the COVID-19 pandemic.

Methods

The sample collected between May and August 2020 across 12 countries/regions consisted of 19 267 adults with information on their circadian type. Statistical analyses were performed by using Complex Sample procedures, stratified by country and weighted by the number of inhabitants in the country/area of interest and by the relative number of responders in that country/area.

Results

Evening-types had poorer mental health, well-being, and quality of life or health than other circadian types during the pandemic. Sleep–wake schedules were delayed especially on working days, and evening-types reported an increase in sleep duration. Sleep problems increased in all circadian types, but especially among evening-types, moderated by financial suffering and confinement. Intermediate-types were less vulnerable to sleep changes, although morningness protected from most sleep problems. These findings were confirmed after adjusting for age, sex, duration of the confinement, or socio-economic status during the pandemic.

Conclusions

These findings indicate an alarming increase in sleep and mental health problems, especially among evening-types as compared to other circadian types during the pandemic.

COVID-19 instructional approaches (in-person, online, hybrid), school start times, and sleep in over 5,000 U.S. adolescents

Study Objectives

To examine associations among instructional approaches, school start times, and sleep during the COVID-19 pandemic in a large, nationwide sample of U.S. adolescents.

Methods

Cross-sectional, anonymous self-report survey study of a community-dwelling sample of adolescents (grades 6–12), recruited through social media outlets in October/November 2020. Participants reported on instructional approach (in-person, online/synchronous, online/asynchronous) for each weekday (past week), school start times (in-person or online/synchronous days), and bedtimes (BT) and wake times (WT) for each identified school type and weekends/no school days. Sleep opportunity was calculated as BT-to-WT interval. Night-to-night sleep variability was calculated with mean square successive differences.

Results

Respondents included 5,245 racially and geographically diverse students (~50% female). BT and WT were earliest for in-person instruction; followed by online/synchronous days. Sleep opportunity was longer on individual nights students did not have scheduled instruction (>1.5 h longer for online/asynchronous than in-person). More students obtained sufficient sleep with later school start times. However, even with the same start times, more students with online/synchronous instruction obtained sufficient sleep than in-person instruction. Significantly greater night-to-night variability in sleep-wake patterns was observed for students with in-person hybrid schedules versus students with online/synchronous + asynchronous schedules.

Conclusions

These findings provide important insights regarding the association between instructional approach and school start times on the timing, amount, and variability of sleep in U.S. adolescents. Given the public health consequences of short and variable sleep in adolescents, results may be useful for education and health policy decision-making for post-pandemic secondary schools.

Eating habits and lifestyle changes among higher studies students post-lockdown in Bangladesh: A web-based cross-sectional study

BACKGROUND

The Coronavirus is still exhibiting cases in Bangladesh thus educational institutes are still ceased over one year, it becomes burdens to students at post lockdown period.

OBJECTIVES

Identifying the changes in eating habits and lifestyles including, physical activity, sleeping hours, and sleep quality after the cancellation of lockdown than the period of restrictions.

METHODS

A quasi-experimental cross-sectional study was conducted among 394 students in Bangladesh using a structured questionnaire from February 3, 2021, to February 13, 2021.

RESULTS

Consuming homemade foods drops by 8.63% at post lockdown than lockdown period. At post lockdown, 26.67% of students gained weight whereas 47.46% of respondents never engaged in any physical works. There has been a significant correlation between weight gain and physical activities (p = 0.007). Not continuing the academic activities from home was significantly associated with weight changes (AOR = 1.73; 95% CI: 1.01, 2.95), meals per day (AOR = 3.25; 95% CI: 1.79, 5.92), screen time for entertainment (AOR = 3.08; 95% CI: 1.78, 5.33), sleeping hours (AOR = 2.23; 95% CI: 1.30, 3.83), and sleep quality (AOR = 2.38; 95% CI: 1.35, 4.23) whereas female gender was related to meals per day (AOR = 1.77; 95% CI: 1.06, 2.95) and sleep quality (AOR = 1.76; 95% CI: 1.09, 2.85). However, 43.91% of respondents never felt any sleep disturbances. The rates of students who always experienced mentally tired, resentment, and sadness at post lockdown was lower than lockdown period. All of these changes were significant (p < 0.000) in terms of the lockdown situation.

CONCLUSIONS

This study shows notable changes in eating habits and lifestyles after lockdown which may indicate the tendency to adopt normal life than restrictions.

An overview of mental health during the COVID-19 pandemic

Since its initial outbreak in late 2019, the COVID-19 pandemic has profoundly affected the global community. In addition to the negative health consequences of contracting COVID-19, the implementation of strict quarantine and lockdown measures has also disrupted social networks and devastated the global economy. As a result, there is rising concern that the pandemic has taken a toll on the mental health of the general population. To better understand its impact, an increasing number of studies examined the effects of the pandemic on mental health and psychosocial implications of enforced quarantine and lockdown. In this article, we aim to review and summarize the findings from a variety of studies that have explored the psychosociological effects of the pandemic and its impact on the mental well-being of the general population. We will also examine how various demographic groups, such as the elderly and youth, can be more susceptible or resilient to the pandemic's mental health effects. We hope to provide a broader understanding of the underlying causes of mental health issues triggered by the pandemic and provide recommendations that may be employed to address mental health issues in the population over the long-term.

Poor Sleep Quality and Its Relationship with Individual Characteristics, Personal Experiences and Mental Health during the COVID-19 Pandemic

While the COVID-19 has dramatically altered our lifestyle and sleep practices, the links between sleep, individual characteristics, personal experiences and mental health during the pandemic require further examination. This cross-sectional, multi-methods study examined differences in language used to describe personal experiences, and mental health, based on sleep quality during the early stages of the pandemic. N = 1745 participants (mean age 42.97 ± 14.46 years) from 63 countries responded to the survey. Sleep quality was assessed using the Pittsburgh Sleep Quality Index and mental health was examined using the Patient Health Questionnaire-9, the State Trait Anxiety Inventory, the Perceived Stress Scale and the UCLA-Loneliness Scale. Quantitative analysis of qualitative, language content of personal experiences was conducted using free-text responses and comments to a question on the survey. Almost 50% of the participants reported poor sleep quality, which was linked to a more negative emotional tone and greater mentions of money or finance related words. Good sleepers reported more positive emotional tone in their experiences. Greater reports of clinical state anxiety, moderate depression and moderate stress were observed in poor sleepers, even after accounting for demographics and pandemic-related factors such as loneliness, financial concerns and risk of contracting COVID-19 disease. Results from this study highlight an urgent need for sleep-related public health interventions. Practitioner education, sleep screening for those with mental health conditions, and encouraging people to adopt digital tools may help to reduce the burden of poor sleep on mental health. While the pandemic itself is a stressful and uncertain time, improving sleep can support positive emotion regulation, improving mood and consequential action.

COVID-19 lockdown and lifestyles: A narrative review

Background: The primary objective worldwide during the coronavirus disease 2019 (COVID-19) pandemic has been controlling disease transmission. However, lockdown measures used to mitigate transmission have affected human behavior and altered lifestyles, with a likely impact on chronic non-communicable diseases. More than a year into the pandemic, substantial peer-reviewed literature has emerged on altered lifestyles following the varying lockdown measures imposed globally to control the virus spread. We explored the impact of lockdown measures on six lifestyle factors, namely diet, physical activity, sleep, stress, social connectedness, and the use of tobacco, alcohol, or other harmful substances. Methods: We comprehensively searched PubMed and the World Health Organization’s global literature database on COVID-19 and retrieved 649 relevant articles for the narrative review. A critical interpretative synthesis of the articles was performed. Results: Most of the articles included in the review identified the negative effect of lockdown measures on each of the lifestyle factors in many parts of the world. Encouraging lifestyle trends were also highlighted in a few articles. Such trends can positively influence the outcome of lifestyle-related chronic diseases, such as obesity and diabetes. Conclusions: The COVID-19 pandemic provides an opportunity to better understand the negative impact of strict lockdown measures on lifestyles. At the same time, it helps us identify and initiate positive behavioral changes, which, if consolidated, could improve chronic disease outcomes. It is up to governments, communities, and healthcare/academic entities to derive benefit from lessons learned from the pandemic, with the ultimate objective of better educating and promoting healthy lifestyles among communities.

COVID-19 Pandemic on Fire: Evolved Propensities for Nocturnal Activities as a Liability Against Epidemiological Control

Humans have been using fire for hundreds of millennia, creating an ancestral expansion toward the nocturnal niche. The new adaptive challenges faced at night were recurrent enough to amplify existing psychological variation in our species. Night-time is dangerous and mysterious, so it selects for individuals with higher tendencies for paranoia, risk-taking, and sociability (because of security in numbers). During night-time, individuals are generally tired and show decreased self-control and increased impulsive behaviors. The lower visibility during night-time favors the partial concealment of identity and opens more opportunities for disinhibition of self-interested behaviors. Indeed, individuals with an evening-oriented chronotype are more paranoid, risk-taking, extraverted, impulsive, promiscuous, and have higher antisocial personality traits. However, under some circumstances, such as respiratory pandemics, the psychobehavioral traits favored by the nocturnal niche might be counter-productive, increasing contagion rates of a disease that can evade the behavioral immune system because its disease cues are often nonexistent or mild. The eveningness epidemiological liability hypothesis presented here suggests that during the COVID-19 pandemic, the evening-oriented psychobehavioral profile can have collectively harmful consequences: there is a clash of core tendencies between the nocturnal chronotype and the recent viral transmission-mitigating safety guidelines and rules. The pandemic safety protocols disrupt much normal social activity, particularly at night when making new social contacts is desired. The SARS-CoV-2 virus is contagious even in presymptomatic and asymptomatic individuals, which enables it to mostly evade our evolved contagious disease avoidance mechanisms. A growing body of research has indirectly shown that individual traits interfering with social distancing and anti-contagion measures are related to those of the nocturnal chronotype. Indeed, some of the social contexts that have been identified as superspreading events occur at night, such as in restaurants, bars, and nightclubs. Furthermore, nocturnal environmental conditions favor the survival of the SARS-CoV-2 virus much longer than daytime conditions. We compare the eveningness epidemiological liability hypothesis with other factors related to non-compliance with pandemic safety protocols, namely sex, age, and life history. Although there is not yet a direct link between the nocturnal chronotype and non-compliance with pandemic safety protocols, security measures and future empirical research should take this crucial evolutionary mismatch and adaptive metaproblem into account, and focus on how to avoid nocturnal individuals becoming superspreaders, offering secure alternatives for nocturnal social activities.

Working from home during the COVID-19 outbreak in Sweden: effects on 24-h time-use in office workers

Background

The COVID-19 pandemic has triggered national recommendations encouraging people to work from home (WFH), but the possible impact of WFH on physical behaviors is unknown. This study aimed to determine the extent to which the 24-h allocation of time to different physical behaviors changes between days working at the office (WAO) and days WFH in office workers during the pandemic.

Methods

Data were collected on 27 office workers with full-time employment at a Swedish municipal division during the COVID-19 outbreak in May–July 2020. A thigh-worn accelerometer (Axivity) was used to assess physical behavior (sedentary, stand, move) during seven consecutive days. A diary was used to identify periods of work, leisure and sleep. 24-h compositions of sedentary, standing and moving behaviors during work and non-work time were examined using Compositional data analysis (CoDA), and differences between days WAO and days WFH were determined using repeated measures ANOVA.

Results

Days WFH were associated with more time spent sleeping relative to awake, and the effect size was large (F = 7.4; p = 0.01; η_p² = 0.22). The increase (34 min) in sleep time during WFH occurred at the expense of a reduction in work and leisure time by 26 min and 7 min, respectively. Sedentary, standing and moving behaviors did not change markedly during days WFH compared to days WAO.

Conclusion

Days working from home during the COVID-19 pandemic in Sweden were associated with longer duration of sleep than days working at the office. This behavioral change may be beneficial to health.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10582-6.

Changes in sleep patterns and disturbances in children and adolescents in Italy during the Covid-19 outbreak

Objective

To examine the impact of home confinement during the COVID-19 pandemic on the sleep patterns and sleep disturbances in Italian children and adolescents.

Methods

Participants completed an anonymous online survey, shared via social media and targeting children and adolescents aged 1–18 years, subdivided into age groups: 1–3, 4–5, 6–12, and 13–18 years. Caregivers completed a modified version of the Sleep Disturbance Scale for Children (SDSC), along with demographic information.

Results

The final sample consisted of 4314 subjects: 2217 males (50.4%) and 2097 females (49.6%). Age group distribution was: 1–3 years 1263 (29.3%), 4–5 years 893 (20.7%), 6–12 years 1848 (42.8%) and 13–18 years 310 (7.2%). We found a significant delay in bedtime and risetime in all age groups. School-age children and adolescents experienced the most significant delay: weekday bedtime ≥23 was reported by 28.4% of 6- to 12-year-old children during lockdown vs. 0.9% before and by 63.5% vs. 12.3% of 13- to 18-year-old adolescents. Risetime was also delayed with most subjects waking up after 8 in all age groups and sleep duration increased in all groups but not in the younger group. The screen time (excluding online lessons) boosted during the lockdown, mainly in older children but also in younger children. Sleep disorders increased in all groups but not in adolescents. Younger groups had an increased prevalence of difficulty falling asleep, anxiety at bedtime, night awakenings, nightmares and sleep terrors.

Conclusion

Our study demonstrates that confinement due to COVID-19 determined a big delay in sleep/wake schedule of children in all age groups as well as an increase of sleep disturbances in all groups but adolescents.

COVID-19 lockdown - Are Austrians finally able to compensate their sleep debt?

In order to control the rapid spread of the COVID-19 pandemic, Austria was put under national lockdown beginning on March 13, 2020, forcing its inhabitants to live in home confinement. The aim of this study was to measure the impact of the lockdown on sleep and dream behavior in Austrian citizens. 77 participants (50 women, M age = 40.88 years, S D age  = 13.72) filled in an online questionnaire during the lockdown between April and May 2020. Sleep quality, sleep quantity, daytime sleepiness, and nightmare frequency were assessed and analyzed in relation to gender, burnout risk, perfectionism and chronotype. Results demonstrated higher subjective sleep quality during lockdown, especially in women. Daytime sleepiness was significantly lower during the lockdown period while sleep duration did not change. Results suggest that sleep issues are less prominent during the COVID-19 lockdown but point to the importance of prevention and treatment of sleep disorders aside from the pandemic. Findings indicate the need for more flexibility in social time structures to relieve those managing tasks from multiple areas of interests such as working mothers. Generalization of results is limited due to small sample size, self-selection bias, and purely subjective measures.

Burden of Sleep Disturbance During COVID-19 Pandemic: A Systematic Review

Coronavirus disease 2019 (COVID-19) pandemic may exert adverse impacts on sleep among populations, which may raise awareness of the burden of sleep disturbance, and the demand of intervention strategies for different populations. We aimed to summarize the current evidence for the impacts of COVID-19 on sleep in patients with COVID-19, healthcare workers (HWs), and the general population. We searched PubMed and Embase for studies on the prevalence of sleep disturbance. Totally, 86 studies were included in the review, including 16 studies for COVID-19 patients, 34 studies for HWs, and 36 studies for the general population. The prevalence of sleep disturbance was 33.3%-84.7%, and 29.5-40% in hospitalized COVID-19 patients and discharged COVID-19 survivors, respectively. Physiologic and psychological traumatic effects of the infection may interact with environmental factors to increase the risk of sleep disturbance in COVID-19 patients. The prevalence of sleep disturbance was 18.4-84.7% in HWs, and the contributors mainly included high workloads and shift work, occupation-related factors, and psychological factors. The prevalence of sleep disturbance was 17.65-81% in the general population. Physiologic and social-psychological factors contributed to sleep disturbance of the general population during COVID-19 pandemic. In summary, the sleep disturbance was highly prevalent during COVID-19 pandemic. Specific health strategies should be implemented to tackle sleep disturbance.