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Lee JY, Moon S, Cho SH, Kim H, Kang HJ, Kim SY, Ryu S, Kim JM, Shin IS, Kim SW. The Relationship Between Fast Food Consumption and Daily Lifestyle Changes During School Closures Following the COVID-19 Pandemic: A Cross-Sectional Study Among Adolescents in Korea. Psychiatry Investig 2024; 21:610-617. [PMID: 38960438 PMCID: PMC11222073 DOI: 10.30773/pi.2023.0283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/12/2023] [Accepted: 03/15/2024] [Indexed: 07/05/2024] Open
Abstract
OBJECTIVE Increased fast food consumption can have adverse effects on health and well-being among adolescents, posing a significant public health concern. The school closures due to the coronavirus disease-2019 (COVID-19) pandemic have led to changes in eating patterns and disrupted a balance diet among adolescents. This study explored the factors associated with fast food consumption among adolescents during school closures due to the COVID-19 pandemic. METHODS A total of 1,710 middle and high school students in Gwangju, South Korea participated in a cross-sectional survey. The self-administered questionnaire included items assessing dietary intake, physical activity, sleep, media use, and sociodemographic information. The Patient Health Questonnaire-9, Generalized Anxiety Disorder-7, and three item version of the UCLA Loneliness Scale were also administered. Multivariable logistic regression was used to examine the factors associated with increased fast food consumption. RESULTS Approximately 34.6% of the surveyed adolescents reported increased fast food consumption during school closures, as well as increased sleep duration, increased sedentary behaviors including watching TV and using the internet, and reduced physical activity. Multivariable logistic regression analysis revealed that fast food consumption during school closures was associated with irregular patterns of main meals and sleep, decreased physical activity, increased internet use, and a lack of daytime adult supervision. CONCLUSION Our results highlight the need for dietary and lifestyle monitoring and guidelines to promote health among adolescents, especially during school closures. In conclusion, nutrition intervention programs aiming to limit fast food consumption and enhance healthy dietary habits among adolescents during long-term school closures are warranted.
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Affiliation(s)
- Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
- Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
| | - Shinhyun Moon
- Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
| | - Seo-Hyun Cho
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Honey Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seon-Young Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
- Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
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Nolvi S, Paavonen EJ, Korja R, Pelto J, Karukivi M, Tuulari JJ, Karlsson H, Karlsson L. Course of child social-emotional and sleep symptoms, parental distress and pandemic-related stressors during COVID-19. Dev Psychopathol 2024; 36:518-532. [PMID: 36794405 DOI: 10.1017/s0954579422001377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Research on the longitudinal courses of child social-emotional symptoms and sleep during the COVID-19 pandemic within societies would be of key value for promoting child well-being in global crises. We characterized the course of children's social-emotional and sleep symptoms before and throughout the pandemic in a Finnish longitudinal cohort of 1825 5- to 9-year-old children (46% girls) with four follow-up points during the pandemic from up to 695 participants (spring 2020-summer 2021). Second, we examined the role of parental distress and COVID-related stressful events in child symptoms. Child total and behavioral symptoms increased in spring 2020 but decreased thereafter and remained stable throughout the rest of the follow-up. Sleep symptoms decreased in spring 2020 and remained stable thereafter. Parental distress was linked with higher child social-emotional and sleep symptoms. The cross-sectional associations between COVID-related stressors and child symptoms were partially mediated by parental distress. The findings propose that children can be protected from the long-term adverse influences of the pandemic, and parental well-being likely plays a mediating role between pandemic-related stressors and child well-being. Further research focusing on the societal and resilience factors underlying family and child responses to the pandemic is warranted.
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Affiliation(s)
- Saara Nolvi
- Turku Institute for Advanced Studies, Department of Psychology and Speech-Language Pathology, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku. Medisiina A (307), Kiinamyllynkatu 10, 20014 Turun yliopisto, Turku, Finland
| | - E Juulia Paavonen
- Department of Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland; Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Riikka Korja
- Department of Psychology and Speech-Language Pathology, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Juho Pelto
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine and Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Max Karukivi
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine & Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Jetro J Tuulari
- Turku Collegium for Science, Medicine and Technology; FinnBrain Birth Cohort Study, Turku Brain and Mind Center & Department of Psychiatry, Department of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center & Department of Psychiatry & Center for Population Health Research, Department of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study & Center for Population Health Research, Psychiatry, Paediatrics and Adolescent Medicine, Department of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland
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Stager LM, Morgan CH, Watson CS, Fobian AD. Sleep and Inflammation during COVID-19 Virtual Learning in Adolescents with Overweight or Obesity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1833. [PMID: 38136035 PMCID: PMC10742253 DOI: 10.3390/children10121833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/10/2023] [Accepted: 11/17/2023] [Indexed: 12/24/2023]
Abstract
(1) Background: Adolescents present as a high-risk group for a range of adverse physical health outcomes during the pandemic, including sleep and C-reactive protein (CRP) levels. As adolescents with overweight or obesity (OWOB) present as an even higher risk group, the present study assessed relationships between sleep and CRP levels before and during COVID-19 in adolescents with OWOB. (2) Methods: Fourteen adolescents with OWOB participated in a pre-COVID1, pre-COVID2, and during-COVID-19 lab visit, measuring sleep and CRP levels. The sample size was limited by the number of participants who provided data before COVID-19 and who were enrolled in virtual school during the recruitment phase. However, our power analyses indicated needing a minimum of 10 participants to achieve adequate power. Pre-COVID1, pre-COVID2, and during-COVID-19 normative expected CRP levels were calculated based on age, sex, race, and body mass index percentile-matched data. Analyses compared pre-COVID1 and pre-COVID2 sleep with during-COVID-19 sleep, during-COVID-19 sleep and during-COVID-19 CRP levels, during-COVID-19 CRP levels with normative expected during-COVID-19 CRP levels, change in CRP levels from pre-COVID1 and pre-COVID2 to during-COVID-19 with normative expected CRP levels during those time periods, and change in CRP levels before COVID-19 with change in CRP levels during COVID-19. (3) Results. During COVID-19, participants experienced decreased sleep efficiency (p = 0.001), later wake time (p < 0.001), longer time in bed (p = 0.021), and onset latency (p = 0.004), compared to pre-COVID1, and decreased sleep efficiency (p = 0.002), longer onset latency (p = 0.006), and later wake time (p < 0.001) and bedtime (p = 0.016) compared with pre-COVID2. During-COVID-19 CRP levels were positively correlated with during-COVID-19 wake times (p = 0.01) and times in bed (p = 0.008). During-COVID-19 CRP levels were greater than normative expected CRP levels (p < 0.001). CRP levels increased more from pre-COVID1 and pre-COVID2 to during-COVID-19 than normative expected changes in CRP levels (p < 0.003). Changes in CRP levels before and during COVID-19 were not significantly different. (4) Conclusions. These findings highlight the consequential effects of COVID-19, including impairments in sleep, on adolescents with OWOB. CRP levels increased more (~5 mg/L) during COVID-19 than normative expected change.
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Affiliation(s)
- Lindsay M. Stager
- Department of Psychology, University of Alabama at Birmingham, 1300 University Blvd, Birmingham, AL 35233, USA; (L.M.S.); (C.H.M.); (C.S.W.)
| | - Casie H. Morgan
- Department of Psychology, University of Alabama at Birmingham, 1300 University Blvd, Birmingham, AL 35233, USA; (L.M.S.); (C.H.M.); (C.S.W.)
| | - Caroline S. Watson
- Department of Psychology, University of Alabama at Birmingham, 1300 University Blvd, Birmingham, AL 35233, USA; (L.M.S.); (C.H.M.); (C.S.W.)
| | - Aaron D. Fobian
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, 1720 7th Avenue South, Birmingham, AL 35233, USA
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Brackx F, De Smedt B, Molenberghs G. A dashboard for the evaluation of the effect of school closures on wellbeing of children and parents. Arch Public Health 2023; 81:178. [PMID: 37789384 PMCID: PMC10548715 DOI: 10.1186/s13690-023-01114-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 05/18/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND We present a dashboard for the evaluation of the impact of school closures on children and parents during the first wave of the COVID pandemic in 2020 on the various components of wellbeing. METHODS Starting from an explorative literature search by a team of experts from diverse fields (e.g., epidemiology, virology, psychology, education, sociology), we developed a dashboard that allows for the quick evaluation of the general effect of school closures on various indicators of well-being in different groups and for the quality of the available research, at a time where a crisis is ongoing. RESULTS It is concluded that there is evidence that the school closures reduced the transmission of COVID in the first wave in springtime 2020. Nevertheless, a multitude of studies show that the school closures also had a negative impact on different components of wellbeing such as academic achievement, time spent on learning and mental health. Furthermore, the school closures affected not only the children and adolescents, but also the parents that were forced to provide more childcare and help with schoolwork. Longitudinal studies on large representative samples with repeated assessments of wellbeing are necessary to understand the long-term effects of the school closures. CONCLUSIONS The dashboard provides a first visual overview of the effects of school closures on wellbeing, and can serve as the basis for a future more systematic review and meta-analysis of the effects of school closures on wellbeing. It can be considered as a paradigm for rapid obtention of scientific evidence, during a quickly unfolding crisis, also in view of underpinning policy advice.
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Affiliation(s)
| | - Bert De Smedt
- Faculty of Psychology and Educational Sciences, KU Leuven, Louvain, Belgium
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Jeong D, Lee H, Kim J. Effects of sleep pattern, duration, and quality on premenstrual syndrome and primary dysmenorrhea in korean high school girls. BMC Womens Health 2023; 23:456. [PMID: 37641079 PMCID: PMC10464156 DOI: 10.1186/s12905-023-02600-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Sleep deprivation is known to be a risk factor for premenstrual syndrome and primary dysmenorrhea in adults. However, it has rarely been investigated in adolescents. The aim of this study was to investigate whether sleep pattern, duration, and quality independently affect premenstrual syndrome and primary dysmenorrhea in adolescent girls. An additional purpose was to investigate the sleep status in Korean adolescent girls during the COVID-19 pandemic. METHODS A cross-sectional survey study was conducted in 519 high school girls aged 15 to 18 years in Gyeonggido, South Korea, in 2021 during the COVID-19 lockdown. Menstrual pain intensity and menstrual symptoms were assessed using the visual analogue scale (VAS) and Cox menstrual symptom scale (CMSS), respectively. Premenstrual syndrome was assessed by the premenstrual symptoms screening tool (PSST). Sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI). The known risk factors of dysmenorrhea, including menstrual and lifestyle characteristics and stress, were assessed as covariates. RESULTS During the pandemic, approximately 68% of girls slept 7 h or less, while about 60% reported poor sleep quality. Additionally, 64% of participants had a bedtime later after 1AM, and 34% woke up later after 8AM. Late bedtime significantly affected VAS (P = 0.05), CMSS severity and frequency (both P < 0.01), and PSST symptom (P < 0.01). Waking up late affected CMSS severity (P < 0.05), PSST symptom (P = 0.05), and PSST function (P < 0.05). However, the significance of these effects disappeared after controlling for covariates. Sleeping less than 5 h affected CMSS frequency (P < 0.05) and PSST symptoms (P < 0.001). After controlling for covariates, the significance of the effect on PSST symptom remained (P < 0.05). General sleep quality and PSQI components, including subjective sleep quality, sleep latency, sleep disturbance, use of sleeping medication, and daytime dysfunction, significantly affected CMSS frequency and severity and PSST symptom after controlling for covariates (P < 0.05, P < 0.01, or P < 0.001). The multiple regression analysis revealed that among sleep characteristics, sleep quality was the most important risk factor of premenstrual syndrome and dysmenorrhea. CONCLUSION Our study result heightens the importance of healthy sleep hygiene, especially sleep quality in the management of premenstrual syndrome and dysmenorrhea in adolescent girls.
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Affiliation(s)
- Daye Jeong
- Graduate School of Alternative Medicine, Kyonggi University (Seoul Campus), 24, Kyonggidae- ro 9-gil, Seodaemun-gu, Seoul, 03746, Republic of Korea
| | - Heakyong Lee
- Graduate School of Alternative Medicine, Kyonggi University (Seoul Campus), 24, Kyonggidae- ro 9-gil, Seodaemun-gu, Seoul, 03746, Republic of Korea
| | - Jaehee Kim
- Graduate School of Alternative Medicine, Kyonggi University (Seoul Campus), 24, Kyonggidae- ro 9-gil, Seodaemun-gu, Seoul, 03746, Republic of Korea.
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Rocha S, Fuligni A. The impact of the COVID-19 pandemic on adolescent sleep behavior. Curr Opin Psychol 2023; 52:101648. [PMID: 37454639 PMCID: PMC10290178 DOI: 10.1016/j.copsyc.2023.101648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023]
Abstract
Restorative sleep is a fundamental component of adolescent wellbeing, and the COVID-19 pandemic presented both challenges and opportunities for adolescents' sleep. In this review, we synthesize emergent themes from the growing scientific evidence for the impact of the pandemic on adolescent sleep behavior across different stages of the pandemic and in different locations around the world. We also highlight the ways in which COVID-19 shaped sleep patterns among college students-a subgroup of adolescents transitioning to emerging adulthood that were particularly impacted by the shift to remote learning. Finally, we discuss variations in the impact according to several potential moderating factors in adolescents' lives and point to areas that require additional longitudinal research.
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Affiliation(s)
- Sarah Rocha
- Department of Psychology, University of California, 2311 Psychology Building, Los Angeles, CA 90095, USA.
| | - Andrew Fuligni
- Department of Psychology, Department of Psychiatry and Biobehavioral Sciences, University of California, 760 Westwood Plaza, Box 62, Los Angeles, CA 90095, USA
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7
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Pillai R, Patel I, Balkrishnan R. Risk factors and strategies for prevention of depression, anxiety and eating disorders among adolescents during the coronavirus disease 2019 (COVID-19) pandemic: a review. GLOBAL HEALTH JOURNAL 2023; 7:78-86. [PMID: 37346460 PMCID: PMC10122953 DOI: 10.1016/j.glohj.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 06/23/2023] Open
Abstract
The purpose of this review is to identify prevalent trends and risk factors in depression, anxiety, and eating disorders in the adolescent population in the post coronavirus disease 2019 (COVID-19) scenario. We examined the literature published on adolescent mental health since the COVID-19 pandemic. We chose to summarize studies published from 2019 to 2022, using bibliographic search tools. We developed criteria for selecting articles for our review using diagnostic indicators and keywords. Mental health conditions such as depression, anxiety and eating disorders are commonly prevalent in this population and have shown increasing rates in the past three years. Some risk factors associated with these diagnoses include reduction in social interaction, increased workloads, routine shifts, sleep quality, social media usage and parental involvement. Routines, sleep cycles, physical activity, and social media should all be considered as a part of prevention in this population. Approaches that seem to be successful include maintaining social ties and avoiding negative social media usage with harmful content. Increased global public awareness, as well as parental awareness, through media campaigns, is critical to slowing the spread of mental health challenges in adolescents and teenagers in the post-COVID-19 era.
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Affiliation(s)
- Rea Pillai
- Department of Public Health Sciences, University of Virginia School of Medicine, P.O. Box 800717 Charlottesville, Virginia, VA 22908, USA
| | - Isha Patel
- Department of Public Health Sciences, University of Virginia School of Medicine, P.O. Box 800717 Charlottesville, Virginia, VA 22908, USA
| | - Rajesh Balkrishnan
- Department of Public Health Sciences, University of Virginia School of Medicine, P.O. Box 800717 Charlottesville, Virginia, VA 22908, USA
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Skripkauskaite S, Creswell C, Shum A, Pearcey S, Lawrence P, Dodd H, Waite P. Changes in UK parental mental health symptoms over 10 months of the COVID-19 pandemic. JCPP ADVANCES 2023; 3:e12139. [PMID: 37753154 PMCID: PMC10519732 DOI: 10.1002/jcv2.12139] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/20/2022] [Indexed: 04/03/2023] Open
Abstract
Background The threats to health, associated restrictions and economic consequences of the COVID-19 pandemic have been linked to increases in mental health difficulties for many. Parents, in particular, have experienced many challenges such as having to combine work with home-schooling their children and other caring responsibilities. Yet, it remains unclear how parental mental health has changed throughout the pandemic or what factors may have mitigated or compounded the impact of the pandemic on parents' mental health. Methods We examined monthly survey data from two linked UK-based longitudinal studies: COVID-19: Supporting Parents, Adolescents and Children during Epidemics' (Co-SPACE) and COVID-19: Supporting Parents and Young Children during Epidemics' (Co-SPYCE). Data from 5576 parents/carers of 2-17-year-old children collected between April 2020 and January 2021 was analysed using mixed-effect modelling and latent class growth (mixture) modelling. Results Parental stress and depression, but not anxiety, were higher during the periods of restrictions. This pattern was most pronounced for parents with primary-school-aged children, those that worked at home or had other adults in the household. Being younger, reporting secondary or below education, working out of home, having secondary-school-aged children or children with special education needs (SEN)/neurodevelopmental disorders (ND) further moderated whether, how and when parental mental health symptoms changed. Although around three quarters of parents reported consistently low mental health symptoms, a substantial minority reported consistently high or increasing symptoms of anxiety, stress and depression. The latter were more likely to be parents who were younger than average, were a single adult in the household, had a pre-existing mental health diagnosis or had a child with special educational needs or a ND. Conclusions These findings emphasise how different personal circumstances and pre-existing inequalities shaped how parents were affected by this unprecedented global pandemic and highlight the need for support and consideration to meet the needs of families in the future.
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Affiliation(s)
- Simona Skripkauskaite
- Department of Experimental Psychology and Department of PsychiatryUniversity of OxfordOxfordUK
| | - Cathy Creswell
- Department of Experimental Psychology and Department of PsychiatryUniversity of OxfordOxfordUK
| | - Adrienne Shum
- Department of Experimental Psychology and Department of PsychiatryUniversity of OxfordOxfordUK
| | - Samantha Pearcey
- Department of Experimental Psychology and Department of PsychiatryUniversity of OxfordOxfordUK
| | - Pete Lawrence
- Centre for Innovation in Mental HealthSchool of PsychologyUniversity of SouthamptonSouthamptonUK
| | - Helen Dodd
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Polly Waite
- Department of Experimental Psychology and Department of PsychiatryUniversity of OxfordOxfordUK
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
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Wesley KL, Cooper EH, Brinton JT, Meier M, Honaker S, Simon SL. A National Survey of U.S. Adolescent Sleep Duration, Timing, and Social Jetlag During the COVID-19 Pandemic. Behav Sleep Med 2023; 21:291-303. [PMID: 35699363 PMCID: PMC9747982 DOI: 10.1080/15402002.2022.2086871] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To assess changes in duration, timing, and social jetlag in adolescent sleep during the COVID-19 pandemic and evaluate the impact of mood, physical activity, and social interactions on sleep. STUDY DESIGN An online survey queried adolescents' sleep before (through retrospective report) and during the initial phase of COVID-19 in May 2020. Adolescents (N = 3,494), 13-19 years old, in the United States (U.S.) answered questions about their current and retrospective (prior to COVID-19) sleep, chronotype, mood, and physical and social activities. Linear regression models were fit for time in bed, reported bed and wake times, and social jetlag during COVID-19, accounting for pre-COVID-19 values. RESULTS Total reported time in bed (a proxy for sleep duration) increased on weekdays by an average of 1.3 ± 1.8 hours (p < .001) during COVID-19, compared to retrospective report of time in bed prior to COVID-19. During COVID-19, 81.3% of adolescents reported spending 8 hours or more in bed on weekdays compared to only 53.5% prior to COVID-19. On weekdays, bedtimes were delayed on average by 2.5 hours and wake times by 3.8 hours during COVID-19 compared to prior to COVID-19. On weekends, bedtimes were delayed on average by 1.6 hours and waketimes by 1.5 hours (all p's < 0.001). Social jetlag of >2 hours decreased to 6.3% during COVID-19 compared to 52.1% prior to COVID-19. Anxiety and depression symptoms and a decline in physical activity during COVID-19 were associated with delayed bed and wake times during COVID-19. CONCLUSIONS During COVID-19, adolescents reported spending more time in bed, with most adolescents reporting 8 hours of sleep opportunity and more consistent sleep schedules. As schools return to in-person learning, additional research should examine how sleep schedules may change due to school start times and what lessons can be learned from changes that occurred during COVID-19 that promote favorable adolescent sleep.
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Affiliation(s)
- Katherine L. Wesley
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children’s Hospital Colorado
| | - Emily H. Cooper
- Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children’s Hospital Colorado
| | - John T. Brinton
- Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children’s Hospital Colorado
| | - Maxene Meier
- Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children’s Hospital Colorado
| | - Sarah Honaker
- Department of Pediatrics, Indiana University School of Medicine
| | - Stacey L. Simon
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children’s Hospital Colorado
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Uccella S, Cordani R, Salfi F, Gorgoni M, Scarpelli S, Gemignani A, Geoffroy PA, De Gennaro L, Palagini L, Ferrara M, Nobili L. Sleep Deprivation and Insomnia in Adolescence: Implications for Mental Health. Brain Sci 2023; 13:brainsci13040569. [PMID: 37190534 DOI: 10.3390/brainsci13040569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/20/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
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.
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Xiao Y, Brown TT, Snowden LR, Chow JCC, Mann JJ. COVID-19 Policies, Pandemic Disruptions, and Changes in Child Mental Health and Sleep in the United States. JAMA Netw Open 2023; 6:e232716. [PMID: 36912834 DOI: 10.1001/jamanetworkopen.2023.2716] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
IMPORTANCE The adverse effects of COVID-19 containment policies disrupting child mental health and sleep have been debated. However, few current estimates correct biases of these potential effects. OBJECTIVES To determine whether financial and school disruptions related to COVID-19 containment policies and unemployment rates were separately associated with perceived stress, sadness, positive affect, COVID-19-related worry, and sleep. DESIGN, SETTING, AND PARTICIPANTS This cohort study was based on the Adolescent Brain Cognitive Development Study COVID-19 Rapid Response Release and used data collected 5 times between May and December 2020. Indexes of state-level COVID-19 policies (restrictive, supportive) and county-level unemployment rates were used to plausibly address confounding biases through 2-stage limited information maximum likelihood instrumental variables analyses. Data from 6030 US children aged 10 to 13 years were included. Data analysis was conducted from May 2021 to January 2023. EXPOSURES Policy-induced financial disruptions (lost wages or work due to COVID-19 economic impact); policy-induced school disruptions (switches to online or partial in-person schooling). MAIN OUTCOMES AND MEASURES Perceived stress scale, National Institutes of Health (NIH)-Toolbox sadness, NIH-Toolbox positive affect, COVID-19-related worry, and sleep (latency, inertia, duration). RESULTS In this study, 6030 children were included in the mental health sample (weighted median [IQR] age, 13 [12-13] years; 2947 [48.9%] females, 273 [4.5%] Asian children, 461 [7.6%] Black children, 1167 [19.4%] Hispanic children, 3783 [62.7%] White children, 347 [5.7%] children of other or multiracial ethnicity). After imputing missing data, experiencing financial disruption was associated with a 205.2% [95% CI, 52.9%-509.0%] increase in stress, a 112.1% [95% CI, 22.2%-268.1%] increase in sadness, 32.9% [95% CI, 3.5%-53.4%] decrease in positive affect, and a 73.9 [95% CI, 13.2-134.7] percentage-point increase in moderate-to-extreme COVID-19-related worry. There was no association between school disruption and mental health. Neither school disruption nor financial disruption were associated with sleep. CONCLUSIONS AND RELEVANCE To our knowledge, this study presents the first bias-corrected estimates linking COVID-19 policy-related financial disruptions with child mental health outcomes. School disruptions did not affect indices of children's mental health. These findings suggest public policy should consider the economic impact on families due to pandemic containment measures, in part to protect child mental health until vaccines and antiviral drugs become available.
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Affiliation(s)
- Yunyu Xiao
- Weill Cornell Medicine, NewYork Presbyterian, Department of Population Health Sciences, New York
| | | | | | | | - J John Mann
- Departments of Psychiatry and Radiology, Columbia University Irving Medical Center, Columbia University, New York
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York
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12
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Kamga Fogno AW, Rouquette A, Gronfier C, Bernard JY, Plancoulaine S. Associations between screen use, outdoor time/daylight exposure and sleep changes during the first COVID-19 lockdown in French children from the ELFE and EPIPAGE2 birth cohorts. CNS Neurosci Ther 2023; 29:1649-1656. [PMID: 36807866 PMCID: PMC10173720 DOI: 10.1111/cns.14128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/08/2023] [Accepted: 02/08/2023] [Indexed: 02/22/2023] Open
Abstract
AIMS To investigate associations between outdoor and screen time and changes in sleep patterns in children from two nationwide birth-cohorts in the SAPRIS project. METHODS During the first French COVID-19 pandemic lockdown, volunteer parents of children enrolled in the ELFE and EPIPAGE2 birth-cohorts completed online questions about their child's outdoor time, screen time, and changes in sleep duration and quality compared with the pre-lockdown situation. In 5700 children (aged 8-9 years, 52% boys) with available data, we assessed associations between outdoor time, screen time, and sleep changes using multinomial logistic regression models adjusted for confounders. RESULTS Children spent on average 3 h08 outdoors and 4 h34 using screens/day (3 h27 for leisure, 1 h07 for class-work). Sleep duration increased in 36% of children and decreased in 13.4%; sleep difficulties appeared/increased in 22.5% and decreased/disappeared/remained stable in 18.3%. After adjustment, increased screen time, especially for leisure, was associated with increased and decreased sleep duration (OR(95%CI) = 1.03(1.00-1.06) and OR = 1.06(1.02-1.10), respectively). No association was observed between outdoor time and sleep changes after adjustment. CONCLUSIONS Our study adds evidence for the association between high leisure-time screen time and shorter sleep time. It supports current screen guidelines for children, especially during leisure time and for those whose sleep duration is short.
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Affiliation(s)
- Alex Wilfried Kamga Fogno
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Alexandra Rouquette
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Paris, France.,AP-HP Paris-Saclay, Hôpital du Kremlin Bicêtre, Service de Santé Publique et d'Epidemiologie, Le Kremlin Bicêtre, France
| | - Claude Gronfier
- Université Claude Bernard Lyon 1, INSERM, CRNS, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, Bron, France
| | - Jonathan Y Bernard
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Sabine Plancoulaine
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France.,Université Claude Bernard Lyon 1, INSERM, CRNS, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, Bron, France
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13
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Rynders CA, Bowen AE, Cooper E, Brinton JT, Higgins J, Nadeau KJ, Wright KP, Simon SL. A Naturalistic Actigraphic Assessment of Changes in Adolescent Sleep, Light Exposure, and Activity Before and During COVID-19. J Biol Rhythms 2022; 37:690-699. [PMID: 36124632 PMCID: PMC9726638 DOI: 10.1177/07487304221123455] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The majority of high school-aged adolescents obtain less than the recommended amount of sleep per night, in part because of imposed early school start times. Utilizing a naturalistic design, the present study evaluated changes in objective measurements of sleep, light, and physical activity before (baseline) and during the first wave of the COVID-19 pandemic (during COVID-19) in a group of US adolescents. Sixteen adolescents (aged 15.9 ± 1.2 years, 68.8% female) wore an actigraphy monitor for 7 consecutive days during an in-person week of school before the pandemic (October 2018-February 2020) and again during the pandemic when instruction was performed virtually (May 2020). Delayed weekday sleep onset times of 1.66 ± 1.33 h (p < 0.001) and increased sleep duration of 1 ± 0.87 h (p < 0.001) were observed during COVID-19 compared with baseline. Average lux was significantly higher during COVID-19 compared with baseline (p < 0.001). Weekday physical activity parameters were not altered during COVID-19 compared with baseline, except for a delay in the midpoint of the least active 5 h (p value = 0.044). This analysis provides insight into how introducing flexibility into the traditional school schedule might influence sleep in adolescents.
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Affiliation(s)
- Corey A. Rynders
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Department of Kinesiology, School of Education and Human Development, University of Virginia, Charlottesville, Virginia
| | | | - Emily Cooper
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - John T. Brinton
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Janine Higgins
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kristen J. Nadeau
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kenneth P. Wright
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado,University of Colorado Boulder, Boulder, Colorado
| | - Stacey L. Simon
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Stacey L. Simon, Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13123 E 16th Avenue, Box B395, Aurora, CO 80045, USA; e-mail:
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14
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Bothe K, Schabus M, Eigl ES, Kerbl R, Hoedlmoser K. Self-reported changes in sleep patterns and behavior in children and adolescents during COVID-19. Sci Rep 2022; 12:20412. [PMID: 36437313 PMCID: PMC9701691 DOI: 10.1038/s41598-022-24509-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 11/16/2022] [Indexed: 11/29/2022] Open
Abstract
The COVID-19 pandemic and lockdowns worldwide forced children and adolescents to change and adapt their lives to an unprecedented situation. Using an online survey, we investigated whether they showed changes in sleep quality and other related factors due to this event. Between February 21st, 2021 and April 19th, 2021, a total of 2,290 Austrian children and adolescents (6-18 years) reported their sleep habits and quality of sleep as well as physical activity, daylight exposure and usage of media devices during and, retrospectively, before the pandemic. Results showed an overall delay of sleep and wake times. Almost twice as many respondents reported having sleeping problems during the pandemic as compared to before, with insomnia, nightmares and daytime sleepiness being the most prevalent problems. Furthermore, sleeping problems and poor quality of sleep correlated positively with COVID-19 related anxiety. Lastly, results showed a change from regular to irregular bedtimes during COVID-19, higher napping rates, a strong to very strong decrease in physical activity and daylight exposure, as well as a high to very high increase in media consumption. We conclude that the increase in sleeping problems in children and adolescent during COVID-19 is concerning. Thus, health promoting measures and programs should be implemented and enforced.
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Affiliation(s)
- Kathrin Bothe
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Salzburg, Austria.
| | - Manuel Schabus
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Salzburg, Austria
| | - Esther-Sevil Eigl
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Salzburg, Austria
| | - Reinhold Kerbl
- Department of Pediatrics and Adolescent Medicine, Leoben Regional Hospital, Leoben, Styria, Austria
| | - Kerstin Hoedlmoser
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Salzburg, Austria.
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15
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Bani‐Issa W, Radwan H, Saqan R, Hijazi H, Fakhry R, Alameddine M, Naja F, Ibrahim A, Lin N, Naing YT, Awad M. Association between quality of sleep and screen time during the COVID-19 outbreak among adolescents in the United Arab Emirates. J Sleep Res 2022; 32:e13666. [PMID: 35670277 PMCID: PMC9348184 DOI: 10.1111/jsr.13666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/03/2022] [Accepted: 05/19/2022] [Indexed: 02/03/2023]
Abstract
The COVID-19 pandemic had a major impact on people of all ages. Adolescents' exposure to online learning is linked to excessive screen time on digital devices, which leads to poor sleep quality. This study aimed to investigate the association between screen time on different electronic devices and sleep quality among adolescents in the United Arab Emirates. This study was based on a self-reported questionnaire, which was administered online to school-aged adolescents (aged 12-19 years). The multicomponent questionnaire collected information on sociodemographic characteristics, sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and screen time (minutes) on TV, TV-connected devices, laptops, smartphones, and tablets on weekdays, weeknight, and weekends using the Screen Time Questionnaire (STQ). Univariate and multivariate analyses were used to identify factors correlated with poor sleep quality. A total of 1720 adolescents were recruited from private and public schools (mean age 14.6 ± 1.97 years). The mean PSQI score was 8.09 ± 3.37, and 74.3% of participants reported poor sleep (cutoff score >5). Mean scores were highest for the sleep latency (1.85 ± 0.97) and sleep disturbance (1.56 ± 0.62) domains. The highest STQ score was observed for smartphones, with a median screen time of 420 min on weekdays and 300 min on weekends. Screen time related to smartphones on weekends (p = 0.003) and increased screen time in bed (p < 0.001) were significantly associated with poor sleep. Our results confirmed the correlation between sleep and screen time in adolescents. The results may inform educational polices that target screen time and sleep among adolescents during and after the COVID-19 pandemic.
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Affiliation(s)
- Wegdan Bani‐Issa
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health SciencesUniversity of SharjahSharjahUnited Arab Emirates
| | - Hadia Radwan
- Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health SciencesUniversity of SharjahSharjahUnited Arab Emirates
| | - Roba Saqan
- Research Institute of Medical and Health SciencesUniversity of SharjahSharjahUnited Arab Emirates
| | - Heba Hijazi
- Department of Health Services Administration, College of Health Sciences, Research Institute for Medical and Health SciencesUniversity of SharjahSharjahUnited Arab Emirates,Department of Health Management and Policy, Faculty of MedicineJordan University of Science and TechnologyIrbidJordan
| | - Randa Fakhry
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health SciencesUniversity of SharjahSharjahUnited Arab Emirates
| | - Mohamad Alameddine
- Department of Health Services Administration, College of Health Sciences, Research Institute of Medical and Health SciencesUniversity of SharjahSharjahUnited Arab Emirates
| | - Farah Naja
- Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health SciencesUniversity of SharjahSharjahUnited Arab Emirates
| | - Ali Ibrahim
- Marketing DepartmentGriffith UniversityBrisbaneQueenslandAustralia
| | - Naing Lin
- PAPRSB Institute of Health SciencesUniversiti Brunei DarussalamGadongBrunei
| | - Yuwadi Thein Naing
- Asia Pacific University of Technology and InnovationKuala LumpurMalaysia
| | - Manal Awad
- College of Dental Medicine – Department of Preventive and Restorative Dentistry, Research Institute for Medical and Health SciencesUniversity of SharjahSharjahUnited Arab Emirates
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16
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Troxel WM. Sleep Health Among Adolescents and Adults During the COVID-19 Pandemic: Introduction to the Special Issue. Behav Sleep Med 2022; 20:291-293. [PMID: 35642293 DOI: 10.1080/15402002.2022.2072113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Wendy M Troxel
- Senior Behavioral and Social Scientist, RAND Corporation, Pittsburgh, Pennsylvania
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