Maintaining normal sleep patterns, lifestyles and emotion during the COVID-19 pandemic: The stabilizing effect of daytime napping

Daily positive and negative affect during the COVID-19 pandemic

The COVID-19 pandemic influenced emotional experiences globally. We examined daily positive and negative affect between May/June 2020 and February 2021 (N = 151,049; 3,509,982 observations) using a convenience sample from a national mobile application-based survey that asked for daily affect reports. Four questions were examined: (1) How did people in the United States feel from May/June 2020 to February 2021?; (2) What demographic variables are related to positive and negative affect?; (3) What is the relationship between experienced stressors and daily affect?; and (4) What is the relationship between daily affect and preventive behavior? Positive affect increased, and negative decreased over time. Demographic differences mirrored those from before the pandemic (e.g., younger participants reported more negative and less positive affect). Stressors such as feeling unwell, experiencing COVID-19 symptoms, exposure to COVID-19, and lack of sleep were associated with less positive and more negative affect. Exercising protective behaviors predicted future affect, and affect also predicted future protective behaviors (e.g., less protective behavior when happy but more when grateful and thoughtful). The implications for public health communication were discussed.

How did trends in sleep duration in 2020 compare to previous years and how did they vary by sex, race/ethnicity, and educational attainment?

Recent evidence utilizing online samples indicates that sleep patterns were significantly altered during the initial months of the SARS-CoV-2 (COVID-19) pandemic/lockdown. However, it remains less clear how sleep duration changed in population-based samples, in the later months of 2020, and across subpopulations. Here we used a population-based sample to document sleep duration trends for the entire year of 2020, compared these trends to the previous years of 2013, 2014, 2016, and 2018, and systematically analyzed whether self-reported sleep duration patterns in 2020 varied by sex, race/ethnicity, and educational attainment. Data were from the Behavioral Risk Factor Surveillance System (n = 2,203,861) and focused on Americans aged 18 years and older. Respondents self-reported the hours of sleep they got in a 24-h period. We fit multinomial and linear regression models to predict the category of sleep duration (six or fewer hours, seven to eight h (base), and nine or more hours) and the raw reports of sleep duration, net of demographic, socioeconomic, and behavioral health covariates. Results revealed significant increases in sleep duration during the months directly after the COVID-19 lockdown (March and April in particular). However, these increases were short lived; reports of sleep duration reverted to historical levels by the Fall of 2020. We also found that the changes in sleep duration trends in 2020 were similar by sex, race/ethnicity, and educational attainment, cumulatively leading to little impact to disparities in sleep duration. In a dramatic, but brief, alteration of population-level sleep duration patterns, disparities in self-reported sleep duration remained intractable.

Unprecedented times and uncertain connections: A systematic review examining sleep problems and screentime during the COVID-19 pandemic

Objective

Sleep has been impacted by the COVID-19 pandemic around the world. Furthermore, screen time has been reported to influence sleep and has increased during pandemic quarantines. This systematic review searched databases to determine if screen time affected sleep during the COVID-19 pandemic.

Methods

PubMed, Nursing and Allied Health Proquest, and Science Direct Health and Lifescience college edition were searched for articles that fit the inclusion criteria. There were 2750 articles initially screened. Then, 119 articles were further assessed to determine eligibility, creating a final sample of 18 articles that explored whether screen time affected sleep.

Results

After reviewing the included articles (n = 18), the main theme revealed that screen time negatively affected sleep during the COVID-19 pandemic, specifically aspects such as sleep duration, sleep quality, sleep onset latency, and wake time. However, several articles countered this implication. Therefore, it is important to consider other factors that may influence the relationship between screen time and sleep.

Conclusions

Although the number of articles included is limited, the overall synthesis suggests that COVID-19-related lifestyle changes, such as increased screen time, may negatively affect sleep health. However, other unidentified factors may have contributed to these findings and warrant further research. Nonetheless, community leaders must consider the long-term consequences of the pandemic and implement initiatives to address sleep challenges due to the intricate connection between sleep and well-being.

The impact of screen time changes on anxiety during the COVID-19 pandemic: sleep and physical activity as mediators

Under the burden caused by COVID-19 and rapid lifestyle changes, many people increased their screen time due to psychological needs and social requirements. The current study investigated the relationship between screen time changes and anxiety symptoms during the pandemic of COVID-19. Furthermore, we examined whether sleep and physical activity would mediate the association between screen time changes and anxiety. The self-developed questionnaire was delivered online to collect people's changes in anxiety, sleep patterns, and screen time during COVID-19. 970 participants (74.4% female) with an average age of 23 years were involved in this study. After adjusting demographic variables, the ordinal logistic regression analyses revealed that a significant increase in screen time was linked with anxiety. Slightly increased screen time, slightly and significantly decreased screen time did not predict anxiety symptoms during the pandemic. The level of anxiety was significantly higher among respondents who reported decreased sleep quality. Sleep quality directly mediated the association between screen time changes and anxiety, while sleep latency did not. The longer sleep latency caused by increased screen time would amplify anxiety by affecting sleep quality. In addition, the relationship between screen time changes and anxiety was also mediated by physical activity. We concluded that the fluctuation of screen time in a modest range does not affect the anxiety level substantially. The significantly increased screen time would contribute to poor sleep (including longer sleep latency and worse sleep quality) and lack of physical activity, which would lead to higher levels of anxiety.

Mediterranean Diet Adherence, Body Mass Index and Emotional Intelligence in Primary Education Students-An Explanatory Model as a Function of Weekly Physical Activity

Adolescence is a key developmental period from a health, physical and psychological perspective. In view of this, the present research aimed to establish the relationship between emotional intelligence, Mediterranean diet adherence, BMI and age. In order to address this aim, (a) an explanatory model is developed of emotional intelligence and its relationship with Mediterranean diet adherence, BMI and age, and (b) the proposed structural model is examined via multi-group analysis as a function of whether students engage in more than three hours of physical activity a week. To this end, a quantitative, non-experimental (ex post facto), comparative and cross-sectional study was carried out with a sample of 567 students (11.10 ± 1.24). The instruments used were an ad hoc questionnaire, the KIDMED questionnaire and the TMMS-24. Outcomes reveal that participants who engage in more than three hours of physical activity a week score more highly for emotional intelligence than those who do not meet this criterion. Furthermore, it was also observed that, whilst the majority of the sample was physically active, improvement was required with regards to Mediterranean diet adherence.

Impact of the COVID-19 pandemic on the physical and psychological health of female college students in Japan

The spread of COVID‐19 has dramatically changed our lives. This study aimed to examine the lifestyles of female college students, focusing on physical activity, sleep status, and anxiety status during the pandemic (a state of emergency) in Japan. 184 female college students completed two questionnaires, anthropometric measurements, and daily activity log and diet record: 115 and 69 participants before and during the pandemic, respectively. Findings showed a significant decrease in physical activity: physical activity levels fell from “normal” to “low” and the daily step counts decreased by half, from 8671 to 4640. In addition, the results from the questionnaires revealed that half of the participants were at risk of having sleep disturbances, and their cycles became more nocturnal, which may have caused higher anxiety states and lower sleep quality during the pandemic. In addition, anxiety states worsened, with 100% of the participants experiencing high anxiety during the pandemic. Monitoring lifestyle disturbances during the pandemic is needed for the development of interventions to improve health among young women.

Sleep during "lockdown" highlighted the need to rethink the concept of weekend catch-up sleep

Purpose

Many people believe in their ability to sleep for longer time on weekends to make up for sleep lost due to early wakeups on weekdays. This widely held belief was not supported by the simulations of rise- and bedtimes on weekdays and weekends with a sleep–wake regulating model. The simulations suggested the inability to extend sleep on any of two weekend nights and they predicted identical weekend sleep durations for weeks with relatively earlier and relatively later weekday risetimes. By April 2020, about half of the world’s population was under some form of “lockdown” due to the COVID-19 pandemic. This “lockdown” provided a new opportunity to demonstrate the predictive power of the sleep–wake regulating models. Therefore, the purpose of this report was to support the prediction of identity of weekend sleep durations after weeks with earlier and later weekday wakeups.

Methods

Weekend and weekday rise- and bedtimes before and during “lockdown” for 31 samples were taken from recent journal publications. Time in bed on weekends and 12 other measures of sleep duration and timing were calculated and simulated.

Results

For only one of 13 measures, weekend time in bed, statistical analysis did not yield a statistically significant difference between the estimates obtained before and during “lockdown”. The model-based simulations pointed to the 0.3-h delay of the sleep–wake cycle in response to the 1-h delay of weekday risetime during “lockdown”.

Conclusion

The model-based prediction was confirmed, thus, highlighting again the necessity to rethink the concept of weekend catch-up sleep.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11325-021-02492-z.

Dissociated profiles of sleep timing and sleep quality changes across the first and second wave of the COVID-19 pandemic

Previous work showed a significant impact of the COVID-19 pandemic on Italians' sleep both during the first wave, when a total lockdown (TL) was imposed, and during the second wave, when a partial lockdown (PL) was mandated (autumn 2020). Here we complement these data by describing the profile of sleep across four time-points: the first and second lockdown (TL, PL) and the months preceding them (pre-TL, pre-PL). An online survey was completed by 214 participants (M_age = 36.78 ± 14.2 y; 159 F) during TL and again during PL. All sleep-related questions (including items of the Pittsburgh Sleep Quality Index) required a double answer, one referred to the current lockdown and one to the month preceding the lockdown. Bedtime and rise time were delayed in TL and then advanced in pre-PL and PL. Similarly, time in bed increased in TL and then decreased in pre-PL and PL. Sleep quality worsened in the two lockdowns compared to the preceding periods and the proportion of poor sleepers correspondingly increased in both lockdowns. Sleep habits and quality displayed different profiles across phases of the pandemic. Sleep timing was altered during the first lockdown and then returned towards baseline (likely due to normalized working schedules). Instead, sleep quality, which markedly worsened during both lockdowns, appears particularly sensitive to changes in life habits and psychological factors, independently of sleep habits. Our findings also point to a possible role of acute and chronic stress (experienced during the first and second wave, respectively) in modulating sleep changes across the pandemic waves.

Prevalence of problematic Internet use and its association with quality of life among undergraduate nursing students in the later stage of COVID-19 pandemic era in China

Background and Objectives

The prevalence of problematic Internet use (PIU) in the post‐COVID‐19 pandemic era is not known. This cross‐sectional study aimed to determine the prevalence of PIU among baccalaureate nursing students (hereafter: nursing students) in the post‐COVID‐19 era.

Methods

A total of 1070 nursing students were consecutively invited to participate in this study from the nursing schools of five universities. PIU and quality of life (QOL) were assessed using the Internet Addiction Test (IAT) and the World Health Organization Quality of Life Scale Brief Version (WHOQOL‐BREF), respectively. t Tests, χ², tests, and Kruskal–Wallis tests were used to compare basic demographic and clinical characteristics between participants with and without PIU. Binary logistic regression analysis was used to examine independent correlates.

Results

The prevalence of PIU was 23.3% (95% confidence interval [CI]: 20.7%–25.8%). Multiple logistic regression analysis revealed that second‐ (p = .024) and third‐year (p = .012) students were more likely to suffer from PIU compared with first year students. Students with more severe depressive (p = .014) and anxiety symptoms (p = .011) were independently and significantly associated with more severe PIU. After controlling for covariates, nursing students with PIU had a lower overall QOL score (p = .002).

Conclusion and Scientific Significance

Problematic Internet use (PIU) was common among nursing students in the post‐COVID‐19 era. Considering the negative impact of PIU on QOL and academic performance, regular screening should be conducted and effective interventions implemented for nursing students with PIU. This was the first study on the prevalence of PIU among nursing students in the post‐COVID‐19 era. The findings of this study could help health professionals and education authorities to understand the patterns of PIU and its influence on QOL among nursing students and to allocate health resources and develop effective measures to reduce the risk of PIU in this population.

Circadian disturbances, sleep difficulties and the COVID-19 pandemic

The COVID-19 pandemic has imposed extraordinary and unpredictable changes on our lifestyle for an unknown duration. Consequently, core aspects of wellbeing including behavior, emotion, cognition, and social interactions are negatively affected. Sleep and circadian rhythms, with an extensive impact on physiology, behavior, emotion, and cognition are affected too. We provided an updated overview of the impact of the COVID-19 pandemic on circadian rhythms and sleep based on the results of published studies (n = 48) in three sections. First, we focus on circadian misalignment due to the pandemic in the general population (including shift workers, health staff, students) and COVID-19 patients and summarize the most critically contributing factors to circadian misalignment. Next, we address sleep difficulties and poor sleep quality during the pandemic, their contributing factors, rate and prevalence, and their effects on both the general population and COVID-19 patients. Finally, we summarize the currently applied/recommended interventions for aligning circadian rhythms and improving sleep quality in both, the general population, and COVID-19 patients during the pandemic situation. Briefly, circadian misalignment and sleep difficulties are common consequences of the pandemic in the general population (with elderly, students, children, health and night-work shifters as risk groups) and COVID-19 patients. Home confinement and its physiological, circadian, and psychological derivates are central to these difficulties. Symptoms severity, treatment progress, recovery duration, and even diagnosis of COVID-19 patients are considerably affected by circadian and sleep difficulties. Behavioral interventions for normalizing the factors that contribute to circadian and sleep difficulties are helpful.

The Relationship between Fear of Infection and Insomnia among Dentists from Oradea Metropolitan Area during the Outbreak of Sars-CoV-2 Pandemic

Various studies have shown the impact of COVID-19 pandemic on mental health, identifying that people with a strong fear of getting infected are more prone to become stressed, depressed, anxious and to experience sleeping disturbance. The present study focuses on the impact of fear of COVID-19 and its relationship with insomnia among dentists. 83 dentists from public and private clinics were included in the research. A questionnaire was especially constructed for this study, consisting of three parts: the first part gathered socio-demographic and medical data, and a succession of self-rated items collected opinions about lockdown and preventive behaviors; the second part evaluated the level of fear of infection with Coronavirus-19 using the Fear of Covid 19 Scale; the third part investigated the presence of insomnia using the Athens Insomnia Scale. Collected data were processed using SPSS (v. 25). The total scores for fear of COVID 19 and insomnia were assessed. A strong positive correlation was identified between the total score of AIS and the total score of FCV-19S. The fear of COVID-19 had a significant positive correlation with the practice of several preventive behaviors. Dentists with chronic diseases were found to be more prone to suffer from insomnia than healthy dentists. Significant differences between women and men in terms of night symptoms were discussed. The findings are useful for dentists and policy makers to evaluate the impact of fear of infection on mental health status.

First-Wave COVID-19 Pandemic in Greece: The Role of Demographic, Social, and Geographical Factors in Life Satisfaction during Lockdown

The onset of the coronavirus pandemic led to profound changes in populations’ everyday lives. The main purpose of this research is to investigate the factors that affected life satisfaction during the first-wave lockdown in Greece. A web-based survey was developed, and 4305 questionnaires were completed corresponding to all Greek regional units. Statistical modeling (multivariate logistic regression) was performed to evaluate to which extent significant geographical attributes and socioeconomic characteristics are likely to influence life satisfaction during lockdown due to the pandemic. In the course of the present work, some key findings emerged: social distancing and confinement measures affected mostly women in relation to men; there was a strong positive association between life satisfaction and age, especially as regards the older population; changes to employment status, increase in psychosomatic disorders, and increased usage of social media were also likely to negatively impact people’s life satisfaction. By contrast, trust in the government and the media and limited health concerns seem to have a strong association with subjective wellbeing. Finally, life satisfaction does not depend much on geographical characteristics such as urbanity or insularity, highlighting that the lockdown had an impact on the Greek population regardless of the physical isolation.