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Xavier MO, Maruyama JM, Santos IS, Tovo-Rodrigues L, Barros AJD, Matijasevich A. Changes of adolescent sleep patterns during the COVID-19 pandemic. Rev Saude Publica 2024; 58:24. [PMID: 38985055 PMCID: PMC11196094 DOI: 10.11606/s1518-8787.2024058005866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/07/2023] [Indexed: 07/11/2024] Open
Abstract
OBJECTIVE The COVID-19 pandemic has raised numerous concerns regarding its effects on individuals' health and lifestyle. We aim to analyze potential changes in adolescent sleep patterns from before and during the pandemic and identify specific predictors of changes. METHODS A subgroup of adolescents from a population-based birth cohort from Pelotas, Brazil, was assessed pre-pandemic (T1, November-2019 to March-2020) and peri-pandemic (T2, August-2021 to December-2021) in in-person interviews (n = 1,949). Sleep parameters, including sleep duration and latency time on workdays and free days, as well as social jetlag (SJL), were assessed using the Munich ChronoType Questionnaire (MCTQ). Socio-demographic, pre-pandemic, and pandemic-related predictors were analyzed. Changes in sleep parameters from T1 to T2 were estimated by multivariate latent change score modeling. RESULTS The latent change factor shows a significant mean increase in workday sleep duration (M = 0.334, p < 0.001), workday sleep latency (M = 0.029, p = 0.002), and free day sleep latency (M = 0.021, p = 0.034), and a decreased in SJL (M = -0.758, p < 0.001) during the pandemic. Female adolescents presented higher increases in workday sleep duration. Adolescents who adopted a stricter social distancing level during the pandemic presented greater increases in workday sleep duration and smaller reductions in SJL. Self-evaluated insomnia during the pandemic predicted lower increases in workday and free day sleep duration and higher increases in workday and free day sleep latency. CONCLUSION The COVID-19 outbreak brought certain advantages regarding increased sleep duration and reduced SJL. However, the observed increase in sleep latency and the influence of self-reported insomnia could be related to psychological distress inherent to the pandemic.
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Affiliation(s)
- Mariana Otero Xavier
- Universidade de São PauloFaculdade de MedicinaDepartamento de Medicina PreventivaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. São Paulo,SP, Brasil
| | - Jessica Mayumi Maruyama
- Universidade de São PauloFaculdade de MedicinaDepartamento de Medicina PreventivaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. São Paulo,SP, Brasil
- Universidade Presbiteriana MackenziePrograma de Pós-Graduação em Ciências do Desenvolvimento HumanoSão PauloSPBrasil Universidade Presbiteriana Mackenzie. Programa de Pós-Graduação em Ciências do Desenvolvimento Humano. São Paulo, SP, Brasil
| | - Iná S. Santos
- Universidade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Luciana Tovo-Rodrigues
- Universidade Presbiteriana MackenziePrograma de Pós-Graduação em Ciências do Desenvolvimento HumanoSão PauloSPBrasil Universidade Presbiteriana Mackenzie. Programa de Pós-Graduação em Ciências do Desenvolvimento Humano. São Paulo, SP, Brasil
| | - Aluísio J. D. Barros
- Universidade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Alicia Matijasevich
- Universidade de São PauloFaculdade de MedicinaDepartamento de Medicina PreventivaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. São Paulo,SP, Brasil
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Kaldenbach S, Hysing M, Strand TA, Sivertsen B. Energy drink consumption and sleep parameters in college and university students: a national cross-sectional study. BMJ Open 2024; 14:e072951. [PMID: 38262632 PMCID: PMC10806792 DOI: 10.1136/bmjopen-2023-072951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 11/08/2023] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVES To investigate the frequency of energy drink (ED) consumption, and the association between ED consumption and selected sleep characteristics and parameters in Norwegian college and university students. We also explored whether these associations varied based on sex. DESIGN Cross-sectional. SETTING Data were gathered from the SHOT2022 study (Students' Health and Well-being Study), a national survey. PARTICIPANTS 53 266 students, aged 18-35 years, enrolled in higher education in Norway (2022). MAIN OUTCOME MEASURES Estimated marginal means were computed from general linear models investigating the association between ED consumption and continuous sleep outcomes, while log-link binomial regression analysis was used for dichotomous sleep outcomes of sleep measures. All models were adjusted for age. RESULTS Among the participants, 4.7% of men and 3.3% of women reported consuming ED daily. The frequency of ED consumption was inversely associated with sleep duration and sleep efficiency, while a direct association was observed with the frequency of ED consumption and sleep patterns such as sleep onset latency and wake after sleep onset across sexes. The strongest association was found between daily ED consumption and short sleep duration where men had a risk ratio (RR) of 2.07; 95% CI 1.77 to 2.42, and women had a RR of 1.87; 95% CI 1.64 to 2.14. CONCLUSION ED consumption was a strong determinant for negative sleep outcomes. Even small amounts of ED were associated with poorer sleep outcomes, which warrant more attention towards the consequences of consuming ED among college and university students.
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Affiliation(s)
- Siri Kaldenbach
- Department of Paediatric and Adolescent Medicine, Innlandet Hospital Trust, Lillehammer, Norway
- Department of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Mari Hysing
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Tor A Strand
- Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Department of Research and Innovation, Fonna Health Trust, Haugesund, Norway
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Perrar I, Alexy U, Jankovic N. Chronobiological changes due to school closures during the COVID-19 pandemic among adolescents in the DOrtmund Nutritional and Anthropometric Longitudinally Designed cohort study. Eur J Pediatr 2023:10.1007/s00431-023-04963-9. [PMID: 37032380 PMCID: PMC10088594 DOI: 10.1007/s00431-023-04963-9] [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: 12/01/2022] [Revised: 03/23/2023] [Accepted: 03/30/2023] [Indexed: 04/11/2023]
Abstract
Due to the lockdown of schools as one of the COVID-19 control measures, adolescents have had the opportunity to re-organise their daily lives; e.g. some of them have adapted their bedtimes to the new situation during the lockdown in favour of their own chronotype. Hence, we investigated differences in chronobiological characteristics (e.g., the midpoint of sleep, sleep duration or social jetlag (SJL); i.e., a discrepancy between biological and social timing) before and during the pandemic lockdown to examine potential changes. We asked participants from the ongoing open cohort Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study to fill out the Munich Chronotype Questionnaire during the COVID-19 lockdown and received the information of participants (n = 66) during the pandemic. A reference group matched for age, season, and sex was randomly selected from the DONALD study to assess participants' chronobiological characteristics prior to (n = 132) the pandemic. Analyses of covariance were applied to examine differences between the two groups reflecting the situation before and during the COVID-19 pandemic. Participants were aged 9-18 years (52% males). In the current examination, average sleep duration across the week was higher among adolescents during the pandemic (β = 00:30; p = 0.0006) and social jetlag was significantly lower (β = -00:39; p < 0.0001). CONCLUSION Our results showed that the COVID-19 lockdown enabled adolescents to adapt their sleeping habits according to their naturally late chronotype, which led to a significant reduction in SJL. These observations are likely to be explained by the effect of school closure. WHAT IS KNOWN • Under 'normal conditions' without pandemic lockdowns, adolescents accumulate a lack of sleep due to social obligations such as school starts, resulting in social jetlag. • A late chronotype or exposure to social jetlag is a known risk factor for the development of chronic diseases. WHAT IS NEW • The COVID-19 lockdown represents a 'natural experiment' that enables adolescents to adhere to their internal biological clock. Without the usual social obligations, social jetlag can be significantly reduced.
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Affiliation(s)
- Ines Perrar
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, DONALD Study, University of Bonn, Heinstück 11, 44225, Dortmund, Germany
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Friedrich-Hirzebruch-Allee 7, 53115, Bonn, Germany
| | - Ute Alexy
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, DONALD Study, University of Bonn, Heinstück 11, 44225, Dortmund, Germany
| | - Nicole Jankovic
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, DONALD Study, University of Bonn, Heinstück 11, 44225, Dortmund, Germany.
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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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Rossi L, Silva C, Charvin I, Da Fonseca D, Bat-Pitault F. Sleep and emotionality in adolescents with anorexia nervosa during the Covid-19 pandemic. EUROPEAN EATING DISORDERS REVIEW 2023. [PMID: 36807392 DOI: 10.1002/erv.2971] [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: 09/20/2022] [Revised: 02/04/2023] [Accepted: 02/06/2023] [Indexed: 02/21/2023]
Abstract
PURPOSE The recent Covid-19 pandemic and its lockdown measures raised concerns about people's mental health, leading to an increased interest in identifying vulnerable groups especially at risk for mental distress. This cross-sectional study investigated the impact of this unprecedented situation on sleeping patterns and emotionality in adolescents with anorexia nervosa (AN). METHODS Variations in sleeping patterns and emotionality of two groups of adolescents with AN, assessed before (N = 50) and during (N = 51) the Covid-19 lockdown were analysed. We further investigated these variations over time, considering the two lockdown periods in France. RESULTS Adolescents self-reported significantly more sleep difficulties and lower rates of positive emotions during lockdown, compared to those evaluated before it. Furthermore, present findings overall suggest that as the lockdown progresses, adolescents with AN show an increased deterioration of sleep quality, as indicated by greater insomnia severity levels. They also show a significant decrease in the subjective experience of positive emotionality, in particular in feelings of tenderness. CONCLUSIONS These sleep and emotionality alterations may have amplified the severity and the incidence of AN in adolescents during the Covid-19 pandemic. These features may therefore represent therapeutic targets to optimise care of adolescents with AN. This is particularly urgent, considering kinetics of the deterioration. Tools such as those provided by cognitive behavioural therapy for insomnia and by the positive psychology framework seem appropriate to guide clinicians in this context. LEVEL OF EVIDENCE Level V, descriptive study (evaluation data retrospectively studied).
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Affiliation(s)
- Lucia Rossi
- IRRCS Istituto delle Scienze Neurologiche di Bologna, UO Neuropsichiatria dell'Età Pediatrica, Bologna, Italy.,Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy.,Child and Adolescent Psychiatry Unit, Salvator University Hospital, Public Assistance-Marseille Hospitals, Aix-Marseille University, Marseille, France
| | - Catarina Silva
- Child and Adolescent Psychiatry Unit, Salvator University Hospital, Public Assistance-Marseille Hospitals, Aix-Marseille University, Marseille, France.,Institute of Neuroscience Timone, CNRS, Aix-Marseille University, Marseille, France
| | - Isabelle Charvin
- Child and Adolescent Psychiatry Unit, Salvator University Hospital, Public Assistance-Marseille Hospitals, Aix-Marseille University, Marseille, France
| | - David Da Fonseca
- Child and Adolescent Psychiatry Unit, Salvator University Hospital, Public Assistance-Marseille Hospitals, Aix-Marseille University, Marseille, France.,Institute of Neuroscience Timone, CNRS, Aix-Marseille University, Marseille, France
| | - Flora Bat-Pitault
- Child and Adolescent Psychiatry Unit, Salvator University Hospital, Public Assistance-Marseille Hospitals, Aix-Marseille University, Marseille, France.,Institute of Neuroscience Timone, CNRS, Aix-Marseille University, Marseille, France
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Thorell LB, Fuermaier ABM, Christiansen H, Steinmayr R, Baeyens D, de la Peña AG, Groom MJ, Idrees I, van der Oord S, van den Hoofdakker BJ, Luman M, Mammarella IC, Skoglund C. Distance learning during the COVID-19 pandemic for children with ADHD and/or ASD: a European multi-center study examining the role of executive function deficits and age. Child Adolesc Psychiatry Ment Health 2022; 16:101. [PMID: 36514179 PMCID: PMC9745722 DOI: 10.1186/s13034-022-00540-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND One of the COVID-19 pandemic consequences that has affected families the most is school lockdowns. Some studies have shown that distance learning has been especially challenging for families with a child with neurodevelopmental disorders such as ADHD or ASD. However, previous studies have not taken the heterogeneity of these disorders into account. The aim of the present study was therefore to investigate differences between families with a child with ADHD, ASD, or both conditions, and to examine the role of underlying deficits in executive functioning (EF) in both children and parents in relation to negative and positive effects of distance learning. METHODS Survey data assessing both negative and positive experiences of distance learning were collected from parents with a child aged 5-19 years in seven Western European countries: the UK, Germany, Spain, Sweden, the Netherlands, Italy, and Belgium. Altogether, the study included 1010 families with a child with ADHD and/or ASD and an equally large comparison group of families with a child without mental health problems. We included measures of three different types of negative effects (i.e., effects on the child, effects on the parent, and lack of support from school) and positive effects on the family. RESULTS Results confirmed that families with a child with ADHD, ASD or a combination of ADHD and ASD showed higher levels of both negative and positive effects of distance learning than the comparison group. However, few differences were found between the clinical groups. Group differences were more pronounced for older compared to younger children. Regarding the role of both ADHD/ASD diagnosis and EF deficits, primarily children's EF deficits contributed to high levels of negative effects. Parent EF deficits did not contribute significantly beyond the influence of child EF deficits. Families of children with ADHD/ASD without EF deficits experienced the highest levels of positive effects. CONCLUSIONS School closings during COVID-19 have a major impact on children with EF problems, including children with neurodevelopmental disorders. The present study emphasizes that schools should not focus primarily on whether a student has a neurodevelopmental disorder, but rather provide support based on the student's individual profile of underlying neuropsychological deficits.
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Affiliation(s)
- Lisa B. Thorell
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Nobels Väg 9, 17177 Stockholm, Sweden
| | | | | | | | - Dieter Baeyens
- grid.5596.f0000 0001 0668 7884KU Leuven, Leuven, Belgium
| | | | | | - Iman Idrees
- grid.4563.40000 0004 1936 8868University of Nottingham, Nottingham, UK
| | | | - Barbara J. van den Hoofdakker
- grid.4494.d0000 0000 9558 4598University Medical Center Groningen, University of Groningen & Accare Child Study Center, Groningen, The Netherlands
| | - Marjolein Luman
- grid.16872.3a0000 0004 0435 165XVrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, & Levvel, Specialists in Youth and Family Care, Amsterdam, The Netherlands
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Pellitteri G, Surcinelli A, De Martino M, Fabris M, Janes F, Bax F, Marini A, Milanic R, Piani A, Isola M, Gigli GL, Valente M. Sleep alterations following COVID-19 are associated with both neuroinflammation and psychological disorders, although at different times. Front Neurol 2022; 13:929480. [PMID: 36062000 PMCID: PMC9428349 DOI: 10.3389/fneur.2022.929480] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction By the end of 2019, severe acute respiratory syndrome coronavirus 2 rapidly spread all over the world impacting mental health and sleep habits. Insomnia, impaired sleep quality, and circadian rhythm alterations were all observed during the pandemic, especially among healthcare workers and in patients with acute and post-acute COVID-19. Sleep disruption may induce a pro-inflammatory state associated with an impairment of immune system function. Objective We investigated the relationship between sleep alterations, psychological disorders, and inflammatory blood biomarkers in patients with post-acute COVID-19. Methods We enrolled 47 subjects diagnosed with COVID-19 pneumonia at Santa Maria della Misericordia University Hospital (Udine, Italy) between March and May 2020. Selected patients were evaluated at 2 months (T1) and 10 months (T2) after discharge. Each time, we collected clinical interviews, neurological examinations, and self-administered questionnaires to assess sleep and life quality, anxiety, depression, and post-traumatic stress disorder. Blood biomarkers of endothelial activation, neuroinflammation, and inflammatory cytokines were also measured at each follow-up. Collected variables were analyzed using comparisons between groups and linear regression models. Results Prevalence of insomnia increased from 10.6% up to 27.3% after COVID-19. Poor sleep quality was found in 41.5% of patients at both study visits. At T1 follow-up, poor sleepers showed higher levels of neurofilament light chain, vascular cell adhesion molecule 1, and interleukin 10; no significant associations were found between sleep quality and psychological disorders. At T2 follow-up, lower sleep quality was associated with higher levels of vascular cell adhesion molecule 1 and interleukin 8, but also with higher scores for anxiety, depression, and post-traumatic stress disorder. Conclusion Our results suggest an association of poor sleep quality with both psychological disorders and neuroinflammation, although at different times, in previously hospitalized patients with moderate-to-critical COVID-19.
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Affiliation(s)
- Gaia Pellitteri
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Andrea Surcinelli
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Maria De Martino
- Division of Medical Statistics, Department of Medical Area, University of Udine, Udine, Italy
| | - Martina Fabris
- Institute of Clinical Pathology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Francesco Janes
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Francesco Bax
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | | | - Romina Milanic
- Institute of Clinical Pathology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Antonella Piani
- Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Miriam Isola
- Division of Medical Statistics, Department of Medical Area, University of Udine, Udine, Italy
| | - Gian Luigi Gigli
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Mariarosaria Valente
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
- Department of Medical Area (DAME), University of Udine, Udine, Italy
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Lee SY, Jang SJ. High School Students' Social Jetlag, Lifelong Competency, and Academic Stress During the COVID-19 Pandemic: A Cross-Sectional Study. J Sch Nurs 2022; 39:181-188. [PMID: 35466764 PMCID: PMC9039591 DOI: 10.1177/10598405221094847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
With the prolongation of non-ordinary situations such as school closures due to the coronavirus disease 2019 (COVID-19) pandemic, high school students have experienced irregular sleep-wake cycles and elevated academic stress resulting from reduced academic achievement and widened gaps in academic performance. This cross-sectional study aimed to investigate the associations among chronotype, social jetlag, lifelong learning competency, and academic stress in high school students during the COVID-19 pandemic. Data were collected through an online survey from May-June 2021. The mean social jetlag was found to be 2 h and 9 min, and multiple regression analysis revealed that social jetlag and lifelong competency affected academic stress. Thus, measures to minimize social jetlag and improve lifelong learning competencies should be implemented to reduce academic stress among high school students. School nurses should identify students with severe social jetlag and provide guidance and interventions to promote sleep hygiene and regular lifestyles.
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Affiliation(s)
- Soo Yeon Lee
- Red Cross College of Nursing, Department of Nursing, Graduate School, ChungAng University, Seoul, Republic of Korea - 06974
| | - Sun Joo Jang
- Red Cross College of Nursing, ChungAng University, 84 Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea - 06974,Sun Joo Jang, PhD, Red Cross College of Nursing, ChungAng University, 84 Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea – 06974.
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Albrecht JN, Werner H, Rieger N, Jenni OG, Huber R. Sleep and Health-Related Characteristics among Adolescents during COVID-19: An Update. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5078. [PMID: 35564473 PMCID: PMC9105238 DOI: 10.3390/ijerph19095078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 01/27/2023]
Abstract
Two opposing effects on adolescents' health during COVID-19 lockdown have been described: A beneficial one due to longer sleep times during school closures and a detrimental one of psychological distress. This study investigated how sleep and health changed in the course of the pandemic when schools were open again. Overall, 12,238 adolescents in Switzerland participated in three cross-sectional online surveys: In 2017 under regular conditions (control group), during pandemic school closures in 2020 (closure group), and in 2021 still under pandemic conditions, but schools were open again (postclosure group). Sleep behavior and health-related characteristics (health-related quality of life; caffeine, alcohol, and nicotine use) in all three groups and depressive symptoms in the closure and postclosure groups were assessed. The sleep period on school days was longer in the closure group (median 9.00 h, interquartile range 8.25-9.75) and similar in the postclosure (7.92, 7.00-8.50) compared to the control group (7.75, 7.08-8.33). Health-related characteristics were better during school closures and similar to worse in the postclosure compared to the control group. Depressive symptom levels were higher in the postclosure than in the closure group. Therefore, beneficial effects were specific to school closures and adolescents' psychological distress increased over the course of the pandemic.
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Affiliation(s)
- Joëlle N. Albrecht
- Child Development Center, University Children’s Hospital Zurich, University of Zurich (UZH), 8032 Zurich, Switzerland; (J.N.A.); (H.W.); (N.R.); (O.G.J.)
- Children’s Research Center, University Children’s Hospital Zurich, University of Zurich (UZH), 8032 Zurich, Switzerland
| | - Helene Werner
- Child Development Center, University Children’s Hospital Zurich, University of Zurich (UZH), 8032 Zurich, Switzerland; (J.N.A.); (H.W.); (N.R.); (O.G.J.)
- Children’s Research Center, University Children’s Hospital Zurich, University of Zurich (UZH), 8032 Zurich, Switzerland
- Department of Psychosomatics and Psychiatry, University Children’s Hospital Zurich, University of Zurich (UZH), 8032 Zurich, Switzerland
| | - Noa Rieger
- Child Development Center, University Children’s Hospital Zurich, University of Zurich (UZH), 8032 Zurich, Switzerland; (J.N.A.); (H.W.); (N.R.); (O.G.J.)
| | - Oskar G. Jenni
- Child Development Center, University Children’s Hospital Zurich, University of Zurich (UZH), 8032 Zurich, Switzerland; (J.N.A.); (H.W.); (N.R.); (O.G.J.)
- Children’s Research Center, University Children’s Hospital Zurich, University of Zurich (UZH), 8032 Zurich, Switzerland
| | - Reto Huber
- Child Development Center, University Children’s Hospital Zurich, University of Zurich (UZH), 8032 Zurich, Switzerland; (J.N.A.); (H.W.); (N.R.); (O.G.J.)
- Children’s Research Center, University Children’s Hospital Zurich, University of Zurich (UZH), 8032 Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich (UZH), 8032 Zurich, Switzerland
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Sleep Quality, Mental Health and Learning among High School Students after Reopening Schools during the COVID-19 Pandemic: Results of a Cross-Sectional Online Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052553. [PMID: 35270245 PMCID: PMC8909739 DOI: 10.3390/ijerph19052553] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/13/2022] [Accepted: 02/17/2022] [Indexed: 12/20/2022]
Abstract
We aimed to assess whether high school students’ sleep quality, mental health and learning changed during the COVID-19 pandemic as adolescents transitioned from learning online back to studying in person. We conducted an anonymous online cross-sectional survey study at three competitive high schools in Vilnius, Lithuania, after they were reopened. Students provided subjective views on their study quality, their health as well as daily life while studying either virtually or in person and completed the Beck depression inventory (BDI), the Generalized anxiety scale-7 (GAD-7) and the Pittsburgh sleep quality index (PSQI). Among 628 (70.4% female) respondents, 268 (42.7%), 342 (54.5%) and 398 (63.4%) are suspected to have depression, an anxiety disorder or poor sleep, respectively. Students reported better study quality (Z = −12.435, p < 0.001) and physical health (Z = −9.176, p < 0.001), but worse sleep quality (Z = −19.489, p < 0.001), shorter sleep duration (Z = −19.509, p < 0.001) and worse self-reported mental health (Z = −2.220, p < 0.05) while learning in person. However, higher scores of in-person study quality and physical health were associated with lower depression and anxiety levels as well as better sleep. Our study suggests that the reopening of schools may exacerbate sleep and mental health-related issues among high school students but also be beneficial for their academic development and levels of physical activity.
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Saxvig IW, Pallesen S, Sivertsen B, Hysing M, Evanger LN, Bjorvatn B. Sleep during COVID-19-related school lockdown, a longitudinal study among high school students. J Sleep Res 2021; 31:e13499. [PMID: 34601775 PMCID: PMC8646238 DOI: 10.1111/jsr.13499] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/25/2021] [Accepted: 09/08/2021] [Indexed: 12/20/2022]
Abstract
There has been great concern about the impact of coronavirus disease 2019 (COVID-19)-related school lockdown on adolescent health. The aim of the present study was to compare sleep patterns before and during COVID-19-related school lockdown, in a large sample of high school students. The present study is based a prospective, longitudinal survey on adolescent sleep health. Phase 1 was conducted in 2019, whereas phase 2 was conducted in 2020 (response rate 60.2%), during the last 10 days of a 60-day long school lockdown. Main outcomes comprised sleep parameters from the Munich ChronoType Questionnaire (MCTQ). A total of 2,022 students provided valid responses to MCTQ in both survey phases. Results showed later sleep timing on schooldays in 2020 compared to 2019 (36 min later bedtimes, Cohen's d = 0.56; 1:35 hr later rise times, Cohen's d = 1.44). Time spent in bed on schooldays increased from 8:20 to 9:19 hr (Cohen's d = 0.78), and sleep duration increased by 45 min (Cohen's d = 0.49). The proportion of adolescents obtaining the recommended ≥8 hr of sleep on schooldays increased from 13.4% (2019) to 37.5% during the lockdown. Social jetlag was reduced from 2:37 hr (2019) to 1:53 hr (2020, Cohen's d = 0.59). Results points to a potential advantageous effect of school lockdown in terms of increased school day sleep duration and reduced social jetlag. As sleep is important for mental and somatic health, it is conceivable that increased sleep duration offered some protection against harmful aspects of the COVID-19 pandemic and associated social restrictions. Future studies should address possible associations between sleep changes and health during COVID-19-related school lockdown.
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Affiliation(s)
- Ingvild West Saxvig
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Centre for Sleep Medicine, Haukeland University Hospital, Bergen, Norway
| | - Ståle Pallesen
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Department of Psychosocial Science, University of Bergen, Bergen, Norway.,Optentia Research Focus Area, North-West University, Vanderbijlpark Campus, Vanderbijlpark, South Africa
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Bergen, Norway
| | - Mari Hysing
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Linn Nyjordet Evanger
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Bjørn Bjorvatn
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Centre for Sleep Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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