Italy was the first western hotspot of the COVID-19 pandemic. In order to contain the spread of the virus, the Italian Government imposed home confinement to the entire population for almost two months. The present study is the first large-scale longitudinal report of the sleep and mental health changes during the prolonged lockdown due to the COVID-19 outbreak. We focused on the gendered vulnerability in a sample of the Italian population since cross-sectional research identified women to be more at-risk than men during this unprecedented situation. 2701 individuals (mean age ± standard deviation, 32.37 ± 11.62; range, 18–82) participated in a web-based longitudinal survey consisting of two measurements. Participants were first-time recruited on social networks and via telephone messages through a snowball sampling and tested during the third week of the lockdown period. Subsequently, a follow-up evaluation was carried out during the seventh week of lockdown. The survey assessed perceived stress, sleep quality, insomnia and depression symptoms, and anxiety, using the following questionnaires: the 10-item Perceived Stress Scale, the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, the Beck Depression Inventory-second edition, and the State-Anxiety Inventory. Women showed the worst condition for all the examined dimensions in both the assessments. Nevertheless, at the follow-up women reported a reduction in perceived stress, insomnia and depression severity symptoms, and anxiety. On the other hand, male participants showed a worsening of perceived stress, sleep quality, and insomnia symptoms. Consequently, the gender prevalence gap of clinical conditions such as insomnia and depression was largely reduced under lockdown. Our investigation pointed to a different time course of sleep and mental health between genders during the home confinement period. Women seemed to show greater long-term resilience during the lockdown. Meanwhile, the male gender emerges as the most vulnerable category to the extension of the restraining measures. Our results suggest that there is no “weaker gender” after a prolonged lockdown. Indeed, the Italian population transversely presented signs of psychological suffering and significant sleep disturbances after the protracted and stressful lockdown period due to the COVID-19 pandemic.

Study Objectives During the coronavirus disease 2019 (COVID-19) lockdown, there was a worldwide increase in electronic devices’ daily usage. Prolonged exposure to backlit screens before sleep influences the circadian system leading to negative consequences on sleep health. We investigated the relationship between changes in evening screen exposure and the time course of sleep disturbances during the home confinement period due to COVID-19. Methods 2,123 Italians (mean age ± standard deviation, 33.1 ± 11.6) were tested longitudinally during the third and the seventh week of lockdown. The web-based survey evaluated sleep quality and insomnia symptoms through the Pittsburgh Sleep Quality Index and the Insomnia Severity Index. The second assessment survey inquired about intervening changes in backlit screen exposure in the two hours before falling asleep. Results Participants who increased electronic device usage showed decreased sleep quality, exacerbated insomnia symptoms, reduced sleep duration, prolonged sleep onset latency, and delayed bedtime and rising time. In this subgroup, the prevalence of poor sleepers and individuals reporting moderate/severe insomnia symptoms increased. Conversely, respondents reporting decreased screen exposure exhibited improved sleep quality and insomnia symptoms. In this subgroup, the prevalence of poor sleepers and moderate/severe insomniacs decreased. Respondents preserving screen time habits did not show variations of the sleep parameters. Conclusions Our investigation demonstrated a strong relationship between modifications of evening electronic device usage and time course of sleep disturbances during the lockdown period. Monitoring the potential impact of excessive evening exposure to backlit screens on sleep health is recommendable during the current period of restraining measures due to COVID-19.

Summary Since the first lockdown of Spring 2020, the COVID‐19 contagion waves pervasively disrupted the sleep and mental health of the worldwide population. Notwithstanding the largest vaccination campaign in human history, the pandemic has continued to impact the everyday life of the general population for 2 years now. The present study provides the first evidence of the longitudinal trajectories of sleep disturbances and mental health throughout the pandemic in Italy, also describing the differential time course of age groups, genders and chronotypes. A total of 1062 Italians participated in a three‐time‐point longitudinal study covering two critical stages of the emergency (the first lockdown in April 2020 and the second partial lockdown in December 2020) and providing a long‐term overview 2 years after the pandemic outbreak (April 2022). We administered validated questionnaires to evaluate sleep quality/habits, insomnia, depression, stress and anxiety symptoms. Analyses showed a gradual improvement in sleep disturbances, depression and anxiety. Conversely, sleep duration progressively decreased, particularly in evening‐type and younger people. Participants reported substantial earlier bedtime and get‐up time. Stress levels increased during December 2020 and then stabilised. This effect was stronger in the population groups apparently more resilient during the first lockdown (older people, men and morning‐types). Our results describe a promising scenario 2 years after the pandemic onset. However, the improvements were relatively small, the perceived stress increased, and the re‐establishment of pre‐existing social/working dynamics led to general sleep curtailment. Further long‐term monitoring is required to claim the end of the COVID‐19 emergency on Italians' sleep and mental health.

Study Objectives: During the COVID-19 lockdown, there was a worldwide increase in electronic devices' daily usage. The exposure to backlit screens before falling asleep leads to negative consequences on sleep health through its influence on the circadian system. We investigated the relationship between the changes in evening screen exposure and the time course of sleep disturbances during the home confinement period due to COVID-19. Methods: 2123 Italians were longitudinally tested during the third and the seventh week of lockdown. The web-based survey evaluated sleep quality and insomnia symptoms through the Pittsburgh Sleep Quality Index and the Insomnia Severity Index. During the second assessment, respondents reported the changes in the backlit screen exposure in the two hours before falling asleep. Results: Participants who increased electronic device usage showed decreased sleep quality, exacerbated insomnia symptoms, reduced sleep duration, higher sleep onset latency, and delayed bedtime and rising time. In this subgroup, the prevalence of poor sleepers and clinical insomniacs increased. Conversely, respondents reporting decreased screen exposure exhibited improved sleep quality and insomnia symptoms. In this subgroup, the prevalence of poor sleepers and clinical insomniacs decreased. Respondents preserving their screen time habits did not show any change in the sleep parameters. Conclusions: Our investigation demonstrated a strong relationship between the modifications of the evening electronic device usage and the time course of sleep disturbances during the lockdown period. Interventions to raise public awareness about the risks of excessive exposure to backlit screens are necessary to prevent sleep disturbances and foster well-being during the home confinement due to COVID-19.