A Longitudinal Study of Subjective Daytime Sleepiness Changes in Elementary School Children Following a Temporary School Closure Due to COVID-19

Abstract

Excessive daytime sleepiness is increasingly being recognized as a major global health concern. However, there have been few studies related to sleepiness and its associated factors in elementary school children. In Japan, all schools were closed from February to May 2020 to prevent coronavirus disease 2019 (COVID-19) outbreaks. The aim of this study was to identify changes in the subjective sleepiness of pupils during the 1.5-year period and to elucidate factors associated with changes in sleepiness. Questionnaire surveys about pupils’ sleep habits and the Japanese version of the Pediatric Daytime Sleepiness Scale (PDSS-J) were conducted longitudinally at one elementary school in June 2019, January 2020, and June 2020. The average ∆PDSS score was 0.94 ± 5.51 (mean ± standard deviation) from June 2019 to January 2020 and −1.65 ± 5.71 (t[498] = 6.13, p < 0.01) from January 2020 to June 2020. Univariate and multivariate logistic regression analyses revealed that decreasing social jetlag was associated with decreasing PDSS scores (OR = 0.77, 95% CI: 0.62–0.96, p = 0.02) during the school closure. A less restrictive school schedule secondary to a COVID-19-related school closure decreased sleepiness in children and was associated with decreasing social jetlag.

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

“…Data on rise-and bedtime on weekdays and weekends before and during "lockdown" were collected from a number of journal papers [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. In Supplementary1_31samples, these 31 samples are listed with some other details (e.g., mean age, method of data collection, etc.…”

“…In different countries around the world, the estimates of weekday and weekend sleep times prior to and during "lockdown" were collected and published for more than 30 samples ( [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]; see Supplementary1_31samples). This dataset allowed the testing of model's prediction of the failure of weekend sleep duration to become shorter in response to later weekday wakeups and longer weekday sleep duration during "lockdown".…”

Which Is More Important for Health: Sleep Quantity or Sleep Quality?

“…According to Komada et al [ 77 ], a COVID-19-related school closure decreased sleepiness in children and was associated with decreasing social jetlag, although with a delay in bedtime. In general, late bedtime is considered to be an unfavorable habit [ 44 ].…”

Changes in Adherence to the 24-Hour Movement Guidelines and Overweight and Obesity among Children in Northeastern Japan: A Longitudinal Study before and during the COVID-19 Pandemic

“…In studies reporting an increase regarding this variable, it seems that the quarantine measures were the reason for this change [23,35,46]. It may also be that the absence of school commuting could increase sleep duration in children; in fact, across Japan, all schools were closed from February to May 2020, to prevent the spread of COVID-19 [47], so school life returned to normal only after this period. Thus, it seems that the COVID-19 pandemic did not have profound effects on sleep duration, denoting that future studies should assess the underlying reasons for the delayed bedtime experienced by children in this sample during the COVID-19 pandemic.…”