Physical Activity, Sedentary Behavior, Sleep and Self-Regulation in Spanish Preschoolers during the COVID-19 Lockdown

Abstract

Background: A better understanding of the effects of the lockdown on lifestyle behaviors may help to guide the public health response to COVID-19 at a national level and to update the global strategy to respond COVID-19 pandemic. The aim of the study was to examine the effects of the COVID-19 lockdown on device-measured physical activity (PA), sedentary time, sleep and self-regulation; and to determine whether PA and sleep are related to self-regulation problems during the lockdown. Methods: PA, sedentary time and sleep were assessed using accelerometry in the week in which the Spanish national state of alarm was declared (n = 21). Parents reported preschooler’s self-regulation difficulties (internalizing and externalizing) before (n = 268) and during the lockdown (n = 157) by a validated questionnaire. Results: Preschoolers showed a decrease in total PA (mean difference [MD] = −43.3 min per day, 95% CI −68.1 to −18.5), sleep efficiency (MD = −2.09%, 95% CI −4.12 to −0.05), an increase in sedentary time (MD = 50.2 min per day, 95% CI 17.1 to 83.3) internalizing (MD = 0.17, 95% CI 0.06 to 0.28) and externalizing (MD = 0.33, 95% CI 0.23 to 0.44) problems. Preschoolers who met the World Health Organization recommendations for PA had lower internalizing scores than non-active peers (MD = −1.28, 95% CI −2.53 to −0.03). Conclusions: Our findings highlight the importance of meeting PA recommendations to reduce psychosocial difficulties during a lockdown situation.

Behavioral and Emotional Changes in Early Childhood during the COVID-19 Pandemic

“…19 This was the same as Alonso-Martinez's report that externalizing behavior was more widely observed by parents. 20 Glynn et al 21 found that children who had family routines tended to reduce symptoms of depression and externalizing behavior. Conduct problems (behavior problems), hyperactivity, and aggressiveness were the most commonly reported externalizing behavior during the lockdown period.…”

“…Conduct problems (behavior problems), hyperactivity, and aggressiveness were the most commonly reported externalizing behavior during the lockdown period. [19][20][21][22][23][24][25] Glynn et al 21 also found that approximately 64% of parents reported an increase in externalizing behavior since the start of the pandemic, with nearly 50% of the total 169 children experienced an increase in tantrum temper.…”

“…A total of five studies reported signs of internalizing behavior in the form of anxiety, depression, somatization, and sleep disturbances. 19,20,[22][23][24] Research conducted by Romero et al 23 stated that 29.2% of children aged 3-6 years experienced emotional problems assessed by using the Strength and Difficulties Questionnaire (SDQ) which on the emotional scale consisted of somatic signs, worry, unhappiness, spoiledness, and fear. 23,26 Another study of children in several European countries stated that more than 20% of children tended to be more spoiled, did not want to sleep alone, were often sad, and experienced of separation anxiety.…”

“…In general, five studies stated that there was a decrease in physical activity and an increase in the duration of recreational screen time in early childhood during COVID-19. 20,[27][28][29][30] Two studies conducted in Spain, namely by Alonso-Martinez et al 20 and López-Bueno et al 29 stated that the difference in physical activity time of children before and during pandemic restriction was 43.3 minutes per day and 92 minutes per week, respectively, whereas the first study measured objectively using a physical activity measuring device for six days. López-Bueno et al 29 found that screen time in children 3-5 years increased by 2.2 hours to nearly four hours of screen exposure.…”

“…There were seven studies comparing sleep patterns of children before and after lockdown. 20,25,28,29,[32][33][34][35] Five studies suggested an increase in sleep duration and a shift in children's sleep time during lockdown. Three of the four studies stated that there was a shift in sleep time, in which children slept later and woke up later.…”