The effect of COVID-19 school closures on adolescent sleep duration: an uncontrolled before-after study

Abstract

Background The coronavirus disease 2019 (COVID-19) pandemic affected almost 1.6 billion students or more than 90% of learners globally. However, the effect of school closures during COVID-19 pandemic on adolescent sleep duration remains unclear. Methods We undertook a cross-sectional electronic survey in six junior and senior high schools in Shanghai, China from late June to early July 2020. We evaluated the changes of sleep duration on weekdays by comparing sleep duration hours and insufficient sleep (< 9 h for children aged 6–13 years or < 8 h for teenagers aged 14–17 years) in COVID-19 school closures and after school reopening. We also investigated possible sex differences in the changes of sleep duration. Results A total of 3265 students completed the survey, the mean age was 14.56 ± 1.99 years, 1567 (47.99%) were girls and 1344 (41.17%) were in grades 10–12. The overall sleep duration decreased from 8.88 h in school closures to 7.77 h after school reopening, and the change (difference: − 1.11 h; 95%CI: − 1.16, − 1.07; P < 0.001) was statistically significant. The prevalence of insufficient sleep increased sharply from 21.10 to 63.98%, and the change (ratio:3.03; 95%CI:2.84, 3.23; P < 0.001) was statistically significant. Besides, the changes were greater in girls than in boys. Conclusion Results of this study revealed that sleep duration was longer and percentage of sufficient sleep was higher during COVID-19 school closures in adolescent students.

Nonconforming gender expression and insufficient sleep among adolescents during COVID-19 school closure and after school reopening

“…We measured sleep duration by collecting the bedtime and wake-up time on normal weekdays during school closure and after school reopening using the four questions [21]: "When do you usually go to bed on weekdays during school closure? ", "When do you usually wake up on weekdays during school closure?…”

“…In calculations of sleep duration, we used the midpoint time for each half-hour interval (e.g., 21:15 for "21:01-21:30") and the minimum or maximum time at the ends of the options (e.g., 18:00 for "No later than 18:00" and 1:00 for "1:00 or later") [21,25]. We then labeled the students as insufficient sleep if they slept less than the recommended sleep duration for their age according to National Sleep Foundation (at least 9 h for school-age children aged 5-13 years, 8 h for teenagers aged 14-17 years, and 7 h for young adults aged 18-25 years) [26].…”

“…In response to the COVID-19 pandemic, lots of cities issued lockdown and stay-at-home orders. Many studies reported that adolescents sleep longer during COVID-19 school closure [21][22][23]. The COVID-19 lockdown creates an uncommon scenario for adolescents living with their family members all days, and it provides an opportunity to examine how the effect of GNC on insufficient sleep changes during and after the COVID-19 lockdown.…”

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

“…After transitioning to online learning, students faced a completely different daily routine that changed their learning experience, sleep patterns and social interactions [ 6 , 7 , 8 ]. While it has been argued that lockdowns may disrupt sleep, exacerbate mental health problems and reduce physical student activity, highschoolers could also benefit from later waking hours and flexible learning schedules [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. However, there remains little data on how high school students perceive the return to live education after several months of online learning [ 17 , 18 , 19 , 20 , 21 ].…”

Sleep alterations following COVID-19 are associated with both neuroinflammation and psychological disorders, although at different times

“…An increased occurrence of nightmares related to COVID-19 was also observed, with similar risk factors (17)(18)(19). Beneficial effects on sleep, however, were found in adolescents due to decreased social jet lag and subsequent sleep deprivation (20)(21)(22). Healthcare workers have been profoundly affected by insomnia, reduced sleep quality, and nightmares, in association with mood disorders and chronic fatigue (23); frontline healthcare workers (i.e., medical staff directly working in COVID-19 care and management) have been found as the most severely involved (24, 25).…”