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.
Highlights
Daytime sleepiness increases significantly with age during adolescence [1]
The six grades were categorized into lower (1st and 2nd grades), middle (3rd and 4th grades), and upper (5th and 6th grades) grades, and Pediatric DaytimeSleepiness Scale (PDSS) scores were compared between these categories at each survey point (Table 2)
The Bonferroni–Dunn’s post-hoc test revealed that PDSS scores in the upper grades were significantly higher than PDSS scores in the lower or middle grades, while there were no significant differences in PDSS scores between the lower and middle grades
Summary
Daytime sleepiness increases significantly with age during adolescence [1]. Sleep laboratory experiments using the Multiple Sleep Latency Test (MSLT) across different age groups have revealed a tendency for greater sleepiness in the mid-afternoon than in the morning or evening in pubertal adolescents [1]. Sleepiness Scale (PDSS), a self-rated measurement of daytime sleepiness, have shown that this score increases with age [2,3]. The prevalence of excessive daytime sleepiness (PDSS > 18) increased from 19.8% at prepuberty to 47.2% at post-puberty [4]. It has been demonstrated that objective and subjective sleepiness increase concurrently with pubertal maturation, while the capacity for sustained daytime alertness in younger children. Excessive daytime sleepiness is increasingly being recognized as a major global health concern, affecting up to 40% of children and adolescents [5,6].
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