Abstract
Background. The COVID-19 lockdown determined important changes in the sleep of a large percentage of the world population. We assessed the modifications of reported sleep patterns and disturbances in Italian children and adolescents with autism spectrum disorders (ASD) or attention deficit hyperactivity disorders (ADHD), compared to control children, before and during the COVID-19 lockdown in Italy. Methods. Parents of 100 ASD, 236 ADHD patients, and 340 healthy children filled out an anonymous online survey and a modified version of the Sleep Disturbance Scale for Children (SDSC), advertised via social media, to evaluate sleep patterns and disturbances of their children before and during the lockdown. Results. Before the lockdown, bedtime and risetime were not different between the three groups. During the lockdown, ADHD children tended to have a later bedtime and risetime than ASD and controls, while ASD children tended to maintain similar bedtime and risetime. Overall, during the lockdown, a reduced sleep duration significantly differentiated clinical groups from controls. Anxiety at bedtime, difficulties in falling asleep, and daytime sleepiness increased in all groups during the lockdown. Hypnic jerks, rhythmic movement disorders, night awakenings, restless sleep, sleepwalking, and daytime sleepiness increased in ASD and ADHD patients, in particular. Conclusions. This is the first study comparing sleep habits and disorders in ASD and ADHD during the lockdown showing specific differences consistent with the core characteristics of two neurodevelopmental disorders.
Highlights
The general confinement from the COVID-19 pandemic and the consequent school closure, interruption of contacts with family members and friends, as well as reduced social and leisure activities, has brought unparalleled modifications to the lifestyle of children and adolescents, with important repercussions on their mental state and behaviors [1].In particular, COVID-19 lockdown resulted in important changes in sleep habits and sleep disorders in a large portion of the world’s population of all ages [2,3,4,5,6]
In face of a great amount of literature on the young and adult general population, only a few studies were conducted on sleep patterns or disturbances of the clinical population, especially children and adolescents with autism spectrum disorder (ASD) [9] and attentiondeficit/hyperactivity and impulsive disorders (ADHD) [10], despite their frequent sleep disturbances and altered sleep patterns, independently by COVID-19 [11]
Several studies [9,10,13,14,15,16,17] reported a high percentage of patients with autism spectrum disorders (ASD) or attention deficit hyperactivity disorders (ADHD) that changed their sleep with a significant worsening of sleep quality and disturbances during the lockdown
Summary
The general confinement from the COVID-19 pandemic and the consequent school closure, interruption of contacts with family members and friends, as well as reduced social and leisure activities, has brought unparalleled modifications to the lifestyle of children and adolescents, with important repercussions on their mental state and behaviors [1].In particular, COVID-19 lockdown resulted in important changes in sleep habits and sleep disorders in a large portion of the world’s population of all ages [2,3,4,5,6]. Several studies [9,10,13,14,15,16,17] reported a high percentage of patients with ASD or ADHD that changed their sleep with a significant worsening of sleep quality and disturbances during the lockdown. ASD children showed significant worsening of sleep disturbances, sleep duration, and sleep quality [14,15] and an increase in bedtime resistance, delay in falling asleep, and night awakenings [17]. We assessed the modifications of reported sleep patterns and disturbances in Italian children and adolescents with autism spectrum disorders (ASD) or attention deficit hyperactivity disorders (ADHD), compared to control children, before and during the COVID-19 lockdown in Italy. This is the first study comparing sleep habits and disorders in ASD and ADHD during the lockdown showing specific differences consistent with the core characteristics of two neurodevelopmental disorders
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