Did the COVID-19 lockdown really have no impact on young children's sleep?

Abstract

Free AccessLetters to the EditorDid the COVID-19 lockdown really have no impact on young children’s sleep? Florian Lecuelle, MSc, Wendy Leslie, MSc, MBA, Stéphanie Huguelet, MSc, Patricia Franco, Pr, Benjamin Putois, PhD, MAS Florian Lecuelle, MSc Swiss Distance Learning University, Brig, Switzerland Pediatric Sleep Unit, Hospital for Women Mothers & Children, Lyon 1 University, Lyon, France Search for more papers by this author , Wendy Leslie, MSc, MBA Clinical Health Psychology, University of Ulster, Ulster, United Kingdom Search for more papers by this author , Stéphanie Huguelet, MSc Swiss Distance Learning University, Brig, Switzerland Search for more papers by this author , Patricia Franco, Pr Pediatric Sleep Unit, Hospital for Women Mothers & Children, Lyon 1 University, Lyon, France Lyon Neuroscience Research Center, CNRS UMR 5292, INSERM U1028, Lyon 1 University, Lyon, France Search for more papers by this author , Benjamin Putois, PhD, MAS Swiss Distance Learning University, Brig, Switzerland Lyon Neuroscience Research Center, CNRS UMR 5292, INSERM U1028, Lyon 1 University, Lyon, France Search for more papers by this author Published Online:December 15, 2020https://doi.org/10.5664/jcsm.8806Cited by:21SectionsAbstractPDF ShareShare onFacebookTwitterLinkedInRedditEmail ToolsAdd to favoritesDownload CitationsTrack Citations AboutABSTRACTCitation:Lecuelle F, Leslie W, Huguelet S, Franco P, Putois B. Did the COVID-19 lockdown really have no impact on young children’s sleep? J Clin Sleep Med. 2020;16(12):2121.INTRODUCTIONCurrently available data on the COVID-19 lockdown suggest that sleep among preschoolers was not affected. In their article, “Early impact of COVID-19 lockdown on children’s sleep: a four-week longitudinal study,” Dellagiulia et al1 observed a disturbance followed by stabilization. This could be an adaptation specific to the first 4 weeks of lockdown observed in 37 children 3–6 years of age. However, we do not know whether this was maintained throughout the entire lockdown period. In a retrospective study that used the Sleep Disorder Scale for Children, Di Giorgio et al2 found no effect of the lockdown on the proportion of children 2–5 years of age with sleep disorders or on the intensity of such sleep disorders. Nevertheless, the retrospective method has its limitations, because parents completed questionnaires on their child’s current and past sleep at the same time. Liu et al3 compared the responses for children 4–6 years of age surveyed in 2018 with the responses for a sample of children surveyed during the COVID-19 lockdown and found no impact on sleep disorders. However, their samples were not paired or similar, either for bed sharing or for room sharing (which could have minimized insomnias and parasomnias), and no matching was done. Using standardized assessments of sleep disorders in a matched age-sex prepost design, we investigated whether COVID-19 increased the prevalence of sleep disorders among French young children.As soon as the lockdown in France ended (duration: 2 months), the Sleep Disorder Scale for Children was distributed4 to 110 French mothers for completion: these assessed the frequency of sleep disturbances in their children during the lockdown. In 2018, this same questionnaire was completed by 316 mothers. Age and sex matching of the children was undertaken, creating 92 pairs of children comparable in age (pre-COVID = 29.4 months, post-COVID = 29.6 months; P > .1), sex (boyspre-COVID = boyspost-COVID = 58% boys), and room sharing/cosleeping (npre-COVID = npost-COVID = 9).The lockdown reduced the number [t(182) = 2.4, P = .02] and duration [t(182) = 2.6, P = .01] of naps. The length of nocturnal sleep increased from 10.3 (standard deviation = 0.9) to 10.9 hours [standard deviation = 1.5; t(182) = −3.5, P < .001], with no impact on the total duration of sleep over 24 hours [t(182) = −0.8; P = .4). The total Sleep Disorder Scale for Children score increased from 35.7 (standard deviation = 7.9) to 42.1 (standard deviation = 12.3) during the lockdown [t(182) = −4.1, P > .001]. The proportion of children scoring above the pathologic threshold (>37) increased from 40% to 62%. Difficulties initiating and maintaining sleep increased [Disorders of Initiating and Maintaining Sleep score: 15.7 vs 19.8; t(182) = −4.3, P > .001], as did the frequency of parasomnia [Parasomnias score: 6.0 vs 7.1; t(182) = −3.0, P = .003].Using a robust methodology, these results are the first to demonstrate a significant increase in sleep disorders among young children during the lockdown. Along with Dellagiulia et al,1 we recommend being vigilant about the sleep habits and about insomnia and parasomnia in preschoolers5 in the event of a future pandemic lockdown.DISCLOSURE STATEMENTAll authors have seen and approved the manuscript. The authors report no conflicts of interest.REFERENCES1. Dellagiulia A, Lionetti F, Fasolo M, Verderame C, Sperati A, Alessandri G. Early impact of COVID-19 lockdown on children’s sleep: a 4-week longitudinal study. J Clin Sleep Med. 2020;16(9):1639–1640. https://doi.org/10.5664/jcsm.8648 LinkGoogle Scholar2. Di Giorgio E, Di Riso D, Mioni G, Cellini N. The interplay between mothers’ and children behavioral and psychological factors during COVID-19: an Italian study [published online ahead of print August 31, 2020]. Eur Child Adolesc Psychiatry. DOI: https://doi.org/10.1007/s00787-020-01631-3 CrossrefGoogle Scholar3. Liu Z, Tang H, Jin Q, et al.. Sleep of preschoolers during the coronavirus disease 2019 (COVID-19) outbreak [published online ahead of print July 27, 2020]. J. Sleep Res DOI: https://doi.org/10.1111/jsr.13142. CrossrefGoogle Scholar4. Lecuelle F, Gustin M-P, Leslie W, Mindell JA, Franco P, Putois B. French validation of the sleep disturbance scale for children (SDSC) in young children (aged 6 months to 4 years). Sleep Med. 2020;67:56–65. https://doi.org/10.1016/j.sleep.2019.09.014 CrossrefGoogle Scholar5. Morgenthaler TI, Owens J, Alessi C, et al..; American Academy of Sleep Medicine. Practice parameters for behavioral treatment of bedtime problems and night wakings in infants and young children. 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