Effects of the COVID-19 Lockdown on Sleep Duration in Children and Adolescents: A Survey Across Different Continents

Abstract

<b>Background:</b> A parent survey was conducted to assess sleep habits of children residing in various countries before and during SARS-CoV-2 pandemic. It was hypothesized that lockdown would be associated with altered sleep duration. <b>Methods:</b> Outcomes were changes in bedtime, wake time and sleep duration in the pandemic compared to before. Logistic regression was applied to evaluate effects of age and covariates on outcomes. <b>Results:</b> 845 questionnaires were analyzed (45.8% female; ages 3-17 years). Adjusted OR (95% CI) for later bedtime during weekdays was 3.00 (1.66-5.44) in the 14-17-years age group and 1.68 (1.17-2.42) in 6-13-years group compared to children aged 3-5 years (P&lt;.01). OR (95% CI) for later wake time on weekdays was 5.55 (3.19-9.64) in 14-17-year-old and 2.33 (1.65-3.30) in 6-13-year-old children relative to those aged 3-5-years (P&lt;.001), while ORs for later wake time on weekends were 2.65 (1.56-4.51) and 1.91 (1.29-2.83), respectively (P&lt;.01). Approximately 40-50% of participants did not experience changes in sleep duration, with the 14-17 years group having the lowest rate of no change (28.4%). The 14-17 years group had 4-fold increased odds for longer sleep duration on weekdays (P&lt;.01), and children aged 6-13 years had 2-fold increased odds for longer sleep duration on weekends relative to the 3-5-years age group (P=.01). <b>Conclusions:</b> Although lockdown was associated with later bedtime and wake time, this shift did not alter sleep duration in approximately half of children. Yet, compared to preschoolers, high-school age children were more likely to sleep more on weekdays and primary school children on weekends.