Relationship between changes in lifestyle and sleep duration due to the spread of coronavirus disease (COVID-19) in older adults: A cross-sectional study

Abstract

Objectives In response to the spread of COVID-19, a state of emergency was declared on April 7, 2020. People were asked to stay at home unless necessary, and studies conducted in Japan and other countries have investigated the impact of these restrictions on the lives and health of older adults. While some studies have focused on sleep, a crucial aspect of the health of older adults, little is known about the relationship between sleep and various lifestyle changes experienced by older adults in Japan during the COVID-19 pandemic. Herein, we aimed to investigate the factors associated with changes in sleep duration among older adults before and after the spread of COVID-19.Methods A random sample of 1,808 men and women aged 65-84 years who lived in Fukushima City, Fukushima Prefecture, Japan was selected. A self-administered anonymous survey was mailed to the participants. Logistic regression analysis was used to identify the factors associated with decreased sleep duration compared to the COVID-19 pre-pandemic. Factors such as basic attributes, lifestyle changes compared with that during pre-pandemic period, stress levels, and involvement with the community were considered in the analysis.Results Of the 1,808 distributed surveys, 1,305 were returned (response rate: 72.2%). After excluding participants with missing data (n＝108), 1,197 responses were included in the final analysis (valid response rate: 66.2%). Among these, 155 participants (12.9%) reported decreased sleep duration. Decreased "social activities/connectedness" (odds ratio [OR]: 2.55, 95% confidence interval [CI]: 1.54-4.22), reduced "average duration of exercise on exercise days" (OR: 2.69, 95% CI: 1.38-5.24), and self-reported "stress in the past month" (OR: 2.41, 95% CI: 1.43-4.06) were significantly associated with decreased sleep duration.Conclusion The spread of COVID-19 was associated with decreased sleep duration among older adults. This decrease was linked to reduced social activity and participation, decreased exercise, and increased stress. To mitigate these effects, maintaining social participation and activities, scheduling regular and manageable exercise routines, and implementing effective stress management strategies while adhering to infection control practices are important.