Adolescent Sleep Patterns and Disturbances Before and During COVID-19

• In Event: Impact of the COVID-19 pandemic on adolescent development: Exploring sleep and mental health

Abstract

Introduction: The COVID-19 pandemic has profoundly impacted daily life, including prolonged social distancing, changes in routines, and increases in stress and psychopathology. Each of these factors alone are associated with poorer sleep under typical circumstances, and when combined during a chronic stressor such as the COVID-19 pandemic, are expected to contribute to marked changes in sleep patterns and functioning. A key limitation of existing studies is their reliance on retrospective or cross-sectional designs. This study prospectively examined changes in adolescent sleep patterns and problems before and during the COVID-19 pandemic and examined predictors of increased sleep problems in adolescents with and without neurodevelopmental risk (ADHD). It was hypothesized that adolescents would have a shift to later bedtimes/wake times, more sleep duration, and greater sleep problems during the pandemic compared to prior to the pandemic. It was hypothesized that adolescents with ADHD would have poorer sleep than adolescents without ADHD both before and during the pandemic. Demographic characteristics, health behaviors during COVID-19 (i.e., exercise, spending time outdoors, social media use), COVID-19-related negative affect (i.e., worried/afraid, sad/lonely, frustrated/angry), concerns about the impacts of COVID-19, and difficulties concentrating due to COVID-19 were explored as concurrent predictors of increased sleep problems during the pandemic.

Study Population: Participants were 122 adolescents (75 males; 58 with ADHD) ages 15-17 years and their parents.

Methods: Parents and adolescents provided ratings of sleep disturbances, and adolescents reported on their sleep patterns, before (September 2019-February 2020) and during (May-June 2020) COVID-19. Adolescents reported on their health behaviors (exercise, time outdoors, media use), negative affect, concerns about impacts, and difficulties concentrating due to COVID-19.

Results: Both bedtimes and wake times shifted later during COVID-19. Parents reported that adolescents had more sleep difficulties during COVID-19 compared to before COVID-19, with rates of clinically-elevated difficulties increasing from 24% to 36%. Adolescents reported more sleep problems, but longer school night sleep duration and less daytime sleepiness during COVID-19. Adolescents with ADHD did not have an increase in school night sleep duration during COVID-19. As a result, compared to adolescents without ADHD, adolescents with ADHD reported shorter school night sleep and were less likely to obtain recommended school night sleep duration (8-10 hours) during COVID-19. Sad/lonely affect predicted increases in parent-reported sleep problems. Spending less time outside and more social media use predicted increases in adolescent-reported sleep problems during COVID-19.

Conclusions: COVID-19 had both negative and positive impacts on adolescent sleep. Adolescents with ADHD did not experience the benefit of increased school night sleep duration like adolescents without ADHD experienced during COVID-19. Sad/lonely affect and health behaviors may be useful intervention targets for reducing negative impacts of COVID-19 for adolescent sleep.

Authors

• Stephen P. Becker, Cincinnati Children's Hospital
  Presenting Author

• Melissa R Dvorsky, Children’s National Hospital; George Washington University
  Non-Presenting Author

• Rosanna Breaux, Virginia Polytechnic Institute and State University
  Non-Presenting Author

• Caroline Cusick, Virginia Commonwealth University
  Non-Presenting Author

• Katherine Taylor, Cincinnati Children's Hospital Medical Center
  Non-Presenting Author

• Joshua Langberg, Virginia Commonwealth University
  Non-Presenting Author