Changes in sleep duration, timing, and variability during the COVID-19 pandemic: Large-scale Fitbit data from 6 major US cities

Rezaei, Naghmeh; Grandner, Michael

doi:10.1016/j.sleh.2021.02.008

Cited by 95 publications

(81 citation statements)

References 27 publications

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“…General sleep disturbances during the pandemic have been particularly prevalent among healthcare workers (Wang et al, 2020 ), whereas other studies have found females in general to be at higher risk (Dal Santo et al, 2021 ; Kilius et al, 2021 ; Pinto et al, 2020 ; Scarpelli et al, 2021 ). A large study using Fitbit data from approximately 160,000 users across six major US cities found that compared to 2019, sleep duration had increased during the 2020 pandemic (Rezaei & Grandner, 2021 ). Bedtime also shifted to later and variability in sleep duration decreased.…”

Section: Introductionmentioning

confidence: 99%

Nightmare content during the COVID‐19 pandemic: Influence of COVID‐related stress and sleep disruption in the United States

Kennedy

Bastien

Ruby

et al. 2021

Journal of Sleep Research

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Nightmares are often associated with psychiatric disorders and acute stress. This study explores how the COVID‐19 pandemic may have influenced the content of nightmares. A sample of N = 419 US adults completed online surveys about sleep and COVID‐19 experiences. Participants were asked about the degree to which they agreed with statements linking greater general stress, worse overall sleep and more middle‐of‐the‐night insomnia with the COVID‐19 pandemic. They were also asked if, during the pandemic, they experienced nightmares related to various themes. Logistic regression analyses examined each nightmare content as outcome and increased stress, worse sleep and more middle‐of‐the‐night insomnia as predictors, adjusted for age, sex and race/ethnicity. Those who reported greater general COVID‐related stress were more likely to have nightmares about confinement, failure, helplessness, anxiety, war, separation, totalitarianism, sickness, death, COVID and an apocalypse. Those who reported worsened sleep were more likely to have nightmares about confinement, oppression, failure, helplessness, disaster, anxiety, evil forces, war, domestic abuse, separation, totalitarianism, sickness, death, COVID and an apocalypse. Those who reported worsened middle‐of‐the‐night insomnia were more likely to have nightmares about confinement, oppression, failure, helplessness, disaster, anxiety, war, domestic abuse, separation, totalitarianism, sickness, death, COVID and an apocalypse. These results suggest that increased pandemic‐related stress may induce negatively‐toned dreams of specific themes. Future investigation might determine whether (and when) this symptom indicates an emotion regulation mechanism at play, or the failure of such a mechanism.

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Section: Introductionmentioning

confidence: 99%

Nightmare content during the COVID‐19 pandemic: Influence of COVID‐related stress and sleep disruption in the United States

Kennedy

Bastien

Ruby

et al. 2021

Journal of Sleep Research

Self Cite

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“…38,39 An overall decrease in SJL as a result of the COVID-19 pandemic, has been observed in prior studies. [2][3][4][5][6][7]40 In an Argentinian cohort, Leone et al 4 reported that subjects slept longer and later during lockdown (on weekdays), exhibiting lower levels of SJL (decreased by 54 minutes). In another international survey across 40 countries, Korman et al 2 reported an overall reduction in SJL of 30 minutes.…”

Section: Discussionmentioning

confidence: 99%

Social Jetlag Changes During the COVID-19 Pandemic as a Predictor of Insomnia – A Multi-National Survey Study

Brandão¹,

Martikainen²,

Merikanto³

et al. 2021

NSS

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Purpose: Lifestyle and work habits have been drastically altered by restrictions due to the COVID-19 pandemic. Whether the associated changes in sleep timing modulate the risk of suffering from symptoms of insomnia, the most prevalent sleep disorder, is however incompletely understood. Here, we evaluate the association between the early pandemic-associated change in 1) the magnitude of social jetlag (SJL) -ie, the difference between sleep timing on working vs free days -and 2) symptoms of insomnia. Patients and Methods: A total of 14,968 anonymous participants (mean age: 40 years; 64% females) responded to a standardized internet-based survey distributed across 14 countries. Using logistic multivariate regression, we examined the association between the degree of social jetlag and symptoms of insomnia, controlling for important confounders like social restriction extension, country specific COVID-19 severity and psychological distress, for example. Results: In response to the pandemic, participants reported later sleep timing, especially during workdays. Most participants (46%) exhibited a reduction in their SJL, whereas 20% increased it; and 34% reported no change in SJL. Notably, we found that both increased and decreased SJL, as a result of the COVID-19 pandemic, were associated with later sleep midpoint (indicating a later chronotype) as well as more recurrent and moderate-to-severe symptoms of insomnia (about 23-54% higher odds ratio than subjects with unchanged SJL). Primarily those with reduced SJL shifted their bedtimes to a later timepoint, compared with those without changes in SJL. Conclusion: Our findings offer important insights into how self-reported changes to the stability of sleep/wake timing, as reflected by changes in SJL, can be a critical marker of the risk of experiencing insomnia-related symptoms -even when individuals manage to reduce their social jetlag. These findings emphasize the clinical importance of analyzing sleep-wake regularity.

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“…During the COVID-19 pandemic, analysis of cloud-based activity data has shown significant changes at the population level in terms of sleep duration and bedtime [72].…”

Section: Monitoring Individual Sleep Quality Under Pandemic-related Movement Restrictionsmentioning

confidence: 99%

Wrist actigraphic approach in primary, secondary and tertiary care based on the principles of predictive, preventive and personalised (3P) medicine

et al. 2021

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Sleep quality and duration as well as activity-rest-cycles at individual level are crucial for maintaining physical and mental health. Although several methods do exist to monitor these parameters, optimal approaches are still under consideration and technological development. Wrist actigraphy is a non-invasive electro-physical method validated in the field of chronobiology to record movements and to allow for monitoring human activity-rest-cycles. Based on the continuous recording of motor activity and light exposure, actigraphy provides valuable information about the quality and quantity of the sleep–wake rhythm and about the amount of motor activity at day and night that is highly relevant for predicting a potential disease and its targeted prevention as well as personalisation of medical services provided to individuals in suboptimal health conditions and patients. Being generally used in the field of sleep medicine, actigraphy demonstrates a great potential to be successfully implemented in primary, secondary and tertiary care, psychiatry, oncology, and intensive care, military and sports medicines as well as epidemiological monitoring of behavioural habits as well as well-being medical support, amongst others. Prediction of disease development and individual outcomes Activity-rest-cycles have been demonstrated to be an important predictor for many diseases including but not restricted to the development of metabolic, psychiatric and malignant pathologies. Moreover, activity-rest-cycles directly impact individual outcomes in corresponding patient cohorts. Targeted prevention Data acquired by actigraphy are instrumental for the evidence-based targeted prevention by analysing individualised patient profiles including light exposure, sleep duration and quality, activity-rest-cycles, intensity and structure of motion pattern. Personalised therapy Wrist actigraphic approach is increasingly used in clinical care. Personalised measurements of sedation/agitation rhythms are useful for ICU patients, for evaluation of motor fatigue in oncologic patients, for an individual enhancement of performance in military and sport medicine. In the framework of personalised therapy intervention, patients can be encouraged to optimise their behavioural habits improving recovery and activity patterns. This opens excellent perspectives for the sleep-inducing medication and stimulants replacement as well as for increasing the role of participatory medicine by visualising and encouraging optimal behavioural patterns of the individual.

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Changes in sleep duration, timing, and variability during the COVID-19 pandemic: Large-scale Fitbit data from 6 major US cities

Cited by 95 publications

References 27 publications

Nightmare content during the COVID‐19 pandemic: Influence of COVID‐related stress and sleep disruption in the United States

Nightmare content during the COVID‐19 pandemic: Influence of COVID‐related stress and sleep disruption in the United States

Social Jetlag Changes During the COVID-19 Pandemic as a Predictor of Insomnia – A Multi-National Survey Study

Wrist actigraphic approach in primary, secondary and tertiary care based on the principles of predictive, preventive and personalised (3P) medicine

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