Impact of COVID-19 Pandemic on School-Aged Children’s Physical Activity, Screen Time, and Sleep in Hong Kong: A Cross-Sectional Repeated Measures Study

Abstract

Despite concerns about the negative effects of social distancing and prolonged school closures on children’s lifestyle and physical activity (PA) during the COVID-19 pandemic, robust evidence is lacking on the impact of the pandemic-related school closures and social distancing on children’s wellbeing and daily life. This study aimed to examine changes in the PA levels, sleep patterns, and screen time of school-aged children during the different phases of the COVID-19 outbreak in Hong Kong using a repeated cross-sectional design. School students (grades 1 to 12) were asked to report their daily electronic device usage and to fill in a sleep diary, recording their daily sleep onset and wake-up time. They were equipped with a PA monitor, Actigraph wGT3X-BT, to obtain objective data on their PA levels and sleep patterns. Students were recruited before the pandemic (September 2019–January 2020; n = 577), during school closures (March 2020–April 2020; n = 146), and after schools partially reopened (October 2020–July 2021; n = 227). Our results indicated lower PA levels, longer sleep duration, and longer screen time among participants recruited during school closures than those recruited before the COVID-19 outbreak. Primary school students were found to sleep on average for an extra hour during school closures. The later sleep onset and increased screen time documented during school closures persisted when schools partially reopened. Our findings illustrate the significant impact of social distancing policies during the COVID-19 pandemic on the sleep pattern, screen time, and PA level in school-aged children in Hong Kong. Professionals should urgently reinforce the importance of improving physically activity, good sleep hygiene, and regulated use of electronic devices for parents and school-aged children during this unprecedented time.

Association between sleep duration and myopia among Chinese children during the COVID-19 pandemic: A cross-sectional study

“…Additionally, our study was conducted during COVID-19 pandemic and children's activities were limited. Their lifestyles changed dramatically ( 28 , 29 ), such as increased screen time ( 17 ) and decreased time outdoors ( 18 ), and their sleep would also be affected ( 19 ). People's lifestyle is also different from usual in a specific living environment, and children's myopic shifts are changed.…”

“…Besides, due to the global pandemic of COVID-19, many countries have implemented social restrictions, including citywide lockdowns, home isolation, and school closures ( 16 ). These restrictions result in lifestyle changes dramatically, such as more screen time ( 17 ), less outdoor activities ( 18 ), and more sleep duration ( 19 ) among children. Compared with pre-COVID, the prevalence of myopia in children increased significantly ( 20 ).…”

Age- and Sex-Specific Physical Fitness Reference and Association with Body Mass Index in Hong Kong Chinese Schoolchildren

“…However, a recent article in Hong Kong reported that that the average daily accumulation of moderate- or above-intensity physical activity time for primary and secondary school students was 15 min and 30 min, respectively, far short of the World Health Organization’s recommendation of 60 min [ 54 ]. Furthermore, time spent in front of electronic screens increased significantly due to the use of electronic products: primary school students’ screen usage increased from 2 h a day to 7 h a day before the pandemic, while middle school students’ screen usage increased from 8 to 9 h a day after the epidemic [ 54 ]. This might be due to the intermittent school closures since February 2020.…”

Health-related quality of life and adherence to physical activity and screen time recommendations in schoolchildren: longitudinal cohort Ciao Corona

“…The COVID-19 pandemic has been shown to affect children’s quality of life [4, 5, 6, 7, 8]. Further, restrictions related to the early phase of the pandemic were associated with more ST and less PA in children [4, 9, 10], as well with an adverse effect on mental health [11, 12].…”