Sleep of preschoolers during the coronavirus disease 2019 (COVID‐19) outbreak

Abstract

Coronavirus disease 2019 (COVID‐19) has resulted in a significantly large number of psychological consequences, including sleep health. The present study evaluated sleep patterns, sleep disturbances, and associated factors in Chinese preschoolers confined at home during the COVID‐19 outbreak. Caregivers of 1619 preschoolers (aged 4–6 years) recruited from 11 preschools in Zunyi, Guizhou province completed the Children’s Sleep Habit Questionnaire (CSHQ) between 17th and 19th February 2020. Data were compared to a sociodemographically similar sample of preschoolers (included in the 11 preschools) in 2018. Compared to the 2018 sample, the confined preschoolers demonstrated changes in sleep patterns characterized by later bedtimes and wake times, longer nocturnal and shorter nap sleep durations, comparable 24‐hr sleep duration, and fewer caregiver‐reported sleep disturbances. Moreover, behavioural practices (sleeping arrangement, reduced electronic device use, regular diet) and parenting practices (harmonious family atmosphere and increased parent‐child communication) were associated with less sleep disturbances in the confined sample. The present study provides the first description of the impact of prolonged home confinement during the COVID‐19 outbreak on sleep patterns and sleep disturbances in preschoolers, as well as highlighting the importance of the link between sleep health and family factors. Given that disrupted and insufficient sleep has been linked to immune system dysfunction, our findings also have potential implications for resilience to infection in young children during the COVID‐19 pandemic. Future studies should further explore deficient sleep as a risk factor for coronavirus infection.

Changes in sleep patterns and disturbances in children and adolescents in Italy during the Covid-19 outbreak

“…Our results on preschoolers are in agreement with this study and with another research carried out on Italian preschoolers in which the lockdown determined a delay of about 1 hour on bedtime and risetime[ 13 ]. This phase shift during lockdown in preschoolers is associated with a decrease in napping in our two younger groups, in agreement with a Chinese report in preschoolers[ 5 ]. In our study, school age children and adolescents showed the most relevant phase delay with about 28% of schoolers and 64% of adolescents falling asleep after 11 p.m. during lockdown vs. 0.87% and 12%, respectively, before.…”

“…According to our study, different reports also showed that the most important negative consequence of the lockdown was the delay of sleep onset and offset. A recent study showed that the confined children had significantly later bedtime and waketime and increased nocturnal sleep duration[ 5 ]. Our results on preschoolers are in agreement with this study and with another research carried out on Italian preschoolers in which the lockdown determined a delay of about 1 hour on bedtime and risetime[ 13 ].…”

“…According to our findings, other investigations reported that school-age children and adolescents were sleeping more hours during a 24-hour period (including naps) than they had been prior to the COVID-19 pandemic[ 14 , 15 ]. Liu et al[ 5 ] described an increase in total sleep duration also in preschoolers. However, data on sleep duration in preschoolers are inconsistent across studies because an Israelian research on infants and children aged 6-72 months reported variable changes in sleep duration, either increase, or decrease or no changes[ 16 ].…”

“…In addition, home confinement can lead to substantial changes of the lifestyle of children, adolescents and their families with loss of the principal zeitgebers that help maintaining a regular routine and sleep/wake schedule. The restrictions led to unconstrained sleep schedules, prolonged screen exposure, limited access to outdoor activities and reduced peer interactions, as well as heightened stress and anxiety that can contribute to unhealthy sleep patterns and sleep disturbances in children and adolescents[ 5 , 6 ].…”

Maternal perceptions of sleep problems among children and mothers during the coronavirus disease 2019 (COVID‐19) pandemic in Israel

“…We are aware of only one study that examined sleep patterns of children during the COVID‐19 crisis. In this recent study (Liu et al, 2020), sleep patterns and sleep disturbances of Chinese preschoolers were studied during the COVID‐19 home confinement. The findings showed that children demonstrated changes in sleep patterns characterised by later bedtimes and wake times, and longer nocturnal and shorter nap sleep durations, compared to children’s sleep patterns in non‐crisis time.…”