Children and adolescents' sleep patterns and their associations with mental health during the COVID-19 pandemic in Shanghai, China.

BACKGROUND

School closures and home confinement due to the ongoing COVID-19 pandemic may lead to disrupted sleep patterns. Consequently, it could increase the risk of children and adolescents' mental health disorders.

METHODS

In this prospective study, we randomly selected ten schools in Shanghai and conducted cluster sampling of students from each school. The first wave of the survey was conducted between January 3 and 21, 2020. Approximately two months after the COVID-19 outbreak declared, a second wave of the survey was conducted. In total, 2427 individuals were surveyed in both waves using the same sampling method. Participants' mental health status (depression, anxiety and stress), sleep patterns and other demographic information were measured in both waves. Multivariate regression analysis was used to examine the associations between sleep patterns and mental health status.

RESULTS

During the COVID-19 pandemic, a total of 873 participants (19.9%), 1100 participants (25.1%), and 670 participants (15.3%) reported depression, anxiety, and stress symptoms, respectively. Significant changes of both sleep duration and sleep-wake cycle patterns were observed before and during the COVID-19 pandemic. Moreover, shorter sleep duration and late to rise patterns (including early to bed late to rise and late to bed late to rise) were found to be associated with higher odds of having mental illnesses during the pandemic.

CONCLUSION

These results suggest there is a pressing need to monitor children's and adolescents' health behavior and mental health and develop timely evidence-based strategies and interventions to mitigate adverse behavioral and psychological impacts caused by these unprecedented challenges.