Department of Chronic and Non-Communicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China.
Chengdu Center for Disease Control and Prevention, Chengdu, China.
Sci Rep. 2024 Sep 18;14(1):21807. doi: 10.1038/s41598-024-72461-5.
The COVID-19 pandemic has critical implications for mental health in children. This study examined how the COVID-19 lockdown affected sleep duration and anxiety symptoms in Chinese school-aged children and the bidirectional association between sleep and anxiety before and during the COVID-19 lockdown. A school-based longitudinal cohort study was conducted to examine the relationship between sleep duration and anxiety scores before and after the COVID-19 lockdown from January to May 2020. Generalized estimating equations model was used to identify variables that contributed to the changes in sleep duration. The bidirectional relationship between sleep duration and anxiety symptoms was explored by cross-lagged analysis. 7681 children completed two waves of surveys were included in the analysis. The daily exercise duration, anxiety symptoms, and sleep duration decreased significantly during the lockdown compared with that before the lockdown. Based on generalized estimating equations model, older age, secondary school, and higher anxiety scores of participants were positively associated with sleep duration, while female and no COVID-19 infection history were negatively associated with it. Cross-lagged analysis showed higher anxiety score of children before the lockdown was significantly associated with shorter sleep duration during the lockdown; and shorter sleep duration of children before the lockdown was also significantly associated with a higher anxiety score during the lockdown. Under the context of the COVID-19 pandemic, there were longitudinal, bidirectional associations between children's anxiety symptoms and sleep duration. For school students, mental health services and sleep education should be considered in the daily health education curriculum.
新冠疫情对儿童心理健康有重大影响。本研究旨在探讨新冠封锁对中国学龄儿童睡眠时长和焦虑症状的影响，以及封锁前后睡眠与焦虑之间的双向关联。采用基于学校的纵向队列研究，于 2020 年 1 月至 5 月期间，调查新冠封锁前后睡眠时长和焦虑评分之间的关系。采用广义估计方程模型，确定影响睡眠时长变化的变量。通过交叉滞后分析探讨睡眠时长与焦虑症状之间的双向关系。共有 7681 名儿童完成了封锁前后两次调查，纳入分析。与封锁前相比，封锁期间儿童的每日运动量、焦虑症状和睡眠时长显著减少。基于广义估计方程模型，参与者年龄较大、就读于中学、焦虑评分较高与睡眠时长较长有关，而女性和无新冠感染史与睡眠时长较短有关。交叉滞后分析显示，封锁前儿童的较高焦虑评分与封锁期间的较短睡眠时长显著相关；封锁前儿童的较短睡眠时长也与封锁期间的较高焦虑评分显著相关。在新冠疫情背景下，儿童的焦虑症状与睡眠时长之间存在纵向、双向关联。对于在校学生，心理健康服务和睡眠教育应纳入日常健康教育课程中。
