Sleep in university students prior to and during COVID-19 Stay-at-Home orders

Abstract

Sleep health has multiple dimensions including duration, regularity, timing, and quality [1-4]. The Coronavirus 2019 (COVID-19) outbreak led to Stay-at-Home orders and Social Distancing Requirements in countries throughout the world to limit the spread of COVID-19. We investigated sleep behaviors prior to and during Stay-at-Home orders in 139 university students (aged 22.2 ± 1.7 years old [±SD]) while respectively taking the same classes in-person and remotely. During Stay-at-Home, nightly time in bed devoted to sleep (TIB, a proxy for sleep duration with regard to public health recommendations [5]) increased by ∼30 min during weekdays and by ∼24 mins on weekends and regularity of sleep timing improved by ∼12 min. Sleep timing became later by ∼50 min during weekdays and ∼25 min on weekends, and thus the difference between weekend and weekday sleep timing decreased - hence reducing the amount of social jetlag [6,7]. Further, we find individual differences in the change of TIB devoted to sleep such that students with shorter TIB at baseline before the first COVID-19 cases emerged locally had larger increases in weekday and weekend TIB during Stay-at-Home. The percentage of participants that reported 7 h or more sleep per night, the minimum recommended sleep duration for adults to maintain health [5] - including immune health - increased from 84% to 92% for weekdays during Stay-at-Home versus baseline. Understanding the factors underlying such changes in sleep health behaviors could help inform public health recommendations with the goal of improving sleep health during and following the Stay-at-Home orders of the COVID-19 pandemic.

Figure 1

Sleep patterns prior to and during the COVID-19 pandemic and changes in time in bed devoted to sleep. (A) Sleep times during weekdays and weekends and relationships between bedtimes and waketimes with sunset and sunrise for baseline and Stay-at-Home. (B,C) Relationship between baseline weekday and weekend time in bed devoted to sleep with the change in weekday and weekend time in bed devoted to sleep. Black bars represent reported sleep times for baseline week and red bars reported sleep times for Stay-at-Home week; black lines represent sunset and sunrise for baseline week and red lines represent sunset and sunrise for Stay-at-Home week (A). Error bars are standard deviations. Black squares show individual participant data and red lines are the best linear fit (B,C).