Impact of COVID-19 lockdown on sleep-wake schedule and associated lifestyle related behavior: A national survey

Abstract

Background: Lockdowns to prevent the community transmission of COVID-19 pandemic has confined the people at home and imposed social restrictions, which is expected to cause alterations in circadian driven sleep-wake schedule and its associated lifestyle behaviors. Design and Methods: An online questionnaire-based survey was conducted to assess the impact of lockdown on the sleepwake pattern, meal timings and digital media exposure time on the Indian population during lockdown. Responses of 1511 participants (age ≥18 years) were analyzed to assess the effect of gender and age on these parameters before and during lockdown. Results: The sleep onset-wakeup times and meals' time was significantly delayed during lockdown, which was more pronounced in younger subjects. However, young individuals reported increased sleep duration at this time. Increased digital media duration was evident in all age groups, mainly in males. However, females reported more delay in sleep onset-waking time and first meal timing with longer sleep duration during lockdown. Conclusions: Discord with social and natural cues due to complete lockdown during COVID-19 pandemic leads to a state of social jetlag with delayed sleep-wake, meal timings and excessive digital media exposure among Indians, which has differential impact on males and females as well as across different age groups. These findings have applied implications in sleep health and related behavior during longer social isolation conditions such as current COVID-19 or similar situations and may help to prepare better for any such future events.

Keywords: COVID-19 lockdown; sleep.

Figure 1.

Distribution of number of respondents across different time slots before and during lockdown. Extended sleep onset time beyond 04:00 h (A) and waking time beyond 12:00 h (B) with reduced sleep duration in most of the respondents, though not marked (C), was evident during lockdown. Late first meal time till 15:00 h (D), lunch time till 17:00 h (E) and last meal time till 24:00 h (F) was present during lockdown. Increased duration of digital media even beyond 10 h (G) and TV viewing duration for more than 5 h was seen for majority of subjects (H) during lockdown. Chi-square result shown in each panel depicts significant (p<0.001) association/ interaction between different time slots and studied variables in relation to lockdown states.

Figure 2.

Comparison of effects of before and during lockdown for different age groups. Significantly delayed sleep onset time in all age groups (A), waking time in all age groups except ≥60 y people (B) and increased sleep duration in age groups of 18-24 and 32-38 y (C) was observed during lockdown. Significantly late first meal time in all age groups (D), lunch time in all age groups except 53-59 y and ≥60 y people (E) and last meal time in all age groups except ≥60 y individuals (F) was evident during lockdown. Digital media duration (G) and TV viewing duration (Figure 2H) also was found to be significantly more during lockdown in all age groups. *p<0.05; **p<0.01; ***p<0.001. Values are expressed as Mean±SE. Post-hoc analysis at the level of p<0.05 denotes the significance of difference in mean change of studied variables across different age groups both before and during lockdown. Highest to lowest mean indicated by ‘a’ to ‘e’ alphabets, where, same alphabet denotes nonsignificant difference among age groups.