Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 21, 2020
Date Accepted: Jan 19, 2021
Date Submitted to PubMed: Jan 25, 2021
Smartphone application-estimated sleep duration before and during COVID-19 in five major metropolitan areas on three different continents
ABSTRACT
Background:
Public health officials have acted swiftly to curb the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and associated coronavirus disease 2019 (COVID-19), often resulting in significant alterations to daily routines among the general population. Sleep deficiency adversely affects immune function and could negatively impact the course of COVID-19.
Objective:
We examined changes to sleep episode duration in five major metropolitan areas before and after the start of the COVID-19 pandemic.
Methods:
We conducted a prospective observational study using data from a smartphone-based sleep tracking software application. Data were obtained from regular users of the smartphone application before and after the World Health Organization declared COVID-19 a pandemic in March 2020. Sleep and wake times were used to calculate sleep episode duration. We compared sleep episode duration before and during COVID-19 using generalized linear mixed models.
Results:
We analyzed 2.9 million sleep episodes. Among the nights analyzed, 34% were from those residing in London, 18% in Los Angeles, 30% in New York City, 9% in Seoul, and 9% in Stockholm. Overall, participants were 52% male and 48% female. Average age among the sample was 35 years (±11 years). Prior to COVID-19, those residing in Seoul had the shortest sleep episode duration (mean=6h15m±0.27m) and those residing in Stockholm and London had the longest sleep episode durations (mean=7h20m±0.25m and 7h17m±0.14m, respectively). The onset of the COVID-19 pandemic was associated with a 14.06m increase of sleep episode duration comparing March 2019 and March 2020 (95%CI: 13.35-14.77m, P <.001) and an increase of 22.31m comparing April 2019 and April 2020 (95%CI: 21.26-23.36m, P<.001).
Conclusions:
Average sleep episode duration unexpectedly increased sharply in the months after the onset of the COVID-19 pandemic. These findings suggest that the implementation of COVID-19 mitigation strategies have provided people worldwide with an increased opportunity to sleep, which may itself enhance the response of the immune system to viral pathogens.
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