Changes in sleep patterns and disturbances in children and adolescents in Italy during the Covid-19 outbreak

Highlights

• The lockdown restriction impacts the sleep/wake pattern and sleep disturbances of children and adolescents.

• Confinement due to COVID-19 determined a significant delay in bedtime and risetime and an increase of sleep duration.

• Screen time (excluding online lessons) boosted during the lockdown, mainly in older children but also in younger children.

• Children had an increased prevalence of difficulty and anxiety at bedtime, night awakenings, nightmares and sleep terrors.

• Sleep disturbances did not worsen in adolescents since the sleep changes were compliant with their physiological sleep need.

Abstract

Objective

To examine the impact of home confinement during the COVID-19 pandemic on the sleep patterns and sleep disturbances in Italian children and adolescents.

Methods

Participants completed an anonymous online survey, shared via social media and targeting children and adolescents aged 1–18 years, subdivided into age groups: 1–3, 4–5, 6–12, and 13–18 years. Caregivers completed a modified version of the Sleep Disturbance Scale for Children (SDSC), along with demographic information.

Results

The final sample consisted of 4314 subjects: 2217 males (50.4%) and 2097 females (49.6%). Age group distribution was: 1–3 years 1263 (29.3%), 4–5 years 893 (20.7%), 6–12 years 1848 (42.8%) and 13–18 years 310 (7.2%). We found a significant delay in bedtime and risetime in all age groups. School-age children and adolescents experienced the most significant delay: weekday bedtime ≥23 was reported by 28.4% of 6- to 12-year-old children during lockdown vs. 0.9% before and by 63.5% vs. 12.3% of 13- to 18-year-old adolescents. Risetime was also delayed with most subjects waking up after 8 in all age groups and sleep duration increased in all groups but not in the younger group. The screen time (excluding online lessons) boosted during the lockdown, mainly in older children but also in younger children. Sleep disorders increased in all groups but not in adolescents. Younger groups had an increased prevalence of difficulty falling asleep, anxiety at bedtime, night awakenings, nightmares and sleep terrors.

Conclusion

Our study demonstrates that confinement due to COVID-19 determined a big delay in sleep/wake schedule of children in all age groups as well as an increase of sleep disturbances in all groups but adolescents.