Prospective examination of adolescent sleep patterns and behaviors before and during COVID-19

Stephen P Becker; Melissa R Dvorsky; Rosanna Breaux; Caroline N Cusick; Katherine P Taylor; Joshua M Langberg

doi:10.1093/sleep/zsab054

Prospective examination of adolescent sleep patterns and behaviors before and during COVID-19

Sleep. 2021 Aug 13;44(8):zsab054. doi: 10.1093/sleep/zsab054.

Authors

Stephen P Becker^{1

2}, Melissa R Dvorsky^{3

4}, Rosanna Breaux⁵, Caroline N Cusick⁶, Katherine P Taylor¹, Joshua M Langberg⁶

Affiliations

¹ Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
² Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.
³ Division of Psychology and Behavioral Health, Children's National Hospital, Washington, DC.
⁴ Department of Pediatrics, the George Washington University School of Medicine and Health Sciences, Washington, DC.
⁵ Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA.
⁶ Department of Psychology, Virginia Commonwealth University, Richmond, VA.

Abstract

Study objectives: To prospectively examine changes in adolescent sleep before and during the COVID-19 pandemic in adolescents with and without ADHD.

Methods: Participants were 122 adolescents (ages 15-17; 61% male; 48% with ADHD). Parents reported on adolescents' sleep duration and difficulties initiating and maintaining sleep (DIMS); adolescents reported on sleep patterns, sleep duration, delayed sleep/wake behaviors, and daytime sleepiness before (September 2019 to February 2020) and during (May-June 2020) COVID-19. Adolescents also reported on their health behaviors, COVID-19-related negative affect, and difficulties concentrating due to COVID-19.

Results: Parents reported adolescents had more DIMS during COVID-19 than before COVID-19, with clinically elevated rates increasing from 24% to 36%. Both bedtimes and waketimes shifted later during COVID-19, and adolescents reported more delayed sleep/wake behaviors. Adolescents also reported less daytime sleepiness and longer school night sleep duration during COVID-19. In considering differences between adolescents with and without ADHD, adolescents with ADHD did not experience an increase in school night sleep duration and were less likely to obtain recommended sleep duration during COVID-19. In the full sample, controlling for ADHD status, COVID-19-related sadness/loneliness was associated with increases in DIMS, and spending less time outside and more COVID-19-related worries/fears were associated with increases in delayed sleep/wake behaviors during COVID-19.

Conclusions: COVID-19 had negative and positive impacts on adolescent sleep. Adolescents with ADHD did not experience the benefit of increased school night sleep duration during COVID-19 like adolescents without ADHD. Negative affect and health behaviors may be useful intervention targets for reducing negative impacts of COVID-19 for adolescent sleep.

Keywords: adolescence; attention-deficit/hyperactivity disorder; coronavirus; health behaviors; negative affect.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adolescent
Attention Deficit Disorder with Hyperactivity* / epidemiology
COVID-19*
Female
Humans
Male
Pandemics
Prospective Studies
SARS-CoV-2
Sleep
Sleep Wake Disorders* / epidemiology

Abstract

Publication types

MeSH terms

Grants and funding