ABSTRACT
COVID-19 lockdowns can influence the sleep quality and daytime condition of patients with narcolepsy. Using data from our cohort study, we investigated changes in the quality of life and the symptom severity of patients with narcolepsy during Taiwan's 2021 lockdown and investigated differences by narcolepsy subtype, sex, and age. Patients with type 1 and type 2 narcolepsy (NT1 and NT2, respectively) aged 6-40 years were retrospectively recruited from our narcolepsy cohort study. These patients were regularly evaluated using the Short Form 36 Health Survey questionnaire (SF-36), the Epworth Sleepiness Scale (ESS), the visual analog scale (VAS) for hypersomnolence, the VAS for cataplexy and sleep diary. We compared the differences between the lockdown and the prelockdown periods by narcolepsy subtype, sex, and age. We used a paired t test analysis to compare differences in the SF-36, ESS, VAS scores and data of sleep diary between the prelockdown and lockdown periods (p1), and an independent t test analysis was used to compare the changes in different subgroups between the prelockdown and lockdown periods (p2). A total of 120 patients with narcolepsy were recruited (mean age 24.22 ± 6.87 years; 58% male); 80 of the patients had NT1 (mean age 25.25 ± 6.79 years; 60% male) and 40 had NT2 (mean age 22.16 ± 6.64, 53% male). During the lockdown period, the ESS score of total patients was decreased (p = 0.039) and body mass index was increased (p = 0.02). The NT1 group decreased significantly (p1 = 0.017), especially in men (p1 = 0.016) and adults (p1 = 0.04); scores for the VT domain of the SF-36 increased significantly in male and adult patients with NT2 (p1 = 0.048 and 0.012). Additionally, male patients with NT2 exhibited significantly decreased scores in the physical and emotional role functioning domains (p1 = 0.028, 0.024). The children and adolescents with NT1 had significantly decreased scores in the general health domain of the SF-36, but no significant change was noted in that of adults (p1 = 0.027, p2 = 0.012). We observed both negative and positive impacts of Taiwan's 2021 lockdown on patients with narcolepsy. A more flexible but structured daily routine with adequate sleep time should be considered for this population during lockdown and nonlockdown periods.
ABSTRACT
Background: Taiwan faced a surge of COVID-19 infections in May 2021. Because new cases were quickly increasing, parents called for school closures. A national parent group used an online survey to collect opinions about upcoming school closings planned by the Ministry of Education. This study evaluated the results of the survey for all respondents and investigated the level of viral transmission following school closures among students in Taiwan. Methods: An online survey titled "Survey of Opinions of School Closures during the Current COVID-19 Outbreak" (SOSC-COVID-19) was designed by the national parent association and then distributed to members of the community throughout Taiwan via local parent groups from May 17 to 18, 2021. The survey included an open-ended respondents' opinions about school closures. Differences among regions and socioeconomic scores (SES) were analyzed with chi-square tests. Results: A total of 8,703 completed survey forms data were analyzed. Nearly all respondents (7,973, 91.6%) approved of school closures; there were no differences of opinions inside and outside municipalities or by regional SES scores. Only 8.4% of respondents were opposed to any type of school closure, believing parents should decide whether their child attended school, which also did not vary with region or SES score. Qualitative feedback from parent and teacher responders indicated students' health and economic impacts were additional concerns that influenced their choice of whether the government or parents should decide about school closures. On the afternoon of May 18, 2021, the government of Taiwan closed all schools. Although a spike in new cases of COVID-19 occurred among students 10 days after school closures, over the next 40 days new cases declined, falling to zero by July 5th. Conclusions: Despite the inability of nationwide school closures to completely halt transmission of the virus within families during the COVID-19 outbreak, school closures helped to impede transmission between students.