ABSTRACT
Introduction: The COVID-19 pandemic has been associated with profound biopsychosocial changes for children, potentially affecting their health and wellbeing. Among these changes are altered sleep patterns and screen time use, however, no work has examined interactions between these two behaviors in the context of the pandemic. Here, we used longitudinal data from the Adolescent Brain Cognitive Development (ABCD) Study® to investigate changes in both sleep and screen time, and their relationship, from before and across the first year of the COVID-19 pandemic in young adolescents. Methods: More than 5000 adolescents (11-14 years;48% girls) completed digital surveys about their sleep and daily screen time use before the pandemic and across six timepoints during 2020- 2021, as part of the ongoing ABCD Study®. Random intercept linear mixed effect models (LMMs) were used to examine longitudinal associations between bedtime, wake-up time, and daily screen time use (social media, gaming), considering age, sex, and school effects. Results: Adolescents' wake up time was delayed (R2 = 0.51;~1.5 hour) during May-August 2020 relative to the pre-pandemic assessment (p<0.01), which was partially related to the summer break (p<0.01), before advancing to earlier times in October 2020. Bedtimes also delayed at all pandemic assessments (R2=0.62;~1 hour), even after starting the new school year (p<0.01), particularly in older adolescents (p<0.01) and girls (p<0.01). Recreational screen time was dramatically higher across the first year of the pandemic, relative to pre-pandemic (p<0.01;~45min social media, ~20min video gaming). More time spent with screen related activities was associated with later bedtimes and wake up times (p<0.01), across the pandemic, with effects being evident in male and female adolescents. Conclusion: Our findings show profound changes in sleep timing and screen time use across the pandemic in young adolescents, and critically, that excessive screen time negatively impacts sleep. As adolescents increasingly turn to more screen usage, these data highlight the need to promote their balanced and informed use of social media platforms, video games, and other digital technology to ensure adequate opportunity to sleep and maintain other healthy behaviors during this critical period of developmental change.
ABSTRACT
Introduction: Adolescence is a transitional life-stage accompanied by large biopsychosocial changes and greater psychophysiological vulnerability. Global events like the COVID-19 pandemic may increase vulnerability to depression and anxiety in this population. Poor sleep is often associated with depression, and both sleep and mood have been shown to be strongly impacted by the COVID-19 pandemic, with most studies focusing on adults. The current study investigates psychological distress in young adolescents during the pandemic, and specifically, whether poor sleep before the pandemic predicts psychological distress. Methods: Self-report data were analyzed from 3099 adolescents (9-10 years at baseline) in the population-based, demographically diverse, Adolescent Brain Cognitive Development (ABCD) study across three pre-pandemic annual visits and 3 monthly time points during the COVID-19 pandemic (ages 11-13 years). At each assessment, children and their guardians completed questionnaires including those about sleep, environment, and psychological wellbeing. Gradient Boosted Tree machine learning algorithms were used to identify the strongest predictors of pandemic-related psychological distress in individuals. We trained models using pre-pandemic sleep measures along with demographics, economic, and social measures during the pandemic. We evaluated the performance of the models using area under curve (AUC) metrics and interpreted the models by using the recently proposed SHapley Additive exPlanations methodology. Results: Pandemic-related perceived stress, fear and sadness were accurately detected with our classifiers (AUC = 0.83 for perceived stress, AUC = 0.73 for fear, AUC = 0.79 for sadness). Across all models, shorter sleep duration, prolonged sleep onset latency, and longer time between waking and getting out of bed predicted greater distress. Moreover, female sex, and pandemic-related factors, including greater family conflict, fewer economic resources, and more screen time contributed to prediction performance in all three models. Conclusion: Findings highlight the importance of addressing sleep problems and ensuring sufficient sleep duration in children to protect against the psychological impact of major life events, including the COVID-19 pandemic. Considering the long-lasting effects of sleep, it would be crucial to improve sleep health by targeted prevention, intervention and increased awareness among adolescents.