Impact of School Start Time Delays and Learning Modality on Sleep Timing and Duration During COVID-19.

OBJECTIVES: To assess the impact of a school start time (SST) delay on adolescent sleep health during the COVID-19 pandemic, and whether there were differences by learning modality. METHODS: Data were collected from a longitudinal study evaluating sleep, education, and health among high school students in Georgia in 2020. Paired t-tests and multivariable linear regression analyses were conducted to examine changes in sleep duration and timing among 9th grade students (n = 134) and their association with the learning modality (remote vs. in-person learner). RESULTS: Students' school day wake times were 1.5 hours later, school night sleep duration was 1.2 hours longer, and social jetlag was 0.9 hours shorter after the school start time delay (all P < .05). The learning modality was a significant predictor of changes in sleep timing but was not associated with changes in sleep duration. CONCLUSIONS: Delayed school start time was associated with positive changes in adolescent sleep health during the COVID-19 pandemic. Sleep timing was affected by the learning modality, however in-person and virtual students had similar gains in sleep duration. Learning modality may be more beneficial for adolescents with early school start times to promote healthier sleep habits.

Sleepless in COVID-19: racial disparities during the pandemic as a consequence of structural inequity.

STUDY OBJECTIVES: Insomnia has been on the rise during the 2019 coronavirus disease (COVID-19) pandemic, which may disproportionately affect racial minorities. This study characterized racial disparities in insomnia during the pandemic and evaluated mechanisms for such disparities. METHODS: Participants included 196 adults (48 Black) from a 2016-2017 clinical trial of insomnia treatment who were reevaluated in April 2020. Race was evaluated as a predictor of change in insomnia, impact of COVID-19, and COVID-19 stress. Mediation models using the PRODCLIN method evaluated the extent to which: (1) COVID-19 impact accounted for Black-White disparities in change in insomnia, and (2) COVID-19 stress accounted for associations between discrimination and change in insomnia. RESULTS: Increases in insomnia symptoms during COVID-19 were greater in Black compared to White participants, with 4.3 times the odds of severe insomnia (Insomnia Severity Index ≥ 22). Symptom severity was associated with pre-pandemic experiences of discrimination. Black participants were also disproportionately impacted by COVID-19, with twice the odds of irreparable loss of income/employment and four times the rate of COVID-19 diagnoses in their sociofamilial network compared to White participants. The disproportionate impact of COVID-19 accounted for 69.2% of the relationship between race and change in insomnia severity, and COVID-19 related stress accounted for 66.5% of the relationship between prior history of racial discrimination and change in insomnia severity. CONCLUSIONS: Black-White disparities in insomnia severity during COVID-19 may be driven by structural inequities resulting in the disproportionate impact of COVID-19 on Black Americans. Results lend support for the minority stress model in the context of sleep health. CLINICAL TRIAL REGISTRATION: Sleep to Prevent Evolving Affecting Disorders (SPREAD). NCT number: NCT02988375. https://clinicaltrials.gov/ct2/show/NCT02988375.