ABSTRACT
Introduction: The unprecedented restrictions imposed due to the COVID-19 pandemic, including movement control orders and lockdowns, altered our daily habits, and severely affected our well-being and physiology. Aims: The studies described in this work were designed to explore the effects of COVID-19 related lockdowns on well-being indicators in different population groups in Israel. Methods: We studied the effects of lockdown in three cohorts: (1) 169 individuals from the general population;(2) 91 undergraduate students and (3) 39 women within fertility age. We used wearable devices (FitBit® smartwatches and TempDrop® sensor), a smartphone app, sleep logs (for up to 5 weeks) and online (Qualtrics®) questionnaires to evaluate multiple well-being indicators before, during and after lockdown in Israel. We used a mixed ANOVA model to study the interplay between different factors on well-being before and after lockdowns. Results: Studies demonstrate effects on sleep latency and/or patterns during lockdown. Moreover studies indicate changes in mood, activity levels, social encounters, resting heart rate (RHR) and menstrual cycle length related to lockdown. In cohort (1) lockdown resulted in decreased mood (p<0.001), increased sleep duration (p<0.001) delayed midsleep point during workdays (p=0.07) and weekends (p=0.02), reduced social encounters (p<0.001), and reduced RHR (p=0.05). Moreover, the data suggest differential effects of lockdown in sub-groups with lower mood (p=0.05) and lower activity (p=0.01) in younger individuals, increased stress (p=0.01), reduced social encounters (p=0.03) and reduced RHR (p=0.06) in females. The strongest reduction in mood was shown in young individuals with early chronotype (p=0.02) while largest change in sleep duration was shown in young people with late chronotype (p=0.04) and older subjects with early chronotype (p=0.04). In cohort (2), There were effects of lockdown (p=0.02) and chronotype (p=0.05) on sleep duration. Increased sleep during lockdown and in early chronotypes. Females slept more during lockdown (p=0.01) and students who work slept less (p=0.02). Midsleep point free days (MSF) was delayed during lockdown (p=0.001) with MSF of late chronotypes later than MSF of early chronotypes (p<0.001). For cohort (3) changes in menstrual cycle length where heterogeneous showing increase, decrease or no change due to lockdown. Interestingly, length of the cycle normalized to pre-lockdown conditions when lockdown was over with women who had increase from pre-lockdown to lockdown had decrease from lockdown to post-lockdown and vice versa. Statistical analysis (mixed ANOVA) of cycle length across time with direction of change as main factor shows no main effects but a highly significant interaction (p<0.001) indicating a different pattern of change across time for each of the groups. Additional findings from this cohort show delay of MSF during lockdown (p=0.002) and an interesting correlation between MSF and menstrual cycle length (p=0.04). Conclusions: COVID-19 lockdowns in Israel had significant effects on the wellbeing of the population with possibly more severe effects in specific subgroups including younger people and females with involvement of additional factors including work status and chronotypes. Hopefully, these lockdown-induced adverse changes can naturally normalize after lockdown ends as shown with the length of the menstrual cycle in cohort (3). No conflict of interest