High sleep fragmentation parallels poor subjective sleep quality during the third wave of the Covid-19 pandemic: An actigraphic study.

Studies on sleep during the Covid-19 pandemic have mostly been conducted during the first wave of contagion (spring 2020). To follow up on two Italian studies addressing subjective sleep features during the second wave (autumn 2020), here we assess sleep during the third wave (spring 2021) in a sample of healthy adults from Campania (Southern Italy). Actigraphic data (on 2 nights) and the Pittsburgh Sleep Quality Index were collected from 82 participants (40 F, mean age: 32.5 ± 11.5 years) from 11 March to 18 April 2021, when Campania was classified as a "red zone", i.e. it was subjected to strict restrictions, only slightly looser than those characterizing the first national lockdown (spring 2020). Although objective sleep duration and architecture appeared in the normal range, the presence of disrupted sleep was indexed by a relevant degree of sleep fragmentation (number of awakenings ≥ 1 min: 12.7 ± 6.12; number of awakenings ≥ 5 min: 3.04 ± 1.52), paralleled by poor subjective sleep quality (Pittsburgh Sleep Quality Index global score: 5.77 ± 2.58). These data suggest that the relevant subjective sleep impairments reported during the first wave could have relied on subtle sleep disruptions that were undetected by the few objective sleep studies from the same period. Taken together with sleep data on previous phases of the pandemic, our findings show that the detrimental effects on sleep determined by the initial pandemic outbreak have not abated across the subsequent waves of contagion, and highlight the need for interventions addressing sleep health in global emergencies.

Dissociated profiles of sleep timing and sleep quality changes across the first and second wave of the COVID-19 pandemic.

Previous work showed a significant impact of the COVID-19 pandemic on Italians' sleep both during the first wave, when a total lockdown (TL) was imposed, and during the second wave, when a partial lockdown (PL) was mandated (autumn 2020). Here we complement these data by describing the profile of sleep across four time-points: the first and second lockdown (TL, PL) and the months preceding them (pre-TL, pre-PL). An online survey was completed by 214 participants (Mage = 36.78 ± 14.2 y; 159 F) during TL and again during PL. All sleep-related questions (including items of the Pittsburgh Sleep Quality Index) required a double answer, one referred to the current lockdown and one to the month preceding the lockdown. Bedtime and rise time were delayed in TL and then advanced in pre-PL and PL. Similarly, time in bed increased in TL and then decreased in pre-PL and PL. Sleep quality worsened in the two lockdowns compared to the preceding periods and the proportion of poor sleepers correspondingly increased in both lockdowns. Sleep habits and quality displayed different profiles across phases of the pandemic. Sleep timing was altered during the first lockdown and then returned towards baseline (likely due to normalized working schedules). Instead, sleep quality, which markedly worsened during both lockdowns, appears particularly sensitive to changes in life habits and psychological factors, independently of sleep habits. Our findings also point to a possible role of acute and chronic stress (experienced during the first and second wave, respectively) in modulating sleep changes across the pandemic waves.

The Effects of the COVID19-Related Lockdown Are Modulated by Age: An Italian Study in Toddlers and Pre-Schoolers.

Although the issue has been repeatedly explored, data on the impact of the COVID-19 pandemic on children's sleep quality are inconsistent. To clarify these discrepancies, here we investigate possible age-related differences. During the lockdown, 112 parents of toddlers (0-3 years, N = 61) and pre-schoolers (4-5 years, n = 51) completed an online survey including the Children's Sleep Habits Questionnaire (CSHQ). Sleep-related items required an additional retrospective judgment, referring to the pre-pandemic period. During the lockdown, sleep schedules were delayed in both age groups whereas sleep quality (CSHQ total scores) improved in pre-schoolers but not in toddlers. Between-groups comparisons revealed that, prior to the lockdown, pre-schoolers showed worse sleep quality than toddlers, whereas this difference disappeared during home confinement. Also, pre-schoolers' sleep timing was advanced before the lockdown and delayed during the lockdown relative to toddlers'. Our data highlight a significant modulation of age on the impact of the pandemic crisis on sleep, with pre-schoolers experiencing greater effects than toddlers. This profile suggests that factors affecting sleep features have different weights at different ages: sleep patterns would be mainly determined by developmental factors (i.e., biological drive) in younger children, whereas environmental factors (e.g., major lifestyle changes) would have a stronger effect on older ones.

Changes in dream features across the first and second waves of the Covid-19 pandemic.

Research during the Covid-19 pandemic has highlighted its significant impact on dreaming. Here we address changes in dream features both during the first wave, when the Italian government imposed a total lockdown, and the second wave (autumn 2020), when a partial lockdown was effected. In April 2020 (total lockdown), 1,622 participants (Mage  = 34.1 ± 13.6 years; 1171F) completed an online survey including the Pittsburgh Sleep Quality Index and a set of questions on dream features and their possible changes relative to the month preceding the lockdown (pre-total lockdown). In November 2020 (partial lockdown), 214 participants (Mage  = 36.78 ± 14.2 years; 159F) from the previous sample completed the same survey. Approximately half of the subjects reported increased or decreased dream frequency (30.5% and 21.8%), length (27.1% and 15.8%) and vividness (31.5% and 17.1%) during total lockdown as well as during partial lockdown (frequency: 30.3% and 13.5%; length: 23.3% and 12.6%; vividness: 31.6% and 24.1%). Dream affect became significantly more negative in total lockdown relative to pre-total lockdown and in partial lockdown relative to pre-partial lockdown (both p < .001). Both in total lockdown and partial lockdown, increased negative dream emotionality significantly predicted changes in dream frequency, length and vividness, and was significantly predicted, in turn, by worsened sleep quality. Our data confirm that dream features are significantly affected by major life changes such as those imposed by a pandemic. The fact that between lockdowns negative dream affect returned almost to baseline level suggests that dream emotionality is closely related to lifestyle and wake-time emotional changes. Also, our findings point to a modulating role of sleep quality on dream emotionality.