Changes in sleep hygiene and sleepiness following social distancing related to COVID-19

ABSTRACT

Introduction: It was expected COVID-19 would result in changes that could impact sleep hygiene and sleep. We examined sleep hygiene and symptoms of disrupted sleep through late April and May and demographic and psychological variables related to vulnerability/ resilience to negative outcomes. Methods: Participants (Part1 N=180, Part2 N=64;ages 18-85) solicited from a college (students, faculty/staff, alumni, parents) and local community (churches, community centers, libraries) completed a 30-minute survey (measures: sleep hygiene (SH), symptoms of sleep disruption, mental health, personality, social distancing, COVID-19 impact/experience, and demographics) for possible prizes. Part 1, April 20th-May 12th, participants answered trait questionnaires and state questionnaires for before and during social distancing, then repeated state questionnaires two weeks later (Part 2). Results: Following initial COVID related changes, 66.1% of participants reported worsening symptoms of sleep disruption, 27.9% reported no change, and 6.3% reported improvements. 40.3% reported worsening SH, 53.5% no change, and 6.3% improvements. At 2-week follow-up, 30.4% of participants shifted from reporting no change to SH improvements over baseline. Overall, participants showed significant worsening of symptoms of sleep disruption (sleepiness, moodiness, avolition, cognitive impairments) and SH behaviors (less consistent bed- and wake-times, more frequently staying too long in bed, more pre-bed alerting activities, more bedtime negative emotion, more use of bed for purposes other than sleep, more active technology use) (d's from .23-1.00). Worsening sleep hygiene with COVID-19 was significantly predicted by younger age (r(157)=.164, p<.05), more avoidant coping (r(151)= -.337, p<.05), lower life satisfaction (r(156)=.200, p<.05) and greater impact/experience of COVID-19 (r(150)= -.270, p<.05). Symptoms of sleep disruption showed similar, but larger, relationships. Conclusion: Initial social distancing may have disrupted routines, added stress, and resulted in worsened sleep and sleep hygiene. Over time some adapted and improved, but most did not. Our results suggest change, especially crises such as a pandemic, may alter established behavior for the worse and/or add significant stress. Without intervention, even the robust, i.e., young, may suffer. Variables identifying those more vulnerable to disrupted sleep following change and those more likely to experience worsening sleep may help identify targets for future interventions.