A Population-Level Analysis of Changes in Circadian Rhythms and Sleep and Their Association with Negative Emotions during the Outbreak of COVID-19 in China

ABSTRACT

Since 2019, COVID-19 began spreading globally and has significantly affected peoples' daily lifestyles. The public was asked to stay at home for constant quarantine and community containment starting on 23 January 2020. To assess the circadian rhythms and sleep changes and their influential factors during the COVID-19 outbreak, a questionnaire was administered to 451 Chinese participants during 20–31 January 2020. The changes in circadian rhythm, sleep–wake cycle, dining, and exercise of the participants and their correlation with negative emotions were analyzed. Furthermore, the effects of three factors (holiday, quarantine, and concerns regarding the pandemic situation) on these changes were assessed. We found that 34.6% of the participants reported circadian rhythm disturbance. Moreover, 67.2% presented negative emotions (worry, fear, downheartedness, anxiety, depression, and stupefaction) regarding the pandemic situation, among which worry was the most prevalent. Gender and age were significant factors for changes in the circadian phases and emotions. There was a correlation between circadian rhythm alterations and negative emotions. In addition, holiday, quarantine, and concerns regarding the pandemic situation had significant effects on circadian rhythms and sleep in a substantial part of the population. Regression analysis demonstrated reciprocal influences between many of these variables. Our findings suggest that circadian rhythms, sleep, and negative emotions in the normal population need to be considered during the pandemic period and that the adjustment of circadian rhythms could help promote sleep, restore emotions and improve public health.