Pre-pandemic sleep behavior and adolescents' stress during Covid-19: a prospective longitudinal study.

OBJECTIVE: To prospectively document changes in adolescents' sleep before versus during the COVID-19 pandemic, and to examine their impact on adolescents' perceived stress. METHODS: Sixty-two typically developing adolescents participated in the study before (Time 1: January 15 to March 13, 2020) and during (Time 2: May 15 to June 30, 2020) the COVID-19 pandemic in Canada. At Time 1, each participant's sleep pattern was assessed in the home environment using actigraphy and sleep logs for seven consecutive nights. Adolescents completed a battery of questionnaires in which they reported on their sleep schedule, duration, and quality, as well as their activities at bedtime, their daytime sleepiness, and their social/emotional behavior. The participants' parents provided demographic information. At Time 2, each participant completed a sleep log, the same battery of questionnaires regarding sleep, and the Perceived Stress Scale. RESULTS: (1) Adolescents' reported sleep was of longer duration and on a delayed schedule during the COVID-19 pandemic compared to pre-pandemic. (2) A larger proportion of adolescents reported meeting or exceeding the recommended amount of sleep during the COVID-19 pandemic compared to pre-pandemic sleep. (3) "Social jet lag" disappeared during the COVID-19 pandemic. (4) A shorter reported sleep duration and higher level of arousal at bedtime at Time 1 were significant predictors of adolescents' perceived stress at Time 2-during the COVID-19 pandemic. (5) A higher levels of arousal at bedtime and lower reported sleep quality at Time 2 were concurrently associated with higher levels of perceived stress among adolescents, even when we controlled for the levels of pre-pandemic emotional or behavioral issues, sleep duration, or sleep quality. CONCLUSION: Sleep duration and cognitive-emotional arousal, which are both modifiable behaviors, were associated with adolescents' perceived stress during the COVID-19 pandemic. These behaviors could be useful targets for preventive interventions aiming to reduce adolescents' stress in the face of stressogenic situations, such as the COVID-19 pandemic.

The impact of COVID-19 related school shutdown on sleep in adolescents: a natural experiment.

OBJECTIVE: During the outbreak of the COVID-19 pandemic in 2020, high schools closed or transitioned to remote teaching. The aim of this study was to describe how the COVID-19 related school shutdown impacted the sleep behaviors of typically developing adolescents. METHODS: A qualitative study was conducted between April 28 and June 3, 2020 with 45 adolescents using one-on-one semi-structured phone interviews. RESULTS: The "natural experiment" caused by the shutdown of schools due to the COVID-19 pandemic led to a 2-h shift in the sleep of typically developing adolescents, longer sleep duration, improved sleep quality, and less daytime sleepiness compared to those experienced under the regular school-time schedule. DISCUSSION: These findings are consistent with previous studies showing that delaying high school start times could be an effective way to extend sleep duration, improve sleep quality, reduce daytime sleepiness and lower adolescents' stress during the school year. As many countries look for ways to reduce the number of interactions between students in schools so that physical distancing is feasible, following teens' delayed sleep biology could offer an affordable solution. For example, staggering arrival times by delaying school start time for older adolescents compared with younger adolescents can reduce the total number of students attending school at the same time. This strategy offers a practical means to reduce school density and the number of interactions between students which are needed to reduce the potential transmission of COVID-19 in schools, while improving adolescents sleep health.

Sleep Duration Is Associated with Academic Achievement of Adolescent Girls in Mathematics.

PURPOSE: To examine the associations between objective measures of sleep during the school week and academic achievement in mathematics and languages in typically developing adolescent girls. METHODS: Eighty adolescent girls aged 12-17 years (M=14.74, SD=1.3) participated. For five consecutive weeknights, sleep was assessed in the home environment using an actigraph. Academic achievement was assessed using report card grades. RESULTS: Girls who obtained on average less sleep than the recommended amount of 8 to 10 hrs per night had significantly lower grades in mathematics compared to girls who obtained the recommended amount (77.61 vs 86.16, respectively; ηp 2=0.11). Hierarchical regression analyses adjusted for age, pubertal status, and socioeconomic status revealed that longer average sleep time was significantly associated with higher grades in mathematics (B=4.78, 95% CI [2.03,7.53]). No significant associations were found between sleep variables and grades in languages. CONCLUSION: Longer average weekday sleep duration is associated with academic achievement of adolescent girls in mathematics.

Determinants of sleep behavior in adolescents: A pilot study.

PURPOSE: To identify determinants of sleep behavior in adolescents of middle to high socioeconomic status. METHODS: Eighteen students (9 boys, 9 girls) with a mean age of 14.9±1.5years were interviewed using a standardized script inspired by the theory of planned behavior. Interviews were audio-recorded and anonymously transcribed verbatim. In addition, participants completed a survey assessing demographic and health characteristics and their sleep duration was measured using actigraphy. RESULTS: Adolescents listed a few positive benefits of healthy sleep and described a large number of immediate negative consequences caused by sleep deprivation. Strong positive/negative emotions were barriers to healthy sleep. The use of electronic devices at bedtime and sports participation were described as both barriers to and facilitators of healthy sleep. Participants indicated their intention to sleep more and to use relaxing activities at bedtime. Some intended to advance their bedtime, but none intended to stop using electronic devices at bedtime. Most participants stated that it would be easy to turn off phones but difficult to turn off movies at bedtime, and many believed that their parents and peers were against engaging in risky sleep behavior. CONCLUSIONS: Interventions that seek to alter adolescents' ability to regulate affect and address their beliefs regarding the use of electronic devices at bedtime, combined with information regarding the long-term impact of sleep health, may improve the effectiveness of sleep promotion programs for adolescents.