Sleep habits of preschool children after the COVID-19 lockdown in a municipality in Paraíba, Brazil
DOI:
https://doi.org/10.36311/jhgd.v34.15838Keywords:
COVID-19, child, sleep, health behavior, health statusAbstract
Introduction: the COVID-19 pandemic has brought changes in routines, use of time, behaviors, social relationships and concerns that can compromise children’s sleep, and studies on the subject are essential.
Objective: to evaluate the sleep habits of preschool children after the COVID-19 lockdown in Brazil.
Methods: this is a cross-sectional study nested in a cohort of live births to assess growth and development up to 1,000 days of age. For this study, data were collected from children at 4 years of age related to biological profile, health status, maternal care, screen time and physical activity, and behavior during the COVID-19 pandemic. The mean scores of the children’s sleep habits (bedtime routine, rhythmicity and affective separation) were analyzed according to the children’s characteristics using the Student’s t-test.
Results: sleep routine was the most impaired sleep habit, with lower averages in cases of hospitalization (p = 0.047), mother’s difficulty in caring for the child (p = 0.003) and great concern about COVID-19 during the pandemic (p = 0.003); followed by rhythmicity, which was also worse in the previous situations. In addition, children with more than 60 minutes of recreational screen time (p = 0.002) and without a mask-wearing routine during the pandemic (p = 0.003) had lower average bedtime routines. Health problems at birth (p = 0.001), hospitalization (p = 0.000), special health needs (p = 0.025) and mother’s difficulty in providing care (p = 0.037) negatively interfered with affective separation.
Conclusion:children with health problems, excessive screen time and concern about COVID-19 during the pandemic, as well as the difficulty of maternal care, influenced children’s sleep habits.
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References
Wong OY, Au CT, Yuen HM, Yu KN, Lan QY, Chan NY, et al. Impact of COVID-19 on the sleep-wake patterns of preschool children. Sleep Med. 2023;101:50-7. https://doi.org/10.1016/j.sleep.2022.10.012
Liu Z, Tang H, Jin Q, Wang G, Yang Z, Chen H, et al. Sleep of preschoolers during the coronavirus disease 2019 (COVID-19) outbreak. J Sono Res. 2021;30:e13142. https://doi.org/10.1111/jsr.13142
Bruni O, Malorgio E, Doria M, Finotti E, Spruyt K, Melegari MG, et al. Changes in sleep patterns and disturbances in children and adolescents in Italy during the Covid-19 outbreak. Sleep Medicine. 2022;91:166-74. https://doi.org/10.1016/j.sleep.2021.02.003
Lim MTC, Ramamurthy MB, Aishwriya R, Rajgor DD, Tran AP, Hiriyur P, et al. School closure during the coronavirus disease 2019 (COVID-19) pandemic - Impact on children’s sleep. Sleep Medicine. 2021;78:108-14. https://doi.org/10.1016/j.sleep.2020.12.025
Bothe K, Schabus M, Eigl ES, Kerbl R, Hoedlmoser K. Self-reported changes in sleep patterns and behavior in children and adolescents during COVID-19. Sci Rep. 2022;12(1):20412. https://doi.org/10.1038/s41598-022-24509-7
Markovic A, Mühlematter C, Beaugrand M, Camos V, Kurth S. Severe effects of the COVID-19 confinement on young children’s sleep: A longitudinal study identifying risk and protective factors. J Sleep Res. 2021;30(5):e13314. https://doi.org/10.1111/jsr.13314
Dondi A, Fetta A, Lenzi J, Morigi F, Candela E, Rocca A, et al. Sleep disorders reveal distress among children and adolescents during the Covid-19 first wave: results of a large web-based Italian survey. Ital J Pediatr. 2021;47(1):130. https://doi.org/10.1186/s13052-021-01083-8
Lucchini M, Bekelman TA, Li M, Knapp EA, Dong Y, Ballard S, et al. Environmental influences on Child Health Outcomes. Impact of the COVID-19 pandemic on children’s sleep habits: an ECHO study. Pediatr Res. 2023;93(3):586-94. https://doi.org/10.1038/s41390-022-02309-z
Ustuner Top U, Cam HH. Sleep disturbances in school-aged children 6–12 years during the COVID-19 pandemic in Turkey. J Pediatr Nurs. 2022;63:125-30. https://doi.org/10.1016/j.pedn.2021.11.008
Abid R, Ammar A, Maaloul R, Souissi N, Hammouda O. Effect of COVID-19-Related Home Confinement on Sleep Quality, Screen Time and Physical Activity in Tunisian Boys and Girls: A Survey. Int J Environ Res Public Health. 2021;18(6):3065. https://doi.org/10.3390/ijerph18063065
Fogno AWK, Rouquette A, Gronfier C, Bernard JY, Plancoulaine S; SAPRIS study group. Associations between screen use, outdoor time/daylight exposure and sleep changes during the first COVID-19 lockdown in French children from the ELFE and EPIPAGE2 birth cohorts. CNS Neurosci Ther. 2023;29(6):1649-56. https://doi.org/10.1111/cns.14128
León Rojas D, Castorena Torres F, Alvarado Ramos S, Del Castillo Morales A, Rodríguez-de-Ita J. Sleep Disturbances and Mental Well-Being of Preschool Children during the COVID-19 Pandemic in Mexico. Int J Environ Res Public Health. 2023;20(5):4386. https://doi.org/10.3390/ijerph20054386
Belmon LS, van Stralen MM, Busch V, Harmsen IA, Chinapaw MJM. What are the determinants of children’s sleep behavior? A systematic review of longitudinal studies. Sleep Med Rev. 2019;43:60-70. https://doi.org/10.1016/j.smrv.2018.09.007
Rana M, Riffo Allende C, Mesa Latorre T, Rosso Astorga K, Torres AR. Sueño en los niños: fisiología y actualización de los últimos conocimientos. Medicina (Buenos Aires). 2019;79(supl. 3):25-8.
Janssen X, Martin A, Hughes AR, Hill CM, Kotronoulas G, Hesketh KR. Associations of screen time, sedentary time and physical activity with sleep in under 5 s: a systematic review and meta-analysis. Sleep Med Rev. 2020;49:101226. https://doi.org/10.1016/j.smrv.2019.101226
Clarke J, Kipping R, Chambers S, Willis K, Taylor H, Brophy R, et al. Impact of COVID-19 restrictions on preschool children’s eating, activity and sleep behaviours: a qualitative study. BMJ Open. 2021;11(10):e051497. https://doi.org/10.1101/2020.12.01.20241612
Singh S, Roy D, Sinha K, Parveen S, Sharma G, Joshi G. Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations. Psychiatry Res. 2020;293:113429. https://doi.org/10.1016/j.psychres.2020.113429
Anders R, Lecuelle F, Perrin C, Ruyter S, Franco P, Huguelet S, et al. The Interaction between Lockdown-Specific Conditions and Family-Specific Variables Explains the Presence of Child Insomnia during COVID-19: A Key Response to the Current Debate. Int J Environ Res Public Health. 2021;18(23):12503. https://doi.org/10.3390/ijerph182312503
Sarialioğlu A, Ayran G, Köse S. Determining the relationship between sleep disturbances in children and parental stress during COVID-19 pandemic. Psychology, Health & Medicine. 2023; 28(4):1100-14. https://doi.org/10.1080/13548506.2022.2163670
Merrill RM, Slavik KR. Relating parental stress with sleep disorders in parents and children. PLoS ONE. 2023;18(1):e0279476. https://doi.org/10.1371/journal.pone.0279476
Cena H, Fiechtner L, Vincenti A, Magenes VC, De Giuseppe R, Manuelli M, et al. COVID-19 Pandemic as Risk Factors for Excessive Weight Gain in Pediatrics: The Role of Changes in Nutrition Behavior: A Narrative Review. Nutrients. 2021;13(12):4255. https://doi.org/10.3390/nu13124255
Ranjbar K, Hosseinpour H, Shahriarirad R, Ghaem H, Jafari K, Rahimi T, et al. Students’ attitude and sleep pattern during school closure following COVID-19 pandemic quarantine: a web-based survey in south of Iran. Environ Health Prev Med. 2021;26(1):33. https://doi.org/10.3390/nu13124255
Kaditis AG, Ohler A, Gileles-Hillel A, Choshen-Hillel S, Gozal D, Bruni O, et al. Effects of the COVID-19 lockdown on sleep duration in children and adolescents: A survey across different continents. Pediatr Pulmonol. 2021;56(7):2265-73. https://doi.org/10.1002/ppul.25367
Sharma M, Aggarwal S, Madaan P, Saini L, Bhutani M. Impact of COVID-19 pandemic on sleep in children and adolescents: a systematic review and meta-analysis. Sleep Med. 2021;84:259-67. https://doi.org/10.1111/jsr.13720
Camacho-Montaño LR, Iranzo A, Martínez-Piédrola RM, Camacho-Montaño LM, Huertas-Hoyas E, Serrada-Tejeda S, et al. Effects of COVID-19 home confinement on sleep in children: A systematic review. Sleep Med Rev. 2022; 62:101596. https://doi.org/10.1016/j.smrv.2022.101596
Richter SA, Ferraz-Rodrigues C, Schilling LB, Camargo NF, Nunes ML. Effects of the COVID-19 pandemic on sleep quality in children and adolescents: A systematic review and meta-analysis. J Sleep Res. 2023;32(1):e13720. https://doi.org/10.1111/jsr.13720
Lins ACL, Figueroa Pedraza D. Velocidade de crescimento de crianças de uma coorte até o sexto mês de vida. Ciênc Saúde Colet. 2021;26(11):5777-92. https://doi.org/10.1590/1413-812320212611.22212020
Batista BHB, Nunes ML. Validação para Língua Portuguesa de Duas Escalas para Avaliação de Hábitos e Qualidade de Sono em Crianças. J Epilepsy Clin Neurophysiol. 2006;12(3):143-8. https://doi.org/10.1590/S1676-26492006000500006
Crowell J, Keener M, Ginsburg N, Anders T. Sleep habits in toddlers 18 to 36 months old. J Am Acad Child Adolesc Psychiatry. 1987;26(4):510-5. https://doi.org/10.1590/2177-9465-EAN-2021-0269
Hayes MJ, Parker KG, Sallinen B, Davare AA. Bedsharing, temperament, and sleep disturbance in early childhood. Sleep. 2001;24(6):657-62. https://doi.org/10.1093/sleep/24.6.657
Schultz LF, Mastroeni SSBS, Rafihi-Ferreira RE, Mastroeni MF. Sleep habits and weight status in Brazilian children aged 4–6 years of age: the PREDI study. Sleep Medicine. 2021;87:30-7. https://doi.org/10.1016/j.sleep.2021.08.020
Arrué AM, Neves ET, Souza Magnago TSB, Cabral IE, Gama SGN, Hökerberg YHM. Tradução e adaptação do Children with Special Health Care Needs Screener para português do Brasil. Cad Saúde Pública. 2016;32(6):e00130215. https://doi.org/10.1590/0102-311X00130215
Bethell CD, Read D, Stein REK, Blumberg SJ, Wells N, Newacheck PW. Identifying Children With Special Health Care Needs: Development and Evaluation of a Short Screening Instrument. Ambulatory Pediatrics. 2002;2(1):38-48. https://doi.org/10.1367/1539-4409(2002)002<0038:ICWSHC>2.0.CO;2
World Health Organization. WHO guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. Genebra: WHO; 2019.
López-Bueno R, López-Sánchez GF, Casajus JA, Calatayud J, Gil-Salmerón A, Grabovac I, et al. Health Related Behaviors Among School-Aged Children and Adolescents During the Spanish Covid-19 Confinement. Front Pediatr. 2020;8:573. https://doi.org/10.3389/fped.2020.00573
Lecuelle F, Leslie W, Huguelet S, Franco P, Putois B. Did the COVID-19 lockdown really have no impact on young children’s sleep? J Clin Sleep Med. 2020;16(12):2121. https://doi.org/10.5664/jcsm.8806
Dellagiulia A, Lionetti F, Fasolo M, Verderame C, Sperati A, Alessandri G. Early impact of COVID-19 lockdown on children’s sleep: a 4-week longitudinal study. J Clin Sleep Med. 2020;16(9):1639-40. https://doi.org/10.5664/jcsm.8648
Aguilar-Farias N, Toledo-Vargas M, Miranda-Marquez S, Cortinez-O’Ryan A, Cristi-Montero C, Rodriguez-Rodriguez F, et al. Sociodemographic Predictors of Changes in Physical Activity, Screen Time, and Sleep among Toddlers and Preschoolers in Chile during the COVID-19 Pandemic. Int J Environ Res Public Health. 2020;18(1):176. https://doi.org/10.3390/ijerph18010176
Ferreira CRT, Leitão FNC, Deus MBB, Bezerra IMP, Deus RRB, Morais MJD. Sleep quality during home distancing in the COVID-19 pandemic in the Western Amazon. J Hum Growth Dev. 2021;31(3):458-64. http://dx.doi.org/10.36311/jhgd.v31.12606
Di Giorgio E, Di Riso D, Mioni G, Cellini N. The interplay between mothers’ and children behavioral and psychological factors during COVID-19: an Italian study. Eur Child Adolesc Psychiatry. 2021;30(9):1401-12. https://doi.org/10.31234/osf.io/dqk7h
Bates LC, Zieff G, Stanford K, Moore JB, Kerr ZY, Hanson ED, et al. COVID-19 Impact on Behaviors across the 24-Hour Day in Children and Adolescents: Physical Activity, Sedentary Behavior, and Sleep. Children. 2020;7:138. https://doi.org/10.3390/children7090138
Suffren S, Dubois-Comtois K, Lemelin JP, St-Laurent D, Milot T. Relations between child and parent fears and changes in family functioning related to COVID-19. Int J Environ Res Public Health. 2021;18(4):1786. https://doi.org/10.3390/ijerph18041786
Viola TW, Nunes ML. Social and environmental effects of the Covid-19 pandemic on children. J Pediatr (Rio J). 2022;98(Suppl. 1):S4-12. https://doi.org/10.1016/j.jped.2021.08.003
Fernandes SCS, Souza VH (Org.). Adesão e acesso às medidas preventivas à covid-19 na perspectiva da teoria da ação planejada [recurso eletrônico]. Maceió: EDUFAL; 2021.
MacKenzie NE, Keys E, Hall WA, Gruber R, Smith IM, Constantin E, et al. Children’s Sleep During COVID-19: How Sleep Influences Surviving and Thriving in Families. J Pediatr Psychol. 2021;46(9):1051-62. https://doi.org/10.1093/jpepsy/jsab075
Moore SA, Faulkner G, Rhodes RE, Brussoni M, Chulak Bozzer T, Ferguson LJ, et al. Impact of the COVID-19 virus outbreak on movement and play behaviours of Canadian children and youth: a national survey. International Journal of Behavioral Nutrition and Physical Activity. 2020;17(1):85. https://doi.org/10.1186/s12966-020-00987-8
Ordway MR, Condon EM, Basile Ibrahim B, Abel EA, Funaro MC, Batten J, Sadler LS, Redeker NS. A systematic review of the association between sleep health and stress biomarkers in children. Sleep Med Rev. 2021;59:101494. https://doi.org/10.1016/j.smrv.2021.101494
Henrique NCP, Hilário JSM, Louzada FM, Scorzafave LGDS, dos Santos DD, de Mello DF. Child sleep habits and maternal perception throughout the child’s first year of life. J Hum Growth Dev. 2022;32(3):321-30. https://doi.org/10.36311/jhgd.v32.13095
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