A two-year research review of sleep studies during the pandemic shows that children and those who contracted COVID-19 took the biggest hit in their sleep quality, according to a recently published study in Sleep Medicine Reviews.
"The number of children with sleep disturbances nearly doubled," said Dr. Michael V Vitiello, senior author of the study, and a UW Medicine psychiatry and sleep expert. "It was somewhat surprising that one of the biggest impacts we found was among the children."
Before the pandemic hit in 2020, the percentage of sleep disturbances reported in children was around 25%, the report noted. During the pandemic, that percentage jumped to 46%, a statistic the study called "alarming." The sleep disturbances among children (designated as 10 to 17 years old in the studies) was attributed to bedtime and wake-up times, inability to do outdoor activities during lockdown, remote learning and lack of in-person social activities.
Children also picked up on the stress of the adults around them, Vitiello noted.
"It was very surprising, a little counterintuitive that children and adolescents would be impacted so much. But if you think about it, they're the ones that don't have the information to process what's going on," said Vitiello, the senior author of the meta-analysis study. "They haven't learned the coping mechanisms, hopefully, that adults have. They're picking up on peer concerns and they're picking up on parental concerns while they're there. So, a lot of things can account for that sensitivity."
This figure was part of a comprehensive sleep study - and one of the largest of its kind - that reviewed 250 research papers worldwide which included 493,000 people in 49 countries, including the US.
This study follows another, much smaller study also senior authored by Vitiello, published in 2021, which showed about 40% of the participants had trouble sleeping. That number broke down into 75% of the COVID patients having problems, 36% of the health care workers and 32% of the general population. Young adults and women seemed particularly hard-hit by the first year of the pandemic, the study noted.
"This increase was particularly striking in young adults and females," he said at the time. "An intersection where the risks of anxiety symptoms, depressive symptoms, and sleep problems are high. Young adults are also more responsive to social isolation. They're not developed as adults in coping skills."
In the larger more recent study, the breakout was similar. Six major populations were identified, with 52% of the COVID-19 patients reporting a problem with sleep, 42.5% of children and adolescents, 41% of the healthcare workers, and 36% of the general population
"Another interesting finding is that the frequency of sleep disturbances reported in 2021 appear to be higher than in 2020, suggesting that the COVID 19 pandemic is continuing to have a negative impact on sleep," he said.
The next steps for his team will be to look at how sleep might be affected now that the pandemic seems to be waning, he said.
"We will be analyzing data to see if the sleep problems recede, stabilize or become worse," Vitiello said. "Often people experience a problem that disturbs sleep, but once that it gone, the sleep disturbance may become chronic. It's an open question right now in the context of the pandemic."
He also said there needs to be follow up on the groups most impacted - children, COVID-19 patients and university students, and pregnant women - on how their sleep, or lack thereof, might be impacting them now. There also needs to be a deeper look at long term health problems which might be connected to lack of sleep during the pandemic, he said.
Studies have already confirmed that sleep loss impacts blood sugar, heart health, brain health and depression. Vitiello said that primary care physicians as well as pediatricians might need to ask about sleep during office visits. Often the questions don't get asked, he said.
"Primarily it's a lack of time or a lack of training," he said. "Do you really want to open that Pandora's box."
But he added, asking about sleep now, maybe help forestall chronic conditions later.
"It's a pay me now or pay me later scenario," he said.
