Elsevier

Sleep Medicine

Volume 85, September 2021, Pages 246-258
Sleep Medicine

Original Article
How does the COVID-19 affect mental health and sleep among Chinese adolescents: a longitudinal follow-up study

https://doi.org/10.1016/j.sleep.2021.07.008Get rights and content

Highlights

  • The adolescents had delayed sleep onset and offset time, longer sleep duration during the quarantine and tended to be morning-ness chronotype.

  • A high prevalence of mental and sleep problems in adolescents occurred before, during, and after the COVID-19 outbreak.

  • Girls and evening chronotype adolescents showed higher anxiety and depression levels, poorer sleep quality, and severe insomnia status.

  • Pre-measured depression level significantly predicted sleep disturbance level at follow-ups, but not vice versa.

Abstract

Objective

The Corona Virus Disease-19 (COVID-19) pandemic has evolved into the largest public health event in the world. Earlier COVID-19 studies have reported that the pandemic caused widespread impacts on mental health and sleep in the general population. However, it remains largely unknown how the prevalence of mental health problems and sleep disturbance developed and interacted in adolescents at different times in the epidemic.

Methods

831 teenagers (aged 14–19) underwent a longitudinal follow-up study to evaluate the prevalence of mental health problems and sleep disturbance among adolescents before, during, and after the COVID-19 breakout in China and to explore the interaction between mental health and sleep across the three measurements. The chronotype, anxiety and depression level, sleep quality, and insomnia were investigated during each measurement.

Results

The adolescents had delayed sleep onset and sleep offset time, longer sleep duration during the quarantine than before and after the epidemic, whereas their chronotype tended to morning type during the epidemic. Yet, the highest prevalence of anxiety, depression, poor sleeper, and insomnia symptoms were observed before but not during the COVID-19 breakout. The females and adolescents who were eveningness type showed significantly higher anxiety and depression levels, poorer sleep quality, and severe insomnia status than the males and the intermediate and morning types. Sleep disturbance was positively associated with mental problems among three measurements. Pre-measured depression level significantly predicted sleep disturbance level at follow-ups.

Conclusion

These findings suggested that adolescents' high prevalence of mental health and sleep problems occurred before the COVID breakout and decreased during and after the epidemic. Gender and chronotype were significant risk factors associated with affective and sleep disturbances. Depression positively predicted later sleep problems, but not vice versa.

Keywords

COVID-19
Anxiety
Depression
Sleep disturbance
Chronotype

Cited by (0)

1

These authors contributed equally to this work.

View Abstract