Changes in Sleep-Wake Patterns and Disturbances Before and During COVID-19 in Urban American Indian/ Alaska Native Adolescents
Open accessAbstract
BACKGROUND: COVID-19 has profoundly affected sleep, although little research has focused on high-risk populations for poor sleep health, including American Indian/Alaska Native (AI/AN) adolescents. METHODS: This is the first longitudinal study to examine changes in sleep with surveys completed before the pandemic and during the early months of COVID-19 in a sample of urban AI/AN adolescents (N = 118; mean age = 14 years at baseline; 63% female). We use a mixed-methods approach to explore how COVID-19 affected urban AI/AN adolescents' sleep, daily routines, and interactions with family and culture. Quantitative analysis examined whether pandemic-related sleep changes were significant and potential moderators of COVID-19's effect on sleep, including family and community cohesion and engagement in traditional practices. RESULTS: 's <.001). Higher levels of family cohesion and higher levels of engagement in traditional practices moderated pandemic-related increases in weekday sleep duration. Qualitative analyses revealed changes in adolescents' sleep and daily behaviors, as well as strategies adolescents used to cope with pandemic-related disruptions in sleep and routines. CONCLUSION: Findings demonstrate positive and negative changes in sleep during COVID-19 stay-at-home orders, including simultaneous increases in sleep duration and sleep-wake disturbances. Results highlight the importance of considering multi-level influences on adolescent sleep, such as early school start times, family dynamics, and cultural factors. A multi-level approach may help guide prevention and intervention efforts to improve adolescent sleep health.
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School closures and the transition to remote learning during COVID-19 led to significant increases in adolescent sleep duration.
“school closures and the transition to remote learning during COVID-19 greatly impacted sleep among adolescents (e.g., [83][84][85]), leading to significant increases in adolescent sleep duration [83].”
From Later School Start Times as a Public Health Intervention to Promote Sleep Health in Adolescents (2023) · cites this paper as [84]
The Quantitative Results report a significant increase in sleep duration during COVID-19 among the urban American Indian/Alaska Native adolescents studied (p < 0.001). The Discussion suggests that COVID-related school schedule changes contributed, but says the study cannot conclusively attribute the increase to the removal of early school start times because the assessment also covered summer vacation. The claim states that causal link more definitively and applies it to adolescents generally. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA longitudinal study among urban American Indian/Alaska Native adolescents showed that sleep duration increased by 130 minutes on average during weekdays during COVID-19.
“a longitudinal study examining changes in sleep before and during the early months of the pandemic among urban American Indian/Alaska Native (AI/AN) showed that adolescents' sleep duration increased by 130 min on average during weekdays during COVID-19 [84].”
From Later School Start Times as a Public Health Intervention to Promote Sleep Health in Adolescents (2023) · cites this paper as [84]
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- Authors
- Troxel, W. M., Palimaru, A. I., Klein, D. J., Dong, L., Dickerson, D. L., Brown, R. A., Johnson, C. L., & D’Amico, E. J.
- Affiliations
- RAND Corporation (US)
- University of California, Los Angeles (US)
- Sacred Path Indigenous Wellness Center, Los Angeles, California, USA
- Corresponding author
- Troxel, Wendy M.
- ORCID
- Venue
- Behavioral Sleep Medicine
- Publisher
- Informa UK Limited
- Published
- 2022-01-06
- Volume
- 20
- Issue
- 3
- Pages
- 343-356
- ISSN
- 1540-2002 (ISSN-L)
- 1540-2010
- PMC
- PMC9167151
- OpenAlex
- W4206830712
- Cited by
- 17
- References
- 46
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 4 · 2023: 8 · 2022: 2
- FWCI
- 3.68
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Behavioral Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute on Minority Health and Health Disparities (R01 MD012190)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- COVID-19 pandemic, adolescent sleep, sleep-wake patterns, sleep duration, sleep disorders, family cohesion, traditional practices, stay-at-home orders, daily routine, coping strategies
- MeSH terms
- Alaska Natives, Alaskan Natives, COVID-19, Adolescent, Female, Humans, Longitudinal Studies, Male, Sleep, Sleep Wake Disorders, American Indian or Alaska Native
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