Prospective examination of adolescent sleep patterns and behaviors before and during COVID-19
Open accessAbstract
Study Objectives: To prospectively examine changes in adolescent sleep before and during the COVID-19 pandemic in adolescents with and without ADHD. Methods: Participants were 122 adolescents (ages 15–17; 61% male; 48% with ADHD). Parents reported on adolescents’ sleep duration and difficulties initiating and maintaining sleep (DIMS); adolescents reported on sleep patterns, sleep duration, delayed sleep/wake behaviors, and daytime sleepiness before (September 2019 to February 2020) and during (May–June 2020) COVID-19. Adolescents also reported on their health behaviors, COVID-19-related negative affect, and difficulties concentrating due to COVID-19. Results: Parents reported adolescents had more DIMS during COVID-19 than before COVID-19, with clinically elevated rates increasing from 24% to 36%. Both bedtimes and waketimes shifted later during COVID-19, and adolescents reported more delayed sleep/wake behaviors. Adolescents also reported less daytime sleepiness and longer school night sleep duration during COVID-19. In considering differences between adolescents with and without ADHD, adolescents with ADHD did not experience an increase in school night sleep duration and were less likely to obtain recommended sleep duration during COVID-19. In the full sample, controlling for ADHD status, COVID-19-related sadness/loneliness was associated with increases in DIMS, and spending less time outside and more COVID-19-related worries/fears were associated with increases in delayed sleep/wake behaviors during COVID-19. Conclusions: COVID-19 had negative and positive impacts on adolescent sleep. Adolescents with ADHD did not experience the benefit of increased school night sleep duration during COVID-19 like adolescents without ADHD. Negative affect and health behaviors may be useful intervention targets for reducing negative impacts of COVID-19 for adolescent sleep.
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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 [85]
The Results report a significant increase in school-night sleep duration during COVID-19 (p = .004), but no significant change in weekend sleep duration (p = .203). The Discussion suggests remote learning may have allowed later sleep schedules; it does not establish that school closures or remote learning caused the increase. (LLM, conf=0.88)
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- Authors
- Becker, S. P., Dvorsky, M. R., Breaux, R., Cusick, C. N., Taylor, K. P., & Langberg, J. M.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- Children's National (US)
- Virginia Tech (US)
- Virginia Commonwealth University (US)
- Corresponding author
- Becker, Stephen P
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-02-25
- Volume
- 44
- Issue
- 8
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC7928571
- OpenAlex
- W3130624949
- Cited by
- 116
- References
- 73
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 13 · 2023: 31 · 2022: 38 · 2021: 21
- FWCI
- 24.89
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- SLEEP (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- VTechWorks (Virginia Tech) (submittedVersion, public-domain)
- PsyArXiv (OSF Preprints) (submittedVersion)
- PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
- Funders
- Cincinnati Children’s Research Foundation (R305A160126)
- Institute of Education Sciences
- U.S. Department of Education
- National Institute of Mental Health (K23MH108603, K23MH122839)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- adolescent sleep, COVID-19 pandemic, attention deficit hyperactivity disorder, sleep duration, daytime sleepiness, negative affect, loneliness, COVID-19-related worry, health behavior
- MeSH terms
- COVID-19, SARS-CoV-2, Adolescent, Attention Deficit Disorder with Hyperactivity, Female, Humans, Male, Prospective Studies, Sleep, Sleep Wake Disorders, Pandemics
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