Children and adolescents’ mental health and association with sleep pattern during the COVID-19 pandemic

School closures and home confinement due to the ongoing COVID-19 pandemic may lead to disrupted sleep patterns. We assessed sleep patterns before and during the pandemic, and their associations with mental health among children and adolescents in Shanghai, China. A total of 7,544 children and adolescents aged 6-17 years were randomly selected from ten schools in Shanghai, China in the first wave of the survey between January 3 and 21, 2020. Approximately two months after the COVID-19 outbreak was declared, a second wave of the survey was conducted among 4,391 children and adolescents from six schools.  

During the pandemic, a total of 873 participants (19.9%), 1,100 participants (25.1%), and 670 participants (15.3%) reported depression, anxiety and stress symptoms, respectively. Children and adolescents had longer sleep duration and were more prone to follow a late to bed late to rise sleep-wake cycle pattern over weekdays during the pandemic than before it. Moreover, shorter sleep duration and late to rise patterns (including early to bed late to rise and late to bed late to rise) were found to be associated with higher odds of having mental illnesses during the pandemic. Timely evidence‐based strategies and interventions are needed to mitigate adverse impacts caused by these unprecedented challenges.

Preprints with The Lancet: Children and Adolescents’ Sleep Patterns and Their Associations with Mental Health During the COVID-19 Pandemic in Shanghai, China