Impact of lifestyle changes during the COVID-19 lockdown on sleep patterns: a population-based study in the Netherlands from the IMPACT project

Abstract

Background: Although there is scientific evidence of an increased prevalence of sleep disorders during the COVID-19 pandemic, we still have limited information on how lifestyle factors might have affected sleep patterns. Therefore, we aimed to identify pandemic-driven lifestyle changes and their potential impact on sleep in the adult population. Methods: Three Dutch cohorts were followed through monthly questionnaires provided in a mobile application that inquired about lifestyle determinants (physical activity, smoking, alcohol consumption, electronic device use, and social media use) and sleep (latency, duration, and quality). The stringency of anti-COVID-19 measures was analysed using the Containment and Health Index (CHI). To assess the association between lifestyle determinants and CHI with sleep, adjusted ordinal response models were fitted using frequentist and Bayesian frameworks. Results: A higher CHI (expressed by one Interquartile Range increase, CHI-IQR) was associated with a 47% increase in the odds of spending more time using electronic devices (OR: 1.47, CI: 1.40-1.53), a 6% decrease in the odds of exercising more hours per week (OR: 0.94, CI: 0.90-0.98) and with 37% fewer odds of consuming alcohol more frequently (OR: 0 .63, CI: 0.60-0.66). CHI-IQR increase was further associated with longer sleep duration (OR: 1.11, CI: 1.05-1.16). Lower frequency of alcohol consumption and higher levels of electronic device and social media use were associated with longer sleep latencies, while lower physical activity levels and increased use of social media and electronic devices were related to poorer sleep quality and shorter sleep duration. Conclusions: The measures applied against COVID-19 were related to changes in lifestyle in terms of physical activity, alcohol consumption and electronic device use, as well as to a modest increase in sleep duration. Increased electronic device use and decreased levels of physical activity and alcohol consumption were related to longer sleep latencies and poorer sleep quality during the pandemic.