Table 4

Changes in sleep duration, bedtime, wake-up time and sleep quality from before to during the lockdown

StudyReported outcome
Measurement toolIndicatorBefore lockdown
(Mean (SD))
During lockdown
(Mean (SD))
During lockdown (vs before lockdown)P value
Adibelli and Sümen, 2020, Turkey84Questionnaire prepared by the research team (increase in sleep time during the pandemic)% With increased tendency to sleep34.2%
Aguilar-Farias et al, 2020, Chile39Adapted from the questions included in the International Study of Movement Behaviours in the Early Years (SUNRISE), pilot-testedSleep duration (hours/day)10.92 (1.80)11.01 (1.86)0.001
Sleep quality (Mean score, range: 1–7)5.68 (1.54)4.93 (1.77)<0.001
Alonso-Martínez et al, 2021, Spain40Wrist-worn GENEActiv tri-axial accelerometerSleep duration (hours/day)9.51 (0.74)9.54 (1.30)0.914
Sleep efficiency (%)84.3%82.2%0.047
AMHSI, 2020, Multi-country70Newly designed sleep-wake patterns questionnaire and daily log adapted from Sleep Diary/Sleep Log of the National Sleep Foundation (NFS, USA)Sleep duration8:36 (1:20)9:34 (0:24)0.05
Araby et al, 2021, Egypt80Questionnaire adapted and translated from CDC fact sheet about stressful effects of COVID-19 pandemic on children and teens, 2020 % With a change of sleep pattern from before to during the lockdownChange of bedtime88.3%
Difficulty to fall asleep49.6%
Wake up afraid and rush to parents42.6%
Avoid bedtime31.4%
Return to bedwetting6.6%
Frequent nightmares31.4%
Brzek et al, 2021, Poland43Questionnaire related to sleeping behaviours during the pandemic period in comparison to the previous periodSleep duration per 24 hours (hours)9.74 (1.18)10.11 (1.21)<0.001
Cacioppo et al, 2020, France85Questionnaire developed by a national multidisciplinary group experienced in disability care, pilot-tested% Reporting increased sleeping difficulties in children during lockdown22.0%
Cellini et al, 2021, Italy71Sleep Disturbance Scale for ChildrenTime in bed (hours)9.37 (0.05)10.21 (0.05)<0.001
Bedtime (hour:mm)21:30 (0.03)22:48 (0.03)<0.001
Rise time (hour:mm)07:11 (0:04)09:01 (0:04)<0.001
Sleep quality (Sleep Disturbance Scale total score; higher scores indicate greater severity of sleep disturbance)38.60 (0.58)39.90 (0.58)0.027
Cerasuolo, 2021, Italy77Children’s Sleep Habits Questionnaire (CSHQ)Bedtime in toddlers and preschoolers (weekdays and weekends)Delayed<0.01
Rise time in toddlers and preschoolers (weekdays)Delayed<0.01
Rise time in toddlers and preschoolers (weekdays)Delayed<0.01
Rise time in toddlers and preschoolers (weekends)No change
CSHQ total score (higher score indicates more disturbed sleep)Toddlers47.51 (8.26)46.82 (8.10)Not significant
Preschoolers51.12 (6.36)47.82 (8.08)0.020
Cheng et al, 2021, Malaysia88Not reportedSleep duration (hours)T1DM, Male8.07 (1.21)9.06 (1.39)0.033
T1DM, Female8.18 (1.31)9.33 (1.33)<0.001
T2DM, Male7.80 (0.71)9.65 (0.94)0.001
T2DM, Female7.64 (1.12)9.55 (1.67)<0.001
Clarke et al, 2021, UK47Topic guide for in-depth interviews to get insights into the perceived impact of lockdown restrictions on preschool children’s physical activity, sedentary behaviour, food intake, and sleepChildren’s sleep qualityMany reported difficulties in getting their child to sleep
DiGiorgio et al, 2020, Italy78Sleep Disturbance Scale for ChildrenSleep Disturbance Scale for Children ScoreNo change0.970
Di Giorgio et al, 2021, Italy89Ad-hoc created questions about their children’s sleep habits% Sleeping 8–11 hours per night73.0%73.0%
% Often having difficulty falling asleep6.0%15.0%0.001
Dondi et al, 2021, Italy81Adapted from the Sleep Disturbance Scale for Children (SDSC)% Reporting more difficulty in falling asleep during lockdown69.3%
Garcia et al, 2021, USA91Adapted from the National Survey of Children’s HealthHours of sleep/weekday8.72 (1.77)9.36 (1.5)0.16
Hours of sleep/weekend9.47 (2.03)10 (1.37)0.2
Guo et al, 2021, China49Change in sleep assessed with the question “Compare with the three months before the outbreak of COVID-19, is there any change in the amount of you (or your child) daily sleeping?”% Reporting no difference in sleep duration47.5%
Kaditis et al, 2021, Multi-country75Bedtime on weekdays and on weekendsDelayed<0.01
Wake time on weekdays and on weekendsDelayed<0.01
Sleep duration on weekdaysIncreased<0.001
Sleep duration on weekendsNo change0.51
Kahn et al, 2021, USA72Objective sleep metrices recorded via videosomnography in the naturalistic home-setting, using Nanit camera monitorsNighttime sleep duration (Mean difference)11.0 min0.01
Morning rise time (Mean difference)9.5 min0.008
Lavigne-Cerván et al, 2021, Spain82BEARS (Sleep screening tool)Sleep quality (BEARS Score-screening for sleep disorder)7.4013.18
Li et al, 2021, China73Pittsburgh Sleep Quality Index (PSQI)Sleep duration (hours/day)6.73 (SE 0.05)7.18 (SE 0.06)0.001
Bedtime22:57:52 (SE 0:02:05)23:22:13 (SE 0:03:02)0.001
Wake-up time06:45:26 (SE 0:01:54)08:05:48 (SE 0:03:08)0.001
Sleep quality (score, higher score indicates lower quality)6.99 (SE 0.09)6.19 (SE 0.09)<0.001
Lim et al, 2020, Singapore50Questionnaire which included information on sleeping patterns of childrenSleep duration (hours/day)9.29 (1.00)9.63 (1.18)<0.001
Bedtime (hour:mm)21:36 (1.02)22:05 (1.25)<0.001
Rise time (hour:mm)06:45 (0:58)07:49 (0.90)<0.001
Liu et al, 2020, China74Children’s Sleep Habit Questionnaire (CSHQ)Nocturnal sleep duration (hours/day)Weekday: 9.47 (0.63)10:38 (1.05)<0.001
Weekend:
9.88 (0.78)
Bedtime (hour:min)21:30 (0.03)22:48 (0.03)<0.001
Rise time (hour:min)07:11 (0:04)09:01 (0:04)<0.001
Total Children’s Sleep Habits Questionnaire Score (higher score indicates lower sleep quality)51.87 (6.77)44.28 (6.06)<0.001
Lokhandwala et al, 2021, USA76Actigraphy data together with daily sleep diary (for validation)24-hour sleep duration (minutes)628.6 (29.4)631.6 (30.7)0.631
Sleep efficiency (%)84.9 (4.6)85.4 (4.5)0.365
López-Bueno et al, 2020, Spain3Sleep duration assessed with the question “How many hours does your child usually sleep daily?”Sleep duration (hours/day)9.10 (1.20)9.20 (1.60)0.129
Luijten et al, 2021, Netherlands83Patient-Reported Outcome Measurement Information System (PROMIS) scalePROMIS Sleep Related Impairment Score (higher score indicates greater sleep impairment)47.60 (10.00)49.90 (8.70)<0.01
Łuszczki et al, 2021, Poland51Assessed with the questions "What is the amount of time you sleep during a 24 h period on school days? What is the amount of time you sleep during a 24 h period on weekends? During the past month, how would you rate your sleep quality overall?”Weekdays sleep duration (hours)8.83 (1.64)8.55 (1.17)<0.001
Weekends sleep duration (hours)10.11 (1.45)9.52 (1.36)<0.001
Sleep quality (Score, higher score indicates better quality)1.70 (0.68)1.78 (0.65)0.032
Masi et al, 2021, Australia92Questionnaire developed by the investigators and pilot tested with clinicians, researchers, and a small group of parents% Reporting reduction in children’s sleep quality43.6%
Medrano et al, 2021, Spain52Sleep time calculated from children’s daily log of wake-up time and bedtimeWeekdays sleep duration (hours/day)9.10 (0.90)9.90 (1.20)<0.001
Weekend days sleep duration (hours/day)9.40 (1.10)10.10 (1.60)<0.001
Mitra et al, 2020, Canada53Secondary data (parents reported time spent on various movement behaviours)% Reporting same sleep duration during lockdown compared to before the lockdown51.8%
% Reporting same sleep quality68.7%
Moore, 2020, Canada27Secondary data (change in child’s movement and play behaviours), test-retest (one-week) reliability assessedChang in sleep quantity from before to during the lockdown (range: 1–5, 1 = a lot less, 3 = no change, 5 = a lot more)Children: 3.21 (0.70)
Youth: 3.63 (0.84)
Change in sleep quality from before to during the lockdown (range: 1–5, 1 = a lot worse, 3 = no change, 5 = a lot better)Children: 3.05 (0.66)
Youth: 3.04 (0.73)
Morgül et al, 2020, UK54Family daily routines and children’s emotional and behavioural symptoms questionnaire developed by Orgilés et alSleep duration (hours/day)9.93 (1.45)9.55 (1.76)<0.01
Munasinghe et al, 2020, Australia55Self-reported 24-hour sleep duration collected via weekly Ecological momentary assessment (EMA)Median sleep hours (OR)1.001.19 (0.57, 2.51)
Nathan, 2021, Australia20Sleep duration assessed from hours and minutes of sleep reported during the night and the daySleep (min/day)614.8 (48.5)612.8 (67.0)0.639
Okely et al, 2021, Multi-country26Questionnaire developed by the researchers based on the recommendations for each behaviour guideline, tested, and refined as part of SUNRISE pilot study24-hour sleep duration (min)664.7 (2.9)641.2 (3.2)-9.2 (−28.9, 10.6)0.341
Bedtime (24 hour:min)21:20 (0:02)22:01 (0:03)0:34 (0:14, 0:54)*0.003*
Waketime (24 hour:min)7:09 (0:02)8:09 (0:03)0:59 (0:34, 1:23)*<0.001*
% With poor sleep quality5.1 (1.0)6.0 (0.9)0.6 (0.1, 1.5)*0.267*
Pietrobelli et al, 2020, Italy94Questionnaire which included question on sleep behaviourSleep time (hours/day)8.46 (0.85)9.11 (1.10)0.003
Pombo et al, 2021, Portugal56Questionnaire developed by the researchers, questions validated by child development experts, and pilot tested% Spending neither more nor less time on sleep during lockdown51.6%
Ramos Socarras et al, 2021, Canada79Questions derived from the Pittsburgh Sleep Quality Index (PSQI)BedtimeDelayed<0.001
Subjective sleep qualityImproved<0.01
et al, 2021, Brazil58Questionnaire created by the research team, elaborated by experts in the field, and tested% Spending not more or not less time on sleep during lockdown compared to before the lockdown47.7%
Türkoğlu et al, 2020, Turkey96Children’s Sleep Habits Questionnaire (CSHQ)Total Children’s Sleep Habits Questionnaire Score (higher score indicates lower sleep quality)47.82 (7.13)50.80 (8.15)0.001
Yang et al, 2020, China66International Physical Activity Questionnaire (IPAQ)-long formWorkdays median sleep duration (hours/day)8.008.10<0.001
Weekends median sleep duration (hours/day)8.509.00<0.001
Zengin et al, 2021, Turkey61Questionnaire prepared by the researchers and reviewed by specialists% With an increased sleep time46.4%
% Sleeping late56.8%
% Getting up late39.0%
  • *Adjusted.

  • T1DM, type 1 diabetes mellitus.