ABSTRACT
Background: Lockdowns to prevent the community transmission of COVID-19 pandemic has confined the people at home and imposed social restrictions, which is expected to cause alterations in circadian driven sleep-wake schedule and its associated lifestyle behaviors.
Design and Methods: An online questionnaire-based survey was conducted to assess the impact of lockdown on the sleep-wake pattern, meal timings and digital media exposure time on the Indian population during lockdown. Responses of 1511 participants (age ≥18 years) were analyzed to assess the effect of gender and age on these parameters before and during lockdown.
Results: The sleep onset-wakeup times and meals’ time was significantly delayed during lockdown, which was more pronounced in younger subjects. However, young individuals reported increased sleep duration at this time. Increased digital media duration was evident in all age groups, mainly in males. However, females reported more delay in sleep onset-waking time and first meal timing with longer sleep duration during lockdown.
Conclusions: Discord with social and natural cues due to complete lockdown during COVID-19 pandemic leads to a state of social jetlag with delayed sleep-wake, meal timings and excessive digital media exposure among Indians, which has differential impact on males and females as well as across different age groups. These findings have applied implications in sleep health and related behavior during longer social isolation conditions such as current COVID-19 or similar situations and may help to prepare better for any such future events.
REFERENCES
1. Borbély AA, Daan S, Wirz-justice A, Deboer T. The two-process model of sleep regulation: a reappraisal. J Sleep Res 2016;25:131–43.
2. Roenneberg T, Kumar CJ, Merrow M. The human circadian clock entrains to sun time. Curr Biol 2007;17:R44–5.
3. Wittmann M, Dinich J, Merrow M, Roenneberg T. Social jetlag: misalignment of biological and social time. Chronobiol Int 2006;23:497–509.
4. Chandrashekaran MK, Marimuthu G, Subbaraj R, et al. Direct correlation between the circadian sleep-wakefulness rhythm and time estimation in humans under social and temporal isolation. J Biosci 1991;16:97-101.
5. Pande B, Parganiha A, Patra P, Pati AK. Short-duration judgment in young Indian subjects under 30 h constant wakefulness. Indian J Exp Biol 2014;52:559-68.
6. Nag C, Pradhan RK. Impact of television on sleep habits. Biol Rhythm Res 2011;43:423–30.
7. Nuutinen T, Ray C, Roos E. Do computer use, TV viewing, and the presence of the media in the bedroom predict school-aged children’s sleep habits in a longitudinal study? BMC Public Health 2013;13:684.
8. Kozaki T, Kubokawa A, Taketomi R. et al. Effects of day-time exposure to different light intensities on light-induced melatonin suppression at night. J Physiol Anthropol 2015;34:27.
9. Štefan L, Horvatin M, Baić M. Are sedentary behaviors associated with sleep duration? a cross-sectional case from Croatia. Int J Environ Res Public Health 2019;16:200.
10. Wehrens SMT, Christou S, Isherwood C, et al. Meal timing regulates the human circadian system. Curr Biol 2017; 27:1768-75.e3.
11. Roenneberg T, Allebrandt KV, Merrow M, Vetter C. Social jetlag and obesity. Curr Biol 2012; 22:939–43.
12. Kantermann T, Juda M, Merrow M, Roenneberg T. The human circadian clock’s seasonal adjustment is disrupted by daylight saving time. Curr Biol 2007;17:1996–2000.
13. Horne JA, Östberg O. A self-assessment questionnaire to determine morningness–eveningness in human circadian rhythms. Int J Chronobiol 1976;4:97–110.
14. Hinton PR, Brownlow C, McMurray I, Cozens B. SPSS explained. 1st ed. London: Routledge; 2004.
15. Roenneberg T, Wirz-Justice A, Merrow M. Life between clocks: daily temporal patterns of human chronotypes. J Biol Rhythms 2003;18:80–90.
16. Chang AM, Aeschbach D, Duffy JF, Czeisler CA. Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness. Proc Natl Acad Sci USA 2015;112:1232-7.
17. Hirshkowitz M, Whiton K, Albert SM, Alessi C, et al. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health 2015;1:40–3.
18. Blume C, Schmidt MH, Cajochen C. Effects of the COVID-19 lockdown on human sleep and rest-activity rhythms. Curr Biol 2020; doi: https://doi.org/10.1016/j.cub.2020.06.021.
19. Wright Jr KP, Linton SK, Withrow D, Casiraghi L, et al. Sleep in university students prior to and during COVID-19 stay-at-home orders, Curr Biol 2020; doi: https://doi.org/10.1016/j.cub.2020.06.022.
20. Adan A, Natale V. Gender differences in morningness–eveningness preference. Chronobiol Int 2002;19:709–20.
21. Cain SW, Dennison CF, Zeitzer JM, Guzik AM, et al. Sex differences in phase angle of entrainment and melatonin amplitude in humans. J Biol Rhythms 2010;25: 288-96.
22. Park YM, Matsumoto K, Shinkoda H, Nagashima H, et al.Age and gender difference in habitual sleep-wake rhythm. Psychiatry Clin Neurosci 2001;55:201-2.
23. Åkerstedt T, Lekander M, Nilsonne G, Tamm S, et al. Effects of late-night short-sleep on in-home polysomnography: relation to adult age and sex. J Sleep Res. 2018;27:e12626. doi:10.1111/jsr.12626.
24. Gupta NJ, Kumar V, Panda S. A camera-phone based study reveals erratic eating pattern and disrupted daily eating fasting cycle among adults in India. PLoS One 12(3): e0172852. doi:10.1371/journal.pone.0172852.
25. Almoosawi S, Vingeliene S, Gachon F, Voortman T, et al. Chronotype: implications for epidemiologic studies on chrono-nutrition and cardiometabolic health. Adv Nutr 2019;10:30-42.
26. Meule A, Roeser K, Randler C, Kübler A. Skipping breakfast: morningness-eveningness preference is differentially related to state and trait food cravings. Eat Weight Disord 2012;17:e304–8.
27. Yamanaka Y, Honma K, Hashimoto S, Takasu N, et al. Effects of physical exercise on human circadian rhythms. Sleep Biol rhythms 2006;4:199-206.
28. Chung N, Bin YS, Cistulli PA, Chow CM. Does the proximity of meals to bedtime influence the sleep of young adults? A cross-sectional survey of University students. Int J Environ Res Public Health 2020;17:2677.doi:10.3390/ijerph17082677.
29. Cellini N, Canale N, Mioni G, Costa S. Changes in sleep pattern, sense of time and digital media use during COVID-19 lockdown in Italy. J Sleep Res 2020;00:e13074. doi:10.1111/jsr.13074.