Anti-COVID-19 measures and lifestyle changes during theCOVID-19 pandemic and sleep patterns in the Netherlands: a longitudinal study

Abstract

Abstract Although there is scientific evidence for an increased prevalence of sleep disorders during the COVID-19 pandemic, there is still limited information on how lifestyle factors might have affected sleep patterns. Therefore, we followed a large cohort of participants in the Netherlands (n=5,420) for up to one year (September 2020-2021) via monthly web-based questionnaires to identify lifestyle changes (physical activity, smoking, alcohol consumption, electronic device use, and social media use) driven by anti-COVID-19 measures and their potential associations with self-reported sleep (latency, duration, and quality). We used the Containment and Health Index (CHI) to assess the stringency of anti-COVID-19 measures and analyzed associations through multilevel ordinal response models. We found that more stringent anti-COVID-19 measures were associated with higher electronic device use (Odds Ratio per Interquartile Range (IQR) increase in CHI: 1.47, 95% CI: 1.40-1.53), less physical activity (OR: 0.94, 95% CI: 0.90-0.98), lower alcohol consumption frequency (OR: 0.63, CI: 0.60-0.66) and longer sleep duration (OR: 1.11, 95% CI: 1.05-1.16). Lower alcohol consumption frequency and higher electronic device use and social media use were associated with longer sleep latency. Lower physical activity levels and higher social media and electronic device use were related to poorer sleep quality and shorter sleep duration.