Adolescent and young adult sleep and sleep-related behaviour change before and during the COVID-19 pandemic lockdown in Canada

BackgroundSleep disturbance is common in adolescents and young adults (AYAs), impacted by stress and academic/scheduling demands that conflict with biological phase delay. COVID-19 lockdowns allowed us to study sleep in AYAs when there are lessened scheduling demands. Additionally, we could test whether a sleep self-management app was helpful during lockdowns.MethodAYAs (ages 15-24 years) before (Pre-Lockdown; n = 65) and during lockdowns in Canada (Lockdown; n = 40) completed sleep diaries on the app; set goals based on generated feedback; and completed more sleep diaries pursuing whatever post-feedback goals they set.ResultsThe Lockdown group reported later and less variable rise times (RT) and spent more time in bed (TIB), both awake and asleep. Pre-Lockdown set a goal to reduce RT variability whereas Lockdown set a goal to decrease TIB, and AYAs made behaviour changes to meet their goals. For both groups, sleep onset, duration of awakenings, sleep duration and efficiency, and insomnia severity significantly improved at endpoint.ConclusionsAYAs slept differently during lockdowns, perhaps due to decreased scheduling. The pandemic revealed the need for accessible strategies to improve sleep health. Findings support the feasibility of using evidence-based apps, and that AYAs can effectively use self-management tools across variable global and social contexts to improve their sleep. What is already known about this topic: Adolescents and young adults (AYAs) experience myriad sleep problems that result from an interaction between (1) biological factors promoting later bedtimes while still requiring more time to recovery from sleep debt than adults, (2) environmental factors such as early school start times, and (3) behavioural factors that delay bedtime and increase pre-sleep arousal.Surveys conducted during initial COVID-19 lockdowns indicated increased rates of sleep disturbance in AYAs.AYAs unique sleep needs and low access to care indicate that tailored, digital self-management tools may be an optimal strategy to improve sleep health in this group.What this study adds: Using a transdiagnostic sleep app, we found that AYAs completing sleep diaries during lockdowns spent more time in bed resulting in more time asleep and more time awake, and their rise time shifted later and became more consistent.AYAs before and during lockdowns set different goals to improve their sleep, but both groups used the app to set and make progress towards their sleep goals and experienced improvements in sleep parameters and subjective insomnia severity.Our data provide initial support for the use of tailored digital solutions to reach this at-need group and indicate that AYAs flexibly use self-management tools to improve their sleep health under shifting global contexts.