Sleep health early in the coronavirus disease 2019 (COVID-19) outbreak in the United States: integrating longitudinal, cross-sectional, and retrospective recall data

BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) caused substantial changes in lifestyle, responsibilities, and stressors. Such dramatic societal changes might cause overall sleep health to decrease (stress view), to remain unchanged (resilience view), or even to improve (reduced work/schedule burden view). METHODS: We addressed this question using longitudinal, cross-sectional, and retrospective recall methodologies in 699 American adult participants in late March 2020, two weeks following the enactment of social distancing and shelter-in-place policies in the United States. RESULTS: Relative to baseline data from mid February 2020, cross-sectional and longitudinal analyses demonstrated that average sleep quality was unchanged, or even improved, early in the pandemic. However, there were clear individual differences: approximately 25% of participants reported that their sleep quality had worsened, which was explained by stress vulnerability, caregiving, adverse life impact, shift work, and presence of COVID-19 symptoms. CONCLUSIONS: Therefore, the COVID-19 pandemic has detrimentally impacted some individuals' sleep health while paradoxically benefited other individuals’ sleep health by reducing rigid work/school schedules such as early morning commitments.