A Longitudinal Analysis of COVID-19 Lockdown Stringency on Sleep and Resting Heart Rate Measures across 20 Countries

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Abstract

Lockdowns imposed to stem the spread of COVID-19 massively disrupted the daily routines of many worldwide, but studies to date are mostly confined to observations within a limited number of countries, based on subjective reports and survey from specific time periods during the pandemic. We investigated associations between lockdown stringency and objective sleep and resting-heart rate measures in 113,000 users of a consumer sleep tracker across 20 countries from Jan-Jul 2020. With stricter lockdown measures, midsleep times were universally delayed, particularly on weekdays, while midsleep variability and resting heart rate declined. These shifts (midsleep: +0.09 to +0.58 hours; midsleep variability: –0.12 to –0.26 hours; resting heart rate: –0.35 to –2.08 bpm) correlated with the severity of lockdown across different countries and highlight the graded influence of mobility restriction and social isolation on human physiology.

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  1. SciScore for 10.1101/2021.03.15.21253668: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.


    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    While this study highlights strengths of being able to rapidly and remotely assess the impact of various intervention policies on sleep and resting heart rate, there are a few limitations to consider. (1) Only sleep periods between 4-12 hours were analyzed. Shorter sleep periods could increase in frequency with work from home arrangements, but is challenging to detect and distinguish from other brief periods of sedentary behavior, e.g. sitting in bed reading a book or watching television. (2) Oura users typically come from middle to upper class households who could be more cushioned by the impact of COVID-19 and have flexible work arrangements. (3) Sleep quality measures were not obtained, which could be affected by anxiety from the impending loss of jobs or contracting the disease. However, one study showed unchanged or even improved sleep quality during the lockdown, particularly once shift workers and individuals who showed symptoms of COVID-19 were excluded from the analyses 5. (4) As these data were extracted from a large wearable database, we were not able to obtain information about occupations, shift work status, free vs. work days or caregiving responsibilities of these users. Those with additional childcare responsibilities due to school closures or have had a member of the household fall ill might also have had to work late hours in order to catch up on work. Not-withstanding these limitations, our model based on stringency indices was able to capture >50% of the v...

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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