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Chronobiology International

The Journal of Biological and Medical Rhythm Research

ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/icbi20

COVID-19 pandemic and lockdown: cause of


sleep disruption, depression, somatic pain, and
increased screen exposure of office workers and
students of India

Piya Majumdar, Ankita Biswas & Subhashis Sahu

To cite this article: Piya Majumdar, Ankita Biswas & Subhashis Sahu (2020) COVID-19 pandemic
and lockdown: cause of sleep disruption, depression, somatic pain, and increased screen exposure
of office workers and students of India, Chronobiology International, 37:8, 1191-1200, DOI:
10.1080/07420528.2020.1786107

To link to this article: https://doi.org/10.1080/07420528.2020.1786107

Published online: 13 Jul 2020.

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CHRONOBIOLOGY INTERNATIONAL
2020, VOL. 37, NO. 8, 1191–1200
https://doi.org/10.1080/07420528.2020.1786107

COVID-19 pandemic and lockdown: cause of sleep disruption, depression,


somatic pain, and increased screen exposure of office workers and students of
India
Piya Majumdar , Ankita Biswas, and Subhashis Sahu
Ergonomics and Occupational Physiology Laboratory, Department of Physiology, University of Kalyani, Kalyani, Nadia, India

ABSTRACT ARTICLE HISTORY


COVID-19 has brought the world into uncharted waters. Many countries are under lockdown, the Received 12 June 2020
economy has ground to a halt, and almost everyone is afraid of dire consequences. The unprece­ Revised 17 June 2020
dented changes that came on so quickly due to the pandemic and stay-at-home confinement to Accepted 17 June 2020
accomplish social distancing and mitigate risk for infection pose many challenges. These include KEYWORDS
compromised health, well-being, and sleep as a consequence of disruption of the daily life routine, COVID-19; lockdown; social
anxiety, worry, isolation, greater family and work stress, and excessive screen time. Our study of 203 distancing; depression; sleep
corporate sector professionals performing ‘9–5ʹ work from home during this phase of the pandemic duration and pattern; screen
and of 325 undergraduate and postgraduate university students substantiates, relative to the time; somatic pain
before lockdown condition, more extensive feelings of sleepiness, with significantly (p < .05)
increased daytime nap duration, and depressive symptomatology (p < .001) that is a matter of
concern. Moreover, the chronic stress of living through a pandemic led to a host of physical
symptoms, like headaches, insomnia, digestive problems, hormonal imbalances, and fatigue.

Introduction
Wuhan residents found post-traumatic stress disorder
India is a densely populated country with a population (PTSD) symptoms were reported by 7% after the
of 1.3 billion people spread across diverse states having COVID-19 outbreak, in particular, by women. Those
wide economic and social disparities, health inequalities, with better sleep quality and fewer early morning awaken­
and distinct cultures that possess great challenge in this ings reported a lessor amount of PTSD symptoms during
era of the COVID-19 pandemic. The first COVID-19 the COVID-19 outbreak (Liu et al. 2020). Another study
case was reported in India on 30th January 2020 and up showed young adults <35 years of age who followed
to 10th May 2020 some 67,152 confirmed COVID cases COVID-19 news updates for >3 hours daily expressed
and 2,206 deaths had been reported across the country. elevated levels of anxiety compared with those who were
India went into a lockdown 25th March 2020 to combat >35 years of age and less exposed to COVID-19 news
the spread of COVID-19 infections and reduce the pres­ updates (Huang and Zhao 2020).
sure on healthcare systems. Accordingly, people were Sedentary lifestyle, excessive screen exposure, and
confined to their homes with limited access to many improper sleep habits culminate in higher BMI among
services, which are temporarily closed, thus producing children and reduce cognitive performance (Dutta et al.
huge complications. 2019). Use of social media and digital devices provides
Lockdown, i.e., home confinement as a measure to a platform to ameliorate social isolation, but when used
mitigate disease outbreak but can affect physical and men­ close to bedtime negatively impacts sleep among young
tal well-being, sometimes drastically (Erren et al. 2020; adults (Orzech et al. 2016). Extensive use of social media
Wang et al. 2020; World Health Organization 2020). by young adults between 18 and 35 years of age is linked
Social isolation as a measure to reduce infection curtails with elevated tendency to develop sleep problems and
access to family, friends, and other social systems that as disruption of daily activities (Sivertsen et al. 2019).
a consequence can cause loneliness, anxiety, and depres­ Additionally, excessive screen time is associated with
sion (Zhou et al. 2020), and motivate greater use of digital problem behaviors attributed to sleep disturbances and
devices that may alter and compromise sleep patterns, inattentiveness (Guerrero et al. 2019; Parent et al. 2016;
physical activity, and mental well-being. A recent study of Tamana et al. 2019).

CONTACT Subhashis Sahu skcsahu@yahoo.co.in In-Charge, Ergonomics and Occupational Physiology Laboratory, Department of Physiology, University
of Kalyani, Kalyani, Nadia-741235, West Bengal, India
© 2020 Taylor & Francis Group, LLC
1192 P. MAJUMDAR ET AL.

Herein, we report the results of our online-based- score from answering the online questionnaire was
questionnaire investigation that surveyed the impact of used to determine the severity of depressive
the lockdown – home confinement and social distan­ symptomatology.
cing – caused by the COVID-19 pandemic on the well-
being and lifestyle behaviors, in particular, mental and
physical health, depressive status, sleep quality, somatic Assessment of body part discomfort
complaints, and digital use. The presence of body part/somatic discomfort was
assessed by the Nordic Questionnaire (Kuorinka et al.
1987), and the body part discomfort rating scale
Materials and methods
(Reynolds et al. 1994) was used to rate the severity of
Study design and study population discomfort by magnitude of the score.
The study was conducted as online questionnaire survey
posted on 14th April 2020 during the COVID-19 pan­ Statistical analysis
demic phase in India. The respondents comprised two
Demographic details and other data are represented as
groups: (i) individuals engaged in the corporate sector,
mean ± standard deviation (SD) and percentages when
performing a ‘9–5ʹ work while confined at home
applicable. Before and during lockdown phase compar­
(N = 203), and (ii) university undergraduate or post­
isons were performed by Student’s t-test. All statistical
graduate students (N = 325). The survey was conducted
analyses were done using SPSS (SPSS Version 20.0, SPSS
in adherence to the Helsinki declaration and approved
Inc., Chicago, IL). In all cases, differences were consid­
by the Departmental Research Committee, University of
ered significant at p < .05.
Kalyani. The response was recorded online; data were
collected between 14th April 2020 and 2nd May 2020.
Results
Socio-demographics Table 1 depicts the demographic features of the office
workers and students of mean age of 33.1 ± 7.11 years
Subjects after providing consent were interviewed for
and 22.1 ± 1.66 years, respectively. Behaviors, like smok­
sociodemographic variables, such as place of residence,
ing and alcohol consumption, were quite common
age, marital status, presence or absence of children, years
among office workers as compared to the student’s
of work experience as well as health behaviors, like
group, though the restricted availability of cigarettes
alcohol intake, smoking habits, diagnosed diseases, and
and alcohol due to the pandemic and lockdown had
use of medicine before or during the pandemic phase.
curtailed these habits.
They were also interviewed regarding device usage and
The respondents reported the presence and intensity
screen exposure time per day, both before and during
(represented as a percentage increase) of health co-
the lockdown days.
morbidities experienced before (BL) and during the
lockdown (DL) phase (Figure 1a,b). There was remark­
Evaluation of sleep parameters able increase in gastrointestinal problems in both
Munich Chrono-Type Questionnaire for non-shift
workers (MCTQ) of Roenneberg et al. (2003) was used Table 1. Socio-demographic details of the office workers
(N = 203) and students (N = 325).
to determine the mid-sleep time during workdays and
Office Workers Students
work-free days before lockdown and also the corre­ Variables (N=203) (N=325)
sponding spans during lockdown. The main sleep and Age 33.1±7.11 years 22.1±1.66 years
nap durations were derived from it. The self-reported Job experience 8.8±5.94 years —-
Sex
inventory-like Epworth Sleepiness Scale (ESS, Johns Male 81.77% (N=166) 39.07% (N=127)
1991) was utilized to deduce drowsiness/sleepiness at Female 18.22% (N=37) 60.92% (N=198)
Marital status:
unusual times and to judge overall sleep quality. Married 70.93% (N=144) —
Unmarried/divorced/ 29.06% (N=59) —
separated
Evaluation of depressive symptomatology Children:
Present 57.63% (N=117) —
Absent 13.30% (N=27) —
The Center for Epidemiological Studies-Depression Habitual smokers 63% (N=128) 9% (N=29)
Scale (CES-D), as described by Radloff (1977), was Habitual drinkers 54% (N=110) —
used to determine depressive status. The obtained Data represented as mean±SD or percentage as where applicable.
CHRONOBIOLOGY INTERNATIONAL 1193

Figure 1. Subsequent increase in health comorbidities among (a) office workers and (b) students during lockdown as compared to
earlier.

groups, followed by hormonal issues. Students reported day) and during (8.2 ± 3.4 hours/day) the lockdown; also,
many other health problems, such as migraine, sinusitis, there was a significant increase in cellphone (p < .001) and
and anemia. Development of hypertension among office television (p < .001) use during the lockdown. Among
workers was especially notable. students, cellphone use increased significantly (p < .001)
The lockdown/pandemic situation increased reliance and drastically as compared to desktop/laptop or televi­
on various electronic devices to connect online, and this sion use. Table 2 describes the comparative distribution
resulted in increased screen time. Figures 2 and 3 show of the overall screen time exposure due to various types of
the use of electronic devices among office workers and device used among the two groups.
students. Office workers compared to students spent Sleep duration and quality were analyzed and
a significantly (p < .05) greater duration of time on their depicted. Mid-sleep time among the office workers and
desktop/laptop computers both before (6.4 ± 2.9 hours/ students is reported in Figure 4a,b, respectively. The
1194 P. MAJUMDAR ET AL.

Figure 2. Box-Whisker plot representing the statistical relation between exposure to screen time (hours/day) before and during
lockdown days among office workers. Data represented as median (horizontal bars inside the box) and range (Y-error bars).
a = represents a significant difference (P < .001) in Cellphone usage before (BL CP) & during (DL CP) lockdown.b = represents a
significant difference (P < .05) in Desktop/laptop usage before (BL DT/LT) & during (DL DT/LT) lockdown.c = represents a significant
difference (P < .001) in Television usage before (BL TV) & during (DL TV) lockdown.

Figure 3. Sunburst plot representing the statistical relation between exposure to screen time (hours/day) before and during lock down
days among students. Data represented according to hierarchy of usage of devices. Values presenting mean hours of exposure per day.
Cellphone usage before (BL CP) & during (DL CP) lockdown. Desktop/laptop usage before (BL DT/LT) & during (DL DT/LT) lockdown.
Television usage before (BL TV) & during (DL TV) lockdown.

curve of the respective groups tends to be flattened office workers when adhering to their regular work
during the lockdown, indicating a preference to go to hours and students when attending university classes
sleep later and rise later than before lockdown. Both and activities had an earlier mid-sleep time than during
CHRONOBIOLOGY INTERNATIONAL 1195

Table 2. Exposure to screen time (hours/day) among office Confinement to home and sedentary activity was
workers and students expressed as mean±SD. associated with discomfort of different body parts in
Lockdown phase the office workers and students (Figure 8a,b).
Student’s Significant discomfort of the neck (p < .001), shoulder
Group Devices Before During t-test P-value
Office Cellphone 3.0 ± 1.59 4.0 ± 2.24 8.698 <0.001
(p < .001), wrists (p < .001), upper back (p < .001), and
workers Desktop/ 6.4 ± 2.90 8.2 ± 3.36 3.25 <0.05 hips/thighs (p < .05) were reported by office workers,
laptop and significant discomfort of the shoulders (p < .001),
Television 0.7 ± 0.09 1.5 ± 1.32 9.989 <0.001
Students Cellphone 3.0 ± 1.36 5.2 ± 1.73 42.471 <0.001 upper back (p < .001), hips/thighs (p < .001), knees
Desktop/ 1.3 ± 0.95 1.6 ± 1.75 3.803 <0.001 (p < .05), and ankles/feet (p < .05) were reported by
laptop
Television 1.1 ± 0.35 1.3 ± 1.02 3.762 <0.001 students. These findings are summarized in Tables 3
Values expressed as mean ± SD. and 4.
NS = Not significant.

Discussion
the lockdown. Sleep duration worsened significantly Socio-demographic detailing of the respondents
(p < .001) during the lockdown among office workers, revealed ~63% of the office workers were habitual smo­
as they reported sleep disturbances: moreover, the range kers and most had a habit of drinking alcohol occasion­
of sleep duration varied between the workers, from 4 to ally, though these habits were compromised during the
~8 h (Figure 5a). Students, on the other hand, main­ lockdown due restricted or unavailability. Also, 9% of
tained a more consistent between-subject sleep duration, the students responded they were habitual smokers. The
perhaps attributed to habit or social influence (Figure majority of the office workers had high blood pressure
5b); sleep duration was increased in students signifi­ and metabolic disease, i.e., diabetes. The development of
cantly (p < .001) during lockdown versus before lock­ the metabolic disorder is partly due to their sedentary
down. Interestingly, a relatively high proportion of office lifestyle, lack of physical activity. During the lockdown,
workers (19%) and students (34%) admitted to be exces­ relative to before lockdown, the proportion of respon­
sively sleepy, depending upon the situation, as depicted dents who reported hypertension and gastrointestinal
in Figure 6; nonetheless, the majority of respondents disturbances increased drastically, from 6.09% to
indicated they had good sleep quality. 8.37%, although the exact cause or linkage is under­
The pandemic and lockdown that restricted people to mined. The association of sedentary lifestyle and beha­
their homes were found to be associated with depressive vior to deleterious health outcomes has been observed in
symptomatology among both office workers and stu­ many studies (González et al. 2017; Tremblay et al.
dents (Figure 7a,b, respectively). Depressive symptoma­ 2010). A 21-year follow-up study on 7744 men (20–­
tology increased from 1.97% to 14.77% among office 79 years of age) initially free of CVD reported sedentary
workers, and even more markedly, from 7.07% to lifestyle/behavior, lack of physical activity, high amount
30.77%, among students. of time spent on television and riding in a car was

Figure 4. Mid-sleep time of the (a) office workers and (b) students during workdays, work-free days (before lockdown) and during
lockdown days. *Data represented as frequency with trendline. MSW = Mid-sleep time during workdays, MSF = Mid-sleep time during
work-free days, MSL = Mid-sleep time during lockdown days
1196 P. MAJUMDAR ET AL.

Figure 5. Box-Whisker plot representing the statistical relation of sleep duration during work days, work-free days and lockdown days
among (a) office workers and (b) students. Data represented as median (horizontal bars inside the box) and range (Y-error bars).* =
represents significant difference (P < .001)# = represents significant difference (P < .05)SDW denotes sleep duration during workdays
before lockdown.SDF denotes sleep duration during work-free days before lockdown.SDL denotes sleep duration during lockdown
days.

Figure 6. Percentage distribution of office workers (inner circle, lighter shade) and students (outer circle, darker shade) with respect to
unusual sleepiness.

associated with hypertension and CVD morbidity and The pandemic and subsequent lockdown resulted
mortality (Warren et al. 2010). Though the number of in social distancing and isolation that had
individuals reporting metabolic disorders, i.e., diabetes, a detrimental effect on mental well-being, with
did not increase during lockdown, a higher proportion increased reliance on digital use presumably to
of workers than students had diabetes. Physical inactiv­ escape the isolation. Use of cellphones among the
ity is associated with higher BMI and obesity, which are office workers and students increased enormously,
established risk factors for diabetes mellitus (Admiraal and most significantly desktop/laptop use among
et al. 2011; Longo-Mbenza et al. 2010). Our study also office workers increased to keep pace with the work
reveals that home confinement, physical inactivity, lack from the home. Among students, cellphone usage
of academic schedule, and stress among the students was more popular than desktop/laptop usage to
resulted in complaints of hormonal imbalances (propor­ enable gossiping, news feed checking, social media
tion rose from 5.85% before to 8.92% during lockdown). updates, and online classes. Differences between the
CHRONOBIOLOGY INTERNATIONAL 1197

Figure 7. Box-Whisker plot representing the statistical relation of depressive symptomatology before (BL) and during (DL) lockdown
days among (a) office workers and (b) students. Data represented as median (horizontal bars inside the box) and range (Y-error bars).
CES-D Scale score 0–15 indicates NOT-DEPRESSEDCES-D Scale score ≥16 indicates DEPRESSED.

two groups in the increase of use of the various types and Tapia-Ayuga 2020; Christensen et al. 2016). Blue
of devices during the lockdown could, at least to light exposure before bedtime is associated with sleep
some extent, reflect the different economics and inefficiency and reduced sleep duration, both among
affordability of the workers versus students. adults and children (Vallance et al. 2015; Wu et al.
Excessive screen time appears to have had 2017). Our findings uncovered an interesting associa­
a detrimental effect on health by severely affecting tion; increased cellphones use among students was
sleep patterns and duration. This is perhaps due to negatively correlated with sleep duration
the suppression of melatonin production, which (r = −0.60); whereas, among office workers increased
helps induces sleep, by the blue light emitted from use of desktop/laptop was negatively correlated with
their screens of devices when used at night (Calvo sleep duration (r = −0.90). Increased total screen
1198 P. MAJUMDAR ET AL.

Figure 8. Hierarchical presentation of body part discomfort felt by the (a) office workers and (b) students before (BL) and during (DL)
lockdown phase. Inner circle depicts different body in hierarchical order of discomfort feeling. Outer circle denotes percentage
response before (BL) and during (DL) lockdown.

Table 3. Analysis of body part discomfort among office workers (r = 0.22), which is consistent with earlier findings
before and during lockdown phase.
(Wu et al. 2015).
Lockdown phase
Home confinement and restricted access led to
Student’ Cohen’s
Body parts Before During t-test P-value d reduced physical activity and increased screen exposure,
Neck 2.2 ± 1.90 3.2 ± 2.79 5.067 <0.001 0.405 which might have played a major role in disturbing sleep
Shoulders 1.9 ± 1.79 2.7 ± 2.68 3.858 <0.001 0.368 patterns. As our study suggests, the curve of the mid-sleep
Elbows 1.2 ± 0.97 1.1 ± 0.66 2.164 <0.05 0.132
Wrists/ 1.3 ±.20 1.9 ± 0.96 4.963 <0.001 0.386 time of the respondents was flattened and shifted toward
hands the right, meaning a greater number of individuals went
Upper back 1.2 ± 1.1 1.8 ± 2.03 3.886 <0.001 0.321
Lower back 1.7 ±1.66 1.7 ± 1.66 NS NS — bed later at night and awoke later in the morning during
Hips/thighs 1.7 ± 1.05 1.4 ±1.35 3.163 <0.05 0.191 lockdown compared to before lockdown. The lockdown
Knees 1.5 ± 1.53 1.3 ± 1.38 1.819 NS —
Ankles/feet 1.2 ± 0.60 1.1 ± 0.70 1.177 NS —
phase hampered their usual bed and rise time due to
Values expressed as mean ± SD.
disturbed or absence of schedule. Lowered availability of
NS = Not significant. natural light, reduced usual ‘time anchors,’ like parents
taking children to school, workers arriving and departing
Table 4. Analysis of body part discomfort among students before
the office, students, and workers attending recurring
and during lockdown phase. social events or going to the gym, markedly diminished
Lockdown phase external cues to keep humans on time and control their
Student’s Cohen’s sleep/wake and other circadian rhythms (Majumdar and
Body parts Before During t-test P-value d Sahu 2019). Also, this unnatural situation contributed to
Neck 2.8 ± 2.23 2.9 ± 2.25 0.326 NS — sleep disturbances and atypical sleep duration, which
Shoulders 2.9 ± 2.33 2.4 ± 2.28 4.179 <0.001 0.195
Elbows 1±0 1±0 NS NS — varied between worker respondents from 4 to ~8 hours.
Wrists/ 1.4 ± 1.29 1.4 ± 1.32 1.0 NS — A significant proportion of the individuals indicated they
hands
Upper back 1.9 ± 1.83 1.5 ± 1.48 5.352 <0.001 0.240 felt sleepy at an unusual time of day, and their sleep was
Lower back 1.7 ± 1.70 1.8 ± 1.76 0.760 NS — affected likely by mental stress, anxiety, and screen expo­
Hips/thighs 1.7 ± 1.62 1.4 ± 1.32 4.400 <0.001 0.203
Knees 1.3 ± 1.09 1.2 ± 0.91 2.200 <0.05 0.099 sure before bedtime. Many reported oversleeping and
Ankles/feet 1.3 ± 1.13 1.2 ± 0.95 2.714 <0.05 0.095 their nap duration had increased significantly (p < .05),
Values expressed as mean ± SD. both among students (3.1 ± 1.23 hours/day) and office
NS = Not significant.
workers (2.5 ± 1.86 hours/day). Our findings are in line
with those of a recent study by Altena et al. (2020).
The presence and increment of depressive symptoms
time among the respondents was associated with were significantly higher during compared to before lock­
higher depressive symptomatology; CES-D score was down. The score of a large number of both office workers
found to be positively associated with screen time and students without depressive symptomatology before
among students (r = 0.26) and office workers lockdown increased during the lockdown. The percentage
CHRONOBIOLOGY INTERNATIONAL 1199

rise of respondents with depressive symptomatology was Authors’ contribution


quite surprising, with a greater percentage increment
SS and PM conceived the study design. PM was responsible for
among students (7.07% to 30.77%) compared to office data collection, manuscript writing, data representation, data
workers (1.97% to 14.77%). Confinement to home plus analysis, and data interpretation. AB contributed to data col­
anxiety and stress most likely contributed to this increase lection. Final approval was made by SS.
in the symptoms of depression. A recent study on
Chinese children also revealed the COVID-19 outbreak
harmed their mental health, making them more Disclosure statement
depressed than before it occurred (Xie et al. 2020). Also, The authors report no conflict of interest.
the CES-D score during lockdown was found to be nega­
tively correlated with sleep duration, both among stu­
dents (r = −0.23) and office workers (r = −0.37), which Funding
is also consistent with previous reports. This is consistent
also with the observation that a proper sleeping pattern, This research work is supported by Personal Research Grant
habit, and timing are associated with improved mental (PRG), the University of Kalyani provided to both PM and SS.
Also, University Research Scholarship (URS), University of
health and reduced depressive score. Kalyani provided to PM.
A significant proportion of respondents reported
pain in certain anatomical sites; this may be attributed
to confinement and awkward posture for a prolonged ORCID
time while working or involved in screen use. Among
office workers, pain and discomfort were prevalent in Piya Majumdar http://orcid.org/0000-0001-6126-1288
Subhashis Sahu http://orcid.org/0000-0002-1584-4551
the neck, shoulders, elbows, wrists/hands, and upper
back during confinement, while complaint of pain in
the lower back, keens, hips/thighs, ankle/feet declined References
significantly during it. Among students, pain and dis­
Admiraal WM, van Valkengoed IG, de Munter JSL, Stronks K,
comfort in the shoulders, upper back, hips/thighs, knees,
Hoekstra JB, Holleman F. 2011. The association of physical
and ankles/feet declined, while discomfort in the wrists inactivity with type 2 diabetes among different ethnic
increased. This may be due to the extended use of the groups. Diabet Med. 28(6):668–672. doi:10.1111/j.1464-
cellphone. Scarabottolo et al. (2017) reported pain at 5491.2011.03248.x
different body parts due to physical inactivity. Altena E, Baglioni C, Espie CA, Ellis J, Gavriloff D,
Holzinger B, Schlarb A, Frase L, Jernelöv S, Riemann D.
We can conclude that social isolation in the form 2020. Dealing with sleep problems during home confine­
of home confinement as an important measure to ment due to the COVID-19 outbreak: practical recommen­
mitigate the risk of COVID-19 infection during this dations from a task force of the European CBT-I academy.
pandemic outbreak has detrimental effects on the J Sleep Res. e13052. doi:10.1111/jsr.13052
population based on the findings of our online Calvo JA, Tapia-Ayuga CE. 2020. Blue light emission spectra
of popular mobile devices: extent of user protection against
study. Mental health and physical well-being were
melatonin suppression by built-in screen technology and
imbalanced as screen exposure increased and the light filtering software systems. Chronobiol Int. in press.
sleep schedule altered. Sleep is critical to physical Christensen MA, Bettencourt L, Kaye L, Moturu ST,
health and effective functioning of the immune sys­ Nguyen KT, Olgin JE, Pletcher MJ, Marcus GM. 2016.
tem. It is also a key promoter of emotional wellness Direct measurements of smartphone screen-time: relation­
ships with demographics and sleep. PLoS One. 11(11):
and mental health, and helps reduce stress, depres­
e0165331. doi:10.1371/journal.pone.0165331
sion, and anxiety. Our study provides scientific input Dutta K, Mukherjee R, Das R, Chowdhury A, Sen D, Sahu S.
into the effect of long-term lockdown on health and 2019. Scheduled optimal sleep duration and screen expo­
wellbeing of individuals and helps inform ameliora­ sure time promotes cognitive performance and healthy
tive approaches. BMI: a study among rural school children of India. Biol
Rhythm Res. 1–13. doi:10.1080/09291016.2019.1646505
Erren TC, Lewis P, Shaw DM. 2020. COVID-19 and ‘natural’
Acknowledgements experiments arising from physical distancing:
a hypothetical case study from chronobiology. Chronobiol
The authors would like to acknowledge the respondents Int. in press.
who had willingly participated in this research and con­ González K, Fuentes J, Márquez JL. 2017. Physical inactivity,
tributed their information for academic purposes. sedentary behavior and chronic diseases. Korean J Fam
Med. 38(3):111–115. doi:10.4082/kjfm.2017.38.3.111
1200 P. MAJUMDAR ET AL.

Guerrero MD, Barnes JD, Chaput J, Tremblay MS. 2019. Sivertsen B, Ø V, Harvey AG, Glozier N, Pallesen S, Aarø LE,
Screen time and problem behaviors in children: exploring Lønning KJ, Hysing M. 2019. Sleep patterns and insomnia
the mediating role of sleep duration. Int J Behav Nutr Phys. in young adults: A national survey of Norwegian university
16(1):105. doi:10.1186/s12966-019-0862-x students. J Sleep Res. 28(2):e12790. doi:10.1111/jsr.13095
Huang Y, Zhao N. 2020. Generalized anxiety disorder, depres­ Tamana SK, Ezeugwu V, Chikuma J, Lefebvre DL, Azad MB,
sive symptoms and sleep quality during COVID-19 epi­ Moraes TJ, Subbarao P, Becker AB, Turvey SE, Sears MR,
demic in China: a web based cross-sectional survey. et al., 2019. Screen-time is associated with inattention pro­
medRxiv. doi:10.1016/j.psychres.2020.112954 blems in preschoolers: results from the CHILD birth cohort
Johns MW. 1991. A new method for measuring daytime study. PLoS One. 14(4):e0213995. doi:10.1371/journal.
sleepiness: the Epworth sleepiness scale. Sleep. 14 pone.0213995.
(6):540–545. doi:10.1093/sleep/14.6.540 Tremblay MS, Colley RC, Saunders TJ, Healy GN, Owenb N.
Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering- 2010. Physiological and health implications of a sedentary
Sørensen F, Andersson G, Jørgensen K. 1987. Standardised lifestyle. Appl Physiol Nutr Metab. 35(6):725–740.
Nordic questionnaires for the analysis of musculoskeletal doi:10.1139/H10-079
symptoms. Appl Ergon. 18(3):233–237. doi:10.1016/0003- Vallance JK, Buman MP, Stevinson C, Lynch BM. 2015.
6870(87)90010-x Associations of overall sedentary time and screen time
Liu N, Zhang F, Wei C, Jia Y, Shang Z, Sun L, Wu L, Sun Z, with sleep outcomes. Am J Health Behav. 39(1):62–67(6).
Zhou Y, Wang Y, et al. 2020. Prevalence and predictors of doi:10.5993/AJHB.39.1.7
PTSS during COVID-19 outbreak in China hardest-hit Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, Ho RC. 2020.
areas: gender differences matter. Psychiatry Res. Immediate psychological responses and associated factors
287:112921. doi:10.1016/j.psychres.2020.112921 during the initial stage of the 2019 coronavirus disease
Longo-Mbenza B, On’kin JB, Okwe AN, Kabangu NK, (COVID-19) epidemic among the general population in
Fuele SM. 2010. Metabolic syndrome, aging, physical inac­ China. Int J Environ Res Public Health. 17(5):1729.
tivity, and incidence of type 2 diabetes in general African doi:10.3390/ijerph17051729
population. Diab Vasc Dis Res. 7(1):28–39. doi:10.1177/ Warren TY, Barry V, Hooker SP, Sui X, Church TS, Blair SN.
1479164109346362 2010. Sedentary behaviors increase risk of cardiovascular
Majumdar P, Sahu S. 2019. Morningness orientation is an disease mortality in men. Med Sci Sports Exercise. 42
important determinant to circadian misalignment and (5):879–885. doi:10.1249/MSS.0b013e3181c3aa7e
tolerance: an Asian perspective. Chronobiol Int. 37 World Health Organization. 2020. Mental health and psycho­
(1):2–28. doi:10.1080/07420528.2019.1682597 social considerations during the COVID-19 outbreak. (No.
Orzech KM, Grandner MA, Roane BM, Carskadon MA. WHO/2019-nCoV/MentalHealth/2020.1). [accessed 2020
2016. Digital media use in the 2 h before bedtime is May 2]. https://apps.who.int/iris/bitstream/handle/10665/
associated with sleep variables in university students. 331490/WHO-2019-nCoV-MentalHealth-2020.1-eng.pdf?
Comput Human Behav. 55(A):43–50. doi:10.1016/j. sequence=1&isAllowed=y.
chb.2015.08.049 Wu X, Tao S, Rutayisire E, Chen Y, Huang K, Tao F. 2017. The
Parent J, Sanders W, Forehand R. 2016. Youth screen time and relationship between screen time, nighttime sleep duration,
behavioral health problems: the role of sleep duration and and behavioural problems in preschool children in China.
disturbances. J Dev Behav Pediatr. 37(4):277–284. Eur Child Adolesc Psychiatry. 26(5):541–548. doi:10.1007/
doi:10.1097/DBP.0000000000000272 s00787-016-0912-8
Radloff LS. 1977. The CES-D scale: A self-report depression Wu X, Tao S, Zhang Y, Zhang S, Tao F. 2015. Low physical
scale for research in the general population. Appl Psychol activity and high screen time can increase the risks of
Meas. 1(3):385–401. doi:10.1177/014662167700100306 mental health problems and poor sleep quality among
Reynolds JL, Drury CG, Broderick RL. 1994. A field metho­ Chinese college students. PLoS One. 10(3):e0119607.
dology for the control of musculoskeletal injuries. Appl doi:10.1371/journal.pone.0119607
Ergon. 25(1):3–16. doi:10.1016/0003-6870(94)90025-6 Xie X, Xue Q, Zhou Y, Zhu K, Liu Q, Zhang J, Song R. 2020.
Roenneberg T, Wirz-Justice A, Merrow M. 2003. Life between Mental health status among children in home confinement
clocks: daily temporal patterns of human chronotypes. J Biol during the coronavirus disease 2019 outbreak in Hubei
Rhythms. 18(1):80–90. doi:10.1177/0748730402239679 Province, China. JAMA Pediatr. doi:10.1001/
Scarabottolo C, Pinto RZ, Oliveira C, Zanuto E, Cardoso J, jamapediatrics.2020.1619
Christofaro D. 2017. Back and neck pain prevalence and Zhou X, Snoswell CL, Harding LE, Bambling M, Edirippulige S,
their association with physical inactivity domains in Bai X, Smith AC. 2020. The role of telehealth in reducing the
adolescents. Eur Spine J. 26(9):2274–2280. doi:10.1007/ mental health burden from COVID-19. Telemedicine
s00586-017-5144-1 E-Health. 26(4):377–379. doi:10.1089/tmj.2020.0068

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