key: cord-0938962-ux5iorfu authors: Lopes, MC; Gutierres, GP; Pavoni, MB; Mendes, ABSMM; Campos, MB; Bastos, IB; Barros, BMB; Salmazo, H; Spruyt, K title: Social media for students’ sleep health promotion – a health intervention report during COVID -19 date: 2021-11-26 journal: nan DOI: 10.1016/j.sleepe.2021.100018 sha: 9915330b1763ac0b4fd51085bea3895266cdfa71 doc_id: 938962 cord_uid: ux5iorfu The COVID-19 pandemic has affected sleep health. Students' sleep health is essential for the performance of neuro-cognitive processes, as well as mental and physical balance. We assume the COVID19 pandemic has modified some sleep habits by prompting environmental and social interaction changes. In this study we surveyed a sample of 300 Brazilian students, with internet access, resident in the Federal District. They completed a questionnaire over two weeks in March 2020, i.e. the second and third week of the social isolation policy enacted in the Federal District due to COVID19. Valid responses from students aged18-24 years were analyzed. The sample was mostly female; 76,3% reported somnolence during the day, 70,2% anxiety and 87,8% worse sleep associated with stress and/or anxiety, which indicated the variables for an educational health intervention design in this context. Further, 53.2% made no effort to avoid screens before sleeping; 73.9% to avoid using the bed for work or watching television and 83.1% to avoid consuming heavy foods before sleeping. We then created an Instagram profile, @comodormimos, which focused on the main sleep issues revealed by participants in the survey. Posts on the profile were based on sleep-related subjects: sleep processes, sleep hygiene practices for students; sleep stages, function and regulation; and sleep-wake circadian rhythms. The profile gained 307 followers, mostly women (61,7%), 18-24 years old. We concluded that the Covid-10 pandemic period increased harmful sleep behavior in students. Further studies are needed to understand the impact of the COVID-19 pandemic on student sleep health. Students' sleep health is essential for the performance of neurocognitive processes (1, 2, 3) , as well as the mental and physical balance (2) . Undergraduate students, therefore, should avoid habits that lead to sleep deprivation as this can cause health and learning difficulties in a short time, due to problems with cognitive skills and emotional state (3, 4) . The school start time effects on adolescent learning and academic performance, emotional health and behaviour is part of the clinical implications of sleep hygiene (5) . The practice of sleep education programs can be follwed by a knowledge-to-action perspective regarding barriers, proposed solutions, and future directions in terms of early to bed, looking for an exploration of adolescent sleep hygiene practices (8, 9) . Probably the sleep behaviors since childhood may affects traditional-age college students. These age-sleep patterns on youth can be predictor factors of sleep across life span. Numerous studies demonstrate that the COVID-19 pandemic has affected sleep health (10, 11) . The influence of sleep before COVID-19 seems to be age dependent, where an epidemiological study had showed that the sleep time were longer in young adults (<25 years) compared to another age group of adults (45-54 years) (11) . There are implications of association between portable screen-based media device and sleep outcomes, and these disruption factors of sleep have been describing in pandemic period (12) . The bed time together with sleep hygiene have been growing as diagnosis and treatment skills on sleep medicine (13) , particularly during COVID-19 in sleep interventions around the world. In view of the fundamental importance of sleep and its regulation by the circadian cycle, sleep hygiene habits are characterized by a set of practices that help to obtain the maximum benefit from hours of sleep by improving environmental factors and reducing bad habits that cause harm. It will also help to avoid or minimize sleep disorders (3). Thus, sleep hygiene is essential at all ages in order to organize the amount and timing of sleep and sleeping rituals including adjusting environmental factors such as light and temperature, not eating high-calorie foods, practicing physical activity every day, maintaining consistent times for going to bed and getting up, and not using electronic devices close to bedtime (15, 16) . However the young adults usually complain about insomnia and cognitive problems during undergraduation (17) . The PEP is developed in the Discipline of Collective Health Practices Simple yet powerful the data-analysis visualization was made easy by an advanced Summary add-on that gave the ability to create interactive dashboards in a snap. It further allowed to quickly analyze collected data that's actively linked to Google Forms (with automatic updates). These google forms offered a quick overview of the collected data via the responses section where it displays summarized graphs and answer items. We created a customized analytics dashboard with specify various chart-types and apply different filters so you can further drill down and analyze subsets of the form responses (22) . Descriptive statistics are presented in this article. Also the instagram was able to give the summary of the data in a customized analytis format. We analysed 307 undergraduate students, the sample that could be included were 300 students, comprised an eminently young population, mostly female (n=185), respectively 61,7% female and 38,3% male, and mostly aged between 18 and 22 years (median=20), respectively 87,3% of the sample. None of the undergraduate students was part time worker. A) online Google survey during COVID-19. In general, repsondents slept for less than 8 hours a day. Overall 7 students were excluded because of a clinical condition that could biastheir answers, and we included 8 students that had children. Hygiene. Briefly, the importance of the subject was explained and some habits listed that can be introduced in their routines. We used some techniques such as connecting to popular culture to relate to the student population. For example the lyrics of Gonzaguinha's song "Never stop dreaming" were published as an encouraging message for the pandemic era. We found data showing that the occurrence of the sleep habits in undergrated students, and it was associated with anxiety and media use before to go to sleep. The interaction between social media and presentive action were well succeed in our protocol during COVID-19 pandemic period. The creation of the @comodormimos profile on We found an increase in the use of the internet before going to sleep among the undergraduate medical students, and this worsened during the COVID-19 period. The media abuse in young adults is probably connected with hedonist circuit that is increased in the modern Society by the bad habits including the intentional delay sleep phase called as social jet lag (23-25). The stress is a useful phenomenon that is natural and biological determinated, affected by pscyssocial and enviromental factors, that is usually seem in undergratuated students. It can implie in a state od hyperarousal follow by bad sleep hygiene. There is an increase in internet use around the world [26] and the majority of internet users are teenagers. Some young people have been diagnosed with Internet addiction (IA) (27) . There is thus a need to understand the potential risks associated with the internet as users display pathological internet use behavior, similar to compulsive gambling, excessive pornography consumption, compulsive shopping, or excessive gaming [28, 29) . The excessive internet use have been associated to other addiction such as pathological gamling, ad it gets worse during night time. Moreover we can see some behavior disorders associated with psychiatric disorders; impulsivity, depression, anxiety, psychosis, obsessive-compulsive symptoms, and social anxiety were reported in a metaanalysis published in 2019 by Alimoradi et al (30) . These authors also hypothesized that children, teenagers, and young adults are most susceptible to IA; a highly vulnerable segment of the population, most of them are still in their developing years. Our results showed that the majority of medical students had bad sleep hygiene. In their childhood, theyprobably were children and adolescentes with sleep problems that were not well acessed by the parents, and now they are medical sutdents with low knowledge in heathy quality. Poor sleep hygiene can have a very negative effect on sleep in adolescents and young adults with IA and there is clear association between internet addiction (and its equivalents), sleep problems, and curtailed sleep duration. Therefore, assisting young people in developing good sleep hygiene (e.g., not using the internet or smartphones before bedtime or while in bed) is relevant in all clinical practice. We found longer sleel duration pattern in undergraduated students. Young adults has an extend sleep duration during weekends as a recovery of sleep restriction during weekday (31) . More data about the conection between sleep hygiene is need. There is a growing in use of portable screen for sleep outcomes (32) . The use of media may increase the sleep psycoeducation. Pediatr 2016;170(12):1202-1208. Sleep loss, learning capacity and academic performance Letter to editor: CoVID-19 pandemic and sleep disorders-a web survey in Italy How much sleep do we need? 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