key: cord-1005619-97o5mq34 authors: Fidancı, İzzet; Aksoy, Hilal; Yengil Taci, Duygu; Fidancı, İlknur; Ayhan Başer, Duygu; Cankurtaran, Mustafa title: Evaluation of the effect of the COVID‐19 pandemic on sleep disorders and nutrition in children date: 2021-03-26 journal: Int J Clin Pract DOI: 10.1111/ijcp.14170 sha: 4e31c3c2578cf397ec345dbe7e2e7dca70ff4bf0 doc_id: 1005619 cord_uid: 97o5mq34 AIMS: The aim of the study was to evaluate the possible changes in sleep behavior and nutrition in children during the pandemic period. METHODS: One hundred fourteen parents who accepted to participate in the study aged 18 and over and who had children between the ages of 6 and 16 were included in the study. A questionnaire was carried out after written consents were obtained. In the first part of the questionnaire, there were a total of 9 questions including socio‐demographic information and nutritional characteristics, and the second part included the “Sleep Disturbance Scale for Children” (SDSC). The data were analyzed with the SPSS 20 statistical program. RESULTS: The total number of participants was 114 parents; 64 (56%) of the children were girls and 50 (43.9%) were boys. Among the participants, the number of children who had COVID‐19 was 38 (33.3%). There was no statistically significant relationship between going through COVID‐19 status and the variables examined in general. The proportion of participants who stated that if the pandemic period was prolonged, COVID‐19 would not change their diet was found to be statistically significant (P = .038). The SDSC score was found to be significantly high in girls (P < .05). CONCLUSION: Sleep and nutritional disorders affect the quality of life for all ages for both genders, and their importance increases even more in extraordinary periods such as pandemic. Sleep problems increasing especially with an accompanying anxiety state may lead to developmental problems as well as deepening psychological disorders. FIDANCI et Al. Sleep disorders greatly affecting the quality of life in children are frequently seen. Although it is stated in the literature that sleep disorders are observed from 30% to 50% of children, the percentage of those who can be diagnosed cannot exceed 4%. 1, 2 Quality and appropriate sleep are valuable for the growth and development of children. Sleep disorders bring many problems along with them. Therefore, early diagnosis and treatment of sleep disorders, especially in childhood, is crucial. 1, [3] [4] [5] Family physicians, who are responsible for providing primary health care services, play a major role in defining sleep disorders for the childhood age group. 6 They make the initial assessment of sleep disorders through physical examination, laboratory tests, and scales. They direct other diagnostic tests (polysomnography, etc) to the upper step. 7 Another factor affecting the quality of life, growth, and development of children is nutrition. Because of the insufficient nutrition in children, irreversible health problems are seen in many countries. Not only the physical but also the emotional and social development of children is directly related to nutrition. 8 Changes in sleep and diet can be observed during periods of behavioral change, and during the COVID-19 pandemic period. It is expected that sleep and nutrition, which are important behaviors for the development of children, will also be influential because of behavioral changes. The aim of our study is to evaluate the possible changes in sleep disorders and nutrition in children during the pandemic. Our study was a questionnaire study conducted with observational and analytical methods. Those who referred to our polyclinics from September to December 2020 for any reason and accepted to participate in the study, who were of the age 18 and over and had children between the ages of 6-16 years were included in the study. Verbal and written consent was obtained from those who agreed to participate in the study. In the first part of the questionnaire, there were a total of nine questions including socio-demographic information and nutritional characteristics, and the second part included the "Sleep Disturbance within the last 6 months. 10 Questions are answered between the statements as "never" (1 point) and "always" (5 points). A minimum score of 26 and a maximum of 130 points can be obtained on the scale. Getting high scores is interpreted in favor of a sleep disorder. T-score tables are available in the original scale in order to provide recommendations. Accordingly, the presence of sleep disorder symptoms is accepted in those with a score above 70. 9,10 Data were analyzed with IBM SPSS V23. Suitability to the normal distribution was examined with Kolmogorov-Smirnov and Shapiro-Wilk. Mann-Whitney U test and Kruskal-Wallis test were used to compare data not showing normal distribution. The relationship between variables was analyzed using Spearman correlation analysis. The data not showing a normal distribution were given as median (minimum-maximum). The level of significance was taken as P < .05. The total number of participants was 114 parents: 64 (56%) of the children were girls and 50 (43.9%) were boys. The number of participants with children who have had COVID-19 was 38. The average age was: 11.32 ± 3.017 (min = 6; max = 16), and the SDSC mean was 40.80 ± 9.139 (min = 27; max = 74). The frequency distributions of the study group, their relations with variables according to COVID-19 status and general variables are shown in Table 1 . There was no statistically significant relationship found between COVID-19 status and the variables examined in general, and the proportion of participants who stated that if the pandemic period prolonged and COVID-19 would not change their diet were found to be statistically significant (Table 1) . SDSC score distributions do not show statistically significant variation according to the factors examined except gender. It was found to be significantly higher in girls (P < .05) ( Table 2 ). When we examine the relationship between age and the SDSC score, no significant relationship was found (Table 3 ). The present study includes sleep and nutrition topics being the two main components for the health of children and quality of life during the COVID-19 pandemic period. In our study, it was found that the nutrition status of children did not show a significant change during the pandemic period. However, sleep disorders were found to be more common in girls. in the original scale study, and as 39.3 ± 7.8 in the study by Huang et al. 8, 9, 11, 12 Our study was conducted during a special period such as the pandemic period; the reason it was found to be slightly higher than the averages given in other studies was considered to be because of the effect of the changes in the general lifestyle of children in this special period. In the Turkish validity and reliability study of the SDSC by Ağadayı et al, sleep disturbances were observed over 70 points in children at a rate of 4%, 9 and in our study, it was calculated over 70 points in 2.6% of children. In addition, the effect of going through the COVID-19 infection on scale scores was evaluated in this study. However, it was seen that it had no effect. In the study, when the children were evaluated in terms of factors that could affect their SDSC scores, it was observed that the SDSC scores of girls were statistically significantly higher than that of boys. In many studies in the literature, it has been stated that sleep disorders are observed more frequently in boys. 13 However, SDSC scores were found to be higher in girls as a result of our study, explaining hormonal changes in the relevant literature 14, 15 ; the fact that the stress factor may create different results according to gender may also be a result specific to this period. There was no statistical difference between nutritional status and changes made and SDSC scores. Sleep problems are common for the adolescent age group. It is very important to raise awareness among adolescents about the effect of sleep quality on growth-development and academic success. [16] [17] [18] Because of the pandemic, there was not enough participants to make a separate evaluation for the adolescent age group, which is a special group in the age range we evaluated in our study. In order to minimize the losses caused by the difficulties experienced during the COVID-19 Pandemic, attention should be given to sleep and nutrition which have a significant place in the quality of life, for all ages both for girls and boys. The higher frequency of sleep disorders in girls reveals the need for parents to be more attentive to these issues in the present study. All of the authors declares that they have no conflict of interest concerning the research, authorship or publication of this article. Research involves only human participants. Informed consent was obtained from all individual participants included in the study. Data sharing not applicable to this article as no datasets were generated or analyzed during the current study. Common sleep disorders in children Management of childhood sleep disorders Diagnosis and management of common sleep problems in children Prevalence of sleep disorders among primary school children Sleep disorders during childhood: a practical review Sleep disorders in children Pediatric sleep questionnaires as diagnostic or epidemiological tools: a review of currently available instruments Çocuklar İçin Uyku Bozukluğu Ölçeğinin Türkçe Geçerlik ve Güvenirlik Çalışması The sleep disturbance scale for children (SDSC) construction and validation of an instrument to evaluate sleep disturbances in childhood and adolescence Salgınların sosyal-psikolojik görünümü: Covid-19 (Koronavirüs) pandemi örneği Changes in lifestyle behaviours during the COVID-19 confinement in Spanish children: a longitudinal analysis from the MUGI project Evaluation of behavioral modification for children with poor appetite Validationof the sleep disturbance scale for children and prevalence of parent reported sleep disorder symptoms in Chinese children Sleep patterns and problems among Chinese adolescents The sleep quality in adolescents and the factors that affect it Sleep problems in adolescence and the effective factors 0858 Teenage girls report higher ımpact of sleepiness during school and personal activities than teenage boys Evaluation of the effect of the COVID-19 pandemic on sleep disorders and nutrition in children