Q2. What future works have the authors mentioned in the paper "Changes in sleep patterns and disturbances in children and adolescents in italy during the covid-19 outbreak" ?
Public health messages regarding the importance of sleep schedules and sleep quality for children and adolescents should be disseminated by health/school authorities: a ) sunlight exposure during daytime hours should be encouraged by parents/guardians ; b ) bedtimes/waketimes should be established ; c ) screen devices should be removed from bedrooms to limit blue light exposure ; d ) use of developmentally appropriate educational tools should be associated with extended family members/friends reading to promote feelings of connectiveness [ 33 ]. Future research should examine whether the COVID-19 crisis and associated physical distancing impact child and adolescent sleep over time, or if special subgroups, such as those with neurodevelopmental diseases, experience more severe or longer-term sleep disturbances. The impact of the COVID-19 pandemic might cause in children and adolescents very severe repercussions that, if not addressed, could have even worse outcomes in the future. The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Q3. What is the effect of delaying school start time?
It is widely recognized that delaying high school start time could extend adolescent school night sleep duration and lower their need to catch-up sleep on weekends, suggesting that later start time could be a durable strategy for counteracting population-wide adolescent sleep deficits.
Q4. What is the main finding of the study?
An important finding of their study is the increase of specific sleep disturbances, mainly represented by falling asleep difficulties, anxiety at bedtime, nightmares, and sleep terrors that were evident in the three younger age groups.
Q5. What are the possible causes of sleep disturbances in children and adolescents in Italy?
sleep disturbances might also be associated to increased levels of stress, due to possible changes in family financial conditions, health concerns, and uncertainty about the future [4].
Q6. What is the main reason why the increase in sleep disturbances in children is related to anxiety?
The increase in symptoms of insomnia, nightmares and sleep terrors in their younger children might be related to the anxiety for the uncertainty about the pandemic, as reported also in adults by different studies [1,10,21] or high school students [22].
Q7. What was the effect of the lockdown on children and adolescents?
The lockdown involved also schools, children and adolescents were confined to their homes for an extended period of time, with schools remaining closed and students only allowed to follow online lessons.
Q8. What is the effect of the parental-report nature of the study?
The parental-report nature of the study may affect their findings and it is possible that the parental perception of their child behavior was heightened during the lockdown, with a potential inadvertent bias in their responses.
Q9. What is the significance of sleep in children and adolescents?
It is known that sleep is crucial for child and adolescent health and wellbeing and the potential for sleep problems to emerge or worsen during home confinement is high.
Q10. What is the reason why the sleep disturbances did not worsen in adolescents?
The fact that sleep disturbances did not worsen in adolescents might be related to the fact that, as mentioned above, the changes observed during lockdown simply made their sleep-wake schedule more compliant with their physiological sleep need.
Q11. What are the main effects of home confinement on adolescents?
All these restrictions might impact even more adolescents, increasing their loneliness, negative affect, lethargy and napping behaviors, screen time and social networking, impacting their sleep quality and schedule.
Q12. What might be influenced by the degree of sleep disorder in some individuals?
This might be influenced by the degree to which people are engaging in coping strategies during the pandemic [28,30,31] or to the fact that home confinement might allow a better adherence to good sleep hygiene behaviors in some individuals.
Q13. What are the main limitations of the present study?
The present research, similarly to other recent studies on the COVID-19 pandemic, used retrospective questions with the risk of pitfalls and biases although data elicited by retrospective questions are quite consistent.
Q14. What is the significance of the increase in the frequency of nightmares in the study?
In particular, the significant increase in frequency of nightmares, in all agegroups but adolescents, might be interpreted as an indicator of acute stress symptomatology linked to COVID-19; this interpretation was also mentioned in an adult Italian study [9].
Q15. How many items were selected for the compilation by parents?
The authors grouped questions related to sleep disordered breathing into one question and selected, in total, 13 items in order to facilitate the compilation by parents.