# Impact of COVID-19 Lockdown on Screen Time and Sleep Quality Among Medical and Allied-Health Undergraduates in Chennai: A Cross-Sectional Study

## TL;DR

This study found that the COVID-19 lockdown increased screen time and worsened sleep quality among medical and allied-health students in Chennai.

## Contribution

The study provides empirical evidence linking increased screen time during lockdown to sleep disturbances in undergraduate students.

## Key findings

- Median screen time increased from 5 hours before lockdown to 8 hours during lockdown.
- Sleep problems rose from 14.3% before lockdown to 23.2% during lockdown.
- Higher screen time was associated with increased odds of poor sleep quality.

## Abstract

Background

The COVID-19 pandemic and subsequent lockdowns disrupted the daily routine of students. Increased screen exposure and altered sleep patterns emerged as potential long-term health concerns during this period. This study aimed to assess screen time and sleep quality among undergraduate students before and during the COVID-19 lockdown.

Methods

A cross-sectional study was conducted among 470 final-year undergraduate students in a medical teaching college and research institute in India from July to December 2020. Data were collected using a pre-tested semi-structured questionnaire, which included screen time, sleep quality assessed using the Pittsburgh Sleep Quality Index (PSQI), and gaming addiction using the Internet Gaming Disorder Scale-Short Form (IGDS9-SF). Information was obtained for periods before and during the lockdown. Statistical analyses included the Wilcoxon signed-rank test, the McNemar-Bowker test, and the multivariable logistic regression.

Results

The median screen time increased significantly during the lockdown compared to before (8 hours vs. 5 hours; p < 0.001). Usage of social media, streaming platforms (OTT (over-the-top)) platforms, and gaming also increased. The prevalence of sleep problems rose from 14.3% before lockdown to 23.2% during lockdown (p < 0.05). Logistic regression revealed a dose-response association between screen time and poor sleep quality: compared with <4 hours, adjusted odds ratios (AOR) were 3.3 (95%CI: 1.2-9.0) for 4-8 hours, 2.8 (95%CI: 0.98-8.1) for 8-12 hours, and 3.9 (95%CI: 1.3-11.6) for >12 hours. Depressive symptoms and higher fear of COVID-19 scores were also significant predictors of poor sleep.

Conclusions

The COVID-19 lockdown significantly increased screen time and sleep disturbances among undergraduate students. Monitoring digital media usage and providing appropriate advice on the importance of sleep are critical during public health crises to promote overall health and functioning among undergraduates.