Severe effects of the COVID-19 confinement on young children's sleep: A longitudinal study identifying risk and protective factors.

The COVID-19 confinement has dramatically altered daily routines, causing decreased sleep quality in adults. This necessitates careful observation, as sleep plays a crucial role in brain maturation and poor sleep increases the risk of psychopathology, particularly in the young population. Through an online survey with one baseline (April 2020) and two follow-up assessments (May and June 2020), we examined the effect of confinement on sleep quality in 452 babies (0-35 months) and 412 preschool children (36-71 months) from several, mainly European, countries. An acute decrease in sleep quality was found in both groups of children. However, at follow-up assessments, this effect rebounded to the level reported for the period before the confinement. Importantly, caregiver's stress level was identified as a substantial risk factor determining lower sleep quality in both groups of children across assessments. Protective factors conserving children's sleep quality included caregiver's engagement in mindfulness techniques or childcare, and the presence of siblings and pets. In the near future, we may repeatedly experience the circumstances of abruptly enforced confinement. Our findings reveal promising pathways of action to protect young children's sleep, with which to essentially mitigate the long-term consequences of the pandemic on brain development and mental health.

Associations between Social Contact, Sleep and Dietary Patterns among Children: A Cross-Sectional Study.

Social isolation in adults can be associated with altered sleep and eating behavior. This study aimed to investigate the interactions between the extent of social contact, eating behavior and sleep in infants and preschool children. In an observational study, 439 caregivers of 562 children aged 0-6 years provided information on sleep (i.e., duration, latency, bedtimes and nighttime awakenings), eating behaviors (i.e., meal size, consumption of sweet snacks, salty snacks, fruits and vegetables) and social contact (i.e., quarantine status, household size, social activities) during the COVID-19 pandemic (April 2020). In infants (0-3 years), the change in meal size and consumption of snacks, fruits, and vegetables did not significantly relate to the extent of social contact. For preschool children (3-6 years), a trend was observed, suggesting that quarantine status was associated with increased meal size. Changes in sleep duration, sleep latency, bedtimes and nighttime awakenings from before to during the pandemic were not significantly linked to the three variables quantifying social contact in both age groups. This study highlights that, contrary to expectations, the extent of social contact has negligible associations with infants' and preschool children's sleep and eating behaviors. These findings indicate that other factors beyond social isolation play a role in shaping children's eating habits and sleep patterns.

Sleep as a protective factor of children's executive functions: A study during COVID-19 confinement.

Confinements due to the COVID-19 outbreak affected sleep and mental health of adults, adolescents and children. Already preschool children experienced acutely worsened sleep, yet the possible resulting effects on executive functions remain unexplored. Longitudinally, sleep quality predicts later behavioral-cognitive outcomes. Accordingly, we propose children's sleep behavior as essential for healthy cognitive development. By using the COVID-19 confinement as an observational-experimental intervention, we tested whether worsened children's sleep affects executive functions outcomes 6 months downstream. We hypothesized that acutely increased night awakenings and sleep latency relate to reduced later executive functions. With an online survey during the acute confinement phase we analyzed sleep behavior in 45 children (36-72 months). A first survey referred to the (retrospective) time before and (acute) situation during confinement, and a follow-up survey assessed executive functions 6 months later (6 months retrospectively). Indeed, acutely increased nighttime awakenings related to reduced inhibition at FOLLOW-UP. Associations were specific to the confinement-induced sleep-change and not the sleep behavior before confinement. These findings highlight that specifically acute changes of children's nighttime sleep during sensitive periods are associated with behavioral outcome consequences. This aligns with observations in animals that inducing poor sleep during developmental periods affects later brain function.

Lack of association between behavioral development and simplified topographical markers of the sleep EEG in infancy.

The sleep EEG mirrors neuronal connectivity, especially during development when the brain undergoes substantial rewiring. As children grow, the slow-wave activity (SWA; 0.75-4.25 Hz) spatial distribution in their sleep EEG changes along a posterior-to-anterior gradient. Topographical SWA markers have been linked to critical neurobehavioral functions, such as motor skills, in school-aged children. However, the relationship between topographical markers in infancy and later behavioral outcomes is still unclear. This study aims to explore reliable indicators of neurodevelopment in infants by analyzing their sleep EEG patterns. Thirty-one 6-month-old infants (15 female) underwent high-density EEG recordings during nighttime sleep. We defined markers based on the topographical distribution of SWA and theta activity, including central/occipital and frontal/occipital ratios and an index derived from local EEG power variability. Linear models were applied to test whether markers relate to concurrent, later, or retrospective behavioral scores, assessed by the parent-reported Ages & Stages Questionnaire at ages 3, 6, 12, and 24 months. Results indicate that the topographical markers of the sleep EEG power in infants were not significantly linked to behavioral development at any age. Further research, such as longitudinal sleep EEG in newborns, is needed to better understand the relationship between these markers and behavioral development and assess their predictive value for individual differences.