When the coronavirus disease 2019 (COVID-19) pandemic reached Greece in February 2020, a national state of emergency was declared. Authorities responded swiftly with aggressive testing and containment measures, often resulting in local or national lockdowns, national school closures and social distancing measures (Parlapani et al., 2020). These lockdown policies, needed to be periodically re-instated to control COVID-19 recurrences during the following year, and Greeks were encouraged to shelter at home and to maintain parents’ work and children’s learning and play indoors. Online working and learning have been widely promoted to replace face-to-face activities until May 2021. These unprecedented changes interrupted family life, professional and academic routines, while both recreational and social relationships have been reduced.
The ongoing COVID-19 pandemic and the associated social restrictions through the pandemic lockdown period had an impact on mental health in the entire population (Hao et al., 2020; Sønderskov et al., 2020; Wang, Pen et al., 2020), while in earlier pandemics, such as severe acute respiratory syndrome pandemic (SARS-CoV-1 in 2003), studies showed the emerge of psychological distress along the pandemic or shortly thereafter (Peng et al., 2010). The emerging literature on COVID-19 crisis suggests that children may also experience increased emotional arousal, increased appetite and sleep disturbances as a result of the pandemic and the restrictive measures (Bruni et al., 2021; Liu et al., 2020). The enormous disruption to preschooler’s everyday routines may have had a significant impact on their health and development.
Poor sleep quality is associated with heightened stress and anxiety related to COVID-19 pandemic (Liu et al., 2020; Wang, Zhang et al., 2020). In addition, the significant disruptions to family lifestyles during home confinement, including prolonged screen exposure and nighttime exposure to screens’ bright light -which may suppress melatonin production-, displacing physical and outdoor activities and peer interaction, may also further exacerbate sleep disturbances (Lissak, 2018; Liu et al., 2020; Nagata et al., 2020). The reduction in active outdoor play and higher-intensity physical activity are directly associated with decreased physical activity levels and more sedentary time, as well as mental health deterioration (Herrington & Brussoni, 2015) and poor sleep in preschoolers (Belmon et al., 2019; Janssen et al., 2020).
The increases in overall screen time may result from activities that include entertainment, online education or/and self-directed learning and may also be an unavoidable reality among families where parents are working remotely. Although excessive screen time may be associated with higher health risks such as poor sleep, sedentary time as well as snacking, or even cardiovascular disease including obesity, high blood pressure, and insulin resistance (Lissak, 2018; Nagata et al., 2020), given the current measurements during COVID-19 pandemic, rises in screen time may be inevitable and even beneficial to foster positive youth development, socialization and education (Nagata et al., 2020). Most remote learning is conducted via screens, while toddlers need social interaction with trusted caregivers to develop their language, motor, cognitive, and social- emotional skills (Chassiakos et al., 2016). Children may also use social media, online activities and virtual games to stay socially connected with relatives, friends and peers while practicing social distancing. In addition, many parents use video chat (e.g. Viber, Skype, FaceTime, Zoom) as an interactive media platform that facilitates social connection with relatives.
It might be expected that eating habits would potentially improve during lockdown, since families staying at home may consume healthier dietary meals and less fast-food, but in contrast, recent studies, suggest the increase of stress- driven eating behaviors and poor eating habits due to the lack of emotional support from family and friends (Philippe et al., 2021; Lopez- Bueno et al., 2020). Higher diet quality, lower body mass index and higher levels of physical activity have been associated with longer sleep duration (Khan et al., 2015).
Most studies exploring COVID-19 effects on mental health and wellbeing have focused on older children and young people, while less attention has been paid on how national lockdowns and restrictive measures have affected the sleep of younger (preschool) children, who require greater parental supervision to manage their activities and habits during lockdown (Clark et al. 2020). In this study, parents of preschoolers (aged two- to six- year- old) shared their children’s experiences of the spring lockdown in 2021. This study aimed to provide important insights into the impact of the pandemic and confinement measures on sleep routines of preschool children in Greece.