Clinics (Nov 2021)

Poor Sleep quality and health-related quality of life impact in adolescents with and without chronic immunosuppressive conditions during COVID-19 quarantine

  • Alberto C. Helito,
  • Livia Lindoso,
  • Sofia M. Sieczkowska,
  • Camilla Astley,
  • Ligia B. Queiroz,
  • Natalia Rose,
  • Claudia Renata P. Santos,
  • Thalis Bolzan,
  • Rita María I.A. Peralta,
  • Ruth R. Franco,
  • Louise Cominato,
  • Rosa Maria R. Pereira,
  • Uenis Tannuri,
  • Lucia Maria A. Campos,
  • Benito Lourenço,
  • Ricardo K. Toma,
  • Karina Medeiros,
  • Andréia Watanabe,
  • Patricia Moreno Grangeiro,
  • Sylvia C. Farhat,
  • Caio B. Casella,
  • Guilherme V. Polanczyk,
  • Bruno Gualano,
  • Clovis A. Silva,
  • Adriana M. E. Sallum,
  • Amanda Y. Iraha,
  • Bianca P. Ihara,
  • Bruna C. Mazzolani,
  • Claudia A. Martinez,
  • Claudia A. A. Strabelli,
  • Claudia B. Fonseca,
  • Dandara C. C. Lima,
  • Debora N. D. Setoue,
  • Deborah F. P. Roz,
  • Fabiana I. Smaira,
  • Hamilton Roschel,
  • Helena T. Miyatani,
  • Isabela G. Marques,
  • Jane Oba,
  • Juliana C. O. Ferreira,
  • Juliana R. Simon,
  • Katia Kozu,
  • Ligia P. Saccani,
  • Lorena V. M. Martiniano,
  • Luana C. A. Miranda,
  • Luiz E. V. Silva,
  • Moisés F. Laurentino,
  • Nadia E. Aikawa,
  • Neusa K. Sakita,
  • Nicolas Y. Tanigava,
  • Paulo R. A. Pereira,
  • Patrícia Palmeira,
  • Simone S. Angelo,
  • Sofia S. M. Lavorato,
  • Tamires M. Bernardes,
  • Tathiane C. Franco,
  • Vivianne S. L. Viana,
  • Vera P. M. F. R. Barros,
  • Yingying Zheng

DOI
https://doi.org/10.6061/clinics/2021/e3501
Journal volume & issue
Vol. 76

Abstract

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OBJECTIVE: To assess the possible factors that influence sleep quality in adolescents with and without chronic immunosuppressive conditions quarantined during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This cross-sectional study included 305 adolescents with chronic immunocompromised conditions and 82 healthy adolescents. Online surveys were completed, which included questions on socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and the following validated questionnaires: the Pittsburgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), and Pediatric Outcome Data Collection Instrument (PODCI). RESULTS: The median current age [14 (10-18) vs. 15 (10-18) years, p=0.847] and frequency of female sex (62% vs. 58%, p=0.571) were similar in adolescents with chronic conditions compared with healthy adolescents. The frequency of poor sleep quality was similar in both groups (38% vs. 48%, p=0.118). Logistic regression analysis, including both healthy adolescents and adolescents with chronic conditions (n=387), demonstrated that self-reported increase in screen time (odds ratio [OR] 3.0; 95% confidence interval [CI] 1.3-6.8; p=0.008) and intrafamilial violence report (OR 2.1; 95% CI 1.2-3.5; p=0.008) were independently associated with poor sleep quality in these adolescents. However, the PODCI global function score was associated with a lower OR for poor sleep quality (OR 0.97; 95% CI 0.94-0.99; p=0.001). Further logistic regression, including only adolescents with chronic conditions (n=305), demonstrated that self-reported increase in screen time (OR 3.1; 95% CI 1.4-6.8; p=0.006) and intrafamilial violence report (OR 2.0; 95% CI 1.2-3.4; p=0.011) remained independently associated with poor quality of sleep, whereas a lower PODCI global function score was associated with a lower OR for sleep quality (OR 0.96; 95% CI 0.94-0.98; p<0.001). CONCLUSION: Self-reported increases in screen time and intrafamilial violence report impacted sleep quality in both healthy adolescents and those with chronic conditions. Decreased health-related quality of life was observed in adolescents with poor sleep quality.

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