Impact of the COVID-19 pandemic on sleep quality and sleep bruxism in children eight to ten years of age

Lima, Larissa Chaves Morais de; Leal, Tiago Ribeiro; AraúJo, Luíza Jordânia Serafim de; Sousa, Myrelle Leal Campos; Silva, Samara Ellen da; Serra-Negra, Junia Maria Cheib; Ferreira, Fernanda de Morais; Paiva, Saul Martins; Granville-Garcia, Ana Flávia

doi:10.1590/1807-3107bor-2022.vol36.0046

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Original Research, Pediatric Dentistry • Braz. oral. res. 36 • 2022 • https://doi.org/10.1590/1807-3107bor-2022.vol36.0046 linkcopy

Impact of the COVID-19 pandemic on sleep quality and sleep bruxism in children eight to ten years of age

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract:

This study aimed to determine the impact of the COVID-19 pandemic on sleep quality and possible sleep bruxism (SB) in children eight to ten years of age. The study hypothesis was that sleep disturbances influenced a higher occurrence of bruxism during the COVID-19 pandemic. A longitudinal study was conducted at two time points: in person prior to the COVID-19 pandemic (T1), and online during the pandemic (T2). The sample comprised 105 children. Parents/caregivers answered a questionnaire addressing sociodemographic characteristics, the use of electronic devices, reported (vs. clinical) SB, and the Sleep Disturbance Scale for Children (SDSC) at both T1 and T2. McNemar’s and Wilcoxon’s tests were used to compare SB and sleep disorders at both time points. Poisson regression analysis determined the relative risk (RR) among the variables, and the incidence of possible SB (p≤0.05). The comparison of the two time points (T1 and T2) revealed a significant increase in possible SB (p<0.01) and sleep disorders (p < 0.04). Children whose parents had a lower schooling level (RR: 2.67; 95%CI: 1.19–6.01), those with their own electronic devices (RR: 1.97; 95%CI: 1.09–2.50), and those with sleep disorders during the pandemic (RR: 1.74; 95%CI: 1.35–2.24) were at greater risk of developing SB during the pandemic. Moreover, the incidence of bruxism and sleep disorders was greater during the pandemic. The factors influencing SB incidence during the pandemic were a lower level of mothers’ schooling, greater access to electronic devices, and the occurrence of sleep disorders.

Keywords Incidence; Bruxism; COVID-19; Child; Sleep Quality

Variable		n (%)
Sex
	Male	48 (45.7)
	Female	57 (54.3)
Ethnicity
	Non-White	67 (63.8)
	White	38 (36.2)
Mother’s schooling
	≤ 8 years of study	39 (37.1)
	> 8 years of study	66 (62.9)
Mother’s age
	≤ 35 years	60 (57.1)
	> 35 years	45 (42.9)
Number of residents in home
	≥ 6	89 (84.8)
	≤ 5	16 (15.2)
Monthly family income
	≤ R$ 1000	56 (53.3)
	> R$ 1000	32 (30.5)
Child’s position in family
	Youngest child	46 (43.8)
	Middle child	22 (20.0)
	Oldest child	37 (35.2)
Access to own electronic devices
	No	88 (83.8)
	Yes	17 (16.2)
Sleep disorder prior to pandemic
	Yes	66 (62.9)
	No	39 (37.1)
Sleep disorder during pandemic
	Yes	74 (70.5)
	No	31 (29.5)
Incidence of bruxism
	Yes	38 (36.2)
	No	67 (63.8)

Variable		Incidence of sleep bruxism		Bivariate		Multivariate
		Yes	No	Unadjusted RR^* * Poisson regression analysis unadjusted for independent variables and incidence of sleep bruxism;		Adjusted RR^ Poisson regression analysis adjusted for independent variables and incidence of sleep bruxism; Variables with p < 0.20 in bivariate analysis incorporated into multivariate model.
		n (%)	n (%)	p-value	(95%CI)	p-value	(95%CI)
Sex
	Male	17 (35.4)	31 (64.6)	0.88	–	–	–
	Female	21 (36.8)	36 (63.2)		–		–
Ethnicity
	White	13 (34.2)	25 (65.8)	0.75	–	–	–
	Non-White	25 (37.3)	42 (62.7)		–		–
Monthly family income
	≤ R$ 1000	18 (32.1)	38 (67.9)	0.27	–	–	–
	> R$ 1000	14 (43.8)	18 (56.3)		–		–
Mother’s age
	≤ 35 years	17 (28.3)	43 (71.7)	0.07	–	–	–
	> 35 years	20 (45.5)	24 (54.5)		–		–
Mother’s schooling
	≤ 8 years of study	20 (51.3)	19 (48.7)	0.01	1.88 (1.14–3.09)	0.01	2.67 (1.19–6.01)
	> 8 years of study	18 (27.3)	48 (72.7)		1		1
Number of residents in home
	≤ 5	35 (39.3)	54 (60.7)	0.11	–	–	–
	>5	3 (18.8)	13 (81.3)		–		–
Child’s position in family
	Oldest child	13 (35.1)	24 (64.9)	0.87	–	–	–
	Middle child	7 (33.3)	14 (66.7)		–		–
	Youngest child	18 (39.1)	28 (60.9)		–
Access to own electronic devices
	Yes	18 (62.1)	11 (37.9)	< 0.01	1.90 (1.09–3.90)	0.04	1.97 (1.09–2.50)
	No	20 (26.3)	56 (73.7)		1		1
Sleep disorder at T1
	Yes	29 (43.9)	37 (56.1)	0.03	1.90 (1.01–3.59)	–	–
	No	9 (23.1)	30 (76.9)		1		–
Sleep disorder at T2
	Yes	35 (47.3)	39 (52.7)	< 0.01	4.88 (1.62–14.71)	< 0.01	1.74 (1.35–2.24)
	No	3 (9.7)	28 (90.3)				1

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[TFN1] ^*
Poisson regression analysis unadjusted for independent variables and incidence of sleep bruxism;

[TFN2] ^**
Poisson regression analysis adjusted for independent variables and incidence of sleep bruxism; Variables with p < 0.20 in bivariate analysis incorporated into multivariate model.