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Sleep quality, alertness and mood state of day-night-shift university students during COVID-19 Pandemic


The sleep-wake rhythm irregularities can cause poor sleep quality and mood changes, such as increased fatigue and sleepiness in the students in consequence of the academic tasks and social life.


The objective of this study was to verify the sleep quality, sleepiness, alertness state and mood state of the university students prior to the day-night-shift classes (online) during the COVID-19 Pandemic.


One hundred sixty-eight university students of both sexes, with a mean age of 23.8±5.4 years, registered from the 2nd to the 7th period in three courses (Medicine, Nursing and Physiotherapy) of the two Brazilian private university in the day (n=90) and night-shift (n=78) were participated of this study. The measurements of sleep quality (Pittsburgh Sleep Quality Index - PSQI), sleepiness (Epworth Sleepiness Scale), alertness state (Karolinska Sleepiness Scale), mood state (Brazil Mood Scale - BRAMS), fatigue (FB) and vigor BRAMS domains (VB) were performed immediately prior to the classes online (day shift = 7h00; night shift = 19h00). The normality of the data was verified using the Kolmogorov-Smirnov test. The Mann-Whitney U test of independent samples was used to compare the variables between day-shift and night-shift university students. The size of the Cohen effect (ES) was estimated. The α-level for all analysis was set at ≤0.05.


The results showed there was a significant difference in sleep quality, fatigue mood domain, and alertness state between university students in the day and night shifts: sleep quality - PSQI (U= 2789.5; p=0.02; ES=0.46), alertness state - KSS (U= 2933.0; p=0.04, ES=0.48) and FB mood domain (U= 2877.0; p=0.05; ES=0.31). However, there was no difference in sleepiness (ESS) and Vigor mood domain (BRAMS) between day-shift and night-shift students. Therefore, the night-shift university students showed a significant worsening of the sleep quality, fatigue mood and alertness state compared to the day-shift students prior the classes.


The results indicated that night-shift students were inattentive, fatigue, and sleepy prior to their academic activities (classes), in addition to presenting poor sleep quality (IQSP>5). Thereby, strategies implementation such as naps, restorative sleep, blue light therapy, and sleep hygiene are important to improve the alertness, attention, general health, and academic performance of the university students during the COVID-19 Pandemic.


Student Health, Circadian Rhythm, Sleep Habits


Área Clínica


Centro Universitário Estácio Belo Horizonte (ESTACIO BH) - Minas Gerais - Brasil, Centro Universitário Mário Palmério (UNIFUCAMP) - Minas Gerais - Brasil, Escola de Artes, Ciências e Humanidades Universidade de São Paulo (EACH-USP) - São Paulo - Brasil, Instituto Master de Ensino IMEPAC (IMEPAC) - Minas Gerais - Brasil, Pontifícia Universidade Católica de Minas Gerais (PUC/MG) (PUC/MG) - Minas Gerais - Brasil


Fernanda Veruska Narciso, Maria Paula Yamaguti, Mariane Resende David, Matheus Araújo, Mariana Ingrid Messias Gonçalves, Marcos André Macedo do Vale Silva, Adriana Neves Silva Carvalho, Fernanda Viegas, Bruno Gonçalves, Vanessa Silva Lemos