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Sleep quality and anxiety in mothers and their children during the COVID-19 pandemic: A cross-sectional survey


Sleep disorders and anxiety are common complaints during childhood. Mothers’ anxiety and depression symptoms might also affect children’s sleep quality in a negative way. Considering that both sleep and anxiety disorders might be affected by environmental factors, the social distancing and other circumstances related to the COVID-19 pandemic might increase the prevalence of anxiety and sleep complaints among mothers and their children.


To analyse the correlation between anxiety and sleep quality in mothers and children from 2 to 10 years old.


Mothers of children from 2 to 10 years old were invited to participate. The participants filled an online survey through Google forms, including a socio-demographic survey, anxiety and sleep questionnaires, both of their own (as a self-report) and of their children. Pittsburgh Sleep Quality Index (PSQI), and Depression, Anxiety and Stress Scale (DASS-21) were used to analyse symptoms on the mothers, while Children’s Sleep Habits Questionnaire (CSHQ) and Child Behavior Checklist (CBCL - both ½-5 and 6-18 years old versions) were used to analyse the children. The questionnaire was made available from August 2020 to January 2021. Data analysis was based on a Spearman correlation matrix and statistical significance level was set at 5%.


A total of 179 mothers were included in this study. Self-reported sleep quality decreased during the pandemic in 55% of the mothers. In relation to children, 40% of mothers reported that they noticed worsening of their sleep quality and 63% reported increased anxiety symptoms. Positive statistic significant correlations were observed between maternal sleep quality (PSQI) and maternal anxiety symptoms (DASS-21) (rho: 0.578, p<0.001), and between both mothers (PSQI) and children (CSHQ) sleep quality (rho: 0.318, p<0.001). A correlation between maternal sleep quality and anxiety symptoms in the children (CBCL) was observed only for children from 6-10 years old (rho:0,399, p=0.001), but not for those from 2-5 years old.


The COVID-19 pandemic has been a challenge to both maternal and children sleep and behavior. During this period, decreased sleep quality in the mothers was correlated with increased anxiety in both mothers and children, as well as with decreased sleep quality in the children.


Sleep; Anxiety; Children; Pediatrics; COVID-19


Área Clínica


Sara Nogueira Ribeiro, Claudia Berlim Mello, Andréia Gomes Bezerra, Sergio Tufik, Gustavo Moreira