COVID-19 Related Mobility Reduction: Heterogenous Effects on Sleep and Physical Activity Rhythms

Mobility restrictions imposed to suppress coronavirus transmission can alter physical activity (PA) and sleep patterns. Characterization of response heterogeneity and their underlying reasons may assist in tailoring customized interventions. We obtained wearable data covering baseline, incremental movement restriction and lockdown periods from 1824 city-dwelling, working adults aged 21 to 40 years, incorporating 206,381 nights of sleep and 334,038 days of PA. Four distinct rest activity rhythms (RARs) were identified using k-means clustering of participants' temporally distributed step counts. Hierarchical clustering of the proportion of time spent in each of these RAR revealed 4 groups who expressed different mixtures of RAR profiles before and during the lockdown. Substantial but asymmetric delays in bedtime and waketime resulted in a 24 min increase in weekday sleep duration with no loss in sleep efficiency. Resting heart rate declined 2 bpm. PA dropped an average of 38%. 4 groups with different compositions of RAR profiles were found. Three were better able to maintain PA and weekday/weekend differentiation during lockdown. The least active group comprising 51 percent of the sample, were younger and predominantly singles. Habitually less active already, this group showed the greatest reduction in PA during lockdown with little weekday/weekend differences. Among different mobility restrictions, removal of habitual social cues by lockdown had the largest effect on PA and sleep. Sleep and resting heart rate unexpectedly improved. RAR evaluation uncovered heterogeneity of responses to lockdown and can identify characteristics of persons at risk of decline in health and wellbeing.
Comment: 30 pages, 3 main figures, 3 tables, 4 supplementary figures