{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:53:48Z","timestamp":1760057628194,"version":"build-2065373602"},"reference-count":68,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Vice Rectorate of Research, La Salle University, Mexico","award":["ID34-2020"],"award-info":[{"award-number":["ID34-2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clocks &amp; Sleep"],"abstract":"<jats:p>Home confinement due to Coronavirus Disease 2019 (COVID-19) led to lifestyle changes that increased sleep disturbances, particularly in areas with higher infection and mortality rates. This study is a retrospective study based on data collected through an online survey conducted during the COVID-19 confinement. It aims to analyze changes in sleep quantity and quality and their association with lifestyle changes in the metropolitan area of Mexico City. A total of 899 adults from this area completed an online questionnaire between June 2020 and February 2021. This study assessed sleep quantity, sleep quality, insomnia symptoms, and lifestyle changes during the confinement period. Results showed that sleep quantity increased (7.10 \u00b1 1.37 vs. 7.43 \u00b1 1.42 h, p &lt; 0.0001), with more participants, especially young adults and women, reporting later bed and wake-up times. The Pittsburgh Sleep Quality Index increased by 1.4 units, with poor sleep quality associated with lifestyle during confinement. Insomnia symptoms, sleep latency, and poor sleep quality also increased, particularly in women. Males and those without chronic comorbidities were less likely to experience poor sleep quality, while tobacco use and later bedtimes increased this risk. This study concludes that, while sleep quantity increased, sleep quality declined, particularly among young adults, women, and those with unhealthy lifestyles. These findings could guide sleep health initiatives tailored to specific lifestyle changes in different population groups.<\/jats:p>","DOI":"10.3390\/clockssleep7010006","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T11:31:17Z","timestamp":1739791877000},"page":"6","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sleep Alterations in the Population of the Metropolitan Area of Mexico and Their Association with Lifestyle Changes During COVID-19 Confinement"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2278-0776","authenticated-orcid":false,"given":"Mar\u00eda del Rosario","family":"Ayala-Moreno","sequence":"first","affiliation":[{"name":"Research Group Study of Non-Communicable Diseases and Aging, La Salle University, Mexico City 06140, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3867-3382","authenticated-orcid":false,"given":"Paola Andrea","family":"Mart\u00ednez-Serrano","sequence":"additional","affiliation":[{"name":"Research Group Study of Non-Communicable Diseases and Aging, La Salle University, Mexico City 06140, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8144-6877","authenticated-orcid":false,"given":"Montserrat Alheli","family":"Melgarejo-Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Laboratorio de Neurobiolog\u00eda del Sue\u00f1o y Metabolismo, Facultad de Medicina, Universidad Veracruzana, Veracruz 91010, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alma Rosa","family":"Hern\u00e1ndez-Mondrag\u00f3n","sequence":"additional","affiliation":[{"name":"Research Group in Management and Leadership for Innovation and Quality of Education, La Salle University, Mexico City 06140, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4147-5240","authenticated-orcid":false,"given":"Azucena","family":"Mart\u00ednez-Basila","sequence":"additional","affiliation":[{"name":"Research and Metabolism Center, Mexico City 03840, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Araceli","family":"Mart\u00ednez-Coronado","sequence":"additional","affiliation":[{"name":"Department of Biological and Health Sciences, Metropolitan Autonomous University, Mexico City 04960, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6649-8659","authenticated-orcid":false,"given":"Mar\u00eda Jos\u00e9","family":"Losana-Valencia","sequence":"additional","affiliation":[{"name":"Research Group Study of Non-Communicable Diseases and Aging, La Salle University, Mexico City 06140, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3657-1764","authenticated-orcid":false,"given":"Esther","family":"Vargas-Medina","sequence":"additional","affiliation":[{"name":"Research Group Study of Non-Communicable Diseases and Aging, La Salle University, Mexico City 06140, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eloisa","family":"Col\u00edn-Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Direcci\u00f3n de Nutrici\u00f3n, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Mexico City 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana","family":"Ben\u00edtez-Rico","sequence":"additional","affiliation":[{"name":"Research Group Study of Non-Communicable Diseases and Aging, La Salle University, Mexico City 06140, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,17]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2021, February 03). Coronavirus (COVID-19) Dashboard. Situation by Region, Country, Territory & Area., Available online: https:\/\/covid19.who.int\/table."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Di Renzo, L., Gualtieri, P., Pivari, F., Soldati, L., Attin\u00e0, A., Cinelli, G., Leggeri, C., Caparello, G., Barrea, L., and Scerbo, F. (2020). Eating habits and lifestyle changes during COVID-19 lockdown: An Italian survey. J. Transl. Med., 18.","DOI":"10.1186\/s12967-020-02399-5"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Hu, Z., Lin, X., Kaminga, A.C., and Xu, H. (2020). Impact of the COVID-19 epidemic on lifestyle behaviors and their association with subjective well-being among the general population in Mainland China: Cross-sectional study. J. Med. Int. Res., 22.","DOI":"10.2196\/preprints.21176"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1007\/s40279-020-01295-8","article-title":"The Challenge of Maintaining Metabolic Health During a Global Pandemic","volume":"50","author":"King","year":"2020","journal-title":"Sports Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1152\/physrev.00010.2018","article-title":"The Sleep-Immune Crosstalk in Health and Disease","volume":"99","author":"Besedovsky","year":"2019","journal-title":"Physiol. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Sampasa-Kanyinga, H., Colman, I., Goldfield, G.S., Janssen, I., Wang, J.L., Podinic, I., Tremblay, M.S., Saunders, T.J., Sampson, M., and Chaput, J.P. (2020). Combinations of physical activity, sedentary time, and sleep duration and their associations with depressive symptoms and other mental health problems in children and adolescents: A systematic review. Int. J. Behav. Nutr. Phys. Act., 17.","DOI":"10.1186\/s12966-020-00976-x"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Kwok, C.S., Kontopantelis, E., Kuligowski, G., Gray, M., Muhyaldeen, A., Gale, C.P., Peat, G.M., Cleator, J., Chew-Graham, C., and Loke, Y.K. (2018). Self-Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose-Response Meta-Analysis. J. Am. Heart Assoc., 7.","DOI":"10.1161\/JAHA.118.008552"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"45","DOI":"10.5664\/jcsm.8800","article-title":"Escalation of sleep disturbances amid the COVID-19 pandemic: A cross-sectional international study","volume":"17","author":"Mandelkorn","year":"2021","journal-title":"J. Clin. Sleep Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"299","DOI":"10.5664\/jcsm.8930","article-title":"Sleep problems during the covid-19 pandemic by population: A systematic review and meta-analysis","volume":"17","author":"Jahrami","year":"2021","journal-title":"J. Clin. Sleep Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s00415-020-10056-6","article-title":"Impacto f COVID-19 lockdown on sleep quality in university students and administration staff","volume":"268","author":"Marelli","year":"2020","journal-title":"J. Nurol"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"654","DOI":"10.17269\/s41997-020-00382-7","article-title":"Sleep and circadian rhythm in response to the COVID-19 pandemic","volume":"111","author":"Morin","year":"2020","journal-title":"Can. J. Public Health"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Shalev-Antsel, T., Winocur-Arias, O., Friedman-Rubin, P., Naim, G., Keren, L., Eli, I., and Emodi-Perlman, A. (2023). The continuous adverse impact of COVID-19 on temporomandibular disorders and bruxism: Comparison of pre- during- and post-pandemic time periods. BMC Oral. Health, 23.","DOI":"10.1186\/s12903-023-03447-4"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Peixoto, K.O., Resende, C.M.B.M., Almeida, E.O., Almeida-Leite, C.M., Conti, P.C.R., Barbosa, G.A.S., and Barbosa, J.S. (2021). Association of sleep quality and psychological aspects with reports of bruxism and TMD in Brazilian dentists during the COVID-19 pandemic. J. Appl. Oral. Sci., 29.","DOI":"10.1590\/1678-7757-2020-1089"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Xiao, H., Zhang, Y., Kong, D., Li, S., and Yang, N. (2020). The Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease 2019 (COVID-19) in January and February 2020 in China. Med Sci Monit, 26.","DOI":"10.12659\/MSM.923549"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., Wu, J., Du, H., Chen, T., and Li, R. (2020). Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open, 3.","DOI":"10.1001\/jamanetworkopen.2020.3976"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Liu, D., Liu, S., Zhu, L., Li, D., Huang, D., Deng, H., Guo, H., Huang, D., Liao, Y., and Mao, Z. (2020). Prevalence and Related Factors of Insomnia Among Chinese Medical Staff in the Middle and Late Stage of COVID-19. Front. Psychiatry, 11.","DOI":"10.3389\/fpsyt.2020.602315"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.jpsychires.2020.07.008","article-title":"Psychological impact of coronavirus disease (2019) (COVID-19) epidemic on medical staff in different posts in China: A multicenter study","volume":"129","author":"Wang","year":"2020","journal-title":"J. Psychiatr. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.sleep.2020.05.018","article-title":"The immediate impact of the 2019 novel coronavirus (COVID-19) outbreak on subjective sleep status","volume":"77","author":"Lin","year":"2021","journal-title":"Sleep Med."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Cellini, N., Canale, N., Mioni, G., and Costa, S. (2020). Changes in sleep pattern, sense of time, and digital media use during COVID-19 lockdown in Italy. J. Sleep Res., 29.","DOI":"10.1111\/jsr.13074"},{"key":"ref_20","unstructured":"Shamah, L.T., G\u00f3mez-Acosta, L.M., Mundo-Rosas, V., Cuevas-Nasu, L., Gaona-Pineda, E.B., Avila-Arcos, M.A., G\u00f3mez-Humar\u00e1n, I.M., and Rivera-Dommarco, J.A. (2020). Ensars-Cov-2. Resultados de la Evaluaci\u00f3n Basal de la Encuesta Nacional de las Caracter\u00edsticas de la Poblaci\u00f3n Durante la Pandemia de COVID-19, Instituto Nacional de Salud P\u00fablica. Available online: https:\/\/cutt.ly\/KSJoA9L."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1037\/amp0000850","article-title":"Sleep in a pandemic: Implications of COVID-19 for sleep through the lens of the 3P model of insomnia","volume":"76","author":"Cox","year":"2021","journal-title":"Am. Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Sadekar, P., Baitinger, J., Conway, S., Clark, M., and Doryab, A. (2023, January 27\u201328). Personalization in Circadian Rhythm-Based Event Scheduling. Proceedings of the Systems and Information Engineering Design Symposium (SIEDS), Charlottesville, VA, USA.","DOI":"10.1109\/SIEDS58326.2023.10137806"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"279","DOI":"10.4300\/JGME-D-12-00156.1","article-title":"Using Effect Size-or Why the P Value Is Not Enough","volume":"4","author":"Sullivan","year":"2012","journal-title":"J. Grad. Med Educ."},{"key":"ref_24","unstructured":"Cohen, J. (1988). Statistical Power. Analysis for the Behavioral Sciences, LEA Publishers. [2nd ed.]."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research","volume":"28","author":"Buysee","year":"1989","journal-title":"Psychiatry Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1017\/S0029665117003974","article-title":"Sleep and dietary habits in the urban environment: The role of chrono-nutrition","volume":"77","author":"Pot","year":"2018","journal-title":"Proc. Nutr. Soc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"347","DOI":"10.21149\/9280","article-title":"Prevalencia de s\u00edntomas de sue\u00f1o y riesgo de apnea obstructiva del sue\u00f1o en M\u00e9xico","volume":"60","year":"2018","journal-title":"Salud P\u00fablica M\u00e9xico"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Hublin, C., Haasio, L., and Kaprio, J. (2020). Changes in self-reported sleep duration with age\u2014A 36-year longitudinal study of Finnish adults. BMC Public Health, 20.","DOI":"10.1186\/s12889-020-09376-z"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1038\/498427a","article-title":"Chronobiology: The human sleep project","volume":"498","author":"Roenneberg","year":"2013","journal-title":"Nature"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Chattu, V.K., Manzar, M.D., Kumary, S., Burman, D., Spence, D.W., and Pandi-Perumal, S.R. (2019). The Global Problem of Insufficient Sleep and Its Serious Public Health Implications. Healthcare, 7.","DOI":"10.3390\/healthcare7010001"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.sleh.2021.02.008","article-title":"Changes in sleep duration, timing, and variability during the COVID-19 pandemic: Large-scale Fitbit data from 6 major US cities","volume":"7","author":"Rezaei","year":"2021","journal-title":"Sleep Health"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1093\/eurpub\/ckaa208","article-title":"Sleep pattern in the US and 16 European countries duringtheCOVID-19 outbreak using crowdsourced smartphone data","volume":"31","author":"Lee","year":"2020","journal-title":"Eur. J. Public Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"R795","DOI":"10.1016\/j.cub.2020.06.021","article-title":"Effects of the COVID-19 lockdown on human sleep and rest-activity rhythms","volume":"30","author":"Blume","year":"2020","journal-title":"Curr. Biol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Ong, J.L., Lau, T.Y., Massar, S.A.A., Chong, Z.T., Ng, B.K.L., Koek, D., Zhao, W., Yeo, B.T.T., Cheong, K., and Cheel, M.W.L. (2021). COVID-19 related mobility reduction: Heterogeneous effects on sleep and physical activity rhythms. Sleep, 44.","DOI":"10.1093\/sleep\/zsaa179"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Priego-Parra, B.A., Triana-Romero, A., Pinto-G\u00e1lvez, S.M., Dur\u00e1n, R.C., Salas-Nolasco, O., Manriquez, R.M., Ramos-de-la-Medina, R., and Remes-Troche, J.M. (MedRxiv, 2020). Anxiety, depression, attitudes, and internet addiction during the initial phase of the 2019 coronavirus disease (COVID-19) epidemic: A cross-sectional study in M\u00e9xico, MedRxiv, 2020.05.10.20095844.","DOI":"10.1101\/2020.05.10.20095844"},{"key":"ref_36","first-page":"10","article-title":"The mediation role of sleep quality in the association between the incidence of unhealthy movement behaviors during the COVID-19 quarantine and mental health","volume":"76","author":"Werneck","year":"2020","journal-title":"SleepMed"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Lewis, R., Roden, L.C., Scheuermaier, K., Gomez-Olive, F.X., Rae, D.E., Iacovides, S., Bentley, A., Davy, J.P., Christie, C.J., and Zschernack, S. (2021). The impact of sleep, physical activity and sedentary behaviour on symptoms of depression and anxiety before and during the COVID-19 pandemic in a sample of South African participants. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-02021-8"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Caroppo, E., Mazza, M., Sannella, A., Marano, G., Avallone, C., Claro, A.E., Janiri, D., Moccia, L., Janiri, D., and Moccia, L. (2021). Will Nothing Be the Same Again?: Changes in Lifestyle during COVID-19 Pandemic and Consequences on Mental Health. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18168433"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1192\/bjp.2020.242","article-title":"Mental health before and during the COVID-19 pandemic in two longitudinal UK population cohorts","volume":"218","author":"Kwong","year":"2019","journal-title":"Br. J. Psychiatry"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.36740\/WLek202106122","article-title":"A study of physical activity levels and quality of life in Young adults during the COVID-19 pandemic","volume":"74","author":"Ovdii","year":"2021","journal-title":"Wiad. Lek."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.sleep.2020.05.011","article-title":"The enemy who sealed the world: Effects quarantine due to the COVID-19 on sleep quality, anxiety, and psychological distress in the Italian population","volume":"75","author":"Casagrande","year":"2020","journal-title":"Sleep Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"434","DOI":"10.2174\/1570159X14666161228122115","article-title":"Melatonin: Pharmacology, Functions and Therapeutic Benefits","volume":"15","author":"Tordjman","year":"2017","journal-title":"Curr. Neuropharmacol."},{"key":"ref_43","first-page":"317","article-title":"Chronodisruption, Metabolic Homeostasis, and the Regulation of Inflammation in Adipose Tissues","volume":"92","author":"Kolbe","year":"2019","journal-title":"Yale J. Biol. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1111\/jpi.12137","article-title":"Melatonin, energy metabolism, and obesity: A review","volume":"56","author":"Amaral","year":"2014","journal-title":"J. Pineal Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.neuroscience.2013.08.049","article-title":"Chronobiology and nutrition","volume":"253","author":"Tahara","year":"2013","journal-title":"Neuroscience"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/S0140-6736(20)30460-8","article-title":"The psychological impact of quarantine and how to reduce it: Rapid review of the evidence","volume":"395","author":"Brooks","year":"2020","journal-title":"Lancet"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Rivera-Rivera, N.R., McGuinn, L., Osorio-Valencia, E., Martinez-Medina, S., Schnaas, L., Wright, R.J., T\u00e9llez-Rojo, M.M., Wright, R.O., Tamayo-Ortiz, M., and Rosa, M.J. (2021). Changes in Depressive Symptoms, Stress and Social Support in Mexican Women during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18168775"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Avery, A.R., Tsang, S., Seto, E.Y.W., and Duncan, G.E. (2021). Differences in Stress and Anxiety Among Women With and Without Children in the Household During the Early Months of the COVID-19. Front. Public Health, 9.","DOI":"10.3389\/fpubh.2021.688462"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/23780231211006977","article-title":"The pandemic penalty: The gendered effects of COVID-19 on scientific productivity","volume":"7","author":"King","year":"2021","journal-title":"Socius"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Brown, S.M., Doom, J.R., Lechuga-Pe\u00f1a, S., Watamura, S.E., and Koppels, T. (2020). Stress and parenting during the global COVID-19 pandemic. Child. Abus. Negl., 110.","DOI":"10.1016\/j.chiabu.2020.104699"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Grossman, E.S., Hoffman, Y.S.G., Palgi, Y., and Shrirab, A. (2021). COVID-19 related loneliness and sleep problems in older adults: Worries and resilience as potential moderators. Pers. Individ. Dif., 168.","DOI":"10.1016\/j.paid.2020.110371"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.14336\/AD.2021.0319","article-title":"Social Distancing, and COVID-19 Risk: Who is more Vulnerable and Why?","volume":"12","author":"Faraji","year":"2021","journal-title":"Aging Dis."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Alves de Menezes-J\u00fanior, L.A., Silva de Moura, S., Gon\u00e7alves, M.A., de Souza, A.A.C., Lins Machado-Coelho, G.L., and Meireles, A.L. (2023). Sedentary behavior is associated with poor sleep quality during the COVID-19 pandemic, and physical activity mitigates its adverse effects. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-16041-8"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Jeong, S.H., Jang, B.N., Kim, S.H., Kim, G.R., Park, E.C., and Jang, S.I. (2021). Association between sedentary time and sleep quality based on the Pittsburgh Sleep Quality Index among South Korean adults. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-12388-y"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Shi, L., Lu, Z.A.L., Que, J.Y., Huang, X.L., Liu, L., Ran, M.S., Gong, Y.M., Yuan, K., Yan, W., and Sun, Y.K. (2020). Prevalence of and Risk Factors Associated With Mental Health Symptoms Among the General Population in China During the Coronavirus Disease 2019 Pandemic. JAMA, 3.","DOI":"10.1001\/jamanetworkopen.2020.14053"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s002130000383","article-title":"A naturalistic investigation of the effects of day-long consumption of tea, coffee and water on alertness, sleep onset and sleep quality","volume":"149","author":"Hindmarch","year":"2000","journal-title":"Psychopharmacology"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1080\/17461391.2020.1842910","article-title":"COVID-19 lockdown: Physical activity, sedentary behaviour and sleep in Italian medicine students","volume":"21","author":"Luciano","year":"2021","journal-title":"Eur. J. Sport. Sci."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"117","DOI":"10.2147\/NSS.S132078","article-title":"The effect of physical activity on sleep quality, well-being, and affect in academic stress periods","volume":"9","author":"Wunsch","year":"2017","journal-title":"Nat. Sci. Sleep"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.smrv.2016.01.006","article-title":"Coffee, caffeine, and sleep: A systematic review of epidemiological studies and randomized controlled trials","volume":"31","author":"Clark","year":"2017","journal-title":"Sleep Med. Rev."},{"key":"ref_60","first-page":"491","article-title":"Confiabilidad y an\u00e1lisis factorial de la versi\u00f3n en espa\u00f1ol del \u00edndice de calidad de sue\u00f1o de Pittsburgh en pacientes psiqui\u00e1tricos","volume":"144","year":"2008","journal-title":"Gac. M\u00e9d M\u00e9x"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1590\/1806-9282.66.s2.143","article-title":"Sleep and immunity in times of COVID-19","volume":"66","author":"Silva","year":"2020","journal-title":"Rev. Assoc. Med. Bras."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Garbarino, S., and Scoditti, E. (2021). On the role of sleep hygiene in health management during COVID-19. Sleep Med., 77.","DOI":"10.1016\/j.sleep.2020.11.036"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Giri, A., Srinivasan, A., and Sundar, I.K. (2021). COVID-19: Sleep, Circadian Rhythms and Immunity\u2014Repurposing Drugs and Chronotherapeutics for SARS-CoV-2. Front. Neurosci., 15.","DOI":"10.3389\/fnins.2021.674204"},{"key":"ref_64","unstructured":"Secretar\u00eda de Salud (SS) (2023, September 20). Comunicado_Tecnico_Diario_COVID-19. 28 Febrero 2021. Available online: https:\/\/acortar.link\/BrIY4b."},{"key":"ref_65","unstructured":"Creswell, J.W. (2010). Educational Research Planning, Conducting, and Evaluating Quantitative and Qualitative Research, Pearson Merril Prentice Hall. [4th ed.]."},{"key":"ref_66","first-page":"37","article-title":"Alfa de Cronbach para validar un cuestionario de uso de TIC en Docentes Universitarios","volume":"10","year":"2017","journal-title":"mktDescubre"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"61","DOI":"10.5664\/jcsm.2342","article-title":"Psychometric characteristics of the Pittsburgh Sleep Quality Index in English speaking non-Hispanic whites and English and Spanish speaking Hispanics of Mexican descent","volume":"9","author":"Tomfohr","year":"2013","journal-title":"J. Clin. Sleep Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.sleh.2014.12.010","article-title":"Adams HPJ National Sleep Foundation\u2019s sleep time duration recommendations: Methodology and results summary","volume":"1","author":"Hirshkowitz","year":"2015","journal-title":"Sleep Health"}],"container-title":["Clocks &amp; Sleep"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2624-5175\/7\/1\/6\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:36:16Z","timestamp":1760027776000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2624-5175\/7\/1\/6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,17]]},"references-count":68,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["clockssleep7010006"],"URL":"https:\/\/doi.org\/10.3390\/clockssleep7010006","relation":{},"ISSN":["2624-5175"],"issn-type":[{"type":"electronic","value":"2624-5175"}],"subject":[],"published":{"date-parts":[[2025,2,17]]}}}