Evening-types show highest increase of sleep and mental health problems during the COVID-19 pandemic - Multinational study on 19,267 adults

Ilona Merikanto, Laura Kortesoja, Christian Benedict, Frances Chung, Jonathan Cedernaes, Colin A. Espie, Charles M. Morin, Yves Dauvilliers, Markku Partinen, Luigi De Gennaro, Yun Kwok Wing, Ngan Yin Chan, Yuichi Inoue, Kentaro Matsui, Brigitte Holzinger, Giuseppe Plazzi, Sérgio Arthuro Mota-Rolim, Damien Leger, Thomas Penzel, Bjorn Bjorvatn

Research output: Contribution to journalArticleScientificpeer-review


Study objectives: Individual circadian type is a ubiquitous trait defining sleep, with eveningness often associated with poorer sleep and mental health than morningness. However, it is unknown whether COVID-19 pandemic has differentially affected sleep and mental health depending on the circadian type. Here, the differences in sleep and mental health between circadian types are examined globally before and during the COVID-19 pandemic.

Methods: The sample collected between May and August 2020 across 12 countries/regions consisted of 19,267 adults with information on their circadian type. Statistical analyses were performed by using Complex Sample procedures, stratified by country and weighted by the number of inhabitants in the country/area of interest and by the relative number of responders in that country/area.

Results: Evening-types had poorer mental health, well-being, and quality of life or health than other circadian types during the pandemic. Sleep-wake schedules were delayed especially on working days, and evening-types reported an increase in sleep duration. Sleep problems increased in all circadian types, but especially among evening-types, moderated by financial suffering and confinement. Intermediate-types were less vulnerable to sleep changes, although morningness protected from most sleep problems. These findings were confirmed after adjusting for age, sex, duration of the confinement or socio-economic status during the pandemic.

Conclusions: These findings indicate an alarming increase in sleep and mental health problems, especially among evening-types as compared to other circadian types during the pandemic.

Keywords: Chronotype; Circadian Rhythms; Coronavirus; Depression; Eveningness; Insomnia; Sleep quality; Stress.
Original languageEnglish
Article number216
Issue number2
Number of pages13
Publication statusPublished - 14 Feb 2022
MoE publication typeA1 Journal article-refereed

Fields of Science

  • chronotype
  • circadian rhythms
  • coronavirus
  • depression
  • eveningness
  • insomnia
  • sleep quality
  • stress
  • 3112 Neurosciences
  • 3124 Neurology and psychiatry
  • 3121 General medicine, internal medicine and other clinical medicine

Cite this