A longitudinal analysis of COVID-19 lockdown stringency on sleep and resting heart rate measures across 20 countries

Lockdowns imposed to stem the spread of COVID-19 massively disrupted the daily routines of many worldwide, but studies to date have been mostly confined to observations within a limited number of countries, based on subjective reports and surveys from specific time periods during the pandemic. We investigated associations between lockdown stringency and objective sleep and resting-heart rate measures in ~ 113,000 users of a consumer sleep tracker across 20 countries from Jan to Jul 2020, compared to an equivalent period in 2019. With stricter lockdown measures, midsleep times were universally delayed, particularly on weekdays, while midsleep variability and resting heart rate declined. These shifts (midsleep: + 0.09 to + 0.58 h; midsleep variability: - 0.12 to - 0.26 h; resting heart rate: - 0.35 to - 2.08 bpm) correlated with the severity of lockdown across different countries (all Ps < 0.001) and highlight the graded influence of stringency lockdowns on human physiology.