Physical Activity and Sleep Lessons Learned from Disruptions at a Residential University in Thailand A Basis for Future Health Interventions

Main Article Content

Serah Carolyn Clarence Gladstone Solomans
Nattapon Chawla
Ratna Balraj
Wilai Laolee
Maxine Newell
Elvin Walemba

Abstract

Existing research shows COVID-19 pandemic restrictions led to widespread disruptions in health-related behaviors, including physical activity (PA) and sleep patterns among university students, faculty and staff. The specific impact of pandemic restrictions and the lack of crisis preparedness at educational institutions are not well documented. This cross-sectional pilot study (n=48) used a self-administered questionnaire to investigate the impact of restrictions on PA and sleep to identify the health impact, possible modifiable behaviors, and policies to target for change in future crises to improve health, academic, and work outcomes, especially for institutions with natural green spaces. It was hypothesized the restrictions reduced adults’ PA levels and negatively impacted sleep. Statistical analyses revealed significant differences (p < .05) in the time spent doing medium- and high-intensity PA, walking, length of time to fall asleep, and hours slept before and during the pandemic. Concentration on infection prevention and spread rather than on health maintenance for those not acutely ill inadvertently discouraged using outdoor spaces for exercise while gym and sports facilities remained closed. These findings indicate the negative impact lockdown restrictions may have on general health, and how organizations can promote behaviors to maintain basic physical and sleep health.

Article Details

Section
Research Articles

References

Angelidi, A. M., Belanger, M. J., Lorinsky, M. K., Karamanis, D., Chamorro-Pareja, D., Ognibene, J., Palaiodimos, L., & Mantxoros, C. S. (2021). Vitamin D status is associated with in-hospital mortality and mechanical ventilation: A cohort of COVID-19 hospitalized patients. Mayo Clinic Proceedings. 96(4), 875–886. https://doi.org/10.1016/j.mayocp.2021.01.001.

Ammar, A., Brach, M., Trabelsi, K., Chtourou, H., Boukhris, O., Masmoudi, L., Bouaziz, B., Bentlage, E., How, D., Ahmed, M., Müller, P., Müller, N., Aloui, A., Hammouda, O., Paineiras-Domingos, L. L., Braakman-Jansen, A., Wrede, C., Bastoni, S., Pernambuco, C. S., … & Hoekelmann, A. (2020). Effects of COVID-19 home confinement on eating behaviour and physical activity: Results of the ECLB-COVID19 international online survey. Nutrients, 12(6), 1583. https://doi:10.3390/nu12061583

Asín-Izquierdo, I., Ruiz-Ranz, E., & Arévalo-Baeza, M. (2022). The physiological effects of face masks during exercise worn due to COVID-19: A systematic review. Sports Health: A Multidisciplinary Approach, 14(5), 648–655. https://doi:10.1177/19417381221084661

Bisson, A. N. S., Robinson, S. A., & Lachman, M. E. (2019). Walk to a better night of sleep: Testing the relationship between physical activity and sleep. Sleep Health, 5(5), 487–494. https://doi.org/10.1016/j.sleh.2019.06.003

Bull, F. C., Al-Ansari, S. S., Biddle, S., Borodulin, K., Buman, M. P., Cardon, G., Carty, C., Chaput, J. P., Chastin, S., Chou, R., Dempsey, P. C., DiPietro, L., Ekelund, U., Firth, J., Friedenreich, C. M., Garcia, L., Gichu, M., Jago, R., Katzmarzyk, P. T., … & Lambert, E., (2020). World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine, 54(24), 1451–1462. https://bjsm.bmj.com/content/ 54/24/1451

Castañeda-Babarro, A., Arbillaga-Etxarri, A., Gutiérrez-Santamaría, B., & Coca, A. (2020). Physical activity change during COVID-19 confinement. International Journal of Environmental Research and Public Health, 17(18), 6878.

Castoldi, R. C., de Ângelo, J. C., Pereira, T. T., Dias, R. M., & Negrão, F. J. (2023). Relationship between physical exercise and COVID-19 (SARS-CoV-2): Systematic review. Sport Sciences for Health, 19(1), 55–67. https://doi.org/10.1007/s11332-022-01028-6

Celis-Morales, C. A., Gray, S., Petermann, F., Iliodromiti, S., Welsh, P., Lyall, D. M., Anderson, J., Pellicori, P., Mackay, D. F., Pell, J. P., Sattar, N., & Gill, J. M. R. (2019). Walking pace is associated with lower risk of all-cause and cause-specific mortality. Medicine and Science in Sports and Exercise, 51(3), 472–480. https://doi.org/10.1249/MSS.0000000000001795

Cho, D.-H., Lee, S. J., Jae, S. Y., Kim, W. J., Ha, S. J., Gwon, J. G., Choi, J., Kim, D. W., & Kim, J. Y. (2021). Physical activity and the risk of COVID-19 infection and mortality: A nationwide population-based case-control study. Journal of Clinical Medicine, 10(7), 1539. https://doi.org/10.3390/jcm10071539

Chouchou, F., Augustini, M., Caderby, T., Caron, N., Turpin, N. A., & Dalleau, G. (2021). The importance of sleep and physical activity on well-being during COVID-19 lockdown: Reunion Island as a case study. Sleep Medicine, 77, 297–301. https://doi.org/10.1016/j.sleep.2020.09.014

Das, A., Azarudheen, S., Chandrasekaran, B., Fernandes, S., & Davis, F. (2023). The plausible effects of wearing face masks on sports performance — A scoping review. Science & sports, 38, (5–6), 474–487. https://doi.org/10.1016/ j.scispo.2022.12.006

Dasso N. A. (2019). How is exercise different from physical activity? A concept analysis. Nursing Forum, 54(1), 45–52. https://doi.org/10.1111/nuf.12296

Didriksen, M., Werge, T., Nissen, J., Schwinn, M., Sørensen, E., Nielsen, K. R., Bruun, M. T., Banasik, K., Hansen, T. F., Erikstrup, C., Ostrowski, S. R., Jennum, P. J., Hjalgrim, H., Ullum, H., & Pedersen, O. B. (2021). Impact of COVID-19 pandemic on sleep quality, stress level and health-related quality of life—A large prospective cohort study on adult Danes. International Journal of Environmental Research and Public Health, 18(14), 7610. https://doi.org/10.3390/ijerph18147610

DiFrancisco-Donoghue, J., De Las Heras, B., Li, O., Middleton, J., & Jung, M. K. (2023). Gaming in pandemic times: An international survey assessing the effects of COVID-19 lockdowns on young video gamers' health. International Journal of Environmental Research and Public Health, 20(19), 6855. https://doi.org/10.3390/ijerph20196855

Diniz, T. A., Christofaro, D. G., Tebar, W. R., Cucato, G. G., Botero, J. P., Correia, M. A., Ritti-Dias, R. M., Prado, M. C. L., & Prado, W. L. (2020). Reduction of physical activity levels during the COVID-19 pandemic might negatively disturb sleep pattern. Frontiers in Psychology, 11, 586157. https:/doi.org/10.3389/fpsyg.2020.586157

Donohue, J. M., & Miller, E. (2020) COVID-19 and school closures. Journal of the American Medical Association, 324(9), 845–847. https://doi.org/10.1001/jama.2020.13092

Driver, S., Reynolds, M., Brown, K., Vingren, J. L., Hill, D. W., Bennett, M., Gilliland, T., McShan, E., Callender, L., Reynolds, E., Borunda, N.,

Mosolf, J., Cates, C., & Jones, A. (2022). Effects of wearing a cloth face mask on performance, physiological and perceptual responses during a graded treadmill running exercise test. British Journal of Sports Medicine, 56(2), 107–113. https://bjsm.bmj.com/content/56/2/107

Epstein, D., Korytny, A., Isenberg, Y., Marcusohn, E., Zukermann, R., Bishop, B., Minha, S., Raz, A., & Miller, A. (2020). Return to training in the COVID-19 era: The physiological effects of face masks during exercise. Scandinavian Journal of Medicine & Science in Sports, 31(1), 70–75. https://doi.org/10.1111/sms.13832

Ezzatvar, Y., Ramírez-Vélez, R., Izquierdo, M., & Garcia-Hermoso, A. (2022). Physical activity and risk of infection, severity and mortality of COVID-19: A systematic review and non-linear dose-response meta-analysis of data from 1,853,610 adults. British Journal of Sports Medicine, 56(20), 1188–1193. https://doi.org/10.1136/bjsports-2022-105733

Freeman, E., Akhurst, J., Bannigan, K., & James, H. (2017). Benefits of walking and solo experiences in UK wild places. Health promotion international, 32(6), 1048–1056. https://doi.org/10.1093/heapro/daw036

Inoue, K., Tsugawa, Y., Mayeda, E. R., & Ritz, B. (2023). Association of daily step patterns with mortality in US adults. JAMA Network Open, 6(3), e235174. https://doi.org/10.1001/jamanetworkopen.2023.5174

Jones, N., Oke, J., Marsh, S., Nikbin, K., Bowley, J., Dijkstra, H. P., Hobbs, F. D. R., & Greenhalgh, T. (2023). Face masks while exercising trial (MERIT): A cross-over randomised controlled study. BMJ Open, 13, e063014. https://bmjopen.bmj.com/content/13/1/e063014.citation-tools

Kelly, P., Kahlmeier, S., Götschi, T., Orsini, N., Richards, J., Roberts, N., Scarborough, P., & Foster, C. (2014). Systematic review and meta-analysis of reduction in all-cause mortality from walking and cycling and shape of dose response relationship. International Journal of Behavioral Nutrition and Physical Activity, 11, 132. https://doi.org/10.1186/s12966-014-0132-x

Kontsevaya, A. V., Mukaneeva, D. K., Myrzamatova, A. O., Okely, A. D., & Drapkina, O. M. (2021). Changes in physical activity and sleep habits among adults in Russian Federation during COVID-19: A cross-sectional study. BMC Public Health, 21(1), 1–12. https://doi.org/10.1186/s12889-021-10946-y

Kritz, M., Thøgersen-Ntoumani, C., Mullan, B., Stathi, A., & Ntoumanis, N. (2021). "It's better together": A nested longitudinal study examining the benefits of walking regularly with peers versus primarily alone in older adults. Journal of Aging and Physical Activity, 29(3), 455–465. https://doi.org/10.1123/japa.2020-0091

Liangruenrom, N., Topothai, T., Topothai, C., Suriyawongpaisan, W., Limwattananon, S., Limwattananon, C., Tisayatikom, K., Patcharanarumol, W., & Tangcharoensathien, V. (2017). Do Thai people meet recommended physical activity level? The 2015 national health and welfare survey. Journal of Health Systems Research, 11(2), 205–220. https://www.researchgate.net/publication/317416626_Do_Thai_People_Meet_Recommended_ Physical_Activity_Level_The_2015_National_Health_and_Welfare_Survey

Liangruenrom, N., Craike, M., Biddle, S. J., Suttikasem, K., & Pedisic, Z. (2019). Correlates of physical activity and sedentary behaviour in the Thai population: A systematic review. BMC Public Health, 19(1), 1–26. https://doi.org/10.1186/s12889-019-6708-2

López-Valenciano, A., Suárez-Iglesias, D., Sanchez-Lastra, M. A., & Ayán, C. (2021). Impact of COVID-19 pandemic on university students' physical activity levels: An early systematic review. Frontiers in Psychology, 11, 624567.

Luciano, F., Cenacchi, V., Vegro, V., & Pavei, G. (2021). COVID-19 lockdown: Physical activity, sedentary behaviour and sleep in Italian medicine students. European Journal of Sport Science, 21(10), 1459–1468. https://doi.org/10.1080/17461391.2020.1842910

Marelli, S., Castelnuovo, A., Somma, A., Castronovo, V., Mombelli, S., Bottoni, D., Leitner, C., Fossati, A., & Ferini-Strambi, L. (2021). Impact of COVID-19 lockdown on sleep quality in university students and administration staff. Journal of Neurology, 268(1), 8–15. https://doi.org/10.1007/s00415-020-10056-6

Marques, A., Santos, T., Martins, J., Matos, M. G. D., & Valeiro, M. G. (2018). The association between physical activity and chronic diseases in European adults. European Journal of Sport Science, 18(1), 140–149. https://doi.org/10.1080/17461391.2017.1400109

Martínez-de-Quel, Ó., Suárez-Iglesias, D., López-Flores, M., & Pérez, C. A. (2021). Physical activity, dietary habits and sleep quality before and during COVID-19 lockdown: A longitudinal study. Appetite, 158, 105019. https://doi.org/10.1016/j.appet.2020.105019

Maugeri, G., Castrogiovanni, P., Battaglia, G., Pippi, R., D'Agata, V., Palma, A., Rosa, M. D., & Musumeci, G. (2020). The impact of physical activity on psychological health during COVID-19 pandemic in Italy. Heliyon, 6(6), e04315.

NHS. (2022, December 15). Walking for Health. https://www.nhs.uk/live-well/exercise/walking-for-health/

Odriozola-González, P., Planchuelo-Gómez, Á., Irurtia, M. J., & de Luis-García, R. (2020). Psychological effects of the COVID-19 outbreak and lockdown among students and workers of a Spanish university. Psychiatry Research, 290, 113108. https://doi.org/10.1016/j.psychres.2020.113108

Pramono, B. A., Hafidz, A., Fajar, M. K., Wijono, Wulandari, F. Y., Kusuma, I. D. M. A. W., & Hooi, L. B. (2023). Comparison between mobile fitness apps users and gender on exercise intensity in university students. Journal of Human Sport and Exercise, 19(2), 550–559. https://doi.org/10.14198/jhse.2024.192.10

Rahmati, M., Shamsi, M. M., Khoramipour, K., Malakoutinia, F., Woo, W., Park, S., Yon, D. K., Lee, S. W., Shin, J. I., & Smith, L. (2022). Baseline physical activity is associated with reduced mortality and disease outcomes in COVID‐19: A systematic review and meta‐analysis. Reviews in Medical Virology, 32(5), e2349. https://doi.org/10.1002/rmv.2349

Raj, U., & Fatima, A. (2020). Stress in students after lockdown due to COVID-19 Thereat and the effects of attending online classes [Research paper]. SSRN Electronic Journal https://ssrn.com/abstract=3584220

Romero-Blanco, C., Rodríguez-Almagro, J., Onieva-Zafra, M. D., Parra-Fernández, M. L., Prado-Laguna, M. D. C., & Hernández-Martínez, A. (2020). Physical activity and sedentary lifestyle in university students: Changes during confinement due to the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 17(18), 6567. https://doi.org/10.3390/ijerph17186567

Ross, R., Chaput, J., Giangregorio, L. M., Janssen, I., Saunders, T. J., Kho, M. E., Poitras, V. J., Tomasone, J. R., El-Kotob, R., McLaughlin, E. C., Duggan, M., Carrier, J., Carson, V., Chastin, S. F., Latimer-Cheung, A. E., Chulak-Bozzer, T., Faulkner, G., Flood, S. M., Gazendam, M. K., & Tremblay, M. S. (2020). Canadian 24-hour movement guidelines for adults aged 18–64 years and adults aged 65 years or older: An integration of physical activity, sedentary behaviour, and sleep. Applied Physiology, Nutrition, and Metabolism, 45(10) (Suppl. 2), S57–S102. https://doi.org/10.1139/apnm-2020-0467

Sallis, R., Young, D. R., Tartof, S. Y., Sallis, J. F., Sall, J., Li, Q., Smith, G. N., & Cohen, D. A. (2021). Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: A study in 48 440 adult patients. British Journal of Sports Medicine, 55(19), 1099–1105. https://doi.org/10.1136/bjsports-2021-104080

Shaw, K. A., Zello, G. A., Butcher, S. J., Ko, J. B., Bertrand, L., & Chilibeck, P. D. (2021). The impact of face masks on performance and physiological outcomes during exercise: A systematic review and meta-analysis. Applied Physiology, Nutrition, and Metabolism, 46, 693–703. https://doi.org/10.1139/apnm-2021-0143

Shen, X., Wu, Y., & Zhang, D. (2016). Nighttime sleep duration, 24-hour sleep duration and risk of all-cause mortality among adults: A meta-analysis of prospective cohort studies. Scientific Reports 6, 21480 (2016). https://doi.org/10.1038/srep21480

Siraj, N. (2023). Binge watching and sleep quality among college students. International Journal of Indian Psychology, 11(1), 1228–1237. https://ijip.in/wp-content/uploads/2023/03/18.01.124.20231101.pdf

Sittichai, N., Parasin, N., Saokaew, S., Kanchanasurakit, S., Kayod, N., Praikaew, K., Phisalprapa, P., & Prasannarong, M. (2022). Effects of physical activity on the severity of illness and mortality in COVID-19 patients: A systematic review and meta-analysis. Frontiers in Physiology, 13, 1030568. https://doi.org/10.3389/fphys.2022.1030568

Stanton, R., To, Q. G., Khalesi, S., Williams, S. L., Alley, S. J., Thwaite, T. L.,Fenning, A. S., & Vandelanotte, C. (2020). Depression, anxiety and stress during COVID-19: Associations with changes in physical activity, sleep, tobacco and alcohol use in Australian adults. International Journal of Environmental Research and Public Health, 17(11), 4065. https://www.mdpi.com/1660-4601/17/11/4065/htm

Stockwell, S., Trott, M., Tully, M., Shin, J., Barnett, Y., Butler, L., McDermott, D., Schuch, F., & Smith, L. (2021). Changes in physical activity and sedentary behaviours from before to during the COVID-19 pandemic lockdown: A systematic review. BMJ Open Sport & Exercise Medicine, 7(1), e000960. https://bmjopensem.bmj.com/ content/7/1/e000960

Sundarasen, S., Chinna, K., Kamaludin, K., Nurunnabi, M., Baloch, G. M., Khoshaim, H. B., Hossain, S. F. A., & Sukayt, A. (2020). Psychological impact of COVID-19 and lockdown among university students in Malaysia: Implications and policy recommendations. International Journal of Environmental Research and Public Health, 17(17), 6206. https://doi.org/10.3390/ijerph17176206

Svensson T, Saito E, Svensson A. K., Melander, O., Orho-Melander, M., Mimura, M., Rahman, S., Sawada, N. Koh, W., Shu, X., Tsuji, I., Kanemura, S., Park, S. K., Nagata, C., Tsugane, S., Cai, H., Yuan J., Matsuyama, S. Sugawara, Y., Wada, K., . . . & Potter, J. D. (2021). Association of sleep duration with all- and major-cause mortality among adults in Japan, China, Singapore, and Korea. (2021, September 3). JAMA Network Open, 4(9): e2122837. https://doi.org/10.1001/jamanetworkopen.2021.22837

Sygit, K., Sygit, M., Wojtyła-Buciora, P., Lubiniec, O., Stelmach, W., & Krakowiak, J. (2019). Physical activity as an important element in organizing and managing the lifestyle of populations in urban and rural environments. Annals of Agricultural and Environmental Medicine, 26(1), 8–12. https://doi:10.26444/aaem/99177

Ukawa, S., Zhao, W., Yatsuya, H., Yamagishi, K., Tanabe, N., Iso, H., & Tamakoshi, A. (2019). Associations of daily walking time with pneumonia mortality among elderly individuals with or without a medical history of myocardial infarction or stroke: Findings from the Japan collaborative cohort study. Journal of Epidemiology, 29(6), 233–237. https://doi.org/10.2188/jea.JE20170341

Ungvari, Z., Fazekas-Pongor, V., Csiszar, A., & Kunutsor, S. K. (2023). The multifaceted benefits of walking for healthy aging: From Blue Zones to molecular mechanisms. GeroScience, 45(6), 3211–3239. https://doi.org/10.1007/s11357-023-00873-8

Wang, F., & Boros, S. (2021). The effect of daily walking exercise on sleep quality in healthy young adults. Sport Sciences for Health, 17, 393–401. https://doi.org/10.1007/s11332-020-00702-x

Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., Dinges, D. F., Gangwisch, J., Grandner, M. A., Kushida, C., Malhotra, R. K., Martin, J. L., Patel, S. R., Quan, S. F., & Tasali, E. (2015). Recommended amount of sleep for a healthy adult: A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep, 38(6), 843–844. https://doi.org/10.5665/sleep.4716

Young, D. R., Sallis, J. F., Baecker, A., Cohen, D. A., Nau, C. L., Smith, G. N., & Sallis, R. E. (2023). Associations of physical inactivity and COVID-19 outcomes among subgroups. American Journal of Preventive Medicine, 64(4), 492–502. https://doi.org/10.1016/j.amepre.2022.10.007

Zheng, C., Poon, E. T., Wan, K., Dai, Z., & Wong, S. H. (2023). Effects of wearing a mask during exercise on physiological and psychological outcomes in healthy individuals: A systematic review and meta-analysis. Sports Medicine (Auckland, N.Z.), 53(1), 125–150. https://doi.org/10.1007/s40279-022-01746-4