The associations of parental COVID-19 related worries, lifestyles, and insomnia with child insomnia during the COVID-19 outbreak.

The impacts of the Coronavirus Disease 2019 (COVID-19) pandemic on sleep health have been studied extensively. However, little is known about sleep problems within the family system during the pandemic. This study aimed to examine the influence of the COVID-19 pandemic on insomnia in both adults and children, and to explore whether parental COVID-19 related worries, lifestyles, and insomnia were associated with child insomnia. A total of 1355 parent-child dyads (39.2% fathers, mean age 38.37 years, SD = 5.34; 52.7% boys, mean age 12.47 years, SD = 1.67) were recruited from Jiangxi province in China from 4 to 18 February 2020. Data on insomnia, COVID-19 related worries, physical activity, and screen time were collected using online questionnaires. Path analysis showed that COVID-19 related worries and screen time were positively associated with insomnia in both parents and children; while children's physical activity was negatively related to children's insomnia. Parents' insomnia, COVID-19 related worries, physical activity, and screen time were positively associated with children's insomnia, COVID-19 related worries, physical activity, and screen time, respectively. Bootstrap tests showed that parents' worries were positively associated with children's insomnia via parents' insomnia and children's worries; parents' physical activity was negatively associated with children's insomnia via children's physical activity, parents' screen time was positively associated with children's insomnia via parents' insomnia and children's screen time. Both parental and child sleep are affected by the pandemic. Parental insomnia, stress reaction, and lifestyles contribute to child insomnia. Child sleep health may be maintained or improved by family bonds, home exercise, and sleep schedules.