{"doi":"10.1080/15402002.2021.2022679","title":"Changes in Sleep-Wake Patterns and Disturbances Before and During COVID-19 in Urban American Indian/ Alaska Native Adolescents","abstract":"BACKGROUND: COVID-19 has profoundly affected sleep, although little research has focused on high-risk populations for poor sleep health, including American Indian/Alaska Native (AI/AN) adolescents. METHODS: This is the first longitudinal study to examine changes in sleep with surveys completed before the pandemic and during the early months of COVID-19 in a sample of urban AI/AN adolescents (N = 118; mean age = 14 years at baseline; 63% female). We use a mixed-methods approach to explore how COVID-19 affected urban AI/AN adolescents' sleep, daily routines, and interactions with family and culture. Quantitative analysis examined whether pandemic-related sleep changes were significant and potential moderators of COVID-19's effect on sleep, including family and community cohesion and engagement in traditional practices. RESULTS: 's <.001). Higher levels of family cohesion and higher levels of engagement in traditional practices moderated pandemic-related increases in weekday sleep duration. Qualitative analyses revealed changes in adolescents' sleep and daily behaviors, as well as strategies adolescents used to cope with pandemic-related disruptions in sleep and routines. CONCLUSION: Findings demonstrate positive and negative changes in sleep during COVID-19 stay-at-home orders, including simultaneous increases in sleep duration and sleep-wake disturbances. Results highlight the importance of considering multi-level influences on adolescent sleep, such as early school start times, family dynamics, and cultural factors. A multi-level approach may help guide prevention and intervention efforts to improve adolescent sleep health.","journal":"Behavioral Sleep Medicine","year":2022,"id":258300,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":17,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.931,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":890634,"name":"Alina I. Palimaru","orcid":"0000-0002-2777-4079","position":1,"is_corresponding":false},{"id":909410,"name":"David J. Klein","orcid":"0000-0001-5022-5839","position":2,"is_corresponding":false},{"id":524230,"name":"Lu Dong","orcid":"0000-0002-1075-9374","position":3,"is_corresponding":false},{"id":890633,"name":"Daniel L. Dickerson","orcid":"0000-0001-7094-091X","position":4,"is_corresponding":false},{"id":890635,"name":"Ryan Brown","orcid":"0000-0002-7960-9518","position":5,"is_corresponding":false},{"id":890636,"name":"Carrie L. Johnson","orcid":"0000-0001-7327-1248","position":6,"is_corresponding":false},{"id":680082,"name":"Elizabeth J. D’Amico","orcid":"0000-0002-8527-7804","position":7,"is_corresponding":false},{"id":334170,"name":"Wendy Troxel","orcid":"0000-0002-2147-8041","position":0,"is_corresponding":true}],"reference_count":46,"raw_metadata":null,"created_at":"2026-07-19T00:25:38.634785Z","pmid":"34989300","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}