Physical activity levels and sleep disturbances in Indonesian primary school students during the COVID-19 pandemic

  • Talitha Dinda Gunawan Faculty of Medicine, Universitas Indonesia, Jakarta
  • Rini Sekartini Department of Child Health, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, 10430, Indonesia
Keywords: COVID-19, children, physical activity, sleep disturbances


Background During the coronavirus disease-2019 (COVID-19) pandemic, the Indonesian government implemented a large-scale, social restriction policy, including the closure of schools and recreational facilities, which potentially altered children’s physical activity and sleep patterns.

Objective To analyze for a possible association between physical activity levels and sleep disturbances in Indonesian primary school students during the COVID-19 pandemic.

Methods This cross-sectional study was conducted on 437 children aged 7-13 years  using data collected online in April-August 2020, including children’s sociodemographic characteristics, physical activity levels, and sleep patterns. The translated Indonesian version of Physical Activity Questionnaire for Children (PAQ-C) and the Children Sleep Habits Questionnaire-Abbreviated (CSHQ-A) were used to collect data. The data analyzed consisted of sociodemographic factors and physical activity levels, sociodemographic factors and sleep disturbances, and physical activity levels and sleep disturbances.

Results Most children were physically inactive (60.87%) and experienced sleep disturbances (73.23%) during the COVID-19 pandemic. Female sex and physical inactivity were significantly associated. Male sex and sleep disturbances were significantly associated. Age 7 as the lowest age group was significantly associated with sleep disturbances. There was no significant association (P=0.248) between physical activity levels and sleep disturbances.

Conclusion Most Indonesian primary school students were physically inactive and had sleep disorders during the COVID-19 pandemic. Female sex and physical inactivity were significantly associated, while male sex and sleep disturbances were significantly associated, age 7 (lower age group) and sleep disturbances were significantly associated. There was no significant association between physical activity levels and sleep disturbances in Indonesian primary school students during the COVID-19 pandemic.


1. Mahalmani V, Mahendru D, Semwal A, Kaur S, Kaur H, Sarma P, et al. COVID-19 pandemic: a review based on current evidence. Indian J Pharmacol. 2020;52:117-129. DOI:
2. Bates L, Zieff G, Stanford K, Moore J, Kerr Z, Hanson E, et al. COVID-19 impact on behaviors across the 24-hour day in children and adolescents: physical activity, sedentary behavior, and sleep. Children. 2020;7:138. DOI:
3. Aldila D, Khoshnaw SHA, Safitri E, Anwar YR, Bakry ARQ, Samiadji BM, et al. A mathematical study on the spread of COVID-19 considering social distancing and rapid assessment: the case of Jakarta, Indonesia. Chaos Solitons Fractals. 2020;139:110042. DOI:
4. Zenic N, Taiar R, Gilic B, Blazevic M, Maric D, Pojskic H, et al. Levels and changes of physical activity in adolescents during the COVID-19 pandemic: contextualizing urban vs. rural living environment. Appl Sci. 2020;10:3997. DOI:
5. Taylor RW, Haszard JJ, Meredith-Jones KA, Galland BC, Heath ALM, Lawrence J, et al. 24-h movement behaviors from infancy to preschool: cross-sectional and longitudinal relationships with body composition and bone health. Int J Behav Nutr Phys Act. 2018;15:118. DOI:
6. Moore SA, Faulkner G, Rhodes RE, Brussoni M, Chulak-Bozzer T, Ferguson LJ, et al. Impact of the COVID-19 virus outbreak on movement and play behaviours of Canadian children and youth: a national survey. Int J Behav Nutr Phys Act. 2020;17:85. DOI:
7. Pietrobelli A., Pecoraro L., Ferruzzi A., Heo M., Faith M., Zoller T., Antoniazzi F., Piacentini G., Fearnbach S.N., Heymsfield S.B. Effects of COVID-19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study. Obesity (Silver Spring). 2020 Aug;28(8):1382-1385. DOI: 10.1002/oby.22861.
8. Zhou S.J., Zhang L.G., Wang L.L., Guo Z.C., Wang J.Q., Chen J.C., Liu M., Chen X., Chen J.X. Prevalence and socio-demographic correlates of psychological health problems in Chinese adolescents during the outbreak of COVID-19. Eur Child Adolesc Psychiatry. 2020;29:749–758. DOI: 10.1007/s00787-020-01541-4
9. Voss C, Ogunleye AA, Sandercock GR. Physical activity questionnaire for children and adolescents: English norms and cut-off points. Pediatr Int. 2013;55:498-507. DOI: 10.1111/ped.12092
10. Markovich AN, Gendron MA, Corkum PV. Validating the children’s sleep habits questionnaire against polysomnography and actigraphy in school-aged children. Front Psychiatry. 2014; 5: 188. DOI:
11. Dapan, Andriyani FD, Indra EN, Indiawati MP, Subeni T, Ramadona ET. Uji validitas dan reliabilitas instrumen Physical Activity Questionnaire for Older Children (PAQ-C) dan Physical Activity Questionnaire for Adolescent (PAQ-A). Yogyakarta: Universitas Negeri Yoygyakarta; 2017.
12. Hartini S, Sunartini, Herini SE, Takada S. Item analysis and internal consistency of children’s sleep habit questionnaire (CSHQ) in Indonesian version. Belitung Nursing Journal. 2017;3:645-655. DOI:
13. Guo YF, Liao MQ, Cai WL, et al. Physical activity, screen exposure and sleep among students during the pandemic of COVID?19. Sci Rep. 2021;11:8529. DOI:
14. Kementerian Kesehatan Republik Indonesia. Laporan Nasional Riset Kesehatan Dasar (Riskesdas) 2018. Badan Penelitian dan Pengembangan Kesehatan; Jakarta, Indonesia: 2018.
15. Kolimechkov S, Lubomir P, Alexandrova A, editors. Physical activity assessment using a modified paq-c questionnaire V. Proceedings of the international scientific congress “Applied sports sciences”. Sofia, Bulgaria; 2017. p. 34650.
16. Bacovic B. Assessment level of physical activity of young school children in Montenegro, using the PAQ-C questionnaire, during the COVID-19 pandemic. Nutr Hosp. 2022; 39: 239-40. DOI:
17. Rahman AM, Chandrasekaran B. Estimating the impact of the pandemic on children’s physical health: a scoping review. J School Health. 2021;91:936–47. DOI:
18. Kaditis AG, Ohler A, Gileles?Hillel A, Choshen?Hillel S, Gozal D, Bruni O, et al. Effects of the COVID?19 lockdown on sleep duration in children and adolescents: a survey across different continents. Pediatr Pulmonol. 2021;56:2265–73. DOI:
19. Curatola A, Ferretti S, Gatto A, Valentini P, Giugno G, Della Marca G, et al. The effects of COVID-19 pandemic on Italian school-aged children: sleep-related difficulties and trauma reactions. J Child Neurol. 2022;37:568–74. DOI:
20. Dunton GF, Do B, Wang SD. Early effects of the COVID?19 pandemic on physical activity and sedentary behavior in children living in the U.S. BMC Public Health. 2020;20(1):1351. DOI:
21. Pombo A, Luz C, Rodrigues LP, Ferreira C, Cordovil R. Correlates of children's physical activity during the COVID?19 confinement in Portugal. Public Health. 2020;189:14?19. DOI:
22. Siegle CBH, Pombo A, Luz C, Rodrigues LP, Cordovil R, Sá C. Influences of family and household characteristics on children’s level of physical activity during social distancing due to Covid?19 in Brazil. Rev Paul Pediatr. 2020;39:e2020297. DOI:
23. Szpunar M, Bourke M, Vanderloo LM, Bruijns BA, Truelove S, Burke SM, Gilliland J, Irwin JD, Tucker P. Parent-reported changes in ontario children's physical activity levels during the covid-19 pandemic. Children (Basel). 2023;10:221. DOI:
24. Aishworiya R, Lim MTC, Ramamurthy MB, Tran AP, Rajgor DD, Goh DYT. Impact of work routines on parents' and children's sleep during the COVID-19 pandemic lockdown. Sleep Med. 2021;88:61-7. DOI:
25. Abid R, Ammar A, Maaloul R, Souissi N, Hammouda O. Effect of COVID-19-related home confinement on sleep quality, screen time and physical activity in tunisian boys and girls: a survey. Int J Environ Res Public Health. 2021;18:3065. DOI:
26. López-Bueno R., López-Sánchez G.F., Casajús J.A., et al. Health-related behaviors among school-aged children and adolescents during the Spanish covid-19 confinement. Front Pediatr. 2020 ;8. DOI:
27. Mitra R., Moore S.A., Gillespie M., et al. Healthy movement behaviours in children and youth during the COVID-19 pandemic: exploring the role of the neighbourhood environment. Health Place. 2020;65:102418. DOI: 10.3389/fped.2020.00573
How to Cite
Gunawan T, Sekartini R. Physical activity levels and sleep disturbances in Indonesian primary school students during the COVID-19 pandemic. PI [Internet]. 2Apr.2024 [cited 20May2024];64(2):106-2. Available from:
Developmental Behavioral & Community Pediatrics
Received 2023-01-12
Accepted 2024-04-02
Published 2024-04-02