Dr Alanna Hare is a consultant physician in respiratory and sleep medicine at Royal Brompton and Harefield hospitals, and runs specialist clinics in sleep disorders (such as insomnia, sleep apnoea and restless legs syndrome), respiratory failure and at home ventilation. She is also secretary of the British Sleep Society.
For World Sleep Day, Friday 19 March, Dr Hare shares why people might not be sleeping as well during the Covid-19 pandemic and what can be done about it.
The unforeseen effects of a national lockdown
It has been almost a year to the day since the UK entered its first lockdown. The pandemic has changed all of our lives and naturally a lot of us are feeling a level of anxiety that we have not experienced before. For many of us, our daily lives have been changed beyond recognition and we all find ourselves tackling new challenges and anxieties previously unimaginable. However, it is not just our daily lives that have been impacted. The pandemic has also had an unexpected impact on our night-routine and sleeping patterns.
Last April, a month into the UK lockdown, people started talking about their broken sleep on social media, with media outlets reporting on the issue, dubbing it ‘coronasomnia’ – an insomnia phenomenon linked to the stress of life during Covid-19. As a sleep specialist, this new trend worried me because sleep is vital for our immune systems to function optimally and also for our ability to manage stress and anxiety. Together with colleagues at the British Sleep Society, we set about looking into the phenomenon of disrupted sleep in the pandemic.
Research into how the nation’s sleep has changed
Through an online survey, undertaken last autumn, we collated data from 843 adults about how they were sleeping – did it take them long to fall asleep, were they waking up in the night and were they having nightmares? We also asked them how they were functioning during the day and how their mental health was.
We discovered that:
- An overwhelming majority (70 per cent) were experiencing a change in their sleep pattern
- Nearly a third (30 per cent) of people were going to bed later and around 30 per cent were having difficulties falling asleep or staying asleep
- Less than half of people (45 per cent) said that their sleep was refreshing
- Nearly half of respondents (46 per cent) said that they felt sleepier than before lockdown
- And, perhaps unsurprisingly, we found that people who were self-isolating were sleeping worse than those who were not (61 per cent vs 52 per cent respectively).
Why is lockdown affecting sleep?
There are many reasons why people may be sleeping poorly during the pandemic. The first is the impact a global pandemic has on our stress levels and mental health; 65 per cent of people who responded to our survey reported that the lockdown was having an impact on their mental health. Whether this was caused directly by the virus or indirectly through work, parenting or financial problems, having poor mental health leads to worse sleep – and vice versa!
The survey results also revealed that other physical changes on our habits and lifestyles during lockdown may also be having an effect. For example, disruption to our daily routines, being exposed to less natural sunlight, being less active and changes to eating habits are all associated with lockdown and all can cause struggles with sleep. One example is alcohol: 26 per cent of our survey respondents said they were drinking more alcohol during lockdown. Although many people believe alcohol can help them get to sleep, alcohol disrupts sleep and reduces the quality of our sleep, especially in the second half of the night.
We increasingly understand that Covid-19 can also have direct effects on the brain and indeed, respondents to our survey who had the virus reported more nightmares and abnormal sleep rhythms than people who did not. This could also be related to some of the symptoms of Covid-19, such as coughing and headaches, disrupting sleep.
How to sleep better
The good news is that there are some simple and small changes we can make to our daily routine and lifestyles that can help us get a better night’s sleep.
- The first thing we can do is set a routine and stick to it. Go to bed at the same time every night and wake up and the same time each morning
- Avoid looking at screens, like laptops, TVs or mobile devices, at least an hour before your scheduled bedtime as the blue light they emit upsets our body’s internal clock. Even switching to table lamps instead of overhead lights can help. If all else fails, try using an eye mask when in bed to shut out all other light
- Keep the bedroom cool. Being too hot can make it harder to fall asleep. It might be surprising, but the optimal temperature is 16-8°C, so try opening a window for a couple of hours before bedtime
- Try to maintain healthy eating habits and get some regular exercise: these can both help us to sleep better. A short walk in the fresh air and natural daylight will also help reset your body clock. Just avoid strenuous exercise in the hour or so before bed
- And finally, if you do wake up during the night, avoid looking at the time – this can make you more anxious. Instead, try some relaxation strategies like mindfulness or progressive muscle relaxation and remind yourself that just resting is good for your brain and body.
The potential public health consequences of lockdown and poor sleep should not be overlooked, and if you are still struggling to sleep, do speak to your GP or a sleep specialist.
Read Dr Hare’s research on Covid-19 and sleep here.