Sleep in the time of coronavirus

I taught a session on sleep for trainees at UCL. This was originally intended to take place in person, but here in the United Kingdom, we have been under a form of COVID-19 related lockdown for some time, which has confined a lot of people to their own homes. I was therefore forced to deliver the teaching via narrated slides. The trainees had some great questions, and there might be scope for me to produce a short video of sleep tips for all during the COVID-19 crisis. A lot of us are spending more time at home, which has its benefits and drawbacks. In light of this, I thought I’d suggest three potential sleep quick wins here:

Start bright: sleep well

It may sound counterintuitive, but starting the day with at least 20 minutes of exposure to bright light (preferably daylight), is one of the best ways to ensure that you are able to get to sleep that night. This is because we have dedicated sensors in our eyes that detect light, and send a signal which makes our melatonin levels drop rapidly. It is this rapid change in melatonin levels that signals that it is time to wake up, and research has shown that it also helps us to feel sleepy as light levels drop in the evening.

Blume, Garbazza & Spitschan, 2019

Figueiro and colleagues, 2017

Fill the daytime with a mix of activities that link with your values

Without the routine and structure enforced by having to go to work / school, and the associated social interaction, physical activity and set meal times, our daytime routines can easily slip. Our body clocks are set primarily by light, but other cues come from eating, activity levels and meeting people, so maximising opportunities for these is key to maintaining a good wake-sleep pattern.

We can often feel inclined to do things because we think we should do them, but they might not link with our core values, meaning that they are less likely to boost our mood and be things that we are naturally driven to sustain. Of course, we all sometimes have to do things that are necessary, but it is important to try and weave enjoyable things in throughout the day too.

Wind down naturally in the evening

With no travel to differentiate between work and home, it can be hard to know when to switch out of work mode, so it might be helpful to engage in a ritual of some kind to mark the end of the work day. This might be a family mealtime, group gaming or socialising either with people in the house or via a video conferencing platform, or perhaps a form of exercise that you enjoy. Once this threshold has been passed, aim to gradually wind down and enjoy the evening as far as possible. Screen-based activities should be tapered down towards bedtime. For the same reasons that bright light is good in the morning, it is unhelpful as we approach bedtime.

Whilst the light that our “smart” devices give off can be unhelpful, it seems that there is something else about them that is damaging to sleep, even if we are not using the screens. Carter and colleagues reviewed 20 studies looking at the impact of smart device use on sleep in children and concluded that the data show that the mere presence of a device has a detrimental impact on sleep quality and quantity. In light of this, and in line with Social Learning Theory, it is therefore especially important for parents and caregivers to model good practice around screen-based devices to children. One way to achieve this is to have a family dock where everyone charges their devices after a certain time in the evening, which could also give an opportunity for pre-bed social wind down time. If anyone is anxious, which might be especially triggered at the moment, this could provide respite from media coverage, and an opportunity to share concerns and talk them through.

Stay safe, and sleep well!

Written by Dr. Charlie Tyack, Clinical Psychologist with significant experience in supporting people with sleep difficulties.

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