COVID-19: Lockdown and Sleep

Working from home - COVID19 - humanfactors101.com
When working from home, normal daily routines can be lost.

The COVID-19 pandemic has caused stress, anxiety, worry and depression for millions of people around the world as they confront illness, bereavement, unemployment and uncertainty.

The coronavirus may be causing another global crisis – inadequate sleep. Several international studies have concluded that the pandemic is associated with high rates of sleep disturbances.

In this article I’ll address the consequences of COVID-19 lockdowns, the increase in home-working and quarantine. These scenarios can have a significant impact on our routines, diet, exercise and social connections – but they also have an adverse impact on our sleep.

Why is sleep important right now?

Getting enough quality sleep has always been important for mental and physical health. Much has been written in the human factors literature about the impact of sleep on human performance. However, sleep also supports our immune systems, and so it’s especially important to get the right amount of quality sleep during the COVID-19 pandemic.

Lockdown, home working and isolation

COVID-19 lockdown - humanfactors101.com
Daily life is usually structured according to many habits, routines, rituals and social cues.

As a consequence of the pandemic, our routines are being broken. We can’t do the things that we normally do to stay active, entertained, stimulated and connected. Our movements are restricted, entertainment venues are closed and sometimes we’re confined to our homes or a quarantine facility.

Those testing positive to the virus, having close contact with a positive case, or crossing borders, may face mandatory hotel quarantine (usually 14 days, but up to 28 days).

Millions of people across the world have been in lockdown. Those able to work remotely (perhaps for the first time) are balancing work, family and home life. When working from home, the lines between personal lives and work can become blurred. Normal daily routines can be lost.

On a positive note, flexible working hours and less commuting time may enable people to sleep and work to their own schedules. For some, this flexibility has actually improved the quality of sleep.

However, for millions of people, the COVID-19 pandemic has greatly impacted the duration and quality of their sleep.

Staying indoors for long periods of time deprives us of the social cues and daylight cues that support our sleep routines:

  • A lack of stimulation (e.g. social contact).
  • Reduced exposure to natural daylight.
  • A reduction in exercise.
  • Increased use of technology due to isolation or spending more time at home.
  • Additional ‘workload’ (e.g. home schooling, childcare, increased work responsibilities).
  • Increased exposure to news and social media.

Whether in quarantine, self-isolation or working from home during a lockdown, the disruptive effects on sleep are similar.

Improving sleep health

Our circadian rhythm is the body clock that keeps us awake during the day and makes us sleep at night. Maintaining this rhythm is essential to the quality and duration of sleep. Human factors specialists have outlined how to get good sleep in general (‘sleep hygiene’), but here I want to focus on the practical steps that can be taken to counteract the adverse effects of lockdown, confinement and changes to our routines during the COVID-19 pandemic.

If you are in lockdown or working from home:

  • Keep established routines: wake up and go to sleep at the same time every day. Getting up at the same time each day is key to maintaining many other daily routines. Be consistent with daily rituals to give your life structure (e.g. shower, eat, work, exercise and sleep at fixed times).
  • Regular physical activity (but not late at night): this will improve both the quality and duration of your sleep.
  • Avoid taking a long nap: taking naps during the day can affect your sleep.
  • Remember to take a lunch break!
  • Keep the bed for sleeping and intimacy: Avoid working, using a computer or phone, eating, or watching TV in bed. This will train your brain to associate being in bed with sleeping.

If you are in mandatory isolation, confinement or quarantine

  • Get exposure to as much light as you can during the day. Sunlight is best, but if natural light is inadequate, turn on all lights during the daytime and dim them in the evening.
  • Make the bedroom as dark as possible when sleeping. This will help your body clock to maintain a day-night routine.
  • If you’re unable to leave a quarantine room, set a routine for as many things as you can control, such as showering, contacting friends, exercise, watching news, meditating etc.
  • Speak with friends or family at the same time each morning – regular early social interaction (either a phone call or video chat) is key.
COVID-19 isolation - humanfactors101.com
If you are confined to a quarantine hotel room, and you cannot avoid using the bed during the day, try to make a distinction between day-time bed use and night-time bed use, for example by having different pillows, or changing a cover.
Online yoga - humanfactors101.com
Exercise each day: Follow an online workout provided by your hotel, TV, healthcare provider, or YouTube.
  • Even if you cannot leave confinement, get dressed each morning and change into night-wear at bedtime.
  • Avoid being sedentary for long periods of time. Move every 20 minutes or so.
  • Be more active during daylight hours and do quieter activities in the evening (reading, watching TV).
  • Keep informed, but don’t follow COVID-19 news constantly. Set certain times during daylight hours when you will watch or listen to news.
  • Use social media to read and share positive information, unrelated to the pandemic.
  • Schedule a brief time each day to discuss stresses or write down your worries and concerns.
  • Avoid caffeine in the evening, and avoid alcohol near bedtime.
  • If you don’t sleep well one night: get up at your normal time, avoid napping during the day, and go to bed at your normal bedtime.
  • Follow a regular winding-down routine each night: this is a cue for your brain to get ready for sleep. For example, take a warm shower, read a book, listen to relaxing music, or meditate.
  • If you are alert or anxious at bedtime, take extra time to relax and unwind before trying to sleep. Only go to bed when you’re sleepy or drowsy.
  • If you can, reduce the temperature in the room to around 65 degrees Fahrenheit (18 degrees Celsius) for ideal sleeping conditions.
COVID-19 - TV - humanfactors101.com
Increased use of television and smartphones is inevitable. Turn off electronic devices 1 to 2 hours before bedtime (as the blue light that they emit can interfere with your body clock).

Further resources

Student mental health during COVID-19, a one-page infographic created by sleep and mental health researchers at Warwick, Glasgow, Northumbria and Strathclyde, UK.

Fitness Studio exercise videos, Provided by the UK National Health Service (NHS). These videos range from 5 to 45 minutes, including a 45-minute “wake-up workout” video that would be helpful for anyone in lockdown or isolation/quarantine. Includes short meditation videos to promote good sleep.

There are many meditation apps on the App Store or Google Play that can help you to fall asleep faster. They will help to quiet the mind and relax the body, ready for a deep rest.

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