Solving our sleep struggles in the pandemic

Whether it’s weird, vivid dreams, tapping away on the laptop at 3am or just feeling exhausted — the Covid-19 pandemic is dramatically affecting work patterns and workers’ sleep. Vicky Powell highlights the latest research on sleep and shares the current advice from sleep experts on how to help workers cope — and feel rested — in the UK’s new working reality.

The nation’s sleep patterns are changing

The coronavirus pandemic is affecting how people sleep in all kinds of ways. Financial pressures, job insecurity and health worries, as well as altered daily routines, are impacting people’s stress levels and, in turn, their sleep. This can create a damaging cycle.

As Dr Ivana Rosenzweig, Head of the Sleep and Brain Plasticity Centre at King’s College London, recently said, “Adequate and good-quality sleep is important to maintain our physical and mental resilience and disturbed sleep is often caused by stress. But we also know that poor sleep can play a role in increasing our levels of stress, which can create a cycle that’s difficult to break.”

Of course, not everything about sleep and the lockdown has been bad news. Recent research has shown that, with workers no longer needing to rise as early for a lengthy commute, one in three Britons working from home have been able to dispense with their alarm clock altogether, and allow themselves to wake up naturally (and a little later) — on average around 7am, instead of about 6am before the pandemic.

This, experts believe, could be beneficial to mood and brain function since it is closer to our average natural genetic wake-up time.

Dr Neil Stanley of The Sleep Consultancy recently highlighted research by the DNA testing company 23andMe which reveals our average natural genetic wake-up time is 7.55 am, but early commutes meant we couldn’t always wake up at the time we are naturally inclined.

Therefore, Dr Stanley says, for those who are now working from home, “You should try to take advantage of a little lie-in, as it will help you keep your circadian rhythm in check, and encourage a better night’s sleep.”

Despite these pros, there are also significant cons associated with workers’ sleep patterns during the pandemic and many people are struggling. Research from King’s College London conducted in May 2020 warned that nearly two-thirds of people have experienced some sort of disturbed rest or sleep problem since the lockdown was announced on 23 March.

Based on more than 2000 Ipsos MORI interviews with adults in the UK, the researchers found the following.

  • Half the population (50%) say their sleep has been more disturbed than usual.

  • This rises to 62% among those who say they’re certain or very likely to face financial difficulties because of disruption caused by coronavirus.

  • People who find coronavirus stressful are, unsurprisingly, more than twice as likely as those who don’t to report disturbed sleep (64% v 29%).

  • Two in 5 (39%) say they’ve slept fewer hours a night on average compared with before the lockdown. Among those who say they’re certain or very likely to face financial difficulties due to Covid-19, this rises to 48%.

  • Some people, in contrast to the above, are getting more sleep but feeling less rested. Three in 10 (29%) say they’ve slept longer hours but feel less rested than they normally would when they wake up. Again, this is even higher among those who say they’re certain or very likely to face financial difficulties because of coronavirus, rising to 4 in 10 (42%).

  • On the other hand, a quarter (24%) say they’ve slept longer hours and feel more rested when they wake up.

  • Vivid dreams also seem to be a feature of lockdown, with 2 in 5 people (38%) reporting having had more vivid dreams than usual.

  • Half (49%) of those who find coronavirus stressful report having had more vivid dreams than usual, compared with a quarter (25%) among those who do not find it stressful.

Commenting on the research, Professor Bobby Duffy, Director of the Policy Institute at King’s College London, said, “Nearly two-thirds of the UK public report some negative impact on their sleep from the Covid-19 crisis, clearly showing just how unsettling the pandemic and lockdown measures have been for a very large proportion of us.

“And this is clearly tied to both how stressful we’ve found the virus itself, and how much we fear the impact of the lockdown on our employment and finances.”

The rise of staggered shifts and night work

Going forward, one of the Government recommendations for allowing employees to safely return to work is the introduction of staggered shifts and working hours.

This, health experts hope, will reduce the likelihood of large numbers of people travelling at peak times as well as help to enable adequate social distancing between workers during their working hours.

The Government guidance suggests that from a practical perspective, businesses could consider splitting staff into teams with alternate days working from home or splitting teams across a day and night shift.

So, for example, a factory or warehouse which previously ran only a small, skeleton night shift might seek to introduce larger-scale night shift working in order to ensure sufficient social distancing throughout employees’ working periods and cut down on peak travelling.

While increased night shift working may help to ensure social distancing and so reduce the transmission of the coronavirus, it is not without risk to the health, safety and wellbeing of workers — including in relation to quality of sleep.

Recent research from the Institution of Occupational Safety and Health (IOSH) has shown that key workers, such as those working in the healthcare, utility and transport sectors, are not only the most exposed to Covid-19 but are more likely to suffer from health-related illness or sustain an injury as a result of shift work.

Those working night shifts were found to be approximately 25–30% more at risk of injury than staff working day shifts.

In addition, it was found that working a 12-hour rather than an 8-hour shift increased the risk of injury, again by 25–30% with risk increasing evenly over 4 consecutive shifts.

Furthermore, the International Agency for Research on Cancer (IARC) — the prestigious agency of the World Health Organization (WHO) — has recently come out and again classified night shift work as “probably” carcinogenic to humans, after a great deal of heated debate on the subject in recent years.

According to the IARC, its new classification as of 2020 is based on “limited evidence of cancer in humans” (for cancers of the breast, prostate, colon and rectum), and “sufficient evidence of cancer in experimental animals” as well as “strong mechanistic evidence in experimental animals”.

Based on best practice in relation to shift work, IOSH has in the past advocated a mixture of commonsense changes by individuals to their lifestyles and practical measures by employers to the working environment. These changes could include:

  • allowing adequate time between shifts for sleep and meal preparation

  • providing at least 48 hours between shift changes

  • providing regular (annual) health checks for shift workers

  • being mindful of the need to transfer staff to day work if required.

Top tips to get sleep back on track

Overall, adapting as effectively as possible to the new normal will be essential in getting workers’ sleep cycles back on track during the coronavirus pandemic.

Writing in The Conversation, Dr Lesley Ingram-Sills of Edinburgh Napier University has shared the following tips, which may help workers to improve their quality of sleep.

  • Establish a new routine. Whether you are furloughed or working from home, Dr Ingram says a good routine is the starting block for engaging with your natural circadian rhythm, and you should be aiming for 7–9 hours sleep a night. She recommends going to bed when you are tired and trying to wake without an alarm, but stopping work, reducing screen time, meditating, or reading at least an hour before bed.

  • Don’t use your bedroom as your office if possible and Dr Ingram suggests keeping electronic devices which emit artificial light and can disrupt the body clock, out of the bedroom.

  • Avoid napping. If your previous night’s sleep was poor you may feel more tired after lunch, but then Dr Ingram suggests that naps be kept short, ie less than 20 minutes.

  • Only drink caffeine before noon says Dr Ingram. (Tea, coffee and alcohol can disrupt sleep during the night. In particular, Loughborough University sleep expert Professor Kevin Morgan warns against using alcohol as a sleep aid since it makes sleep more shallow and can lead to earlier wake-ups if you drink rather more than you should.)

  • Exercise. Dr Ingram says both aerobic and resistance exercise has been shown to have positive effects on sleep.

  • Exposure to both natural light (and dark) helps to keep body clocks in balance and make us tired says Dr Ingram.

Creating a worry buffer

Dr Ingram says, “Not only is routine good for our sleep cycle, it’s also beneficial to our mental health.”

In this regard, Professor Kevin Morgan has the following advice to help manage stress and worries during the Covid-19 pandemic.

He says, “These are worrying times for all of us. We are worried about our own health. We may be worried about the health of people close to us and our loved ones.

“The problem in relation to sleep is when we take our worries to bed and those worries become a barrier to falling asleep. One strategy that we’ve used successfully in therapy is to create what we call a worry buffer.

“This is a brief period of time, 20 minutes or half an hour, set aside during the day where we suggest to people they go to a quiet place with a pen and a pad and they sit and they actually concentrate on the things that are worrying them. They write them down, and then while they are thinking about them, they might write down responses or solutions to these problems.

“If these worries return when you’re trying to get to sleep at night, you now are in a position to say to yourself, ‘These worries are in hand; I can return to them tomorrow. I am already engaged in a constructive response to them’ and you can give yourself permission to just fall asleep.”

The value of sleep, especially before midnight

Not all sleep is created equal; sleep type and quality does change as the night wears on, with deeper and potentially more restorative non-rapid eye movement (REM) sleep dominating in the early part of the night, ie roughly before midnight. In contrast, as the hands of the clocks move toward dawn — the usual time when we have those intense dreams — lighter REM sleep becomes more prevalent.

Therefore, one employee might sleep from 10pm–6am while another’s shifts may require they sleep from 3am–11am. Both are getting their 8 hours, but chances are the first worker will feel more rested.

An old sleep adage is that every hour of sleep before midnight is equal to two hours of sleep after midnight. And indeed, some health experts believe an hour or so of solid sleep before midnight can transform health. This clearly has implications for night shift workers, but also homeworkers who’ve taken to nocturnal working on important projects until 4am during the lockdown.

There may not be a simple, one-size-fits-all solution to these challenges but knowledge and awareness of the value of sleep is, at least, a good start.

So perhaps the most important conclusion to take from all the recent research on sleep in the coronavirus is simply its vital importance to the health of the workforce.

In the words of Dr Ivana Rosenzweig, part of the King’s College research team, “It is… important to acknowledge that a quarter of participants reported they were sleeping more and feeling better for it, which highlights that, as a society, we simply do not get the chance to sleep as much as we need, and that this pandemic is allowing some of us to rediscover the importance of sleep.”