Coronavirus: how to sleep better

Why’s it important we’re sleeping well?

We spend one-third of our lives sleeping. The longest a human has ever gone without sleep is only 11 days. It’s clear that sleep is important, perhaps even more so now.

Impact on immunity

Recently, there’s been a lot of misleading information about miracle remedies or magic supplements that can improve our immunity, most of which are poorly supported by robust science. But there’s one weapon we have which has been consistently proven to improve our immunity, and that’s high-quality sleep.

When we sleep, our autonomic nervous system, which comprises both a ‘fight’ or ‘rest’ mode, is shifted into ‘rest’ mode by deep sleep. In ‘rest’ mode our heart rate decreases, cortisol (the stress hormone) decreases, and our body goes into immune stimulation mode. During this process, our immune army restocks, and we can fight infection better.

On the flip side, being sleep deprived can put strain on our immune system. In his bestselling book ‘Why we sleep’, sleep expert Professor Matthew Walker noted that those who are sleeping 5 hours per night are four times as likely to catch a cold than those people sleep 8 hours.

A fascinating study also demonstrated that just one night of sleep deprivation in healthy individuals results in a 70% drop in natural killer cells. Natural killer cells are like immune assassins that attack cancer cells, which naturally appear in your body every day and fight infection.

Key points:

• Sleep is a chance for our immune system army to recover and restock
• Being sleep deprived makes our immune system weak and leaves us prone to colds and infection
• Sleep deprivation reduces our natural killer cells which can impair our immune response.

Impact on our mental wellbeing

A lack of sleep can have an impact on our outlook on life, our ability to deal with challenges, and also our motivation and energy levels.

It’s well established that disrupted sleeping patterns are a key symptom of almost every mental health disorder. In particular, the link between sleep deprivation and anxiety and depression has been extensively researched. People with insomnia were found to be 10 times more likely to have clinical depression and 17 times more likely to have anxiety.

This link is complex. We know that poor sleep can lead to emotional changes often experienced with anxiety and depression, but at the same time, these symptoms can also further disrupt our sleep. Either way, sleep can undoubtedly have a big influence on our mood and mental health.

As well as emotional stability, research suggests that our social skills suffer from sleep deprivation. A study demonstrated that emotional empathy (our ability to recognise and respond to other peoples’ emotions) significantly decreases after sleep restriction. This means that we might struggle to feel sympathy and compassion when we’re overtired.

Key points :

• As well as being a consequence, sleep might actually contribute to psychiatric conditions
• Sleep deprivation also reduces our social skills and ability to sympathise with others.

Why are we sleeping less and what can we do about it?

1) Disruption to our daily routines

Disruptions to our daily routine, or even a lack of routine, can make it more difficult for the body to know when to switch off at night. For most of us, the normal ‘time anchors’ or events that are set in our daily routines are no longer there, such as picking up the kids from school, commuting home from work, or going to an evening gym class.

We might also find we’re oversleeping in the mornings as we no longer need to commute into work. This can make it more difficult to fall asleep at our usual bedtime in the evening.

How can we fix this?

Setting a regular sleep routine is one of the best ways to start improving our sleep quality.

In order to commit to a regular sleep schedule, you need to choose a time for bed and stick to it. Remember to count backwards from the time you need to wake up in the morning, so you’re still getting a full 8 hours of sleep. If you know you need to wake up at 6 am, then your bedtime should be no later than 10 pm.

Alongside going to bed at the same time each night, aim to wake up at a similar time every morning.

It can also be helpful to reincorporate time ‘anchors’ into your daily routine. For example, try to shower and get dressed before work each day, even if you’re not leaving the house. Aim to eat your meals at the same time every day and schedule out specific time blocks for work and exercise.

Where possible, avoid using your bed for other activities including watching TV, eating, or working. This can cause our brain to make an association between our bed and wakefulness, which makes it more difficult for our mind to switch off when it’s time to sleep.

Key points:

• Disruptions to our usual daily routine can interrupt our sleep/wake cycle and make it harder to fall asleep
• Setting a regular bedtime and waking time each day can help our body switch off at night.

2) Less exposure to sunlight

Our bodies have an internal ‘clock’ found in the brain. This clock regulates our circadian rhythm, the 24-hour biological cycle that determines when our bodies are primed to stay awake and be productive, and when we feel tired and want to go to sleep.

The circadian rhythm isn’t 100% accurate. Sometimes it’s a bit longer than 24 hours, sometimes a bit shorter. For this reason, it needs signals from the external environment to adjust itself. The most important signals that adjust this internal clock are daylight and darkness.

Light also helps to prevent the release of the sleep hormone called melatonin. So seeing the sunlight in the morning can reduce that amount of melatonin in our body, which helps us become more awake and alert. At night time, when there is no more light, melatonin levels in our blood begin to rise, causing us to feel sleepy.

Since we’re isolated at home with outdoor exercise limitations, it’s likely we also won’t be getting the same exposure to sunlight as we usually would, especially in the mornings.

How can we fix this?

Where possible aim to schedule your daily exercise in the morning to get some exposure to sunlight, which can help regulate your sleep/wake cycle.

You can also try opening windows and blinds in your house during the day to let in more natural light. Even if the sun isn’t shining, you’ll still get benefits from this.

Key points:

• Sunlight can help to regulate our body’s internal ‘clock’ called our circadian rhythm
• In lockdown, we might not be exposed to as much daylight compared to usual
• Where possible, try to get outside in the morning and let natural daylight into the house.

3) Increased screen time

Since we’re spending all our time at home, many of us will have increased the amount of time we’re watching tv, video calling friends, or scrolling through social media on our phone.

This can be problematic because these devices emit blue light, which interferes with our sleep cycle. While exposure to this light in the morning can help keep us awake during the day, too much exposure at night can ‘trick’ our brain into thinking it’s light outside when it’s actually time for sleep.

How can we fix this?

Try to avoid looking at any screens for at least 2 hours before going to sleep.

Instead of watching TV before bed, find some alternative relaxation activities such as playing a board game, reading a book or magazine, colouring or craft activities, listening to an audiobook, or learning a new hobby like painting or sewing.

Some people also find it helpful to get into the habit of leaving their phones and other devices outside the bedroom. This prevents the temptation to do screen-based activities before bed. If you currently use your phone as an alarm clock in the morning, it might be worth investing in a separate alarm clock instead.

Key points:

Blue light from screens at night time can ‘trick’ our brains into thinking it is day time and mess up our sleep schedule
Avoid looking at screens 2 hours before going to bed and find screen-free ways to unwind before sleep

4) Increased intake of alcohol

A survey conducted by Alcohol Change UK recently found that almost one in five people have increased the amount of alcohol they’re consuming in lockdown.

Drinking alcohol close to bedtime initially helps us to fall asleep. This is why people often associate alcohol with being a sleep aid. However, drinking alcohol before bed significantly impacts how much REM and deep sleep we get.

Although we may fall asleep faster, we’re likely to stay in the light sleep phases for longer and wake up frequently throughout the night. As a result, we can feel mentally and physically exhausted in the morning. The more you drink before bed, the more pronounced these effects are.

How can we fix this?

Try replacing the alcohol with a non-alcoholic alternative. Sparkling water with a lime wedge and unsweetened peppermint tea are good options as they contain no added sugar and aren’t caffeinated. You could also aim to set a challenge of avoiding alcohol on weekdays.

For more tips on reducing your alcohol intake, read our post here.

Key points:

• Alcohol before bed influences the amount of deep and REM sleep you experience
• Try swapping an alcoholic drink for a decaffeinated hot drink or sparkling water
• A good goal to set yourself is to avoid drinking alcohol on weekdays.

5) Increased worry and stress

Finally, it’s likely that many of us will be experiencing higher levels of stress and anxiety at the moment. We’re living through unprecedented times and there’s a lot of uncertainty around the future of our healthcare systems and economy.

This can undoubtedly cause us to stay awake at night worrying, which prevents our brain from switching off.

How can we fix this?

Writing a journal entry before bed can help you to switch off your mind by getting your thoughts out of your head and onto paper. Reflecting on our thoughts each day has a surprising number of benefits, including helping us reason through our problems and conflicts, clearing our minds and organising our thoughts, and relieving stress by allowing us to get our anxieties and frustrations out.

To help calm your mind, you could also try meditation, stretching, or listening to a podcast before bed. There are many other ways you can unwind before bed, it’s just about finding something that works for you! Here are a few other suggestions:

• Taking a warm bath
• Yoga
• Gentle walking
• Deep breathing
• Completing a puzzle
• Colouring
• Reading a book

Being mindful of your exposure to the news, headlines, and social media can also help you control your levels of stress and anxiety. Try placing a time limit on how long you spend watching the news or reading articles and be sure you’re only engaging with trusted media outlets.

Key points:

• Increased worry and stress in the current environment can make it more difficult to fall asleep
• Journaling or writing a diary entry is a good way to get thoughts out of your head before bed
• Other relaxing activities you can try include meditation, yoga, or listening to a podcast before bed.

Take home message

• Sleep deprivation is a common problem for many of us in the setting of the current coronavirus pandemic
• Getting enough high-quality sleep is very important for both our immunity and our mental wellbeing
• There are many reasons we might not be sleeping well at the moment, including disruption to our usual routine, reduced exposure to sunlight, more screen time, increased alcohol intake, and increased worry and stress
• To improve our sleep, it’s important we set a regular sleep routine and aim to go to bed at the same time each night
• We should try to increase our exposure to sunlight during the day and decrease our exposure to blue light from screens at least 2 hours before bed
• Be mindful of alcohol intake which can disrupt our deep and REM sleep cycles
• Implement regular relaxation strategies before bed, including writing a journal, meditation, and taking a warm bath.