Professor of Psychology Alice Gregory is an expert in sleep and its associated difficulties and a member of the Pediatric Sleep Council.
Ahead of the release of the new paperback edition of her popular-science book Nodding Off: The Science of Sleep from Cradle to Grave we asked Professor Gregory how sleep and sleep research has been impacted by the Covid-19 pandemic.
Sarah Cox: How has two months of lockdown impacted people’s sleep health?
Alice Gregory: Covid-19 is so new that published data are only beginning to emerge about sleep and the pandemic – but there are certainly lots of hypotheses. Social media tells us that many people are reporting many changes to their usual sleep patterns. The situation we find ourselves in at the moment seems to impact almost every aspect of life, including factors affecting sleep such as exposure to bright light, the consistency of our routines, the amount of exercise we are getting and our stress levels.
Some people are reporting waking during the night, which could be because of the anxieties they may have; or perhaps because they are trying to get more sleep than they might need. Others, who struggle to get enough sleep under usual circumstances, perhaps because of long commutes, a demanding work schedule or busy social life, may have new-found opportunity to sleep.
Some are reporting odd dreams too, and there are many possible explanations for this. For example, we need to wake up in order to remember a dream – so increased night waking or more relaxed starts to the day may help to explain why dreams are being recalled more than usual.
SC: It’s been a time of huge upheaval for children, with most unable to go to school or see friends. How might this have affected their sleep?
AG: Lockdown has had the potential to impact sleep for better and for worse. As with adults, a reduction in sunlight exposure, an irregular routine, and increased stress levels can all negatively impact sleep in children too. Other factors could have an effect on sleep too – such as an increased use of electronics, which can be particularly problematic when present in the pre-sleep period.
But there are also potential up-sides of this situation for sleep too. As discussed in Nodding Off, for many years there have been campaigns around the world arguing for school to start later in the day for adolescents. This is because we see a change in sleep timing during this stage of life – where sleep timing becomes later. This change appears to be associated with puberty, occurs internationally and is also found in some other mammals. In line with this, adolescents may find it difficult to fall asleep early, which can mean that under normal circumstances the wake time necessary for the school day is problematic.
This situation can also contribute towards ‘social jetlag’ where sleep timing shifts between week days and weekends and has been linked to multiple problems. The increase in home-learning associated with the pandemic means that some adolescents now have greater flexibility in setting their sleep timing and schedules to be more in line with their own biological rhythms. However, schedules should not shift too late – as this could result in problems when school resumes.
SC: Can you share some advice for parents, to help their child’s sleep?
AG: My top tips include establishing a consistent routine (ensuring that the family wakes up at the same time every day, for example) and not letting bedtime become too late. It can also be useful to avoid screen time – particularly before bedtime and to discourage children from working in bed so that space does not become associated with arousal. Getting exposure to bright light during the day and obtaining regular exercise is also helpful.
There are multiple other tips available to parents and information has been posted about this elsewhere. For example, the Pediatric Sleep Council has produced some tips online. A task force of the European Cognitive Behavioural Therapy for Insomnia (CBT-I) academy has also issued some tips for dealing with sleep problems during home confinement due to the pandemic.
SC: Earlier this year The Touch Test was launched to survey public attitudes to touch. You’re now analysing data collected relating to sleep – what do you think you might find?
AG: The Touch Test was launched in January and data collection continued until March 30th. The main aim of the study was to explore people’s attitudes towards the physical experience of touch which is particularly important to establish following movements such as #MeToo. My role in the project was to think about how touch might be related to sleep.
Of course what none of us could have realised as we designed the study was that there would be such seismic shifts in touch-experiences over the period during which we were collecting data. Certainly, as COVID-19 spread in the UK we were encouraged not to shake hands with others or even touch our own faces – and social distancing and shielding has left many without hugs from loved ones.
Other factors may have shifted over this period too, such as the way we sleep. Given the changes in the number of Covid-19 cases in the UK over the time-period of data collection, we hope to also use the data collected to tell us more about this period in time. For example, will people who provided data at an earlier date report better sleep quality (perhaps reflecting lower anxiety levels and a more standard routine) than those who provided data later in the study? Will sleep length change – perhaps increasing as the study continues, due to a reduction in commuting and fewer social events? We have ideas as to what we might find but have not yet run these analyses so don’t know for sure.
Find out more about sleep, sleep science and Covid-19 from Professor Alice Gregory via her recent interview with The Telegraph and co-authored editorial in the Journal of Child Psychiatry and Psychology
Nodding Off: The Science of Sleep from Cradle to Grave is published by Bloomsbury and available to buy in paperback from 21 May 2020