How has COVID-19 lockdown affected our sleep? SleepQuest Findings
Updated: Aug 19, 2020
For many people, the COVID-19 lockdown has been a time of great stress and anxiety. For others, the normal stresses of daily life have been relaxed. Regardless, it can be agreed that it has been an unusual time for everyone, and the knock-on effect on our physical and mental well-being may be significant.
We in the ReMemBr Group at the University of Bristol are interested in understanding brain health and the many factors that influence it. Sleep is hugely important for health, with poor sleep being linked to increased chance of cardiovascular disease, mental illness, and dementia.
We noticed through speaking to people at the start of the lockdown that sleep was often being affected. Some reported worsened sleep, while others felt that their sleep had never been better. This was clearly something which needed to be researched, so we launched the SleepQuest study – an online collection of questions designed to understand how, if at all, the COVID-19 lockdown had affected people’s sleep, and what factors determined how sleep had been affected. We included questions about overall sleep quality, general lifestyle factors and self-help sleep strategies that people have found useful.
3474 people completed our questionnaire between 29th April and 13th May 2020. This was during the period in which lockdown in the UK was most severe - with only one trip outside per day permitted by the government restrictions. This unique opportunity also allowed us to study the association between sleep quality and time spent outside.
How has the lockdown affected our sleep?
Half of everyone we asked said that their sleep had changed in some way during the lockdown. 35% of people said that their sleep had worsened during the lockdown and 15% said their sleep had improved. Our finding that COVID-19 lockdown has impaired people’s sleep in the UK is also in line with data from across the world, including China, the US, Italy, and several other European countries.
What factors determine whether our sleep has improved, worsened or stayed the same?
We found that depression and anxiety were associated with greater likelihood of sleep having worsened. Other factors associated with worsened sleep included having a confirmed or suspected infection with COVID-19 and caring responsibilities.
It is unclear from our data whether sleep problems were caused by lockdown-related anxiety and depression, or whether anxiety and depression were pre-existing (and potentially made worse by lockdown). However, our findings are in line with other research from other countries showing links between the COVID-19 outbreak and higher levels of anxiety, low mood and sleeplessness.
In contrast, improved sleep during lockdown was associated with spending more time outside. This may be because daylight helps the brain to know when it is daytime, and therefore, when it is time to go to sleep.
People who spent time outside in the morning had overall better sleep quality than people who spent time outside in the afternoon or evening. Interestingly however, this benefit was dependent on the genetically-determined preference for mornings or evenings – your chronotype. ‘Owls’ (people with a preference for going to bed later) benefited the most from being outside early in the day, whereas for ‘Larks’ (people who prefer to wake up early) the time of day was less important.
Women were less likely to report that their sleep had stayed the same compared to men, and more likely to report that their sleep had either improved or worsened. Likewise, even though older people reported overall worse sleep quality, they were less likely to say that it had become worse during lockdown than younger people.
What have people found helpful to promote sleep during lockdown?
The things that people found helpful in managing their sleep are shown in the graph below. The most effective strategies were exercising during the day, reducing caffeine consumption, keeping to a routine, and reading before bed. The least helpful was having a hot drink before bed, though even this had a slightly positive effect on sleep. These are all in line with evidence-based recommendations for managing sleep. Go to the 'Resources' tab above to find out more information about these strategies.
Our findings have been submitted as a 'preprint article' here, where full details about the study can be found:
Please note, the findings have not yet undergone peer review, and so should be interpreted with care. We will post another update as soon as the findings are published in a peer-reviewed journal.
More to follow…
PHQ8: Patient Health Questionnaire (8 questions)- a questionnaire used to assess mood and depression
GAD7: Generalised Anxiety Disorder questionnaire (7 questions) - a questionnaire used to assess anxiety levels
DBAS16: Dysfunctional Beliefs and Attitudes about Sleep (16 questions) - a questionnaire used to measure a person's general attitudes to sleep.