As World Sleep Day arrives just after the schools reopen, it’s fair to say the Pandemic has been hard for parents, including the different sleep patterns they and their children may have adopted during Covid-19.
How can we have a regular sleep? Â
We need to remember the two processes that regulate both the timing and length of sleep: Circadian regulation (process C) and homeostatic control (process S) also known as the two-process model of sleep. Although many other factors affect sleep, such as environment, stress, and medications; understanding these two processes will help us strive towards a consistent sleep schedule. Process C refers to our internal clock, regulated by a part of our brain called the suprachiasmatic nucleus (SCN) of the hypothalamus. This clock regulates and controls the 24-hour sleep-wake cycle via the influence of light and melatonin. In the absence of light (as during the evening hours) melatonin is produced promoting sleep but in the presence of light, the production of melatonin ceases, signalling our brain that is daytime and we need to wake up. Our behaviour can override these natural signals. For instance, bright lights at night shut down the production of melatonin, delaying sleep until late hours of the night.
It is important to remember that sleep is involved with many physiologic systems such as memory consolidation, control of inflammation, hormone regulation, cardiovascular regulation and many other important functions, therefore insufficient sleep duration and poor sleep quality will be associated with several significant adverse health outcomes. Reduced sleep duration has been shown to cause impairments in cognitive and executive function, while poor sleep has been associated with poor mental health.
The World Sleep Society recommends the following 10 steps to achieve healthy sleep:
- Fix a bedtime and an awakening time.
- If you are in the habit of taking a nap, do not exceed 45 minutes of daytime sleep.
- Avoid excessive alcohol ingestion 4 hours before bedtime and do not smoke.
- Avoid caffeine 6 hours before bedtime. This includes coffee, tea and many sodas, as well as chocolate.
- Avoid heavy, spicy, or sugary foods 4 hours before bedtime. A light snack before bed is acceptable.
- Exercise regularly, but not right before bed.
- Use comfortable bedding.
- Find a comfortable temperature setting for sleeping and keep the room well ventilated.
- Block out all distracting noise and eliminate as much light as possible.
- Reserve the bed for sleep and sex. Donâ€™t use the bed as an office, workroom or recreation room.
Covid-19’s impact on sleep:
Covid-19 has had a huge impact on children and young peopleâ€™s sleep as time on technology goes into overdrive and bedtimes creep later, according to a new national sleep survey.
Three organisations â€“ The Sleep Charity, The Sleep Council and Sleepstation â€“ joined forces to ask the nation about their childrenâ€™s sleep during Covid-19 and the results from the first 2,700 respondents are an early warning sign about the long-term negative impact on kidsâ€™ slumber. This supports the newly published paper from the Journal of Child Psychology and Psychiatry (May 2020) that suggests the potential for sleep problems to emerge or worsen during and following the pandemic is high.
The survey found that as many as 70% of children under 16 are going to bed later â€“ but are also waking later (57%) â€“ showing that a significant drift in bedtime schedules has already happened. This represents a clear risk with an obvious knock-on effect when schools re-open.
Worryingly, children are becoming more heavily reliant on technology with nearly three quarters (74%) of parents reporting that their children are using electronic devices (TVs, tablets, gaming machines and phones) significantly more during the coronavirus lockdown.
Vicki Dawson, CEO of The Sleep Charity, said: â€œThese are extraordinary times and we fully understand why bedtimes and wake up times have slipped. But we are worried about how children will transition back to a normal routine once schools do reopen, especially given the indications that reception, Year 1 and Year 6 could go back early June.
â€œAs we enter the eighth week of lockdown, children may be using the internet or other technology for several reasons. They are likely to need more access to schoolwork or online learning challenges but it is likely that parents are allowing children to play on devices while they work or participate in online webinars or calls.
â€œWhatâ€™s more important is how much screen time is being used as a crux of support and how much is used before bedtime. Ideally, we would advise parents that all screens â€“ including the TV â€“ are turned off at least an hour before bedtime so that melatonin levels (the sleepy hormone) can increase.
â€œWith limited support available, we have to recognise that Covid-19 could lead to increased sleep problems in children and young people. Ultimately that has a knock-on effect and may influence their daytime behaviour â€“ including hyperactivity, tearfulness and irritability â€“ and family life. In fact, the paper published in the Journal of Child Psychology and Psychiatry indicated that sleep problems could be worse for children and adolescents who are at a heightened risk for the onset of sleep and mental health disturbances.â€
The survey also reveals that a third (33%) of children are sleeping longer than normal, indicating that it will be harder to transition back to previous sleep routines once they return to school. Nearly two in 10 are sleeping less which, if this persists as lockdown continues, could impact on physical, mental and emotional health and wellbeing.
76% of parents also feel that Covid-19 is affecting their ability to maintain routines, enforce boundaries and remain patient. More than half of these parents report moderate to severe disruption to their ability to parent effectively.
More than half (54%) also reported that they were finding it much harder to stay asleep during lockdown, with the problem affecting them significantly more than those without children (43%).
A staggering 84% of parents are also finding that their sleep interferes with their ability to function the next day, compared to 75% of non-parents.
Vicki added: â€œUnderstandably, lockdown is having an enormous impact on family life and it doesnâ€™t surprise us to hear that parents are struggling to retain routine â€“ being a parent is a really difficult job! We are experiencing longer days at home, with parents juggling remote working and trying to â€˜schoolâ€™ their children. Children are also having to adapt. They have been forced to deal with massive disruption to their normal activities including missing school, splitting from their friends and not being able to go to their normal out of school activities â€“ or even to the park.
â€œWe want to help parents recognise that while itâ€™s tempting to allow later bedtimes and lazier mornings â€“ and extend electronic device use â€“ it can take two or three weeks to change a new habit. With children going back on March 8th, routines need adapting now.â€
Vicki shares some of the top tips on how to help keep a routine in place:
Try to keep a consistent sleep schedule. If bedtimes/wake times have drifted, start to move them slowly forward by 10 or 15 minutes every two to three days
Put a stop to all electronic devices (including parents) an hour before bedtime. Use this time as a family (and with no extracurricular activities) to play a board/card game, colour or do a jigsaw. It is relaxing for both parents and children
Try to get out in daylight for at least half an hour every day helping reset childrenâ€™s body clocks â€“ even in lockdown, children are permitted to enjoy one hour of exercise
Try to keep schoolwork and toys out of the bedroom â€“ and certainly donâ€™t send them to the bedroom as a sanction. Ideally, use bedrooms just for sleeping.
What is World Sleep Day and who came up with it?
The World Sleep Society celebrated World Sleep Day on Friday 19th March 2021. The slogan for the 14th annual World Sleep Day is â€œRegular Sleep, Healthy Futureâ€. Itâ€™s a call for all sleep professionals to advocate and educate the world about the importance of sleep for achieving a optimal quality of life and improve global health.
For the past 13 years there have been various slogans highlighting the different aspects of sleep.
2020 â€œBetter Sleep, Better Life, Better Planetâ€
2019 â€œHealthy Sleep, Healthy Agingâ€
2018 â€œJoin the Sleep World, Preserve Your Rhythms to Enjoy Lifeâ€
2017 â€œSleep Soundly, Nurture Lifeâ€
2016 â€œGood Sleep is a Reachable Dreamâ€
2015 â€œWhen Sleep is Sound, Health and Happiness Aboundâ€
2014 â€œRestful Sleep, Easy Breathing, Healthy Bodyâ€
2013 â€œGood Sleep, Healthy Agingâ€
2012 â€œBreathe Easily, Sleep Wellâ€
2011 â€œSleep Well, Grow Healthyâ€
2010 â€œSleep Well, Stay Healthyâ€
2009 â€œDrive Alert, Arrive Safeâ€
2008 â€œSleep Well, Live Fully Awakeâ€
The focus on regular sleep for 2021 is based on the benefits that regular sleep offers. Studies have demonstrated that stable bedtimes and rise times are associated with better sleep quality in young, middle-aged adults, and seniors. Regular sleepers have better mood, psychomotor performance, and academic achievement. Some examples of stable bedtimes could be 9:30/10pm and stable rise times could be 8:30/9am.