How Can I Reset it?

There is increasing evidence that during various phases and levels of COVID-19 lockdowns, our sleep quality has deteriorated, so that its timing is earlier or later than we would prefer, and irregular. When our internal bio-neurological 24-hour waking and sleeping clock is not aligned with the timing requirements of our external social and work environments, our disrupted circadian rhythm results in sleep disorders. Other behaviour, such as concentration, mental processing capabilities and creative thinking, which varies within the 24-hour cycle, are affected by disrupted sleep. This makes it important to understand how COVID-19 has disrupted circadian rhythms, and what behavioural interventions could help restore it to avoid long-term deleterious effects on our mental and physical well-being.

Body Clocks and Behaviour

In reality, we have more than one internal body clock., although our brain’s hypothalamus is seen to play the dominant role. All our body tissues and organs contain their own clocks. That necessitates collaboration amongst our network of clocks, a role it is suggested our central clock, in the brain’s hypothalamus, performs.  Light is transmitted to the hypothalamus via our eyes, although it is thought there could be other pathways, and this information is used by our central clock to synchronise internal physiological with external environment timing. When all is well in our world, the functioning of all clocks is dynamically synchronised. It is true to say, all has not been well in most of our worlds since the first quarter of 2020, when the pandemic began to spread at an alarming rate across borders and continents.

Covid-Related Sleep Disorder Effects

In his Sleep Research in 2020: COVID-19 related sleep disorders overview in the LANCET, Markku Partinen makes reference to the growing incidence of COVID-19 related sleep disruptions. One of the earliest studies from China he mentions, involving 7236 respondents on COVID-19 impacts, reported an 18% incidence of sleep disorders   Maria Rosario Gualano et al.’s later research in Italy, at the end of its first lockdown period, found anxieties related to COVID-19 and confinement were highly correlated with sleep disorders, with 42% of their 1515 participants experiencing poor sleep quality.

Aside from confinement, work from home conditions for professional employees have tipped the scales in favour of disrupted sleep, as a client, Max, experienced:  I find myself working and in video cons day and night. This intrudes into family time. Across time-zone emails arrive late at night for my urgent response.  I am desperate to unplug and unwind.

Working late into the night, he experienced raised body temperature. Whilst this enabled mental alertness, it simultaneously postponed the onset of sleepiness, which requires a drop in body temperature. Light exposure from his laptop that time of night, signaled time to wake up to his brain, and these body temperature and light characteristics strongly influenced his disrupted sleep. Inevitably, he became irritable and despondent as the pandemic wore on, without any certainty of when and how it would end.

Working mothers with young children, home schooling them and fitting in domestic chores, in between work tasks, have had their days spill over into nights. Maria Rosario Gualano et al.’s findings concurrently show women had an increased risk of sleep disorders, as compared with their male counterparts.

A Post-COVID-19 World of Work

The way most employees have been working remotely from anywhere in the world, in their homes, will not be entirely abandoned in the post-pandemic world of work. Behavioural adaptations towards regularising sleep-waking to an approximately 24- hour circadian clock rhythm could result in better coping with the side-effects of this new way of work.

Behavioural Interventions: Resetting Circadian Rhythm

These actions have had positive benefits for some individuals with sleep disorders, arising from a desynchronisation between internal body clocks and external environmental timing needs.

• Exposure to sunlight during the day, and darkening rooms as much as possible at night, help to reset our bodily clocks to a more regular 24-hour circadian rhythm  
• Adjusting the intensity of light from computer screens could minimise room brightness at night
• As always, physical exercise contributes to wellness, and in this case resetting your circadian rhythm through physical activity, provided that it is done more than an hour before bed time, could be beneficial too
• Regularising meals to the same time every day, could reset your liver clock and other digestive organs
• Maintaining regular sleep and waking up times, wherever possible, could contribute to neutralising the circadian clock disruption
• If you have unavoidable early evening video con interactions or other work to attend to, try napping in the early afternoon, for a duration of no more than 30 minutes, so that it does not disrupt your night-time sleep. Even if you do not fall asleep, just closing your eyes in a quiet, darkened room, wearing an eye mask, would suffice.

Influencing company culture to encourage ‘heads down’ days, where no video cons are scheduled and no late-night incoming emails are attended to, would re-inforce the effects of these interventions.

Should your sleep disorder persist after putting these behaviours into action for more than 14-30 days, consult your medical doctor for referral to a Neurologist about your sleep disorder.