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Effect of lockdown on sleeping patterns

“Oh Sleep it is a gentle thing/Beloved from pole to pole”, wrote Coleridge. We all love our sleep, but several factors can affect it. Sleep is intricately linked to natural phenomena like sunlight and ambient light, the daily routine, and importantly, stress. The COVID-19 pandemic has hit our health, society, economy, and education, and naturally our sleep as well.

The pandemic has affected everyone’s stress levels differently. For those who do not have to make the daily commute to work and are working from home, the pressures of ‘normal’ life have reduced. However, stress levels have sky-rocketed for daily-wage workers, migrant laborers and those depend-ing on daily income from business. Health workers are devastated by the death of their patients, and fears of contracting the COVID-19 virus and spreading it to their families.

The average adult sleeps for about 6 hours 38 mins - still short of the 7+ hours of sleep recommended for adults as shown by a previous survey in April 2017. The same group again analyzed users’ sleep data in March 2020, during the peak of the COVID-19 pandemic. Interestingly, they found that people are going to bed later but getting more sleep, and more quality rest during lockdown. The young – perhaps deprived of late-night socializing - had the largest improvement in sleep duration and quality.

In India, according to a Philips sleep survey, 55% of Indian adults “snooze” their alarm once or twice, while 17% of Indian adults “snooze” at least 5 times- indirect evidence of our lack of adequate, restor-ative sleep. When it comes to relationships, 47% adults say their partner’s difficulty in sleeping makes them sleep separately, affecting their relationships. We don’t yet have data on sleep patterns among India patients in the COVID-19 times, but anecdotal evidence suggests that while some are sleeping better others are experiencing stress related insomnia. Working from home, introduces the element of loss of regular routine - sleeping during the day, going to bed later at night and staying in bed late.

The lockdown is already being lifted, and it is wise to prepare for “normal” sleep habits. We need to respect our body’s internal clock, practice sleep hygiene and avoid a rebound epidemic of sleep dis-turbances post-COVID-19. How to do this?

· Follow a fixed sleep-wake routine, matching your expected routine post-lockdown. This can help induce a state of normalcy even in such unusual times.

· Ensure adequate sunlight exposure.

· Shut off all electronic devices and TV at least 1 hour before bedtime.

· Avoid large meals, caffeinated drinks and vigorous exercise for at least 3 hours before you sleep.

· Do not self-medicate for insomnia. There are healthier solutions. Practice yoga or relaxation exercises to reduce anxiety levels.

· Persons using a Continued Positive Airway Pressure (CPAP) machine for Obstructive Sleep Ap-nea (OSA) should use it regularly. Untreated OSA is associated with heightened inflammation, which increases the risk of bad outcomes with COVID-19.

If you experience difficulty in sleeping despite all the above measures, seek help from a physician, and follow his/her prescription.

Let us use the lessons learnt during the COVID-19 pandemic and change our sleep and waking life for the better

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Dr Murali Mohan & Dr Sharanya Mohan

Guest Author Dr Murali Mohan, Senior Consultant Pulmonologist, Narayana Hrudayalaya Dr Sharanya Mohan, Dr B R Ambedkar Medical College, Bangalore

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