Sleepless in Lockdown: unpacking differences in sleep loss during the coronavirus pandemic in the UK

Abstract

Background: Covid-19 has a disproportionate impact on the health of individuals from Black, Asian, and Minority Ethnic (BAME) groups and those in certain occupations, whilst the indirect impacts of COVID-19, such as school closures and home working, has disproportionately affected young persons and women. Concern over such direct and indirect effects may also impact upon sleep. We explore the levels and social determinants of self-reported sleep loss among the UK population during the pandemic, focusing on ethnic and gender disparities.

Methods: data from Understanding Society (USoc) COVID-19 Study collected monthly from April to July 2020 were linked to Wave 9 of USoc conducted in 2018/19, providing baseline information about the respondents prior to the pandemic. The analytical sample included 10,918 respondents aged 16 and above who took part in all four waves survey and had available data for sleep loss, providing 43,672 person-month of data. Mixed-effects regression models were fitted to consider within- and between-individual differences.

Findings: the cross-sectional prevalence rate of sleep loss in April 2020 amongst all aged 16 and over was 24·3%. Prevalence then declined slightly over the next three consecutive months, with women and BAME individuals reporting higher levels of sleep loss each month. Longitudinally, women were more likely to report sleep loss than men (odds ratio [OR] 2·2 [95% CI 2·0–2·5]) over four months. Being female, having young children, perceived financial difficulties and COVID-19 symptoms were predictive of sleep loss. Once these covariates were controlled for, the bivariate relationship between ethnicity and sleep loss (2·0 [1·6–2·4]) was reversed (0·8 [0·7–1·0]). Moreover, the strength of the association between gender and ethnicity and the risk of sleep loss varied over time, being weaker among women in May (0·7 [0·6–0·8]), June (0.6 [0·5–0·7]) and July (0·7 [0·6–0·8]) compared with April, but positively stronger among BAME individuals, especially in June (1·4 [1·0–1·9]).

Interpretation: the pandemic has widened sleep deprivation disparities, with women with young children, COVID-19 infection and BAME individuals experiencing sleep loss, which may adversely affect their mental and physical health.

Funding Statement: this research was supported by the Economic and Social Research Council Centre for Population Change (grant number ES/K007394/1) at the University of Southampton.

Declaration of Interests: the authors have declared no competing interest.

Ethics Approval Statement: this study uses secondary data for the collection of which ethical approval has been obtained by the survey team. All relevant ethical guidelines at the University of Southampton have been followed.

Keywords: COVID-19; Pandemic; Sleep Loss; Mental Health; Gender; Ethnicity

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Identifiers

ORCID for Jane Falkingham: orcid.org/0000-0002-7135-5875

ORCID for Maria Evandrou: orcid.org/0000-0002-2115-9358

ORCID for Min Qin: orcid.org/0000-0002-5941-9979

ORCID for Athina Vlachantoni: orcid.org/0000-0003-1539-3057

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