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Combat COVID-19 With Sleep

Dr. Els van der Helm

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September 29, 2020

The rampant spread of COVID-19 calls for us to focus on an immune system booster that is frequently ignored - sleep.

Current approaches to fight COVID-19

Organizations around the world are forced to focus their attention on the health and safety of their employees in the face of COVID-19. Most of us have now heard the advice of more frequent and thorough hand washing, no more handshaking, and coughing and sneezing in your elbow instead of your hands. In addition, company policies are quickly adapted with the aim to reduce the virus spread such as travel bans, working from home, and cancellation of large events.

These are all effective ways to directly combat the virus as we’ve seen in some of the hardest-hit countries already. However, there is one piece of advice that deserves more attention in order to keep employees safe that is still often overlooked: proper sleep.


COVID-19 Global Cases by the Center for Systems Science and Engineering, John Hopkins. 11 March 2020
COVID-19 Global Cases by the Center for Systems Science and Engineering, John Hopkins. 11 March 2020

What does COVID-19 have to do with sleep?


Recent scientific studies have shown that sleep loss leads to an immediate decline in our immune system’s ability to fight off viruses and bacteria, as well as our recovery after infection.

Sleep Duration

One study, for instance, on 164 men and women found that sleeping less than 6 hours a night over the course of one week increased the likelihood of developing a cold by a whopping 4.2 times, compared to sleeping more than 7 hours a night during that same period¹. And although 7 hours a night is better than 6 or less, another study showed that 8 or more hours of sleep a night is preferable, further decreasing our risk of developing a cold².

Although the exact optimal amount of sleep is unclear, sleeping less than 6 hours a night has consistently been linked to increased health risks. For instance, one study found that in a sample of nearly 57,000 women, those who reported sleeping 6 hours or less a night were at significantly greater risk of developing pneumonia compared to those sleeping 8 hours a night³.

Sleep Quality

Beyond sleep duration, it seems that sleep quality is an equally important immune system booster. The sleep duration study above looked at the amount of time participants spent awake in bed, trying to sleep². They found that while 7–8 hours of total sleep is a reasonable target, even minimal amounts of sleep disturbances, such as 10 to 38 minutes of staying awake in the case of an 8-hour sleeper, are associated with a 3.9 times increase in the risk of developing a cold.

Measuring Sleep Quality

Exactly how poor sleep affects the immune system remains unclear; consistent immune system changes related to specialized cells called T-cells, natural killer cells, cytokines, and the activation of inflammatory pathways⁴ may be among the drivers that lead to an increased risk of upper respiratory infections. 

Sleep after infection

Sleep is not just critical to our immune system before infection – it’s equally important in helping our immune system after we’ve been infected. Most of us will have experienced that we indeed sleep differently when we’re sick. Studies have found that more sleep in the two days before an infection led not only to increased resistance to infection, but also to higher  survival rates after infection⁵. Specifically, increases in non-rapid eye movement (NREM) sleep led to increased survival rates after an infection⁶.

Such findings suggest that changes in sleep after infection are also important determinants of disease and mortality levels. A very recent study by theUniversity of Tübingen in Germany found that this effect might be partially driven by the way in which sleep after infection can boost the effectiveness of our immune system’s T-cells⁷.


Ways to help your employees


Ensure that all your employees are aware of the preventative role that sleep can play in helping them stay healthy and increasing their odds of successfully fighting the virus. This knowledge can be shared through live webinars with sleep experts, email communication, or other channels your organization uses (e.g. internal social channels such as Slack). We are currently implementing similar initiative sat some of our clients and seeing a great demand for knowledge on this topic.


You can go beyond “planting a seed for change”: it’s critical to also support employees with implementing this advice. In our experience, simply creating awareness is not enough to achieve impact. For successful behavioral change to happen, people really need coaching focused on changing their habits – starting with the habits that are most relevant to them. 

Behavior change is always challenging –and even more so in stressful times with lots of change. But the COVID-19 outbreak also offers unique sleep-specific opportunities for employees to start changing their habits, given the immediate changes they are already experiencing in their daily lives. Perhaps international travel has suddenly disappeared from their calendar, removing the challenges of jet lag and sleeping away from home. For others, it might have removed their daily commute to the office, freeing up an hour or more each day that can be devoted to sleep and sleep-supporting habits. 

Given that your employees are likely more home-bound than ever, it’s critical to focus on sleep solutions that can provide coaching in a digital and scalable manner, such as app-based and webinar-based sleep support, to ensure anyone can start working on their sleep, whether they are at home or in the office.

Shleep's Digital Sleep Coaching Platfor


Address sleep in your organization

This month happens to be Sleep Awareness Month, making it the ideal moment to address the topic. Reach out to our team at hello@shleep.com if you’re interested in sleep support for your organization. 

REFERENCES

¹Prather, A. A., Janicki-Deverts, D., Hall, M. H., & Cohen, S. (2015). Behaviorally assessed sleep and susceptibility to the common cold. Sleep, 38, 1353-1359

²Cohen, S., Doyle, W. J., Alper, C. M., Janicki-Deverts, D., & Turner, R. B. (2009). Sleep habits and susceptibility to the common cold. Archives of internal medicine, 169, 62-67.

³Patel, S. R., Malhotra, A., Gao, X., Hu, F. B., Neuman, M. I., & Fawzi, W. W. (2012). A prospective study of sleep duration and pneumonia risk in women. Sleep, 35, 97-101.

⁴Besedovsky L, Lange T, Born J. Sleep and immune function. Pflugers Arch. 2012;463:121–137.

⁵Kuo, T. H., & Williams, J. A. (2014). Increased sleep promotes survival during a bacterial infection in Drosophila. Sleep, 37, 1077-1086.

⁶Toth, L. A. (1993). Tolley EA, and Krueger JM. Sleep as a prognostic indicator during infectious disease in rabbits. Proc Soc Exp Biol Med, 203, 179-192.

⁷Dimitrov, S., Lange, T., Gouttefangeas, C., Jensen, A. T., Szczepanski, M., Lehnnolz, J., ... & Besedovsky, L. (2019). Gαs-coupled receptor signaling and sleep regulate integrin activation of human antigen-specific T cells. Journal of Experimental Medicine, 216, 517-526.

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