Mental Health Awareness Week 2022: Is loneliness keeping you awake?

This year’s theme for Mental Health Awareness Week is loneliness. Sleep problems and loneliness often go together. When you’re tired, you’re less likely to feel like socialising, but few people realise that loneliness can also be a trigger for poor sleep.

What is loneliness?

We all feel lonely sometimes. It’s part of being human. We’re wired for social contact. Loneliness happens when we’re dissatisfied with the nature of our human connections.

Loneliness isn’t necessarily the same as being alone. Some solitude can be healthy. One person might feel lonely despite having lots of friends, whereas someone else with just a few close relationships might feel well connected.

A survey by the BBC in 2018 found that 16-24 year olds were the loneliest age group in the UK, with 40% saying that they felt lonely, versus 27% of other adults. A survey during lockdown in March/Apr 2020 also found that loneliness affected 1 in 4 adults, with younger people, and those separated or divorced more likely to be affected.

How is loneliness linked to poor sleep?

Loneliness is an undesirable feeling in itself, but it is also linked to negative longer term health outcomes, including increased rates of depression, alcoholism, heart disease and cognitive decline. It has been suggested that loneliness can be as harmful to our health as smoking 15 cigarettes a day.

One reason that loneliness has negative health outcomes may be because feeling lonely can lead to poorer quality sleep. A recent review of 27 different studies found a positive association between poor quality sleep and loneliness (Griffin et al 2020). Loneliness acts as a stressor on the body, and many of us know well that stress of all kinds can interfere with good quality sleep.

Could poor sleep make us vulnerable to loneliness?

There has been little long term research to determine whether loneliness causes poor sleep, or poor sleep causes loneliness. In fact, the relationship almost certainly goes both ways.

Lab studies have found that if you deprive someone of sleep, the parts of the brain involved in detecting threats become more sensitive, while the ‘pro social’ circuits which promote social interaction are inhibited. A sleepy person will be less inclined to socialise in their time off, and is more likely to choose to stay further away from other people. In fact, one study that tracked mood, sleepiness and social contact over 3 weeks found that a change from feeling very alert, to very sleepy, decreases the odds of social contact that day by 70% (Holding et al 2020).

Interestingly, if we feel tired and sleepy, this might also deter other people from wanting to socialise with us. Sleep deprivation is linked to a blunting of emotional expression and lower charisma, which could make us less fun to be around. Facial cues such as redder eyes, hanging eyelids, dark circles and pale skin are easily detected by observers, and are linked to perceptions of sadness and fatigue, and lower ratings of attractiveness.

It is easy to see how a negative cycle of poor sleep, social withdrawal and loneliness could perpetuate itself; when we opt out of social occasions after a poor night’s sleep, other people may also become less likely to seek us out, and we end up feeling more isolated.

How can we tackle loneliness and poor sleep?

If poor sleep and loneliness have a two-way relationship, then anything that you do to help protect your sleep might have a positive impact on those pro-social networks in the brain, and make it easier to seek out company.

This means that if you are feeling lonely, a positive first step could be to implement some healthy sleep habits such as:

• waking up at the same time each day
• getting outdoors into natural daylight in the morning
• engaging in regular exercise.

These three steps can also boost overall wellbeing.

But what about interventions to target loneliness?

Acknowledge that you’re lonely, and talk about it

There is absolutely no shame in feeling lonely. Like other feelings such as hunger and thirst, it’s there to protect us - it should be a cue for action. If you’re feeling lonely, think about whether there is a family member or friend that you can talk to about it. It is highly likely that the person you speak to will have felt the same at some point, and can empathise and help you to brainstorm ideas to help. You can also make an appointment with your GP if you’re struggling to cope with loneliness.

Build up your daily community

If you work from home alone, shop and bank online, and live far from family, you may be spending more time than ever before on your own, and feeling isolated. It might help to get back into the habit of shopping locally, going for a walk in the same places, or joining a gym or local community group, so that you start to interact with the same people on a regular basis.

Connect, or re-connect more deeply with friends

It can feel daunting to make new friends if you’re feeling out of practice. One way to ease yourself back into feeling more sociable could be to write, email, or call a friend you haven’t spoken to for months, or years. A whatsapp or Facebook message is quick and easy, and could be used to schedule a proper catch up call. Recent research shows that we have a tendency to think that other people won’t want to have ‘deep’ conversations and so we revert to shallow small talk. In fact, when complete strangers are prompted to discuss their hopes, fears, regrets and more intimate feelings, it leads to a deeper sense of connection and satisfaction (Kardas et al 2021).

Spend time with like-minded people, doing the things you enjoy

We tend to make friends naturally with people who enjoy the same hobbies. It might feel a bit cringey to go out and try and recruit friends, but if you concentrate on the activity, the friendship will probably take care of itself. Think about something you used to enjoy, or would like to learn afresh, that can be booked as a group - flower arranging, cooking, horse-riding, paddleboarding.. whatever is on your bucket list.

Volunteering

Research consistently shows that volunteering is linked to increases in wellbeing, and a sense of purpose. Volunteering is also a great way to meet new people and feel part of a cause or community. Being kind to others increases our own levels of happiness, as well as theirs.

If you would like to find out more about loneliness, or even volunteer, check out the Marmalade Trust, the UK’s leading loneliness charity for people of all ages, or the NHS Every Mind Matters pages.