Nadege Alexandria Puddicombe, BMSc '25
Nadege Puddicombe
The Association Between Social Isolation and Sleep Health Before, During, and After the COVID-19 Pandemic - A Systematic Review
-Project supervised by Dr. Saverio Stranges and Dr. Kelly Anderson
Abstract
Background: COVID-19 drastically altered social interactions, leading to increased social isolation and disruptions in sleep health. This systematic review compares the association between social isolation and sleep health across pre-pandemic, pandemic (partial and full lockdown), and post-pandemic periods. By analyzing findings across different age groups, gender, and urban-rural settings, this study aims to assess the association between social isolation and sleep health over time.
Data and Methods: A systematic search was conducted using Medline, Embase, and Web of Science to identify studies measuring social isolation (e.g., loneliness, quarantine, reduced contact) and sleep health (sleep duration, disturbances, variability) from 1990 to 2024. Studies were categorized into pre-pandemic (1990-2019), pandemic (full lockdown, and partial lockdown), and post-pandemic (lifted lockdown) periods. The risk of bias was assessed using the CLARITY assessment tools.
Results: Pre-pandemic studies established a baseline relationship, with loneliness and psychological distress significantly predicting poor sleep outcomes. Adolescents with higher parental support had better sleep, while older adults faced insomnia. During full lockdown, children in high-caregiving strain households had 2.42 times higher odds of sleep disturbances. Young adults (20-40 years) experienced increased loneliness, digital overuse, and worsened sleep. Middle-aged adults reported anxiety-induced sleep disruption. Older adults faced the highest risk, with 73% of those experiencing anxiety and depression reporting sleep disturbances. Economic stressors and digital behaviors emerged as key mediators. Post-pandemic findings indicated partial recovery, but sleep disturbances persisted in vulnerable populations
Conclusion: COVID-19 amplified the pre-existing association between social isolation and sleep health, with full lockdown exacerbating negative outcomes across all age groups. Post-pandemic, some improvements were noted, but persistent sleep issues highlight the need for long-term social support interventions to mitigate future risks.
About Nadege
Nadege Alexandria Puddicombe, BMSc '25, MSc Candidate, completed her Year 4 Research Project supervised by Dr. Saverio Stranges and Dr. Kelly Anderson in the Department of Epidemiology and Biostatistics.
