The impact of sleep deprivation and anxiety on social understanding and social functioning

Poor sleep and anxiety pose significant economic and social challenges. Inadequate sleep costs the UK economy 1.3-1.9% of Gross Domestic Product each year and has significant health and social consequences. Common mental health difficulties, such as anxiety, account for 17.6 million sick days yearly and reduce GDP by around 1.3%. Additional to this are the indirect costs of poor sleep and anxiety - the costs to our social understanding, social interaction and social relationships. Understanding other people's perspectives, beliefs, desires and feelings is important. The sophistication with which humans do this is one of the things that has led to our success as a species. We live in large communities and cooperate to meet shared goals. We learn from others, teach our children and care for those more vulnerable than ourselves. Each of these activities relies on our understanding of what other people see, believe, want or feel. Sometimes others tell us this information, but sometimes we have to infer it from the way they act.

Everyday experience suggests poor sleep and anxiety affect our social understanding. Who has not noticed anxious students nervously ignoring each other as they wait for an exam? How many of us have spent time apologizing to our mothers when we forgot to send them a birthday card because we were exhausted after over-working towards a deadline? Emerging experimental evidence supports the suggestion that sleep deprivation and anxiety can change our social understanding and that those with long-term experiences of sleep problems or anxiety experience social difficulties. What is less clear is exactly how sleep and anxiety impact on our social understanding and how variability in these experiences impacts our longer-term social functioning. One hypothesis that is consistent with the literature is that anxiety makes us more selfish, encouraging us to focus on our own point of view at the expense of others. Another is that sleep deprivation makes us more muddled, making it harder to distinguish between our own point of view and other people's. A third is that those with better sleep and lower levels of anxiety will function better in the longer term because they understand people better.

To look at the impact of sleep deprivation, we will test people on three tasks, after having them remain awake for a whole night. The tasks will investigate their ability to think about other people's thoughts and feelings. Their responses will be informative as to whether sleep deprivation has caused them to have difficulties in distinguishing between their own thoughts and feelings, and other people's. To look at the impact of anxiety, we will induce anxiety in people and then have them do the very same tasks. People will be made anxious by recalling and writing about a time they felt anxious. Here, we predict people's responses will show evidence of increased selfishness in their judgments. To look at the relationship between long-term, everyday tendencies towards anxiety and poor sleep, and social difficulties, participants will complete a number of questionnaires and short experimental tasks. We will use sophisticated statistical modelling to test the relationship between people's traits in these areas.

Each of these experiments will provide exciting new evidence for how everyday experiences impact on our social understanding. They will also open up new avenues for investigation, looking at the impact of these findings. Clearer evidence for the way in which poor sleep and anxiety impact social understanding is highly relevant to clinical populations, such as those with insomnia, generalized anxiety disorder and autism. Further, specialist populations, such as new parents, junior doctors or soldiers in combat have to experience poor sleep and anxiety at the same time as making crucial social judgments. The novel insights offered by our project will provide a model for understanding how their abilities are affected.

Maximising the economic and societal impact of the project is a key concern. Optimising our social understanding and interaction is important for our personal and professional lives. Providing people with accurate and useful models for how sleep and anxiety affect our lives is important. We are committed to ensuring the findings of the project are of benefit to non-academic audiences. The project provides a clear model for understanding the link between sleep, anxiety and social understanding.

A primary non-academic impact of our work will be in helping the general public to understand the effect that sleep deprivation and anxiety have on their social understanding. At one time or another, everyone experiences anxiety and poor sleep. The impact of poor sleep and anxiety on our social interaction is not always obvious to us. By helping people to understand this impact, we can help them to choose i) Whether to prioritise sleep and relaxation and ii) How to manage social situations when sleep-deprived or anxious.

The project also has the potential to impact clinical populations and the work done by healthcare professionals to support them. Clinical levels of problems with sleep (e.g. Insomnia) and anxiety (e.g. Generalised Anxiety Disorder) are highly prevalent. Co-morbid difficulties with sleep and anxiety are also common in a range of physical health conditions, mental health conditions and neurodevelopmental disorders (e.g. Autism, Schizophrenia, Epilepsy). Understanding the likely impact of the poor sleep and anxiety experienced by these groups on their social interaction and relationships is important for healthcare professionals. By knowing this, they can adjust their interventions (e.g. focus on cognitive vs. behavioural components of Cognitive Behavioural Therapy) and give good advice to their clients.

Professionals exposed to sleep deprivation will benefit from the knowledge gained through this project. Numerous professions predict periods of acute and/ or chronic sleep deprivation, e.g. junior doctors, nurses, paramedics, military personnel and lawyers. Each of these professions includes practical application, but also social interaction. Understanding how social understanding is affected by poor sleep will aid decision-making on training and working practices - e.g. how many night shifts should junior doctors do in a row? Further, it can help structure decision-making for professionals when sleep-deprived, perhaps through introducing check-lists or providing more time for social interaction.

Similarly, some professions also make experiences of acute or chronic anxiety more likely. Police officers, emergency respondents, teachers and military personnel all experience higher rates of anxiety than the general population. Again, social interaction is vital for occupational success and again project outcomes could impact working practices and amelioration of difficulties - would providing teachers with anxiety management strategies improve their engagement with their students? Are there levels of anxiety that mean police officers cannot effectively do their jobs? The current project will be informative in predicting outcomes if changes to training/ practice are made.

People's personal circumstances can also predispose them to sleep and anxiety. For example, new parents experience significant levels of sleep deprivation and are commonly anxious. They also have to show significant sensitivity to the social experiences of their baby. New parents and the professionals who work with them will benefit from understanding how sleep and anxiety are likely to affect them. Similarly, students revising for exams commonly experience high levels of anxiety and reduced sleep. The findings of the current project will inform whether engaging in relaxation or gaining more sleep would be beneficial- for instance for students of subjects where understanding others is important (e.g. medical and nursing students).