COVID-19 has led to unprecedented changes in virtually every aspect of our lives, including sleep patterns. Approximately 10% of the population suffers from chronic insomnia and the pandemic has created a multitude of new challenges contributing to an increase in sleep difficulties, even for those who were previously good sleepers.
A recent study reported a striking increase in internet searches for insomnia during the rise of COVID-19 in the spring of 2020. Even more telling is the time of day that searches occurred — peaking at 3 a.m. on Sunday nights — the worst night of the week for most insomniacs.
How the Pandemic Adds to Sleep Problems
“Coronasomnia,” a new term coined by sleep experts, refers to sleep problems related to the COVID-19 pandemic. Increased stress and anxiety are obvious contributors to poor slumber. Even worse, social distancing and quarantining lead to isolation and depression, further exacerbating the problem. Surveys of sleep since the onset of the pandemic show more sleep dissatisfaction, poorer sleep quality and even a signal for increased use of sleeping pills.
Not only has the pandemic been a major stressor, but it has also created a new level of uncertainty for most people. Quarantines, working from home, school closures with virtual learning and social distancing have profoundly disrupted our lives. Sunlight along with daily activities and routines help keep our sleep/wake rhythm on track. Being stuck inside the house disrupts the external cues our brains need to promote wakefulness.
[READ: Sleep Disorders and Chronic Pain.]
Sleep Loss Adds Up
Chronic sleep loss contributes to a host of problems including diabetes, heart disease, high blood pressure and weight gain to name a few. Who hasn’t gained a few pounds in the last year, right? It also has a negative impact on our ability to regulate emotions and mood which can lead to interpersonal conflicts and compromise relationships.
Further, the virus has significant implications for people with obstructive sleep apnea, the most common form of breathing disturbance in sleep, affecting over 1 in 4 adults. Research published in 2020 found people with OSA to be 8 times more likely to contract the virus compared with age-matched controls.
In addition, individuals with OSA who contracted COVID-19 had increased risk of hospitalization and respiratory failure. While OSA shares risk factors and comorbidities with negative COVID-19 outcomes including obesity, high blood pressure, diabetes and lung disease, emerging research suggests that it may be an independent risk factor for poor outcomes of COVID-19.
There is a silver lining … at least for some of us. While many experienced more sleep difficulties throughout the pandemic, others are actually getting more and better shut eye than ever before. Humans have a natural circadian rhythm that keeps our sleep/wake patterns on a 24-hour schedule.
But not everyone’s internal clock matches with normal societal schedules and demands. Early birds and night owls feel most alert and most sleepy at different times. Decreased commute time due to working from home and more flexible work and school schedules have allowed some to adjust their sleep period to better fit with their own natural rhythm.
[READ: How to Prepare for a Sleep Apnea Test.]
Sleep Strategies for the Pandemic and Beyond
In spite of the overwhelming challenges, there are several steps that you can take to promote better sleep during the pandemic.
— Keep a normal daily routine. Set the alarm for a consistent wake time to start your day. If you work from home, incorporate regular routines to help provide cues throughout the day. These include showering and getting dressed after waking up, eating meals at the same time each day and taking breaks just like you would at work.
— Avoid using your bedroom and especially your bed as an office. Sleep experts agree that creating a strong association between sleep and the bed is important. This helps train your brain that the bed is the place for slumber and not the place to work, think or worry.
— Stay active. Exercise is a great natural stress reliever and can help build sleep drive, thereby improving sleep quality. But avoid intense exercise and strenuous activity within a few hours of bedtime to give your body time to cool down.
— Avoid or limit naps. A short power nap (15-20 minutes) can be beneficial if it’s not too late in the day, but sleeping longer or later may disrupt your slumber the following night.
— Show me the light. Getting natural sunlight in the morning can boost alertness and keep our sleep/wake rhythms on track.
— Be cautious with alcohol and caffeine. Caffeine is a stimulant and can cause sleep disruption when consumed later in the afternoon or evening. Alcohol may help people feel more relaxed, but it tends to disrupt sleep quality and should never be used as a sleep aid.
— Wind down. Create a buffer zone to help wind down before bedtime. This can include reading for pleasure, stretching, meditating or taking a warm bath. Avoid surfing the web, watching the news and engaging in social media especially before bedtime. Blue light from electronics can delay natural melatonin production which is a hormone that helps regulate the sleep/wake cycle, so experts recommend limiting screen time on cellphones, tablets and computers for 30-60 minutes before bedtime.
[READ: Does Melatonin Work for Sleep?]
If Lifestyle Changes Don’t Help
If you continue to struggle with sleep disturbances despite lifestyle changes, don’t fret. Cognitive behavioral therapy for insomnia, or CBT-I, is usually the next treatment of choice. It’s preferred over sleep medications that tend to not be as effective, particularly over the long haul. CBT-I is a multi-component treatment strategy that helps identify and replace thoughts and behaviors that cause or worsen sleep problems with habits that promote sound slumber. Unlike medications, CBT-I addresses the underlying causes of sleep disturbances. CBT-I is delivered by behavioral sleep medicine experts or through web-based programs, like Go! To Sleep at Cleveland Clinic.
The stay at home orders and quarantining delayed health care utilization early on during the pandemic. However, quick pivoting by health care systems and providers resulted in rapid expansion of telehealth services including for sleep disorders.
CBT-I and screening for sleep apnea have become increasingly accessible through telemedicine. A recent study showed patients who completed CBT-I virtually had similar benefits compared with those who received in-person therapy.
Healthy sleep is a cornerstone of wellness. We all need it, particularly under stressful circumstances. Adequate sleep is also crucial for boosting immunity and preventing infection. So, if you are one of the many struggling to get your forty winks during the pandemic, there’s light at the end of the tunnel.
Here’s to a good night’s sleep!
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‘Coronasomnia’ — Another Byproduct of the Pandemic originally appeared on usnews.com
