Sleep

Sleep and Your Psychological Health During a Pandemic

Here are just a few things to know about coping and sleep during a pandemic...

Posted Oct 29, 2020

Unsplash/Fernando
Source: Unsplash/Fernando

More than half a year into the coronavirus pandemic, how are you sleeping? Are you up at night worrying about work, finances, family schedules, all of the above? Are you staying up late to take care of all the stuff you can’t get done during the day because of changes to your kids’ school schedules? Are you feeling isolated from friends, colleagues, extended family?

Short-term insomnia rates soared at the start of the outbreak. Now chronic insomnia is likely soaring, too.

Acute insomnia is a sudden onset of insomnia symptoms, usually in response to a disruptive, stressful life event. Short-term insomnia happens throughout our individual lives. A job loss, a relationship strain, an illness in the family—something unexpected happens and suddenly you can’t sleep. There’s scientific evidence that large-scale events—things like earthquakes and wildfires–create spikes in acute, or short-term, insomnia in affected populations. For the first time in our lifetimes, the large-scale crisis that’s unfolding is happening to everyone around the world.

A number of studies found high rates of insomnia in response to the early days and weeks of the pandemic, including a large-scale study in China, which found that at least 20% of participants met clinical criteria for insomnia. When scientists compared pandemic insomnia rates to pre-pandemic rates, they found the prevalence of clinical insomnia had increased by 37%.

Under any circumstances, acute insomnia often evolves into chronic insomnia. Acute insomnia typically resolves over a period of days or weeks. Chronic insomnia lasts for three months or more, with insomnia symptoms appearing several nights a week, week after week. Estimates suggest that roughly 50% of people with insomnia experience symptoms for a year or more.

Chronic insomnia raises risks for long-term health and functioning, including heart disease and metabolic disorders like diabetes, as well as depression and cognitive decline. I wrote recently about the links between disrupted sleep and Alzheimer’s disease.

Given the ongoing stress and upheaval that most people are facing several months into the pandemic, I expect that many cases of acute insomnia are now chronic.

WHAT TO DO: It’s time to take a careful, honest look at your sleep. Most of us experienced a series of sleep-deprived nights in the early days of the pandemic. If your sleep is still disrupted, if you’re routinely having trouble falling asleep and staying asleep, if you’re waking early and feeling unrefreshed by your sleep, you’re experiencing the symptoms of chronic insomnia.

Acknowledging your sleep issues is the first critical step to improving your long-term health. There are a range of treatments for chronic insomnia, including cognitive-behavioral therapy that’s specifically designed for insomnia, as well as natural supplements, mind-body awareness practices, and modifications to sleep routines and sleep hygiene habits. Identifying any underlying medical conditions that may be affecting your sleep—and any potentially sleep-disrupting side effects of medications you’re taking—is also an important step.

Discuss your symptoms with your doctor to determine the right course of therapy for your individual sleep issues. I always encourage people to seek the expertise of sleep specialists.

Clinicians, educators, community leaders: we need more public health work that specifically addresses the sleep disruptions occurring in the pandemic. Don’t wait for someone else to do it—get organized to educate and support your community about the importance of tending to sleep.

Proximity to ‘hot spots’ affects the severity of sleep problems and psychological stress 

Research has found that the severity of both insomnia and psychological distress during the pandemic is closely tied to individuals’ proximity to coronavirus outbreaks. Proximity here means a few different things:

Location. Being closer to the geographical site of a severe outbreak can heighten both sleep issues and trigger more anxiety, stress and depression.

Degree of exposure and threat. Essential workers and people working in places where outbreaks are more likely to occur are also at greater risk for sleep disruption and psychological distress. That’s everyone from health care workers to people working in places such as nursing homes, manufacturing sites, and even schools and universities. And the perception of threat is likely just as significant to sleep and stress as the actual, statistical measurement of risk for people who are working in places where groups congregate.

With pandemic hot spots shifting around the U.S. and the world, different regional populations will experience different levels of exposure at different times, with shifting risks for sleep problems.

WHAT TO DO: Be prepared to respond to changing circumstances. We talk about emergency preparedness in terms of evacuation plans, go-bags, stores of supplies, plans to meet family in a designated space, plans to care for and transport pets in an emergency. These days, we all need an emergency preparedness plan for sleep. That includes:

Supplies of any supplements or medications you’re using for sleep and psychological health. I’ve written extensively on supplements and natural remedies for sleep, from melatonin to magnesium to cannabis. Important: Always consult your doctor before beginning a new supplement routine. 

A sleep-focused game plan for when life gets turned upside down. Many readers have already lived through severe coronavirus outbreaks in their local regions, while others are living through it now. Still others may have a relatively low presence of coronavirus in their local area, but that may change in the coming months. We all need to develop plans for how we’ll protect our sleep if and when daily routines change again suddenly. We can’t predict exactly what that will look like, but we have a pretty good idea: schools shift to remote or reduce in-person hours, exposure to someone who’s sick means your family has to quarantine, stricter physical distancing measures means you can’t engage in your normal exercise regimen.

Take time NOW to plan for an altered routine that includes sufficient time for sleep. Set aside time for work, schooling, and household stuff around sleep—not when you would otherwise be sleeping. It’s a tall order, but your rest is fuel for your health, ability to function and maintain psychological health through this ongoing challenge.

I wrote in the spring about how each chronotype can use their individual preferences to create routines that support sleep, productivity, and emotional balance during these challenging times. This advice is just as relevant now as it was back then!

In my next post, I will go into some more things you should know about sleeping during a pandemic.

Sweet Dreams,

Michael J. Breus, PhD, DABSM