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By: Chester Wu, MD
It would be difficult to find someone whose life has not been disrupted by the pandemic. Nowhere is that more evident than in our routines, including work and sleep schedules. Beyond schedule disruptions, the stress of coping with so many changes may have provided an additional sleep disruption for some.
Our sleep is guided by our circadian rhythm, a biological clock that is influenced by the environment around us. The amount of sunlight we are exposed to, physical activity, social interaction, occupational demands, and timing of meals—collectively referred to as “zeitgebers” or “time-givers” in German—provide cues to our body about when we should be sleeping or awake. In other words, with the factors that anchor our sleep disrupted, sleep patterns can and will shift over time.
As stay-at-home restrictions relax for many communities and life returns to a new normal, our bodies will need to recalibrate and readjust. The following are some recommendations to adjust sleep back to normal.
Assessing the Damage
Everyone has a circadian rhythm that directs your body's sleeping and waking, and this is often not aligned to society’s demands. Adolescents and young adults are often biologically predisposed to have a “night-owl” pattern of staying up late and sleeping in. Without the structure provided by school, a work commute, or the ability to exercise at a gym, our sleep will revert to a natural sleep window or even become irregular. Therefore, the first step is often to start tracking sleep through a sleep diary. Collecting a week’s worth of data (i.e., when you go to bed, how long it takes to fall asleep, how many awakenings each night, and when you got out of bed) will help you determine when your natural sleep window is, and how different it is from when you will need to sleep and wake up once life returns to normal.
An alternative to manually maintaining a sleep diary is to use a wearable device, such as a smart-watch or fitness watch, that tracks sleep through activity and heart rate. A recent study in the journal Sleep showed that consumer wearables are just as effective at determining when you are asleep and awake as existing, established research devices.
Creating the Right Conditions
After reviewing your sleep schedule, you should have a better idea of whether you tend to be a night owl or an early bird. From there, making an adjustment is a slow, steady process. Start by practicing healthy sleep hygiene:
- Create a pleasant sleep environment that is cool, dark, and quiet.
- Develop a wind-down routine leading up to bed that signals to your body that it is time to sleep. This should involve relaxing, low-stimulation activities such as reading a book or meditation.
- To also help train your body’s sleep rhythm, maintain a consistent bedtime and waketime every day.
- Avoid meals and heavy exercise at least two hours before bedtime. Both are examples of zeitgebers or cues that activate the rest of your body, making sleep less likely.
- Limit or stop napping during the day.
- Minimize or eliminate caffeine, nicotine, and alcohol several hours before bed. These can cause more difficulty falling asleep or fragment your sleep more throughout the night.
Take Small, Progressive Steps
Being too ambitious in adjusting your sleep can exacerbate insomnia or cause excessive sleepiness during the day. Building practices for good sleep is a methodical process and taking these steps can help.
- Shift your time in bed slowly. If you are currently going to sleep at 12 a.m. and waking up at 8 a.m., but normally go to sleep at 10 p.m. and wake up at 6 a.m. for work, jumping directly to that schedule may be too difficult and jarring to your body. You might have several nights of not being able to fall asleep and becoming frustrated and subsequently feel tired the following day. Instead, try adjusting your window of sleep by 15 minutes per day. This is a much more natural and tolerable change for your body and mind.
- Melatonin timing. Melatonin is a chemical that your brain produces to communicate to the rest of your body that it is time to sleep. Over-the-counter melatonin supplements can be taken to help guide your internal body clock as it adjusts to a new sleep schedule. However, appropriate dosing and timing of the melatonin is something you should discuss with a health care provider.
- Bright-Light Therapy. The strategic avoidance and exposure to light have been studied because light can suppress melatonin secretion and help shift the internal body clock timing. Consumer light therapy products are often advertised to help with mood or seasonal affective disorder. Exposure to light therapy in the morning after waking up may help activate your body and mind, reinforcing the shift of your sleep. Again, exact timing and duration of exposure should be discussed with a health care provider if you are still struggling.
As life returns, hopefully soon, to a sense of normalcy, having a sleep pattern back in line with societal demands will have you primed to hit the ground running again.
Chester Wu, MD is the director of Menninger's Sleep Medicine program. He completed his psychiatry residency training at Baylor College of Medicine and a fellowship in Sleep Medicine at Stanford University School of Medicine. He earned his medical degree at the University of Texas Medical Branch and his undergraduate degree from Texas A&M University, where he graduated summa cum laude.
