Sleep and Coping During the Pandemic

A few more things to know about sleep and psychological health in a pandemic.

Posted Nov 01, 2020

Source: unsplash/AnthonyTran

These are unprecedented times, with unprecedented challenges that are creating unprecedented stress and widespread problems for sleep. We’re learning more all the time about the impact of the pandemic on sleep and emotional health. It feels like the right time to check in about the latest science on how sleep is being affected, and what you can do to get your best rest during these stressful days and nights.

Today I am talking about a few more things to know about sleep during a pandemic.

Social isolation is a big challenge for sleep and mental health 

We don’t talk enough about the impact of social isolation—and the loneliness it can create—on sleep. Right now, so many of us are living at a distance from the in-person social networks that provide us with support, comfort, fun, and a sense of connection that’s both enlivening and calming.

Scientific research shows that loneliness hurts sleep quality and sleep quantity. Research also shows that the quality (not the quantity) of our friendships predict how well we sleep. And recent research from the University of California, Berkeley shows that in turn, lack of sleep heightens feelings of loneliness and isolation.

What to Do: Use this two-way street between sleep and social isolation to your advantage. Prioritizing sleep will help ease the psychological burden of the social distancing and isolation you’re living with. And finding ways to engage with people who provide you with a sense of connection will help you sleep better.

That can mean all sorts of things—having a quiet dinner with your partner, taking a long walk with a friend, reaching out virtually to people who “get you,” who make you feel good and make you laugh. Join a support group—virtual support groups are everywhere these days, for parents, seniors, health care workers, for people feeling the emotional strain of this prolonged period of social distancing. Get involved with helping others. Remote and safe in-person volunteer work can provide you with a powerful sense of connection.

Your sleep will improve when you strengthen your social ties.

Our chronotypes may be chronically out of sync

Circadian rhythms regulate sleep-wake cycles, as well as most of the body’s important processes, including hormone production, immune system activity, appetite and metabolism, cognitive functioning. Our internal clocks serve as very precise timekeepers of all this biological activity to keep us functioning normally. Even small disruptions to the timing of circadian rhythms can create significant problems for sleep, mood, health, and productivity. And biological clocks are affected by the same processes they regulate, including sleeping and eating.

The pandemic has thrown daily schedules out of whack and introduced a number of new challenges for circadian clocks. We’re still spending way more time at home than is normal for most of us, and work and school schedules are less fixed and predictable. For many of us, sleep and wake times have changed, and are less consistent. Plenty of us are getting less sunlight, and more exposure to artificial light at night. Eating routines may have changed, with a tendency to eat later in the day that many people may be experiencing. We may be getting less exercise.

Ideally, our daily routines align with and reinforce our chronotype—when we work, when we rest, when we eat and exercise, when we play and have fun. 

Research coming in has shown that during the pandemic, bedtimes and waketimes have shifted to later hours and that people are using more digital media at night before bed, increasing sleep-disruptive nighttime light exposure, which will further shift the timing of our biological clocks.

Chronotypes that are out of sync negatively affect sleep routines, mood, energy levels, our ability to be productive. And there are long-term risks to health, including elevated risks for cardiovascular and metabolic diseasescancerobesity, and neurodegenerative disease.

What to Do: Reclaim a schedule that aligns with your chronotype. It may not look like the one you had before the pandemic. But if you’re working in alignment with your individual chronotype and being consistent about sticking to routines for sleep and activity, you are doing great, important work on behalf of your mental health, your sleep, and your overall health.

Psychological distress has soared during the pandemic—and it’s hurting sleep

A number of studies conducted during the pandemic have delivered similar, unsurprising news: Stress, anxiety, depression, and other forms of psychological distress have spiked. Research from the earliest days of the pandemic in China showed that more than 18% of the population was experiencing clinical levels of anxiety, and nearly 25% had depression. Other research from China and elsewhere around the world has returned similar results, in some cases showing significantly higher levels of generalized anxiety—and a strong connection between anxiety levels and time spent focusing on the coronavirus outbreak.

An analysis of research that’s investigated depression, anxiety, and stress in the pandemic found that each may be present in about a third of the general population. Among health-care workers, rates of anxiety, stress and depression are even higher, with about 45% experiencing anxiety and about 50% experiencing depression symptoms.

The implications here for sleep and health are profound. There is a close, bi-directional relationship between stress and mood disorders and sleep problems. Psychological distress also weakens the immune system, disrupts circadian rhythms, and raises risks for other psychological conditions including PTSD, ADHD, panic attacks and suicide.

What to Do: Don’t suffer silently. And don’t try to tough it out through chronic stress, anxiety, or feelings of depression, overwhelm, or hopelessness. Recognize that your sleep and your psychological health are connected, and that addressing any sleep issues you’re having is one way to improve and protect your mental health, in the short and long term.

Recognize also that improving sleep on its own may not be enough to restore emotional and psychological balance and well being. And the presence of anxiety, depression, and/or chronic stress may make it difficult to achieve significant improvements to your sleep. Cognitive behavioral therapy and other forms of psychotherapy—all available through telehealth and other virtual platforms—are a wise and important step to take. Waiting to seek out therapeutic help will only make sleep and psychological problems worse.

If you are having thoughts of suicide, know that you are not alone. If you or someone you know needs help, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text 741-741 for the Crisis Text Line. If you are in danger of acting on suicidal thoughts, call 911.

We’re in a long-haul journey through this pandemic, learning together, in real time, its effects on sleep and psychological health. We’ll get through by supporting each other, by learning all we can about the challenges we’re facing to sleep and mental health, and by putting that research-based knowledge into constructive action to improve our daily routines and seek out the medical and therapeutic support we need to stay rested and well, physically and emotionally.

Sweet Dreams,

Michael J. Breus, PhD, DABSM

The Sleep Doctor™

To find a therapist, please visit the Psychology Today Therapy Directory