Getting a good night’s rest under stressful conditions is hard enough, but sleeping well during an ongoing pandemic can feel impossible some nights.
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It’s not just you, though. Stress-related insomnia due to the COVID-19 (coronavirus) pandemic is definitely a thing, and it even has a name: coronasomnia.
As you might expect, coronasomnia is more complicated than typical stress-related sleeplessness because it’s not just about the virus; it’s also about everything else that’s changed because of the virus.
We talked to behavioral sleep medicine psychologist Michelle Drerup, PsyD, about the issues surrounding COVID insomnia, the effects on your health and what you can do to combat the issue and increase those necessary hours of sleep.
“Coronasomnia, or covidsomnia, is the term to describe sleep problems related to stress caused by the COVID-19 pandemic,” says Dr. Drerup.
You’re probably not surprised to hear that sleep troubles and the coronavirus go hand-in-hand — and that stress and sleep don’t mix. “Any type of stress is often the main trigger for insomnia, difficulty falling asleep or waking up and having an inability to return to sleep,” says Dr. Drerup.
“Stress impacts every area of our life so, of course, it’s going to impact sleep,” she adds. “And that is even further complicated by the ongoing COVID-19 pandemic that’s consumed our lives for much of the last few years.”
Indeed, stress levels skyrocketed during the pandemic for many reasons, including loneliness, economic hardships, juggling work and school, and navigating parenting challenges.
If you’re having trouble sleeping because of the pandemic, you’re not alone. “Increase in sleep issues, specifically insomnia, has been shown to be a concern all over the world,” says Dr. Drerup. “In the United Kingdom, a study published last year showed that the number of people experiencing insomnia increased from 1 in 6 to 1 in 4, while insomnia rates in China rose from 14.6% to 20% during the peak lockdown period.” According to a study published in the American Academy of Sleep Medicine, there were 2.77 million Google searches for “insomnia” in the U.S. during the first five months of 2020 — an increase of 58% over the same duration in the previous three years.
“The increase in sleep disturbances is due to increased stress and anxiety that the pandemic has brought on, including the impact of the uncertainty and the constant barrage of information we are exposed to at this time,” says Dr. Drerup. “Our normal routines and level of daily activity have been disrupted and this has likely negatively impacted sleep for many people.”
But not only is the pandemic a giant stressor for many people, but it’s also created new levels of uncertainty since there’s no ending on the horizon. That lack of expiration date also compounds the sleep disruptions you experienced last year.
“We are experiencing pandemic fatigue, or COVID burnout, which can negatively impact sleep,” Dr. Drerup says. “Sheltering in place, homeschooling, avoiding large gatherings and public places, wearing a mask and not being able to do ‘normal’ activities has contributed to this experience.”
Being stuck in our houses more can also cause complications in our sleeping patterns, she adds. “Being at home more can disrupt the light-based cues for wakefulness. Sunlight and light exposure helps keep your circadian rhythm on schedule.”
And with many of us still in work-from-home situations, she says, some people might have different hours and sleep in. But that’s not necessarily a positive thing overall, because it can make it more difficult to fall asleep the next night and can contribute to the vicious cycle of insomnia.
In addition to the anxiety brought on by the pandemic, social distancing and quarantining can lead to more isolation and depression, Dr. Drerup adds, which can also cause significant sleep issues.
While Dr. Drerup notes that some COVID-19 survivors with long-term symptoms experience insomnia, the Centers for Disease Control and Prevention (CDC) does not list this sleep disorder as a common symptom. “Pandemic-related stress is the more likely cause of insomnia in these individuals,” she says.
However, all of this stress and lack of sleep can have big, negative impacts on your overall health. One concern that’s specific to the pandemic, Dr. Drerup says, is the effect on our immune system. “When someone is chronically sleep-deprived,” she says, “they tend to have lowered immunity and that makes our susceptibility to viruses higher.”
A lack of sleep also has a negative impact on our emotional regulation and mood. “If we’re already feeling stressed about the virus,” Dr. Drerup points out, “then lack of sleep will drive that up.”
“When we’re getting a healthy amount of sleep, we tend to have better cognitive functions,” she adds, “so things like memory and decision making can be impacted by poor sleep.”
The rest of your body can suffer from a chronic loss of sleep, as well, leading to issues with worsening cardiovascular and metabolic issues, including an increased risk of weight gain, diabetes and high blood pressure.
While these are bad enough, happening during the stress of a pandemic can compound the issues. “It’s that vicious cycle,” Dr. Drerup says. “If I’m tired, I’m going to be less likely to exercise and I’m going to be less likely to do things that actually enhance my mood. And it compounds those other anxieties and stressors — and even depression — that people might already be experiencing.”
All of this, in turn, impacts how you snooze. “Increased rates of anxiety, depression and increased alcohol substance use related to pandemic stress have also led to increased rates of sleep disturbance.”
Many of us are having more intense dreams than usual as a result of the stress and anxiety of the pandemic and the way in which our brains are processing everything. And these stressful dreams can result in even more stressed waking hours.
“People often describe it like, ‘I was sleeping but it was exhausting sleep. I felt like my mind was going the whole night and I don’t feel more restored because the sleep was so active,’” says Dr. Drerup.
There are a number of ways we can improve our sleep experience — cutting down on screen time before bed, a better diet, more exercise — but Dr. Drerup has some suggestions about how we can approach these aspects with the pandemic in mind to help relieve stress before bedtime.
To say there’s a lot happening in the world these days is an enormous understatement. And while it’s good to stay informed throughout the day, try to avoid oversaturation of news and other bad habits like “doomscrolling.” This is especially important in the evening.
“People are very connected to the news these days and watching the news before bedtime in the evening. But this is setting you up to have those worries, those anxieties at night,” Dr. Drerup says. “Avoiding that stressful news or other information before bed can help ease those feelings of anxiety at least a little bit.”
As Dr. Drerup mentioned, a lot of stress comes from an upending of our daily routines. But, she adds, you can get some relief by creating a daily schedule and routine and sticking to it. “Try to keep a consistent bedtime and a consistent waketime no matter the day of the week,” she says.
She adds that now that with flexible work-from-home scheduling, you might decide to push your bedtime and waketime back a bit. “That’s okay,” she says, “If it fits with your schedule and you don’t have to change it around frequently, that’s fine. Consistency is key.”
Making sure you get enough light exposure in the morning is an underrated part of our circadian rhythm and one that many people are missing with morning work routines. “It’s a simple thing that happens when you go to the office in the morning, whether you’re in the car or walking into the office,” says Dr. Drerup.
Instead, many of us aren’t going outside at all in the morning, moving from bedroom to computer to start our workday. “The impact of not even having those kinds of daily activities, getting that light exposure, can negatively impact sleep,” she adds.
Naps can be a good way to recoup some energy, especially if you work from home and can easily slide from office space to the couch or bed. “If people are home more often,” Dr. Drerup notes, “the temptation to nap might be stronger.”
But it’s all about moderation, she adds. “A short cat nap or power nap early in the afternoon can be helpful for some people. But longer naps and naps later in the evening can disrupt sleep.”
One problem that might come up, particularly during times of stress and stress dreams, is waking up in the middle of the night and not being able to fall back asleep. Not only does it mean less sleep, but it also probably means more frustration.
If you haven’t fallen asleep after about 20 minutes, consider getting up and going to a different room. Distracting yourself, in the form of reading, calming yoga stretches or a relaxing hobby like knitting can help, says Dr. Drerup.
By going to a different room, you can keep it — in your mind — as a place of peace and relaxation and not associated with the annoyance of interrupted sleep.
Just avoid too much stimulation, especially from your phone, tablet or computer. Whether it’s doomscrolling on social media or the aforementioned blue light, those devices will do more harm than good in this situation.
You know the feeling: you wake up in the middle of the night, check your clock and then proceed to stress out about the need to fall back asleep but that stress just keeps you up instead.
Trying not to stress in that situation is easier said than done but there are options in terms of relaxation that could make it easier. Relaxation techniques like meditation, guided imagery and progressive muscle relaxation can go a long way in helping you fall asleep.
Practicing these techniques during the day can help you prepare for when this happens at night, says Dr. Drerup.
“Try to develop these skills when you’re awake but feeling calm and in a good emotional space instead of trying it for the first time when you’re in bed at night,” she says. That should make it easier to implement these exercises when you need them most.
If you’ve been lacking sleep for several nights in a row, it might be tempting to rely on an over-the-counter sleep aid to ensure sleep. And while that’s fine from time to time, you don’t want to rely on it regularly, says Dr. Drerup.
“One problem is that people will often still feel drowsy in the morning, almost hungover, in a way, until the medicine wears off. You might feel like this even if you get a full night’s sleep,” she says. “It can also start to compound your sleep issue if you wake up in the morning and still feel drowsy and wind up staying in bed longer. That can then lead to issues falling asleep the next night.”
Another issue that can befall someone over-reliant on these OTC sleep aids is that they might lose their effectiveness. “People who rely on these aids, tend to develop a tolerance to the sedative effects after a few consecutive nights of using it,” Dr. Drerup points out.
If you have insomnia, you may be tempted to try out melatonin as a more natural option. But as Dr. Drerup points out, while you might see improved results, immediate sleep aid is not the supplement’s primary purpose.
“The research we have on the effectiveness of melatonin isn’t for people who have insomnia. It’s for people who have circadian rhythm disruption,” she says. “If you don’t feel sleepy until midnight, and you take a low dose earlier in the evening, that can help shift your own rhythm so that you feel sleepy earlier.”
It’s also important that you take the right dose. While you can buy doses of up to 10 mg, that’s way more than your body needs and Dr. Drerup suggests taking a much smaller dose, between 1 to 3 milligrams.
One more option you might want to consider is cognitive behavioral therapy for insomnia (CBT-I). “Whether someone had this chronic insomnia or sleep issue before or it’s a more recent onset with the pandemic, it’s a treatment that’s well-researched and has extremely good efficacy and effectiveness for patients,” Dr. Drerup says.
If CBT-I is something you’d like to consider as a means of treating your sleep problems, she advises talking to your healthcare provider to see the best path forward for treatment.