Getting a good night’s rest under stressful conditions is hard enough but during a pandemic? It 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’s 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.
From loneliness to economic hardships to juggling work and homeschooling, there are multiple factors in our lives as a result of the pandemic that have caused stress levels to skyrocket and sleep hours to plummet. And this loss of sleep, especially over time, has a negative effect on your overall health.
We talked to sleep psychologist Michelle Drerup, PsyD, DBSM, about the issues surrounding coronavirus insomnia, the effects on your health and what you can do to combat the issue and increase those necessary hours of sleep.
Stress and sleep
It’s probably not surprising to hear 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.
“That 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 outbreak that’s consumed our lives for much of the year.
The pandemic factor
Not only is the pandemic a giant stressor for many people, but it’s also created a new level of uncertainty for many. “It’s caused a disruption in our daily lives,” Dr. Drerup says, “and that includes things like school and gym closures, working from home and social distancing. This has caused a lot of upheaval to our daily routines.”
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 help keep our circadian rhythm on schedule.”
And with many of us experiencing new 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 falling asleep the next night and can lead to a vicious cycle that includes 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.
The impact on your health
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 the 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.”
Stressing out, even in your dreams
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.
How can you combat the pandemic stress?
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.
Take a break from the news
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.”
Stay on schedule
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 there’s some flexibility with 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.”
Shine a light
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 new 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. But we’re not doing that as much anymore,” 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 or to help kids get ready for virtual school. “The impact of not even having those kinds of daily activities, getting that light exposure, can negatively impact sleep,” she adds.
Skip the naps
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.”
Get up and distract yourself
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, 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.
Avoid clock anxiety
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, they tend to develop a tolerance to the sedative effects after a few 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 10mg, that’s way more than your body needs and Dr. Drerup suggests taking a much smaller dose, between 0.3 and 1 milligram.
Cognitive behavioral therapy
One more option patients might want to consider is cognitive behavioral therapy (CBT). “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 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.