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Pandemic Insomnia: Yes, It’s a Thing

Pandemic Insomnia: Yes, It’s a Thing

Anxiety, stress, schedules in disarray. It’s harder to sleep now than ever. Here’s what you can do to get the rest you need.

Updated April 17, 2020; 7:30pm EST

In normal times, about 25 percent of Americans experience acute insomnia every year. And while no studies have been published yet that show an increase in insomnia due to the COVID-19 pandemic, anecdotally, physicians and therapists have seen a spike in patients suffering from sleep problems.

“People are getting thrown off of their regular routines,” says Camilo A. Ruiz, DO, medical director at Choice Physicians Sleep Center in Fort Lauderdale, Florida and member of the American Academy of Sleep Medicine. When habits are interrupted and changed, especially quickly and drastically, our bodies react. One of those possible reactions: insomnia.

“People cannot find the ability to fall asleep and stay asleep,” Dr. Ruiz says. “Even if they do, the quality of their sleep tends to be very poor.”.

The loss of sleep may result from a host of factors: “Loss of employment, financial hardships, worry about a loved one diagnosed with COVID-19, no childcare, online school, being confined to the home for most of the day,” explains Teresa Ward, RN, PhD, professor and chair in child, family and population health nursing at the University of Washington School of Nursing and co-director of the Center for Innovation in Sleep Self-Management in Seattle.

“These situations are stressful, unexpected and create a lot of uncertainty,” she adds. That means sleep can be hard to find.

Why we need to sleep
Adding to the frustration is the fact that now is a time when we really need the benefits of sleep to stay healthy.

“Sleep plays a vital role in our body’s ability to maintain balance,” says Ruiz. He notes that proper rest helps our immune systems function, keeps hormone levels in check and flushes waste products from our brains.

“Many biological processes that keep us healthy and prepare us for the following day occur during sleep time,” Ruiz says. “When we don’t partake in that, it hinders the body’s ability to heal itself.”

Sleep also plays a key role in our mental health, says Ward, as lack of sleep is common in those struggling with depression, anxiety, bipolar disorder, PTSD and ADHD, although it’s not exactly known why. “Although the underlying mechanisms between lack of sleep and mental health are not fully understood, sleep seems to play an important role,” says Ward.

Even for those without diagnosed mental health issues, it can be hard to regulate emotions, make decisions or think clearly when you’ve gotten very little sleep, especially when you’re already feeling increased anxiety due to the pandemic.

What to do about insomnia right now
If you are having issues falling or staying asleep, try these four tips:

Try to keep your daily routines, even if your life has changed. “Routines are important as they help structure our day, our evening and daily activities,” Ward says. That means going to bed and waking up at the same time every day, even weekends. 

Have a worry time. It’s useful to distract yourself with things that make you happy, like watching a funny movie or a comedy on TV. But you should also try designating a “worry time” each day to help contain distressing thoughts and anxieties.

“Relax, sit back and think about yourself and think about those things that are bothering you,” says Karl Doghramji, MD, medical director of the Jefferson Sleep Disorders Center at Jefferson University Hospitals in Philadelphia.

Make sure this worry time is on your schedule at a specific moment and is ideally done in a place other than your bedroom. “If you don’t schedule it, the rest of your day will be filled with worries and they may diffuse into your sleep or into other parts of your day,” Dr. Doghramji says.

If you can’t fall asleep, get up. Normally, you should be able to fall asleep 20 minutes after going to bed. But if you’re unable to drift off, get up and leave your bedroom. “Try to sit somewhere with low light and read something simple,” says Ruiz, like a magazine or a physical book—not one on an electronic device. “Hopefully drowsiness will overcome you and you can go back and sleep,” he says.

Ruiz notes that the same is true if you wake up in the middle of the night. “You don’t want to stay in bed for a half hour because it’s a self-fulfilling prophesy—you become frustrated with the process and that frustration furthers insomnia,” he says.

Take care of your mental health. If you’ve been diagnosed with a mental health condition that you feel is being exacerbated, seeking treatment can help ease the insomnia. While going into a therapist’s or doctor’s office might not be easy right now, teletherapy is more widely available. The Coronavirus Aid, Relief and Economic Security (CARES) Act has made this easier too, by both providing funding for telehealth services and easing regulations on who can use them. Many private health insurance plans are also waiving co-pays for telehealth services.

Medically reviewed in April 2020.

Sources:
“Insomnia.” SleepFoundation.org.
W Zheng, X Luo, H Li, et al. “Prevalence of insomnia symptoms and their associated factors in patients treated in outpatient clinics of four general hospitals in Guangzhou, China.” BMC Psychiatry. 18, 232 (2018).
TW Kim, J Jeong, S Hong. “The Impact of Sleep and Circadian Disturbance on Hormones and Metabolism.” International Journal of Endocrinology. 2015.
Sara Harrison. “Scientists Now Know How Sleep Cleans Toxins From the Brain.” Wired.com. October 31, 2019.
N Hauglund, C Pavan, M Nedergaard. “Cleaning the sleeping brain – The potential restorative function of the glymphatic system.” Current Opinion in Physiology.15. 10.1016/j.cophys.2019.10.020.
“Lack of Sleep and Cancer: Is There a Connection?” HopkinsMedicine.org.
“Depression and Sleep.” SleepFoundation.org.
“Sleep Disorders.” ADAA.org.
AK Gold, LG Sylvia. “The role of sleep in bipolar disorder.” Nature and Science of Sleep. 2016;8:207–214. June 29, 2016.
“Sleep and PTSD.” PTSD.VA.gov.
“ADHD and Sleep.” SleepFoundation.org.
“Sleep Deprivation and Deficiency.” NHLBI.HIH.gov.   
“Patient education: Insomnia treatments (Beyond the Basics).” UpToDate.com. March 2, 2020.
“Health Insurance Providers Respond to Coronavirus (COVID-19).” AHIP.org.

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