Written by Rachael Gilpin, Content Writer
Our collective sleep health as a society has suffered in the wake of one of the deadliest plagues in human history. Not only is the virus itself harmful with potentially lasting effects, even post-recovery, but the environment created in its wake has left many struggling to cope. The ability to visit public venues without anxiety has changed for many, and the mental adjustments around safety have likely profoundly affected your health and sleep.
Managing stress and lifestyle changes could pose a challenge for many regarding rest. Forcing yourself to sleep is virtually impossible, but rest is critical for our well-being, so recovering and taking back our health is essential to our prosperity.
COVID-19 has altered our worlds forever, but there are ways to get back on track.
The Connection Between Sleep and Health
Dr. Chelsie Rohrscheib, a sleep specialist, and neuroscientist at Tatch, explains how changes in your immune system will almost always affect your sleep.
When our body is busy fighting off a virus or bacteria, the “increased immune activity usually leads to longer sleep times and gives us the urge to sleep during the day. The increase in the need for sleep is because we require sleep, specifically stage 3, to strengthen the immune system, increase the activity of certain immune cells, such as T-cells, and create antibodies.”
This also works conversely; our health becomes compromised when we don’t get enough rest. When our body isn’t fueled with enough sleep, we’re more at risk for developing a multitude of physical and mental health conditions, including:
- Depression
- Anxiety
- Cardiovascular Issues
- Diabetes
- Alzheimer’s disease
- Dementia
- Cognitive Issues
- Infections
Effects of COVID-19
While many individuals make a full recovery and experience no lasting symptoms from COVID-19, others are still enduring the consequences. Cultural shifts regarding health and safety can still afflict even those who never contract the virus.
Long COVID
Through our discussion with Dr. Lizz Esther, MD and medical consultant, we learned Long COVID is a term used to describe the prolonged symptoms of COVID-19 that occur for more than 12 weeks after full recovery. She says that “insomnia complaints have been two to three times higher” in our post-covid culture.
Dr. Esther explains that long-term symptoms also include irregular sleep-wake cycles, daytime sleepiness, and disturbed sleep. Anxiety and depression are also related to Long COVID, both of which happen to be insomnia symptoms.
Nerve Damage
Esther reports that COVID-19 is known to cause severe damage to cranial nerves, peripheral nerves, and muscles. As a result, “this causes poor motor skills and coordination,” as well as facial palsy, difficulty breathing, and pins and needles sensations in the limbs. These effects can lead to a significantly impaired quality of life and could negatively affect sleep.
COVID Anxiety, Depression, & Post-Traumatic Stress Symptoms
Even those of us who’ve squeaked through the pandemic relatively unscathed may have been affected in less apparent ways.
For those of us who’ve kept jobs through the pandemic, adapting to a new routine where you’re working from home or around your family more can still create significant stress. These abrupt changes in daily life could profoundly affect our ability to close our eyes and switch off come bedtime.
According to Dr. Esther, many patients are presenting psychological problems in addition to physical complaints. The most common ailments being stress, suicide, and depression due to uncertain economic times. She further explains that “the rate of suicide has increased, and anti-anxiety prescriptions are flying off the shelves among young people.”
She says, “the most common symptom of anxiety and depression is insomnia.” However, pinning down the cause of insomnia can be difficult because insomnia can create anxiety, and anxiety can create insomnia[1], snowballing into a frustrating chicken-or-the-egg cycle.
Anxiety & Worry
Some of the most stressful events that can happen in our lives include the death of a loved one, divorce, major illness or injury, and moving. Until recently, this list didn’t include a global pandemic because we haven’t experienced one in recent years. However, enduring a significant pandemic can present enough stress to leave a lasting effect on one’s health.
Further, a pandemic can exceptionally be stressful if you’re a parent or don’t have a financial safety net, like family (with disposable wealth) nearby, should you find yourself in a pinch. Not only is a pandemic stressful when it comes to our bank accounts, but it can present enormous health risks as well, one of which is insomnia.
Depression
According to Dr. Leahy, an attending psychologist at New York Presbyterian/Weill Cornell Medical Center, Covid-19[2] “is the perfect storm for depression” which also happens to be a symptom of sleep disorders. With such extreme shifts in our daily lives, enduring long periods of separation and social distancing, coupled with loneliness, the coronavirus has likely affected many individuals’ mental health, and the residual effects could present hurdles.
Depression has become more common in those who experience significant fear of infection or had to change their place of residence during quarantine, according to research[3]. These groups often experienced greater levels of loneliness, feared death, hopelessness, and trouble with sleep.
Depression is also a precursor to insomnia. According to Dr. Jaydeep Tripathy, a primary care doctor at Doctor Spring, depression is one of the leading causes of sleep problems for people with COVID and long-haul COVID. Further, he explains, “Post-COVID-19 syndrome can also cause fatigue and brain fog, making it more difficult to get quality sleep at night. Long-haul symptoms can happen to anyone, even with mild patients and asymptomatic patients.”
Learn More: Connection Between Sleep and Depression
Reintegration Stress
Experiencing stress around reintegrating into the world is not uncommon. Suddenly having the ability to frequent shops and restaurants after having limited freedom can feel jarring. You may encounter anxiety at the thought of being near multiple people, and after over a year of potential off-and-on quarantining, this can be expected.
When managing these feelings, it’s important to keep in mind everything you’ve endured over the last year and a half. While we’ve all had our own experiences separate from our neighbors, we’ve all gone through a tumultuous time that has likely left a few mental scars, so if you want to ease back into regular life slowly, don’t push yourself further than you’re ready.
Reintegration stress is a valid issue that deserves to be handled with care and patience. Pushing yourself too quickly could leave you awake at night, causing you to lose shuteye.
Set Your Body Up to Recover From a Pandemic
Enduring a pandemic is exhausting, and so is figuring out how to go back to “normal.”
Stick to a Schedule
Being cooped up inside for weeks or months on end can wreak havoc on your internal clock. Without external factors such as going to an office every day or working out at a gym, many of us stayed up late watching TV, consumed late-night snacks, or other activities to help curb stress or depression to cope with intense lifestyle shifts. However, these might have contributed to poor sleep habits as a result.
According to the Mayo Clinic[4], going to bed at the same time every night can help to reinforce your body’s sleep-wake cycle. Decide on a reasonable bedtime to stick to nightly, and be sure to allow your body plenty of time to mentally wind down before it’s time to go to sleep.
Little tricks like putting your phone away and turning off your TV well before lights-out can help eliminate blue light and help you get some shuteye. Mellow activities we recommend before bed include reading a book, journaling, or listening to relaxing music.
Your Bedroom is for Sleep
Going into an office every day provides a clear boundary between work and play, and working from home can lead to difficulty “unplugging” when it’s time to switch off and recharge.
According to Dr. Tripathy, COVID-19 created significant shifts in how we work. He explains, “work-from-home setups [have] blurred the distinction of spaces at home,” meaning that people who work in their bedrooms will likely eliminate the brain’s association of bedroom and sleep. Also, this causes many people to lose their work-life balance, as it’s become common to work before or past expected work hours.
Separate the space in which you sleep and the space you work as much as possible. We realize not everyone has the luxury of extra square footage, but even something simple like a retractable curtain to provide some degree of separation could create a healthy boundary.
Soak Up the Sunlight
Without the socialization and distraction of coworkers and an office environment, it’s easy to get stuck at a desk all day without taking enough breaks. Splitting up your day into manageable chunks with little rewards like short walks between tasks can help you feel less overwhelmed and more motivated to tackle your duties.
Further, according to research, exposure to morning sunlight and even artificial light helps to produce more melatonin come bedtime, allowing you to slip into dreamland quicker than those who don’t get enough sun. So, next time you consider not taking a break to power through, remember walking outside is good for your sleep health.
Care for Your Mental Health
Feeling covid-fatigued isn’t unusual, so if your sleep routine is hurting from navigating new ways of life, you’re not alone. Rest can suffer from mental health strain, but there are ways to help.
Foster Connection
The amount of depression and anxiety instances have increased in the past year, particularly among young people. Even as restaurants and shops begin to open up, the residual mental effects of 2020 can take time to lift, so staying cognisant about your mental state is still essential to your wellness.
According to Patrick H. Finan, Ph.D., a John Hopkins[5] sleep researcher, “depression itself is associated with sleep difficulties such as shortening the amount of restorative slow-wave sleep a person gets each night.” Further, research shows that depression can lead to heightened stress regarding financial or familial struggles and challenges regarding daily tasks. This stress may spark more frequent night wakings or more trouble getting back to sleep than someone without depression.
We may avoid or alleviate depression and insomnia symptoms by making the connection with loved ones a priority. Even if you can see people in person again, this can still cause stress after long periods of isolation. Whether you do that through voice notes, mail, video chatting, or just more frequent phone calls, regularly connecting with those you care about can help.
Diet & Exercise
Research has shown substantial correlations between diet and sleep[6]. Even healthy foods can mislead us. Foods such as onions, tomatoes, fruits, garlic, and dark chocolate could keep you away at night due to their acidic qualities.
Our digestive system could keep us awake if we eat too late in the evening. When our body is still processing it becomes more difficult for us to settle down into restorative sleep. Further, those who suffer from heartburn may experience increased discomfort because when we lay flat, there is no gravity to keep stomach acid down.
Besides solid foods, alcohol, nicotine, and caffeine are all known to keep you awake at night. Even if you drink coffee early in the morning, depending on how your digestive system works, caffeine could keep you up long after. The half-life for caffeine is 1.5 to nine hours, meaning it can stay in your system and disrupt your sleep-wake cycle for over 15 hours after consumption.
If you’re having trouble with sleep, cutting back or eliminating any of these things could make a difference.
Learn More: How Digestion Affects Your Sleep Quality
Be Gentle With Yourself
As we near the end of a global pandemic, many of us may struggle with conflicting emotions. We may be desperate to socialize with family and friends, but after months or even a year of not seeing many people, feelings of confusion could be overwhelming. There is no need to dive into a pre-covid lifestyle quicker than whatever feels comfortable.
Make Rest a Priority
Knowing which comes first, depression or insomnia, is challenging, as either could be a symptom of the other. Making sleep a pillar in your life might help you get what you need to feel your best.
An hour or two before bed, make sure all screens are off and you’re allowing your mind to wind down. Listening to relaxing music, meditating, or reading a book is a great way to unplug from a hectic day.
You could further foster rest by turning your bedroom into a peaceful, calm environment. Darkness helps produce melatonin, the hormone that encourages sleep, so blackout curtains could be a wise investment. Further, using a sleep mask or earplugs may help drown out external stimuli, helping get your rest routine back on track.
Sleep Remedies
All our bodies and brains are unique with various difficulties and struggles, so what may not work for one person could work well for someone else.
CBT-I
According to Dr. Lizz Kinyua, MD and Medical Consultant, CBT-I is one of the best ways of treating insomnia. Cognitive Behavioral Therapy for Insomnia is a form of therapy that takes a short and structured approach to combat this issue. CBT-I[7] explores the connection between the brain, our behavior, and how we sleep.
A trained specialist will help you identify feelings, thoughts, and behaviors that trigger symptoms. The specialist will then assist you in reframing these challenges in a way that promotes, instead of hinders, sleep. Treatment length can vary but typically takes between six to eight sessions[8].
Melatonin
Melatonin is a naturally occurring hormone in all our bodies that helps us wind down and fall asleep when the sun goes down, and it becomes dark. When the sun rises and we’re exposed to daylight, our brain senses this, and melatonin[9] decreases.
Trouble falling asleep could be mitigated by buying this over-the-counter hormone from a local pharmacy or drugstore. Dosages vary from 1 mg to 10 mg, but we recommend starting small as it is known to leave people feeling groggy when they take a higher dose.
View Our Guide: Best Melatonin Supplements
Stress & Anxiety Management
Making a concerted effort to manage your stress and anxiety could help significantly with rest. When our brains are rattling through thoughts as we lay in the dark in bed, many of us become more stressed at the idea that we can’t fall asleep, further inhibiting our ability to get some shuteye.
Actively managing anxiety and stress through self-care routines could help. Things like regular exercise, meditation, and diet adjustments can go a long way. Even something as simple as getting outside for a walk in the fresh air can alleviate built-up stress from your workday.
As you navigate this tricky time, remember that your feelings are worth consideration; if you have trouble sleeping, you’ve got options to help.
Rachael Gilpin
Content Writer
About Author
Rachael is a content writer for Sleep Advisor who loves combining her enthusiasm for writing and wellness.
Back Sleeper
Sources and References:
[1] “Insomnia”, Mayo Clinic, Mayo Foundation for Medical Education and Research, 15 Oct. 2016.
[2] “Coronavirus Depression: How to Protect Your Mental Health”, NewYork-Presbyterian, 13 Apr. 2020.
[3] Gonca Ustun, “Determining Depression and Related Factors in a Society Affected by COVID-19 Pandemic – Gonca Ustun, 2020”, SAGE Journals
[4] “6 Steps to Better Sleep”, Mayo Clinic, Mayo Foundation for Medical Education and Research, 17 Apr. 2020.
[5] “Depression and Sleep: Understanding the Connection”, Johns Hopkins Medicine
[6] “How Your Diet Can Affect Your Sleep”, Piedmont Healthcare
[7] “Insomnia Treatment: Cognitive Behavioral Therapy Instead of Sleeping Pills”, Mayo Clinic, Mayo Foundation for Medical Education and Research, 28 Sept. 2016.
[8] Wilfred R. Pigeon, “Treatment of Adult Insomnia with Cognitive-Behavioral Therapy”, Journal of Clinical Psychology, U.S. National Library of Medicine
[9] “Melatonin: What You Need To Know”, National Center for Complementary and Integrative Health, U.S. Department of Health and Human Services