HEALTH PLUS MED­ICAL COR­RE­SPON­DENT

The nov­el coro­n­avirus has brought the world in­to un­chart­ed wa­ters. There’s still so much un­known about this pan­dem­ic — how much the dis­ease will spread, whether hos­pi­tals can man­age the cri­sis, when the econ­o­my can re­cov­er — and such un­cer­tain­ty of­ten brings anx­i­ety that dis­rupts sleep as a rac­ing mind keeps the body toss­ing and turn­ing.

Sleep is crit­i­cal to phys­i­cal health and ef­fec­tive func­tion­ing of the im­mune sys­tem. It’s al­so a key pro­mot­er of emo­tion­al well­ness and men­tal health, help­ing to beat back stress, de­pres­sion and anx­i­ety.

How sleep im­pacts men­tal health

Every 90 min­utes, a nor­mal sleep­er cy­cles be­tween two ma­jor cat­e­gories of sleep — al­though the length of time spent in one or the oth­er changes as sleep pro­gress­es.

Dur­ing “qui­et” sleep, a per­son pro­gress­es through four stages of in­creas­ing­ly deep sleep. Body tem­per­a­ture drops, mus­cles re­lax, and heart rate and breath­ing slow. The deep­est stage of qui­et sleep pro­duces phys­i­o­log­i­cal changes that help boost im­mune sys­tem func­tion­ing.

The oth­er sleep cat­e­go­ry, REM (rapid eye move­ment) sleep, is the pe­ri­od when peo­ple dream. Body tem­per­a­ture, blood pres­sure, heart rate, and breath­ing in­crease to lev­els mea­sured when peo­ple are awake. Stud­ies re­port that REM sleep en­hances learn­ing and mem­o­ry and con­tributes to emo­tion­al health — in com­plex ways.

Al­though sci­en­tists are still try­ing to tease apart all the mech­a­nisms, they have dis­cov­ered that sleep dis­rup­tion — which af­fects lev­els of neu­ro­trans­mit­ters and stress hor­mones, among oth­er things — wreaks hav­oc in the brain, im­pair­ing crit­i­cal think­ing, and emo­tion­al reg­u­la­tion. In this way, in­som­nia may am­pli­fy the ef­fects of psy­chi­atric dis­or­ders, and vice ver­sa.

Chal­lenges to Sleep Dur­ing a Pan­dem­ic

With such un­prece­dent­ed changes com­ing on so quick­ly, it’s un­der­stand­able that the im­por­tance of sleep is fly­ing un­der the radar. But as we ad­just to stay-at-home rec­om­men­da­tions and try to re­main healthy in a time of COVID-19, fo­cus­ing on sleep­ing health of­fers tremen­dous ben­e­fits.

Mil­lions of peo­ple suf­fered from in­som­nia be­fore the coro­n­avirus and un­for­tu­nate­ly, the pan­dem­ic cre­ates a host of new chal­lenges even for peo­ple who pre­vi­ous­ly had no sleep­ing prob­lems.

Dis­rup­tion of Dai­ly Life

So­cial dis­tanc­ing, school clo­sures, quar­an­tines, work­ing from home: all bring pro­found changes to nor­mal rou­tines for peo­ple of all ages and walks of life.

• It can be dif­fi­cult to ad­just to a new dai­ly sched­ule or lack of a sched­ule.

• Keep­ing track of the time, and even the day, can be hard with­out typ­i­cal time “an­chors” like drop­ping chil­dren at school, ar­riv­ing at the of­fice, at­tend­ing re­cur­ring so­cial events, or go­ing to the gym.

• Be­ing stuck at home, es­pe­cial­ly if it has low lev­els of nat­ur­al light, may re­duce light-based cues for wake­ful­ness and sleep, known as zeit­ge­bers, which are cru­cial to our Cir­ca­di­an Rhythm.

• If you are not work­ing now or your week­ly hours have been de­creased due to COVID-19, you may be tempt­ed to over­sleep each morn­ing. Sleep­ing more than sev­en to eight hours per night can make wak­ing up on time much more dif­fi­cult, even if you use an alarm. Over sleep­ers may al­so feel grog­gy, ir­ri­ta­ble and un­fo­cused through­out the day.

Stress-Re­lat­ed Fa­tigue

The chron­ic stress of liv­ing through a pan­dem­ic can lead to a host of phys­i­cal symp­toms, in­clud­ing per­sis­tent headaches, mem­o­ry laps­es, and di­ges­tive prob­lems. Stress-re­lat­ed fa­tigue is an­oth­er com­mon side ef­fect. The MAYO CLIN­IC de­fines fa­tigue as “a near­ly con­stant state of weari­ness that de­vel­ops over time and re­duces your en­er­gy, mo­ti­va­tion and con­cen­tra­tion.” Even if you re­ceive an ad­e­quate amount of sleep at night, fa­tigue can still leave you feel­ing tired and un­mo­ti­vat­ed in the morn­ing.

Greater Fam­i­ly and Work Stress

Keep­ing up with work-from-home oblig­a­tions or man­ag­ing a house full of chil­dren who are ac­cus­tomed to be­ing at school can pose re­al prob­lems, gen­er­at­ing stress and dis­cord that have been shown to be bar­ri­ers to sleep.

Eco­nom­ic con­cerns are af­fect­ing near­ly every­one as well. As eco­nom­ic ac­tiv­i­ty stalls and job loss­es mount, it’s nor­mal to wor­ry about in­come, sav­ings, and mak­ing ends meet.

Ex­cess Screen Time

Ex­cess screen time, es­pe­cial­ly lat­er in the evening, can have a detri­men­tal im­pact on sleep. Not on­ly can it stim­u­late the brain in ways that make it hard to wind down, but the blue light from screens can sup­press the nat­ur­al pro­duc­tion of mela­tonin, a hor­mone that the body makes to help us sleep.

Ex­perts agree that get­ting con­sis­tent, high-qual­i­ty sleep im­proves vir­tu­al­ly all as­pects of health, which is why it is wor­thy of our at­ten­tion dur­ing the coro­n­avirus pan­dem­ic.

In spite of the daunt­ing chal­lenges, there are a hand­ful of steps that can pro­mote bet­ter sleep dur­ing the coro­n­avirus pan­dem­ic.

If these ef­forts don’t pay off im­me­di­ate­ly, don’t give up. It can take time to sta­bilise your sleep, and you may find that you need to adapt these sug­ges­tions to best fit your spe­cif­ic sit­u­a­tion.

Cre­at­ing Qual­i­ty Sleep Hy­giene Prac­tices

Es­tab­lish­ing a rou­tine can fa­cil­i­tate a sense of nor­mal­cy even in ab­nor­mal times. It’s eas­i­er for your mind and body to ac­cli­mate to a con­sis­tent sleep sched­ule, which is why health ex­perts have long rec­om­mend­ed avoid­ing ma­jor vari­a­tion in your dai­ly sleep times.

Sleep-spe­cif­ic as­pects of your dai­ly sched­ule should in­clude:

• Wake-Up Time: Set your alarm, by­pass the snooze but­ton, and have a fixed time to get every day start­ed.

• Wind-Down Time: This is an im­por­tant time to re­lax and get ready for bed. It can in­volve things like light read­ing, stretch­ing, and med­i­tat­ing along with prepa­ra­tions for bed like putting on pa­ja­mas and brush­ing your teeth. Giv­en the stress of the coro­n­avirus pan­dem­ic, it’s wise to give your­self ex­tra wind-down time each night.

Re­serve Your Bed for Sleep

Sleep ex­perts em­pha­size the im­por­tance of cre­at­ing an as­so­ci­a­tion in your mind be­tween your bed and sleep. For this rea­son, they rec­om­mend that sleep and sex be the on­ly ac­tiv­i­ties that take place in your bed.

On any giv­en night, if you find that you’re hav­ing a hard time sleep­ing, don’t spend more than 20 min­utes toss­ing and turn­ing. In­stead, get out of bed and do some­thing re­lax­ing in very low light, a mind­ful­ness prac­tice or jour­nalling and then head back to bed to try to fall asleep.

See the Light

Ex­po­sure to light plays a cru­cial role in help­ing our bod­ies reg­u­late sleep in a healthy way. As you deal with dis­rup­tions to dai­ly life, you may need to take steps so that light-based cues have a pos­i­tive ef­fect on your cir­ca­di­an rhythm.

• If you can, spend some time out­side in nat­ur­al light. Even if the sun isn’t shin­ing bright­ly, nat­ur­al light still has pos­i­tive ef­fects on cir­ca­di­an rhythm. Many peo­ple find out­door time is most ben­e­fi­cial in the morn­ing, and as an added bonus, it’s an op­por­tu­ni­ty to get fresh air.

• Be mind­ful of screen time. The blue light pro­duced by elec­tron­ic de­vices, such as mo­bile phones, tablets, and com­put­ers, has been found to in­ter­fere with the body’s nat­ur­al sleep-pro­mot­ing process­es. As much as pos­si­ble, avoid us­ing these de­vices for an hour be­fore bed. You can al­so use de­vice set­tings or spe­cial apps that re­duce or fil­ter blue light.

Prac­tice Kind­ness, Grat­i­tude and Fos­ter Con­nec­tion

It might not seem crit­i­cal to your sleep, but kind­ness and con­nec­tion can re­duce stress and its harm­ful ef­fects on sleep and will im­prove our emo­tion­al well­be­ing dur­ing this Pan­dem­ic. So start by be­ing grate­ful for breath!

Look out for HEALTH PLUS every Tues­day for more in­for­ma­tive and health­ful ar­ti­cles. If you have any ques­tions or con­cerns re­gard­ing this top­ic, please email Guardian­Health­Plus2020@gmail.com