I’m usually an extremely scheduled person, including when and how long I sleep. A few months ago (pre-pandemic), I consistently fell asleep around 11 PM and woke up around 7 AM, without fail. Now? I’m all over the map! I have come to realize that my trouble sleeping isn’t just because of me, and quarantine is playing a huge role.
Sleep is crucial for many biological processes, such as reducing inflammation, stress, and risk of developing psychological and neurological illnesses; additionally, it helps the body repair and can ward off illness . So you would think that in the current world, with COVID-19 running amok, sleep would be a major priority, but my brain and body seem to disagree.
Figure 1 Getting a good night’s sleep can be a game-changer, and its importance is growing with COVID-19. (Source: Help Guide)
One major cause of sleep disruption, either through insomnia, fragmented sleep, or nightmares, is heightened anxiety levels. With COVID-19 dominating the media, threatening our health and safety, and no signs of quick improvement in terms of case numbers, deaths, and state and federal restrictions (at least in the U.S.) , everyone is affected everyday, thus leading to increased anxiety.
Additionally, the pandemic impacts almost every aspect of our lives, including economic decisions, health risks, and social well-being. The pandemic’s influence on even one of those important parts of our culture can alter and disrupt our sleep .
The relationship between stress and sleep has been studied in detail, but is a complex issue. This is due to the fact that stress itself is a complex condition with many factors (emotional, cognitive, and behavioral) and varies from person to person, and therefore remains not fully understood. What we do know is that stress impacts the normal levels of several types of our neurotransmitters and hormones, such as cortisol, adrenocorticotropic hormone (ACTH), dopamine, and norepinephrine, which impact our brain activity and function. These neurotransmitters and hormones can shift the balance between sleep and awake states .
While stress can impact a lot of different hormones and neurotransmitters, I want to focus on one of them, cortisol. Cortisol is a stimulating hormone, and is important for our fight-or-flight (or freeze) response . Additionally, it is an element on the hypothalamic-pituitary-adrenal axis (HPA) axis of the brain, which regulates body functions such as stress responses (heart rate, body temperature, etc.) and sleep-wake cycles . In situations of prolonged stress (ahem pandemic), the HPA axis can be continually activated, leading to an increase in cortisol production, therefore ruining our peaceful nights.
Normally, cortisol has a rhythm, rising early in the morning and declining throughout the day . The activity of the HPA axis (and cortisol release/production) is at its lowest level in the evening (barring any extreme stressors), which plays a crucial role in helping us relax before sleep .
Figure 2 Average cortisol cycles over 24 hours. (Source: ZRT Lab)
In addition to increased cortisol levels due to stress, poor sleep quality and sleep patterns can also lead to increasing cortisol production/release/levels , resulting in an unfortunate cycle of dysregulated cortisol levels, which can only be addressed through decreasing stress and improving sleep patterns.
As I mentioned previously, cortisol is not the entire story. Other hormones and neurotransmitters also play big roles in regulating our normal 24-hour cycles, such as melatonin (which is commonly known as the sleep hormone). Luckily, while it can be difficult to manage stress levels during a pandemic, we can make changes in our lives to aid our sleep.
Decrease your screen time, especially right before bed. The blue light from our screens tells our brain to reduce melatonin (the sleep hormone).
- Try reading, playing a board game, doing a puzzle, or (if you can’t stay away from screens) invest in some blue light glasses!
Utilize your energy during the day. Increased down-time can make it harder to fall asleep at night.
- Try incorporating some exercise throughout the day (my current favorite is dance parties with my puppy).
Maintain a regular sleep-wake routine (I know it’s hard!)
- Set reminders on your phone or smart watch! Try to schedule in ~8 hours of ‘sleep time’ every day, including some time to wind down.
Practice self-care. Call your friends/family, take a walk, soak in the bath, do whatever makes you feel relaxed.
- Make sure that you are prioritizing your health (physical, mental, and emotional). Take time for yourself and do the things that make you feel at your best (while keeping the appropriate social distance!).
Most importantly, remind yourself that quarantine/pandemic-related sleep issues will not last forever. States are beginning to re-open and we will (hopefully) be back to somewhat normal routines soon! fingers crossed
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