En español | If you've noticed that your sleep has been a little off these last six months, you're not alone. A number of surveys, polls and studies reveal a similar trend: The pandemic is rattling sleep schedules.
Some are finding it hard to sleep at all; others are dozing throughout the day and night. All the while, the health of millions of Americans is suffering. After all, sleep deficiency leaves you more than a little moody. It can increase risk for a number of chronic health problems — including diabetes, obesity, high blood pressure, kidney disease, heart disease and depression. Sleep is also a critical part of immune function. If you miss out on what your body needs, your risk for infection could increase, according to the Centers for Disease Control and Prevention (CDC).
So what's going on? And can it be fixed? AARP interviewed three sleep experts to pinpoint the factors at play when it comes to pandemic-related sleep issues — and the most effective ways to reclaim your rest.
1. Anxiety, stress and fear are fueling insomnia
Elevated stress brought on by job loss, health concerns and fear of the unknown is one reason why people are reporting more sleep problems. In July, 53 percent of American adults said that stress and worry related to the coronavirus had a negative impact on their mental health, according to a Kaiser Family Foundation report. What's more, 36 percent reported difficulty sleeping.
"The mother of insomnia is stress,” says Michael Perlis, director of the behavioral sleep medicine program and associate professor in the department of psychiatry at the University of Pennsylvania's Perelman School of Medicine.
Chronic insomnia, a sleep disorder characterized by an inability to initiate or maintain sleep three or more times per week, typically affects 10 to 14 percent of adults. But sleep specialists say they've seen an uptick in the number of patients who are struggling to get shuteye — and that trend will likely continue as millions of Americans remain out of work and case counts for coronavirus infections continue to climb.
"At the end of the day, we're likely to see a lot more insomnia because there are a lot of people whose quality of life and way of life is fundamentally threatened,” Perlis adds.
How does stress interfere with sleep? The body and mind need to be in “slower states” to successfully shift from awake to relaxed, explains Lisa Medalie, a behavioral sleep medicine specialist at the University of Chicago and founder of the sleep app Dr. Lullaby. But elevated stress makes the sleep transition “more challenging” because it “ramps us up and gets our heart beating faster.” And if this persists, a person becomes vulnerable to insomnia.
Solution: Tackle the stress and the sleep problems
It's important to address stress and anxiety, if you have it. Take care of your emotional health by taking care of your body: Eat well-balanced meals and avoid excessive alcohol use. It's also critical to find a balance with the news these days, which can trigger pandemic-related stress. The CDC recommends staying informed, but avoiding too much exposure to the news, and making the time to unwind and engage in activities you enjoy. And don't forget to share your concerns with family and friends — even if you can't do so in person.
Stress-related insomnia is often short-lived, but if it gets in the way of your daily activities, including sleep, for several days in a row, it's important to contact your health care provider or reach out to a mental health professional.
If your sleep issues persist for more than a month, seek treatment for the sleep problem, regardless of what may have triggered it, Perlis says. “And know that an ounce of early intervention can save you a pound of cure (and a lot of unnecessary suffering).”
According to most experts, including the American College of Physicians, the first line of treatment for chronic sleep issues is cognitive behavioral therapy for insomnia (CBT-I), a tailored approach that helps people identify the underlying causes of their insomnia and adopt behaviors to change it. (You can locate a provider on the Society of Behavioral Sleep Medicine's website, and many are offering services virtually because of the coronavirus.)
2. Changes in routines upend sleep schedules
The pandemic has ushered in a number of changes that have impacted daily routines, including sleep. People plagued with long commutes to the office are finding that a work-from-home life means they can stay up later at night and sleep in longer, come morning. Less structured days also allow more time for naps.
For some, the extra sleep flexibility is working out just fine. Individuals whose busy lives were preventing them from getting the minimum seven hours of recommended sleep are finally feeling well-rested. For others, the extra sleep time is causing problems.
Perlis likens sleep flexibility to pizza dough: If you stretch your sleep time out at night and/or nap during the day because you can — and not necessarily because you need to, you will end up with a dough that gets “thinner and thinner and thinner, until it starts breaking into pieces,” he says. And similar to thin and broken pizza dough, a thin and shallow sleep cycle doesn't do a person much good — it can disrupt the body's internal clock and lead to insomnia.
The key, Perlis says, is to find a balance. “It has forever been assumed more sleep is better ... but it's a dose thing. Dose too little, bad. Dose too much, bad. Dose just right? Perfecto."
Changes in sleep routines extend beyond the ability to hit snooze or take a mid-afternoon nap. Many are finding themselves in new living situations that also present challenges when it comes to sleep, says Vivek Jain, director of the Sleep Disorders Center and associate professor of medicine at the George Washington University Hospital.
For the first time since the Great Depression, a majority of young adults (52 percent) are living with their parents due to pandemic-related circumstances, according to a new report from the Pew Research Center. Grandparents also have moved in with their children to lend a hand with childcare while schools and day care centers remain closed.
Pointing to possible space constraints and conflicting schedules, Jain says these major changes mean “everybody's sleeping life has been affected.”
Solution: Get back on a schedule
If your sleep issues are due to a newly inconsistent or intermittent sleep schedule, go back to what was working — even if that means you accumulate fewer total hours of sleep. (And yes, this may mean you need to cut out the naps.)
"If you can anchor your wake time and wake up at the same time every day, that's a great start for a consistent sleep schedule,” Medalie adds.
When you do sleep, make sure your bedroom is quiet, dark and at a comfortable temperature, the CDC recommends. It also helps to avoid large meals, caffeine and alcohol before bedtime.
3. More screen time, less exercise
An increase in screen time is further contributing to the uptick in sleep troubles, experts say. Bedrooms once reserved for downtime have been transformed into makeshift offices, and in-person meetings have been replaced by online conferences. Even time spent with friends has moved to the virtual world.
How is this affecting sleep? Medalie explains that the blue spectrum light generated from screens “tells the brain to stop producing melatonin,” a hormone that regulates the body's sleep-wake cycle. And when this biological clock gets disrupted, insomnia can set in.
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Hand in hand with more screen time is a more sedentary lifestyle. Shutdowns and stay-at-home orders have closed gyms, postponed sports seasons and canceled exercise classes. Researchers at the University of California, San Francisco (UCSF) reported a significant drop in step counts among smartphone users worldwide once coronavirus-related restrictions went into place. And an AARP survey found one third (32 percent) of older adults who exercised regularly before the pandemic have since decreased their level of activity.
"People who exercise regularly tend to sleep better, so with less exercise, we're also at risk for sleep problems,” Medalie says.
Solution: Ditch the screens at bedtime, make exercise a priority
Ban the blue light from your bedroom: Turn off your devices an hour before bedtime, and if you think you will be tempted to check them, consider leaving phones, tablets and computers in another room to charge overnight.
"The hour before bed really should be ‘me time.’ It should be a time where you're taking care of yourself ... a time where you can lower the somatic arousal system and get your mind and body in the right place for sleep,” Medalie says.
Being physically active during the day also makes it easier to fall asleep at night. Federal guidelines recommend adults get at least 150 minutes of exercise each week (or 30 minutes a day, five days a week). If exercising outside the home is not an option, AARP has a number of workouts you can do from your living room.
Finally, avoid sleeping pills as much as possible, which can increase risk for falls and aggravate memory issues — especially among older adults.