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Is Sleep Disruption Dragging You Down?

The pandemic may be disrupting your nighttime routines

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En español | The past year of quarantine has led to insomnia and sleeplessness for many. A 2020 study of pandemic data from China and Italy found high rates of sleep disruption in the general population throughout the crisis, from acute insomnia to poor sleep hygiene (too much screen time before bed, for example). That can do more than drag us down; it can directly relate to cardiovascular disease, says Brooke Aggarwal, assistant professor of medical sciences in the cardiology division of the Vagelos College of Physicians and Surgeons at Columbia University.

Your Post-COVID Health Checklist

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The key question

Am I getting through the day without fatigue?

If you're falling short on quality and consistency of sleep, it's going to show up in the way you feel throughout the day.

Test yourself: Bedtime consistency

Each morning write down what time you fell asleep the night before, whether you woke up in the night, what time you woke up and whether you woke up with the aid of an alarm. Then, whenever you make an entry into your food journal, rate how much energy you feel on a scale of 1 to 10, with 10 being “Ready to climb Everest” and 1 being “Ready to fall down.”

Patterns to look for:

  • Are you on a routine? Aggarwal defines a “regular sleep schedule” as falling asleep and waking up within the same 45- to 60-minute window each day. Anything outside of that raises your risk of hypertension and diabetes.

  • The pandemic has made it easy to be lax in the name of binge-watching and no morning commute. “Maybe we stay up a little bit later, and we may sleep in a little bit,” Aggarwal says. “These disruptions in circadian rhythm can also put you at risk for weight gain. If you don't get enough quality sleep, you're more likely to gain weight. And if you are overweight, you're more likely to not sleep well.”

  • Is your sleep influencing your eating? A study of nearly 500 women up to age 76 found that lower-quality sleep was linked to greater food intake and poor diet. Conversely, a study in Nutrients found that a diet high in healthier fare was associated with higher sleep quality and fewer sleep disturbances. Eating more fruits, vegetables and legumes did the trick.

  • Do you fall outside six and nine? Getting fewer than six or more than nine hours of sleep daily is a red flag and a sign of an underlying sleep disorder, like insomnia or apnea. More red flags: not feeling rested when you wake up, daytime sleepiness and irritability. The good (and bad) news: You're not alone. We sleep about 27 minutes less per decade from midlife until age 80.

  • Do you now need a pill to sleep better? Occasional help from an over-the-counter sleep aid or melatonin is fine, but if you're taking it more than once a week, you're doing yourself more harm than good, Aggarwal says. You may have some underlying sleep issue you aren't addressing, and those products aren't designed for chronic, long-term use. That's true even for “natural” remedies like melatonin.

What's Your Chronotype?

Your chronotype is your preferred time of day for normal activities. Night owls have an evening chronotype. The majority of people fall into the morning or intermediate chronotypes. One study of more than 500 women found that morning and intermediate people tend to have better health habits and better sleep habits, be less sedentary and have a lower risk of cardiovascular disease than night owls.

If you're taking melatonin over the counter, that could make your sleep worse over time if you're not speaking to your doctor about it,” Aggarwal says. “Melatonin is typically used for short cases like jet lag. It's not meant to be a long-term solution."

And be cautious as you get older. One study found that people 70 and older who were given antihistamines to get to sleep during a hospital stay were at increased risk of cognition difficulties and more likely to have longer hospital stays, while prescription drugs like benzodiazepines have been linked to daytime sleepiness and poor motor coordination in older folks. Even over-the-counter melatonin can pose a risk when used long-term, says Agarvaal. If you're needing a pill to fall asleep, see your doctor.

Aging and Sleep

A large 2017 review of sleep studies confirms that our sleep patterns do change as we pass age 60. One key thing researchers now know: Aging can affect function of specific neurons in the hypothalamus that regulate your circadian rhythm. That's literally your body clock. This is yet another argument for healthy daily routines for eating, exercise and, yes, sleeping to keep your brain as young as possible.

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