Impact of COVID-19 on Sleep Tips

Ingredients for Good Sleep

There are several key “ingredients” to a night of good quality sleep. These include:

• A high need for sleep, known as sleep drive
• Appropriate timing in our circadian rhythm
• Low hyperarousal

In order to have a high need for sleep, we need to have had a sufficiently long time period of being awake since the last time we slept. The longer it has been since we have been awake, the more sleepy we are likely to feel, so going to bed when sleepy is a good sign that our body’s sleep need is high. If we try to go to bed when we are not sleepy, that sets us up for difficulty falling and staying asleep. Additionally, we sleep best when our intended sleep period occurs during our body’s physiologically determined placement for sleep that is for most of us, at night. If we try to sleep outside of this window, even if we are very sleepy, it can also be difficult to fall and stay asleep. Lastly, even if we have a high sleep need and we’re getting in bed at the best bedtime range for our body, if we are too “wound up”, whether that be cognitively, emotionally, or physically, we will have a hard time transitioning to sleep. There are many things that can contribute to hyperarousal, including worry or stress, physical conditions or illness, or even simply spending too much time in bed awake so that our bodies learn to become more alert when in bed.

How Does COVID-19/Social Distancing Impact Our Sleep?

While the concept of social distancing itself does not directly impact our sleep, it can lead to changes in our behaviors either during the day or night that can cause or exacerbate sleep disruption. For a while, these behavior changes may not affect our sleep or may even feel beneficial, but over time will alter the key ingredients of sleep and lead to sleep inability, known as insomnia. Weeks or months down the road, you may find you are stuck with poor sleep. Here are a few examples:

• When working from home, using the bed and bedroom for work, social, and other daily activities. This can be particularly challenging if you are sheltering in place from a small dwelling or sharing your dwelling with others and have no other private space for these activities.
• Increased mental exhaustion from the extra effort needed for basic activities like meal-planning, running errands, and work duties may lead to trying to sleep too much. You might also try to sleep too much to cope with boredom from being home all the time.
• Not setting a consistent daily schedule for tasks, eating, etc, especially if you have telework with schedule flexibility, or have been placed on furlough or laid off, or used to attend classes or other scheduled group activities. Eventually, the lack of time cues can be confusing to our body and can lead to drifts in our schedule where we may progressively delay bed and wake time.
• Sheltering in place without any time spent outside leads to reduced natural light exposure compared to previous routines, dampening our body clock.
• Increased stress and multitasking may lead to worry and hyperarousal that interferes with sleep or leads to nightmares.
• Viewing social media or news focused on COVID-19 may also lead to worry and hyperarousal.
• Lack of physical activity including purposeful exercise can also disrupt sleep.
• Coping with stress related to COVID-19 and social distancing with substances such as caffeine, alcohol, or nicotine.

What Strategies Counteract Negative Sleep Effects From COVID-19/Social Distancing?

Even if your sleep is not currently disrupted, you may want to consider proactive steps you can take to keep insomnia from developing during this time. Given the problematic issues noted above, strategies generally include doing the opposite. Helpful strategies to implement, particularly for prevention of future sleep problems, include:

• Develop a regular daytime schedule where similar tasks, eating, physical activity, and breaks, occur at approximately the same time. Write them down and post them for accountability. This doesn’t mean you can’t be flexible, but sticking with your plans will help keep cues to your body as consistent as possible. For physical activity, consider that activity too close to bedtime may delay when your body feels ready to sleep.
• Increase your daytime light exposure. Ideally, this would be via sunlight and time spent outside, but if not, keep room lighting bright. This is crucial just after you wake up. Conversely, several hours before bedtime, begin to dim lights and avoid blue light exposure particularly.
• Keep daytime and nighttime cues distinct. You should have spaces you use solely or primarily during daytime and vice versa. Wear typical daytime attire at day, pajamas at night. For daytime, active activities are best. For nighttime, develop a “wind down” routine of quiet activities.
• Avoid napping. Napping will reduce your sleep drive and contribute to problems falling asleep later that night. If absolutely unavoidable, keep naps short (10-15 minutes). Napping is alright if you are in a situation where sleep deprivation has compromised your safety, often when shift or high work loads reduce your sleep opportunity, such as providing medical care or operating machinery.
• Limit time spent viewing news and social media about COVID-19. This does not mean avoid entirely, just do not excessively spend time on these, and especially not close to bedtime.
• Implement stress management strategies such as individual, outdoor exercise at an appropriate distance from others, or group exercise via an online class, deep breathing, mindfulness, imagery, yoga, etc.
• Avoid increased use of substances such as caffeine, nicotine, and alcohol.
• Ensure a bedroom environment conducive to sleep: dark, quiet, cool, and comfortable.

What if Your Sleep is Already Poor?

If your sleep is currently poor, you likely are looking for strategies you can use in the current situation to obtain better sleep. If nothing else, the primary strategies we recommend you employ right away to improve your sleep are:

• DO NOT get in bed unless you are sleepy and about to go to sleep for the night. Preferably, to the extent possible, do not even be in the bedroom outside of sleep time. Again, any activities that are not sleep, such as work, reading, even thinking, in bed can result in teaching our bodies to be awake whenever we are in bed, even at night. This also means if you find yourself awake in bed at night, get out of the bed and don’t get back in until you are truly sleepy again. Take some time to rest and relax outside of the bed rather than trying to force sleep to happen.
• Maintain a consistent bedtime-waketime schedule. Wake time in particular is crucial. If you stay up late some nights, that is alright, but keep your consistent wake time, even if you don’t have to commute in to work at a certain time or do not currently have an externally required schedule.

Give both of these strategies several weeks if you already have poor sleep. Sleep problems and particularly insomnia were a common occurrence among the general US population prior to COVID-19 and the need for social distancing. Because of this, we have decades of research documenting their beneficial effect, in all kinds of environments and situations.
Most importantly, remember that everyone has sleep problems and it is alright to have a bad or two (or three!) of sleep problems; it would be unusual to have a great night of sleep every night even without the current context of COVID-19. When you experience a bad night of sleep, do not panic and try to chase sleep by getting in bed earlier, napping, or sleeping in. Stick with these sleep promoting strategies and know that your body has protective mechanisms to help compensate for times like this when we may not sleep at our best. Thinking, if not tonight, then tomorrow night will help you acknowledge a rough night and still maintain healthy sleep practices. Don’t chase sleep directly-the harder you run, the further away it will go!