The pandemic’s effect on people’s health goes beyond the illness itself. Dealing with stress, anxiety and recurring sense of loss is altering our wellbeing, and more than 50% of Americans are seeing the consequences in sleep disruptions.
If you regularly struggle to fall asleep, you’ve had recurring dreams where you forgot to wear a mask in public, or are finding it harder to wake up; know you’re not alone. Along with feeling sad or tired, sleep disturbances are a growing issue that affect many people around the world as a result of Covid-19 stress and anxiety.
For two years, there’s been a constant worry about getting sick and about the health of our loved ones. But people have also been worrying about financial and career uncertainty, how to balance work and family, and how to stay connected despite social distancing. This has impacted the quality and quantity of our sleep, whether we realize it or not. And even as we’re starting to see an end to the pandemic, several stressors will remain, such as economic uncertainty, and new ones will arise, such as transitioning from social distancing to social environments when some people still don’t feel ready. In an interview with Dr. Kannan Ramar, president of the American Academy of Sleep Medicine, he said that “It’s certainly possible that these factors could cause stress that interferes with sleep.”
The American Academy of Sleep Medicine (AASM) refers to these sleep disturbances as “COVID-somnia.” And 56% of adults in the United States have experienced it. According to Dr. Ramar, “Common sleep disturbances experienced during the pandemic include problems falling or staying asleep, sleeping less, experiencing worse quality sleep, and having more disturbing dreams.” The Academy’s research, which was held in March 2021, showed that the rate of COVID-somnia even goes higher among people 35 to 44 years old, where it rises to 70%, and although it affects men more — 59% have experienced disturbances — it’s also taking the toll on women (54%).
A collective sense of loss
COVID-19 is not only haunting American’s dreams, but it’s also affecting people all over the world. This year, The Lancet published the article “Sleep research in 2020: COVID-19-related sleep disorders,” which reveals that people are struggling with sleep globally. The first studies of sleep disorders associated to COVID-19 were held in China and they revealed that about 35% of these participants had symptoms of general anxiety, 20% of depression, and 18% of poor sleep quality. These studies also showed that those people who were most worried about the pandemic presented more symptoms.
Disturbed sleep was also reported in Italy where 57% Italians admitted having poor sleep quality, 32% high anxiety and 42% high distress. Among the symptoms shown in these studies some of the most common were insomnia, nightmares, sleep apnoea, fatigue, and exhaustion.
So, why is this happening? Dr. Kannan Ramar says that “The COVID-19 pandemic has caused stress, anxiety and disruption to the daily routine, which can all impact quantity and quality of sleep. And a lack of healthy sleep affects mood, energy level, work performance and overall health.”
In an interview with Transpersonal Psychotherapist, Hilda Zepeda, she explains that people tend to feel anxious in the face of radical life changes, especially those they didn’t choose. “By nature, humans resist changes that are beyond their control. And now, we’re dealing with all types of change: in health, family, house, work, and overall lifestyle. Anxiety happens when you feel afraid, and we’re in a constant state of fear. People are afraid of death, of the suffering that could happen before death, of having to let go things they were attached to, like jobs, and of not knowing when they will be able to recover what they’ve lost.
Something important that Hilda highlights is that people are going through a sense of loss, even if they’re not aware of it. “In many of my therapies I’ve heard people say ‘it (the pandemic) took my life away from me.’ And this is grief.” The psychotherapist explains that people are mourning, and not only those who have lost friends or family to the illness, but mourning a general sense of loss. “Dealing with the pandemic means dealing with loss, whether it’s of health, of your job, of your stability, or your lifestyle. There’s a collective sense of loss that people aren’t seeing, but that is affecting them on a physical and emotional level, such as sleep disturbances.”
Fear, loss, worry, stress and anxiety are all factors that alter your nervous system. These activate the fight-or-flight response in the brain, which is the physical reaction that responds to a threat or an attack. It is what keeps you alert and ready to act. When the nervous system is under this stress, it releases hormones like cortisol or adrenaline. In order to fall asleep, the body should release a different hormone: melatonin. Cortisol and melatonin are opposites, the first causes the body to be active, whereas the second intends for it to be inactive. So, when either one of these gets out of balance, sleep becomes disturbed.
Zepeda explains that what’s happening now is precisely an imbalance, because people are constantly going through stressful situations. She mentions that even watching the news can alter our nervous system. “This is a vicious cycle because after you go through an altered state, it comes a deep sense of tiredness. People are feeling tired because they’re constantly stressed, and this state of apparent calm is not reassuring, so it starts to affect your emotional state. People are feeling sad, and can even feel depressed. This happens because the reason behind the suffering is not being solved,” the therapist adds.
Do not sleep on it
Not sleeping well (or not sleeping at all) is not healthy, and shouldn’t be ignored. The CDC states that adults need seven or more hours of sleep per night for their best health and wellbeing. But it’s not just about the amount of time, also about enjoying deep, restorative sleep.
Dr. Kannan Ramar shares that “getting the right amount of sleep affects mood and quality of life. It also boosts your immune system and strengthens the effectiveness of the vaccination (for COVID-19).”
Caring for sleep is caring for the overall health of the body and the mind, and this is crucial not only for adults but for kids too. Dr. Ramar explains that some children are also having trouble getting quality sleep since their daily routines are likely impacted by the pandemic. Hilda Zepeda adds that kids are mostly suffering from nightmares.
In order to deal with these disorders, Dr. Ramar recommends the following: “Many patients find that appropriate sleep hygiene (good sleep habits) will help them get better sleep, while those with chronic insomnia will benefit from cognitive behavioral therapy for insomnia, which includes strategies such as stimulus control, sleep restriction and relaxation therapy.”
Transpersonal psychotherapist, Hilda Zepeda, recommends having a strong support system to talk to and seeking professional help, like going to therapy, if the disturbance doesn’t improve. “It’s important to talk with family and friends about what’s troubling you, so you don’t feel alone,” she says. “When you talk about it in therapy you tap into your emotions and you process them, so the physical alterations start to wind down. You transition from the negative pole you were in, to a healthier pole. You understand that you cannot change what you’re living, but you can adapt and learn.”
According to Zepeda, people are reacting to loss with anger, frustration and sadness, and they are not aware that they are mourning. Even if what they lost is their weekly coffee with friends or their exercise routine at the gym, it’s still a loss and it’s causing them grief. So the first step is understanding why you’re feeling angry and frustrated, so you can consciously choose what to do about it. “You always have the freedom to choose, and you have the creativity to adapt. This pandemic is giving us the opportunity to learn about ourselves. When you manage to see the opportunities in a harsh situation, like this one, then you’ll see how all your system changes for the better.”
Technology as a path to better sleep
And just like sleep disturbances are growing, so is the interest of people to fight them. A positive thing that has come up is that people are taking action and, instead of settling for a bad night, they are proactively looking for ways to improve their current situation. Google Trends shows that the search for “how to fall asleep easier” has grown 500% year over year. Similar search trends are also rising, such as “how much sleep do you need,” “sleeplessness covid,” “restore sleep aid” and “natural sleep aid for adults.” These last two with an overwhelming increase of 4,800% and 4,700% respectively.
In response to this growing interest, many digital tools have also grown and become available to help people relax and restore their sleep. One company that has invested many efforts on this topic is Headspace. During the pandemic, they added to the mobile app new features dedicated to sleep, from guided meditations, to sleep casts, breathing exercises and relaxing music and sounds that last up to 500 minutes (which is the recommended 8 hours of sleep).
According to the company’s blog “meditation helps lower the heart rate by igniting the parasympathetic nervous system and encouraging slower breathing, thereby increasing the prospect of a quality night’s sleep.” The company even made a mini series for Netflix called “Headspace Guide to Sleep” and offers free playlists for better sleep on YouTube.
To deal with uncertainty, lifestyle changes and evolving challenges we need energy, focus and a clear mind. The only way to achieve this is through sleep. After a restful night, problems are easier to figure out and we’re in a better mood to deal with whatever life throws at us. Although there’s still many things we don’t know about what’s to come, we know what we can control, and that’s how we react. One way to do it is by taking care of our health, starting tonight.