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April 10, 2020 — 4 p.m EST
Last night I was on a cruise except all the whales weren’t in the ocean; they were on the ship. The night before that, I sat in a chair that wouldn’t stay planted to the ground. Ever since the COVID-19 pandemic began, my sleep has been seriously disrupted. In those few hours a night when I am able to completely let go to sleep, my nights have been filled with bizarre dreams. I know I’m not alone, which is why I want to say this loud and clear: It’s okay if you’re not sleeping during COVID-19.
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My initial thought when I had a few nights of restless sleep was to panic; if I’m not getting enough sleep, my immune system won’t be strong enough to fight off a potential illness…right? But instead of spending another night worrying, I set out to get some answers as to why sleep is so difficult right now, and what can be done to help it. In the wake of COVID-19, sleep resources like SleepFoundation.org have updated its guidelines to reflect the current pandemic. These foundations are also posting resources that can be helpful to get your sleep back on track, but to dig a little deeper, DoctorOz.com spoke with Dr. Alan Schwartz, adjunct professor at the University of Pennsylvania Perelman School of Medicine, and former Director of the Johns Hopkins Sleep Center and Center for Interdisciplinary Sleep Research and Education, to find out how to break the vicious cycle of poor sleep and to try to understand what’s going on in our brains at night.
How Stress Influences Sleep
It probably doesn’t come as a shock that stress has a heavy hand in how fast you’re able to fall asleep. “Under normal circumstances, everyone usually takes a few minutes to settle down after turning out the light, and clear our minds before falling asleep,” says Dr. Schwartz. “What's worse is that the longer we spend time lying in bed awake, the more we end up struggling to fall asleep. Our anxieties can take on a life of their own, and get us all riled up, which further compounds our difficulty in falling asleep.”
He says stress influences your ability to fall asleep more than it relates to the ability to stay asleep. If you’re desperate for a silver lining right now, there is one! Dr. Schwartz says a few bad nights of sleep can actually help you get back to your regular sleep-wake pattern, if you stave off naps. “As a result, your sleep drive increases, which makes for a better night of sleep thereafter. After a sleepless night or two, rest assured that you'll tend to fall asleep faster and will have fewer awakenings in the middle of the night. So you can count on your brain's own internal mechanisms to recover some of the sleep that you lost during the previous night or two. As your sleep improves, you can harvest its restorative functions once again,” he says.
What’s With the Vivid Dreams Right Now?
Many people have reported wild and vivid dreams during the COVID-19 pandemic. According to Dr. Schwartz, your dreams may not necessarily be more vivid than usual right now, you’re just having an easier time remembering them. “Vivid dreams are usually a function of the fact that you are awakening repeatedly within a short period of time [that you had the] dream itself,” he says. “We often forget our dreams simply because we have remained asleep well beyond the dreaming or REM sleep episode (when dreams tend to occur).”
Dr. Schwartz points out, however, that it’s normal to wake up a few times throughout the night, and this could even increase as you get older. What’s unusual, he says is that during times of stress, you’re not able to fall back asleep as quickly or as easily, which could increase anxiety. “It generally takes about four minutes of wakefulness in the middle of the night to remember that you've actually awakened,” says Dr. Schwartz. “It's the [mounting] stress [during this time] that prevents you from falling back asleep rather than the awakening per se that leaves you with the impression that you are waking up so many times at night. In other words, it is quite likely that you are awakening the same number of times at night, but for longer periods of time when you are stressed,” this is why you could be remembering your dreams now more than ever.
What Can Be Done to Combat Poor Sleep?
1. Avoid Lying in Bed If It Takes You Longer Than 15 Minutes to Fall Asleep
Dr. Schwartz says the bedroom should only be used for sleep or sex and nothing more — this includes worrying. Leave the room and engage in a relaxing activity, such as reading a book, doing a puzzle, or talking with a family member or roommate in a dimly lit room. You should avoid any stressful activities like bill paying or watching the news. When you feel tired again — no matter how long it takes — return to the bedroom and try going to sleep again.
2. Maximize Your Sleep Drive
Dr. Schwartz says you can take back control by owning your sleep deprivation and using it to your advantage. This can be done by “limiting the total amount of time allowed for sleep at night and by avoiding daytime naps altogether,” he says. This way you don’t over sleep and force your body to get back on some sort of schedule. “For example, if you generally need 7.5 hours of sleep per night under normal circumstances, you should allow yourself only 7 hours of lapsed time from lights out to your final up-out-of-bed wake up time, regardless how much of that time you actually spent asleep.”
3. Be Mindful of Alcohol Intake
Although alcohol can help you fall asleep quickly, it can affect your sleep quality. Dr. Schwartz says the “medicinal use of alcohol and other psychoactive substances should be strictly avoided in patients with sleep difficulties.” It may cause an increase in sleep disruption as it’s metabolized in the body, and may also increase the severity of snoring and sleep apnea, particularly in those who already experience both.
If you’re still experiencing sleep issues that you think cannot be rectified by behavioral changes, don’t hesitate to reach out to your doctor for his or her opinion. “As a general rule, sleep medications are used as an adjunct rather than primary therapy for insomnia,” says Dr. Schwartz. Try out some of these tips first to see if your sleep improves. It’s incredibly helpful to see the silver lining of poor sleep, and use it to your advantage, as Dr. Schwartz suggests. If you’re experiencing a few nights of poor sleep, try to reassure yourself that this is only making it easier for you to sleep in the future.