COVID-19 Q&A:
I am really having a difficult time sleeping right now, what can I do to make it better?
Answer:
Dr. Elliott Lee, sleep specialist
During this exceptional time, we may be feeling more anxious and it’s understandably difficult for some people to get a decent night’s sleep.
Sleep plays a critical role in staying strong and healthy, and to maintain immune function. The things we have to look out for with respect to sleep are quantity, quality, and timing. All three have to be addressed in order to get the maximum benefit.
Some people believe a good sleep is defined by the length of time spent asleep, but quantity doesn’t matter if the quality of sleep is poor. Sleeping at the right time – a “sleep window” relative to our own internal clock – is also key.
Maintaining regular sleep and wake times and cutting down on disturbances go a long way to improving sleep! In fact, getting a good sleep at night actually starts with what we do during the day.
During the day:
- Avoid naps, alcohol, and caffeine.
- Exercise! Ideally we should exercise at the same time every day but if that’s not possible, any exercise is better than none. Exercising in the morning can be particularly effective for sleeping better at night.
- Practice physical distancing but don’t forget to connect with people, by telephone, online, or from across the street. This connection helps distract us from the anxiety of our current situation and sleep better at night.
- Try a cognitive technique called worry time to displace worries earlier in the day. Every evening, take 20 to 30 minutes to write down your worries and to-do lists. Then tell yourself you are not allowed to think about these things until the next worry time. If done consistently, these things can help train the brain into thinking about these worries earlier in the day, so they don’t sabotage sleep at night.
At night:
- Reserve your bed for sleep or intimacy.
- Maintain a comfortable environment. Make sure you address darkness, noise, and temperature in your bedroom.
- Stay off your phone or computer in the evenings. There is an “infodemic” of COVID information, which, for the majority of us, does not help us sleep well. Save the news review for the morning.
- The other issue with mobile phones – besides the psychological stimulation – is the physiologic stimulation from the light. The light from the screens tricks our brain into thinking it’s daytime by suppressing the production of melatonin at night (a hormone that facilitates and maintains sleep). Try to avoid using backlit screens within two hours of bedtime.
- Avoid clock watching. Sleep is a funny thing – the more we think about sleep, the more difficult it is to fall and stay asleep! So when we look at the clock, we often think it’s too late, or we need more sleep, or we don’t have enough time. These kinds of thoughts make it harder to fall and/or stay asleep. So it’s important to get rid of the clocks (unless there’s some important appointment) and generally listen to our bodies to tell us when the body is ready to go to sleep and wake up in the mornings.
- Develop a relaxing routine before bedtime – e.g. meditation, yoga, deep breathing, progressive muscle relaxation. There are several apps that can help with this if needed.
- Practice gratitude instead of worrying at bedtime. Reflect on things that you are grateful for right now.
- If you are awake more than 20 minutes, get out of bed, do something relaxing, and go back to bed when you are sleepy.
These are challenging times, and we are all feeling some degree of anxiety. There is no better time to reevaluate – and hopefully improve – our sleep habits.
