Protecting Your Sleep During a Pandemic
As a behavioral sleep specialist, I spend a good portion of my day trying to help people who can’t sleep. The latest pandemic warnings, along with the orders to self-quarantine, have created changes in daily rhythms and increases in fear that have really escalated the risk of insomnia creeping back into the lives of my former and current clients. Our capacity to sleep well is inherently related to our capacity to feel a sense of safety, and there are some challenges to feeling truly safe for many people in this new age of COVID-19. While I don’t know the solution to the pandemic, sleep is critical to our immune function, and I definitely have some solutions to optimize sleep.
Stay on schedule. Our ability to sustain sleep is very much related to our entrained clock system, known as our circadian rhythm. The more that your circadian rhythm has consistency, the easier it is to have reliable sleep. As everything has been getting cancelled, it is really easy to get off of schedule, and the drift in schedule can translate to sleep challenges. I usually recommend that people establish a stable wake time that they can commit to most days of the week, including the weekends. We can force a wake time much more than we can force falling asleep, so it is easier to imagine that being consistent with wake timing will eventually lead to a stable time for falling asleep as well. Allowing yourself to compensate for a tough night by sleeping in the next day will actually result in worsening episodes of insomnia. Set your alarm to the desired time, and remain in bed, in the dark, until the alarm goes off to entrain that consistent time.
Get outside. Although we are being told to “Shelter in Place” or “Stay-at-Home,” neither of those instructions ban you from being outside for any length of time. When we are outside in full spectrum light (preferably for some time without sunglasses), bright light exposure facilitates the production of serotonin, our antidepressant neurotransmitter. We all need about 30-60 minutes each day in bright, full spectrum light to adequately regulate mood, and this is actually an important part of the sleep pathway as well. Daily bright light exposure, paired with nightly exposure to darkness, are key components to the circadian pathway, and both parts are really essential to circadian rhythm.
Exercise, with some intensity. One of the biggest errors that we make when trying to cope with insomnia is scaling back our physical activity. Yes, insomnia makes you feel exhausted and exercising when exhausted is REALLY unappealing, but this really can be THE thing that puts your sleep back on course. Here’s why: Intense exercise provides feedback to our brain that we are physically handling our problems. When we are anxious or start to experience a lot of wakefulness at night, this is often driven by increased activity in our sympathetic nervous system (called heightened sympathetic tone). You can think of this as your fight or flight response turned on, and the best possible feedback for the fight or flight response is an actual fight or flight. My favorite prescription for times like this? Short hill sprints at maximum pace- aim for 4-6 that last about 45-60 seconds each.
Step away from the media, all media. It is essential to evaluate the costs and benefits of staying informed of everything that is happening related to COVID-19. If you know that you are doing everything you can do to keep you and your family as well as possible, then it is likely time to step away from the information. It is especially important to step away from the media when you are getting close to bedtime, as your brain needs a 90-120 minute period of dimmer light to allow for appropriate melatonin production to facilitate sleep onset. This does not mean that you need to sit in the dark, but it does mean that it is best to avoid devices that are close to your face for at least 90 minutes before bed- no Ipad, smart phone, or laptop.
Face your fears. If your brain uses time in bed to try to process all of the fears or worries you may have, then it is important to spend some time actually allowing yourself to attend to these scary thoughts, during the day. A horror movie director once stated that the secret to a good horror movie is to keep the monster hidden for as long as possible. He said that the longer you keep the monster hidden, the higher the audience’s fear. This process also tends to work with our own fears and concerns, and is why spending time writing and processing about our fears can be a key part of allowing us to let go of them at night. I typically recommend writing for 5-10 minutes in the evening about all of the fears or worries that may have come up during the day, and any possible solutions (realistic or not) that also may exist for these concerns. Whenever your brain reminds you of these concerns during the night, gently remind yourself that you have already dealt with them and will deal with them again tomorrow.
Make your bed a great place to be. Dreading the bed can also be a key part of insomnia, and our relationship with our sleep environment is very essential to our capacity to rest. Sleep is a time of intense vulnerability, and our brains are predisposed to only want to allow for this degree of vulnerability when everything is very safe. If your brain has decided something is unsafe about your sleep environment, whether it is because the room gets too hot or your spouse snores, wakefulness is a reasonable response to that lack of safety. Try to make sure that the environment is actually a place where you want to be (feels good, smells good, sounds soothing) and reinforce for yourself that the bedroom is a really safe place to sleep. Avoid checking the clock at night (this is a performance check that is very unhelpful!) and focus on how you are lucky to be in this safe space where nothing is expected of you.
Someday, hopefully sooner rather than later, COVID-19 will pass, and my hope is that you will be able to return to the daily rhythms that have felt good in your life. In the meantime, let’s keep sleeping on track as much as possible!