The MGH Virtual Visits Team was honored with the 2020 Nathaniel Bowditch Prize for its quick and innovative work during the COVID-19 pandemic.
Getting a full night’s sleep is just as important to your overall health as eating nutrient-packed meals and regular exercise. In fact, high-quality sleep should be viewed as a necessity, not a luxury. It can help your body to reduce anxiety, regulate mood, increase energy, strengthen your immune system and, overall, function well.
The COVID-19 pandemic has brought about universal uncertainty and has been the source of new anxiety and tension for many people. Many report a significant decline in the amount and quality of sleep—the result of poor sleep hygiene, or the habits that help you cultivate a good night’s sleep.
“Sleep is a strong drive, but it’s vulnerable to a lot of negative influences,” says John Winkelman, MD, PhD, chief of the Sleep Disorders Clinical Research Program in the Department of Psychiatry at Massachusetts General Hospital. “You want to limit those negative influences as much as possible, so that natural sleep drive can just crash over you like a wave when it’s time to sleep.”
In his work, Dr. Winkelman specializes in research regarding various sleep disorders, including insomnia and restless legs syndrome. Below, he shares tips to improve your sleep during the COVID-19 pandemic and beyond.
Create a Regular Sleep-Wake Schedule
For many, changes in commuting, socializing and other typical inclusions of their pre-pandemic agendas have caused their sleep routines to adjust—so much so that the difference in bedtime and wake time between weekdays and weekends has been greatly diminished. For those who may have been experiencing sleep deprivation before, there is a new opportunity to sleep in later than normal on most days. This may have produced better and longer sleep for some during the pandemic.
“The difference between bedtime and wake time on weekdays and on weekends is called social jetlag,” says Dr. Winkelman. “We evolved on a planet that spins at the same rate, seven days a week, and sleep is best when it follows that regularity including regular bedtimes and wake times. It doesn't spin faster on weekdays and then slow down on weekends.”
The key, he says, is reducing external stressors that may influence quality of sleep. Dr. Winkelman advises to create a schedule for day-to-day life—when you exercise, eat meals, socialize, etc.—to ensure that a consistent sleep schedule is viable.
However, be careful to avoid taking naps as part of your regular day, he says. Naps will interfere with sleep drive that builds up throughout the day leading to less sleepiness at night.
“And wake up with the sun,” he says. “Natural light is an influential guide for your body. The sunlight tells your body it’s time to wake up.”
Create a “Worry Log”
Many people struggle to fall asleep at night, as they worry about stressful parts of their days. And throughout the pandemic, stressors have certainly increased. You may be concerned about your or your loved one’s health, financial circumstances, job insecurity or something else.
One way to cope with nighttime stress is to journal during the day about the things causing you anxiety.
“Instead of worrying about this or that when you get into bed or in the middle of the night, write it all down and put your worries on paper in the late afternoon or early evening,” says Dr. Winkelman.
This mental trick will help to reduce the psychological stimulation, taking the anxious thought out of your head and onto a list that can be attended to in the morning.
In tandem with journaling, Dr. Winkelman recommends exploring meditation or progressive muscle relaxation techniques in bed, where you tense certain muscle groups as you inhale and relax them as you exhale.
Watch What You Drink
Particularly during quarantine, it can become tempting to drink alcohol more than was the norm pre-pandemic. While many people report that drinking alcohol right before bed can help them fall asleep, Dr. Winkelman advises not using it as a sleep aid.
“Alcohol generally helps people fall asleep, but it leads to a wake-up effect that is not conducive to a good night’s sleep,” he says. “You don’t stay asleep when you’ve had alcohol prior to bedtime. So, you may fall asleep, but the quality of sleep is significantly less.”
Other activities that can interfere in a similar way are eating meals or drinking caffeine too close to bedtime.
Engage in Relaxing Activities Before Bedtime
The proliferation of technology has made television time part of the routine at the end of a long day. Although television or online material may distract from the anxieties and stress of our daily lives its content is often not relaxing and, in fact, may further stimulate worry. Similarly, the bright light from devices may interfere with sleep.
“There is a lot of attention on blue light at this time, and I think that bright light of any kind, and especially that which is conveying information which increases arousal level, should be limited to the daytime,” says Dr. Winkelman. “No need to buy blue light glasses; just turn off the device and either read using a low light or listen to music or a relaxing podcast.”
Rather than catching up on the news or watching an action-packed show prior to bed, try reading or watching something relaxing and distracting before bed.
“Similarly, these can also be great activities to engage in if you find yourself waking up in the middle of the night and struggling to fall back asleep. They take your mind off the usually non-productive, excessively stimulating thoughts that occupy us when we lie awake for a long time at night,” he says.
Sleep When Tired
The key to sleep, says Dr. Winkelman, is truly listening to your body. When you are ready for sleep, more often than not, your body will fire off biological signals to let you know, such as yawning, droopy eyes and body fatigue. Tuning into your sleep drive is a significant way to improve your sleep.
“That sleep drive usually appears 16 hours after you have woken up,” says Dr. Winkelman. “It’s not always best to just go to bed because it’s bedtime. If you're feeling sleepy, go to bed. If you're not feeling sleepy, or if you have too much on your mind, then try to engage in other activities first to calm and de-stimulate your body and mind.”
Your body will tell you when it’s the right time to hit the pillow, he says.
When to Seek Medical Help
Dr. Winkelman says that the general rule of thumb is to consult with a medical professional if you are not sleeping well, or at all, for at least three nights a week for one month. Poor sleep at this rate can signify a deeper issue or sleep disorder such as insomnia, sleep apnea or restless legs syndrome. Consult with your primary care provider who will then recommend whether you should meet with a sleep specialist.
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