The best bridge between despair and hope is a good night’s sleep. E. Joseph Cossman
Yeah...thanks, Mr. Cossman. Sleep is not easy to do during a global pandemic.
According to the National Sleep Foundation, there are many reasons why we're losinng sleep due to COVID-19:
Our daily lives have been disrupted.
My husband started working from home in mid-March. Our younger daughter has been taking all her high school classes online. Our older daughter is finishing up physical therapy school and has been struggling to find clinics who will allow her to finish up her clinical rotation requirements. All this to say that my family is going through the same thing you are likely going through: a collective kabosh on life as we knew it. And importantly, disruptions to our daily routine also disrupt our biological rhythms and sleep patterns.
We're all worried.
(Way to state the obvious, Pam.)
"It's hard to imagine we don't have a lot of our fellow Americans under incredible stress right now, either from getting sick or being afraid of being sick or losing their jobs," Dr. Glen Stettin, Senior Vice President and Chief Innovation Officer at Express Scripts, told Newsweek. The article reported a 34% increase in anxiety medication among Americans over the past few months.
We're all feeling depressed and isolated.
(Again with the obvious, Pam.)
Here's another quote from the Journal of the Americal Medical Association: "In the context of the COVID-19 pandemic, it appears likely that there will be substantial increases in anxiety and depression, substance use, loneliness, and domestic violence..."
We are facing a difficult cycle of social distancing bringing on social isolation, which has direct ties to poor mental health. These feelings are exacerbated in those currently dealing with the loss of a loved one due to COVID-19, as one of our primary sources of comfort during grief is social connection.
We're all under greater work and life stress.
High school and college graduates are skipping a major celebratory milestone this year due to COVID-19. Those just entering the work force are finding that jobs are scarce due to hiring freezes. And that's not counting all those who have lost their jobs or been furloughed during this difficult time.
We're spending more time in front of screens.
As I will describe later, light-emitting phones and devices can disrupt the production of melatonin, the main chemical used to regulate our biological clocks. This is one reason why binge-watching Netflix before bed can disrupt your sleep.
Why We Need Our Sleep During COVID-19
If you haven’t picked up this book yet, do it. It’s a fascinating read. (Just don’t try to read it before going to sleep. Trust me.)
Now, we don’t really need a neuroscientist to tell us what we already know by experience: sleep deprivation messes with our emotions. Just think of the meltdowns your children (and maybe you) have had, and the go-to solution that was probably passed down to you through umpteen generations: “Give that kid a nap.”
But the research studies Walker cites in his book reveal a disturbingly long list of sleep-related issues.
In children and adolescents, sleep disturbance is linked to behavioral problems, bullying, aggression, and suicide.
In adults, disrupted sleep patterns are found in depression, anxiety, PTSD, schizophrenia, and bipolar disorder. In fact,
There are NO psychiatric conditions in which sleep remains normal.
Science simply provides a more detailed picture of what’s happening behind it all. Sleep deprivation acts like a lead foot on the brain’s emotional “gas pedal.” This ramps up feelings of irritability, impulsivity and anxiety. At the same time, it hampers the brain’s emotional “brake” that usually checks unhelpful and unhealthy feelings.
We’ve talked about this same brain imbalance before as a common part of mood disorders like depression and anxiety. So, it’s really no surprise to find it here. As Walker points out, it probably points to a two-way relationship between sleep and mood. Our mood can certainly affect our sleep, but brain imaging studies would suggest that sleep can also affect our mood.
If that’s the case, then one important way to treat feelings of stress, depression and anxiety is to make sure we get enough sleep.
How to get a great night’s sleep
There are 3 parts to healthy sleep: amount, regularity, and quality.
In terms of amount, seven to eight hours is thought best for most of us.
Sleep regularity means that we go to sleep and wake up at roughly the same times every day, including weekends. (I know. I like sleeping in on weekends, too.) This helps regulate our biological clocks and produce those all-important mood chemicals in the brain.
You’ve probably heard that changing work shifts – morning to night or night to morning – can be particularly hard on your mind and body. The drastic effect this has on the biological clock explains why. If you must do this, try to ease into the change gradually, shifting one hour at a time.
The Do's and Don'ts of Quality Sleep
In terms of quality, several things can help. The following tips come from Matthew Walker’s book How We Sleep.
A specialized form of cognitive behavioral therapy has been developed for insomnia, often abbreviated CBT-I. More information on how to find CBT-I practitioners can be found in this article by the Mayo Clinic.
Feel free to download or pin this image for easy reference:
One final point. Although we’ve focused on sleep for the most part here, it’s worth remembering that the same treatments that apply to other types of depression may apply here. If you are struggling with feelings of worthlessness and hopelessness, cognitive therapy can be helpful.
Buysse D. J. (2014). Sleep health: can we define it? Does it matter? Sleep, 37(1), 9–17. doi:10.5665/sleep.3298.
Geoffroy, P. A., Schroder, C. M., Reynaud, E., & Bourgin, P. (2019). Efficacy of light therapy versus antidepressant drugs, and of the combination versus monotherapy, in major depressive episodes: a systematic review and meta-analysis. Sleep medicine reviews, 101213.
Walker, M. (2017). Why We Sleep: Unlocking the Power of Sleep and Dreams. Scribner, NY. pp.146-152, 269-270, 277.
Dr. Pamela Coburn-Litvak has published research articles on exercise and stress in Neuroscience and Neurobiology of Learning and Behavior. Her latest book, Leaving the Shadowland of Stress, Anxiety, and Depression, was published in 2020.
After receiving a Ph.D. in Neurobiology and Behavior from the State University of New York at Stony Brook, she served as both Assistant Professor of Physiology & Pharmacology and Special Assistant to the Vice President for Research Affairs at Loma Linda University in Loma Linda, California. She then joined the Biology department at Andrews University and developed courses in human physiology as well as the neurobiology of mental illness. She also founded Rock @ Science LLC, a company that specializes in health and science education and web development. She co-developed the brain and body physiology segment of the Stress: Beyond Coping seminar with its creator, Dr. William “Skip” MacCarty, DMin.
Dr. Coburn-Litvak currently lives in California with her husband. Their two daughters are mostly grown and attending school elsewhere.
When she’s not studying or teaching about stress, she enjoys stress-relieving activities like puttering around the garden, taking nature walks with her family, knitting, cooking, and reading.