Brain COVID-19 (coronavirus) Featured Mental health

COVID-19: Sleep problems, dreams and nightmares

Sleep problems

How are you sleeping these days?

Too much? Too little? Are you waking up in the middle of the night?

Are weird and vivid dreams, or nightmares disturbing your slumber?

As the COVID-19 pandemic continues, people are experiencing greater levels of stress and anxiety than ever before, which is taking a toll on people’s sleep. Experts say, in this time of distress, sleep should be a top priority.

“Good sleep can be beneficial for your physical and mental health,” says Dr. Mark Boulos, sleep expert and neurologist. “It can actually improve your immunity to help your body fight off illnesses.”

“During times of stress, it is very important to pay special attention to getting optimal sleep,” explains Dr. Ari Zaretsky, chief of psychiatry. “Sleep enhances both physical and emotional resilience to stress.”

Trouble sleeping during COVID-19

There is a lot to worry about lately and we are all facing a great deal of uncertainty which can affect normal patterns of sleep.

Sleep experts say insomnia may be more prevalent in times like these.

“Insomnia occurs when it is difficult to fall asleep and stay asleep,” says Dr. Boulos. “Sometimes people will fall asleep but wake up in the middle of the night and can’t get back to sleep. Elevated stress levels and information overload can cause sleep problems. In other cases, there may be medical issues causing insomnia such as sleep apnea or restless leg syndrome, and some medications can also interrupt a person’s sleep cycle.”

A change in routine can also make it difficult to fall asleep as many families are adjusting to a new way of life with self-isolation, children no longer attending school, and with more people working from home, or coping with unemployment. This disruption to typical daily schedules can lead to inconsistent bedtimes, wake times, or taking longer naps throughout the day which can impact normal sleep cycles.

Sleep problems: sleeping too much

In otherwise healthy adults, experts say eight to nine hours of sleep a night is typically a sufficient amount of sleep.

If you’re sleeping in more often than usual, your body may be catching up on sleep, but, if you or someone in your household is sleeping for hours and hours each day, something else may be going on.

“Most guidelines say more than nine hours of sleep over an extended period of time, could be a sign of a larger problem,” says Dr. Boulos. “Individuals who don’t want to wake up or get out of bed and spend large amounts in bed all the time may be dealing an underlying medical or psychiatric issue.”

“There is a well-known relationship between sleep disturbance and psychiatric conditions such as depression and anxiety disorders,” adds Dr. Zaretsky. “People should seek mental health assistance if their sleep disruption is prolonged and affects their functioning and also if this sleep disruption is associated with other psychiatric symptoms such as severe sadness, tearfulness, loss of appetite, emotional withdrawal, panic attacks or thoughts of death.”

Dreaming during the COVID-19 pandemic

Have you had strange dreams during the pandemic?

Worldwide, people are taking to social media and reporting having vivid dreams or nightmares and being able to remember them in detail.

Dreaming occurs during REM (rapid eye movement) sleep, a later stage of sleep when the brain is active.

“Dreams are usually a constellation of thoughts and memories from earlier in the day, and often earlier in life.  During this unusual time of a pandemic, lots of thoughts are going through people’s minds,” says Dr. Boulos. “When people dream, these thoughts can be combined; some dreams are related to reality, but others are not and are just made up in the mind of the person while they sleep.  With all these stressors going on, dreams may be quite unusual during COVID. Part reality, part fiction, inter-twined with stress, anxiety and worry.”

“If you are woken during REM sleep, you are much more likely to remember your dream,” says Dr. Zaretsky. “Psychologically, it is believed that nightmares are dreams that pertain to stressful issues that we have not been able to resolve. During the COVID-19 pandemic, many people are experiencing vivid dreams and nightmares as they face fear and uncertainty about the future. This is a normal human reaction.”

Tips for managing sleep during the COVID-19 pandemic

If you are a health care worker, sleep is incredibly important, especially if you’re doing shift work. Here are 10 tips to help healthcare workers get better sleep during COVID-19 and some tips for healthcare workers for coping at work and home during COVID-19.

Not only is getting a good night’s sleep “physically and mentally restorative” explains Dr. Zaretsky. It is beneficial for brain health, which can help improve productivity.

“Sleep is also extremely important for proper memory functioning and proper neural function,” he adds.

Here are some general tips to help with getting more quality ZZZZZ’s:

Keep a sleep schedule or routine

Having a routine creates structure to your day, which can be reassuring and provide some normalcy when everything else is so uncertain.

When planning your sleep schedule, remember to include some time to relax before bedtime to help your brain wind down. Establish a set bedtime and use an alarm to wake up at the same time each day. Stick to your routine and avoid hitting the snooze button to help regulate your day.

Naps

Sleep experts say brief power naps can be helpful if a person is getting less than six hours of sleep at night. A short power nap of about 10 to 20 minutes, earlier in the day rather than later in the afternoon, can help give your brain a boost. Being at home, it can be tempting to nap throughout the day or for longer periods of time, but this can get in the way of a good night’s rest. Bottom line: if you’re going to nap, keep it to less than 20 minutes and avoid napping in the afternoon.

Shutdown screens before bed

Power down devices an hour or two before bedtime. The blue light emitted from electronics disrupts your internal clock and delays the release of melatonin, a hormone that prepares your body for sleep. Try leaving your smartphone to charge in another room to help avoid checking the latest headlines in the middle of the night. Limiting screen time can help manage information overload during the COVID-19 pandemic and minimize watching distressing news before bedtime which can lead to feelings of stress and anxiety.

Other tips for improved sleep hygiene

Doing something relaxing before bedtime to help wind down can help improve your sleep, such as taking a warm bath, reading a book, listening to relaxing music or meditating. Eating nutritious meals, and avoiding caffeine and alcohol in the evening, can help foster good sleep hygiene.

Stay active

Regular physical activity and moderate aerobic exercise can help you fall asleep and get a better sleep at night. Experts say exercise is best earlier in the day and to avoid working out too close to when you’re going to bed. Exercise causes the body to release endorphins which can potentially keep you awake.  Finish your workout at least two to three hours before bedtime. Check out these tips for staying physically active while staying at home.

It is important to know you are not alone. People around the world are trying to cope with change and a new way of living. Whether you find comfort in spirituality, writing in a journal, finding ways to stay connected with family and friends while physically distancing, or by learning a new hobby, there are many different ways to manage your mental health, which can help lead to improved sleep.For more resources and information about COVID-19 from Sunnybrook experts read our blog.

If you or someone you know is thinking about suicide or in severe emotional distress, please call 911 or visit your local emergency department.

If you feel like you are in crisis or need somebody to talk to, community resources are here to help.

Crisis Services Canada

  • 24-hour, toll-free 1-833-456-4566
  • Text: 45645 (4 p.m. – midnight ET)

About the author

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Jennifer Palisoc

Jennifer Palisoc is a Communications Advisor at Sunnybrook.

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