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How to get to sleep when you’re in survival mode

What is insomnia? | Causes of insomnia | Coronavirus anxiety | How sleep problems affect your health | Sleep remedies

Ahhh, that feeling of drifting off to sleep shortly after your head hits the pillow. It’s truly the stuff dreams are made of. But, when slumber feels impossible—and no number of sheep will lull you into a peaceful sleep—it’s the stuff of nightmares. Having trouble sleeping can lead to all kinds of stress, and stress can make it harder to get any shuteye. Insomnia, especially when caused by anxiety, can be a vicious cycle. Right now the entire world has one common source of worry: a global pandemic. Chances are you’ve experienced some level of coronavirus anxiety, but can the stress of a pandemic increase your chances of laying awake at night?

What is insomnia?

Insomnia is a sleep disorder that is characterized by difficulty falling asleep or staying asleep. It can include waking up too early, and not being able to get back to bed or a lack of restorative sleep. In other words, it’s the type of tossing and turning that leaves you groggy in the morning. Chances are if you’re dealing with insomnia when you should be sleeping, your daytime functioning is impaired, too.

Why am I having trouble sleeping at night?

There are lots of causes of insomnia. It could be a change in schedule or travel-related jetlag that disrupts your circadian rhythm. Or, something as simple as eating a big meal too late at night. Many attribute difficulty sleeping to too-little or too-much exercise during the day. Using screens close to bedtime and having a sleep environment that’s bright or overly warm have also been linked to restlessness.

If you find yourself lying awake at night with thoughts racing through your head, it’s a good sign that your insomnia is stress- or anxiety-related. Concerns about work, school, money, or relationships can trigger sleepless nights, as can traumatic events such as moving, a divorce, the death of a loved one, or even a novel coronavirus strain that’s spreading around the world. 

Can coronavirus anxiety lead to insomnia? 

“Anxiety can cause trouble sleeping and lead to insomnia,” explains Nina Riggins, MD, Ph.D., an associate professor of neurology at the University of California, San Francisco. If you are concerned that your anxiety is leading to sleep problems you must address your anxiety with a healthcare provider, she says. 

It can also lead to fragmented sleep—meaning, you wake up multiple times during the night. During the coronavirus pandemic, many people have reported disturbing or vivid dreams. While anxiety can trigger nightmares, these are more likely due to more frequently waking during REM (dreaming) sleep, which makes you more likely to remember your dreams, according to HelpGuide.

“Since [the] COVID-19 pandemic is a major stressor in the world, resulting in significant psychological, physical, social and financial disruptions, it can result in significant sleep disturbance by itself, or as part of a mood disorder,” says Svetlana Blitshteyn, MD, the director of Dysautonomia Clinic, and a clinical assistant professor of neurology at the University at Buffalo Jacobs School of Medicine. Dr. Blitshteyn also notes that insomnia can also lead to depression and anxiety—it’s a two-way street.

According to one study, which examined the impacts of COVID-19 in China, sleep problems sky-rocketed due to coronavirus anxiety, while anxiety, acute stress, and depression also increased significantly. For those who lived in Hubei province, the epicenter of the pandemic, and those who were front-line workers during COVID-19, instances of reported insomnia were even more severe. The study reports that during the peak of the pandemic respondents reported an increase of 37% in clinical insomnia.

Does insomnia affect your health?

When you have trouble sleeping, it doesn’t just affect your mood. Insomnia can make you more susceptible to infection with whatever virus is going around—whether it’s the common cold or COVID-19—and make it more difficult to recover if you do get sick. While you’re asleep, your immune system releases cytokines. These proteins help to promote sleep, but they also help fight infection and inflammation. When you sleep less, your body produces less, which impacts your immune response, according to the Mayo Clinic.

If your insomnia becomes chronic, it can make you more prone to dangerous events like car crashes. Or, increase your risk for chronic conditions like hypertension, diabetes, obesity, depression, heart attack, and stroke. In other words, it’s important to take steps to get the z’s your body needs before a lack of sleep causes health problems.

How can I fix my sleeping problem?

“Sleep hygiene is the first step that we advise our patients to practice,” says Dr. Blitshteyn. Natural sleep remedies may include:

  1. Turning off your screens before bed. There’s been an increase in screen-time during the pandemic, so this is more important now than ever.
  2. Avoiding action-packed movies, horror films, or the news before bed—particularly COVID-related news! In other words, stay away from stressful content that might trigger anxiety at night.
  3. Trying relaxation techniques and breathing exercises in bed to soothe anxious feelings.
  4. Ensuring you are going to bed and waking up around the same time, even if you are staying home. During the pandemic, wake times may have drifted later and later, without the required morning commute. Changing the time you go to sleep and wake up can disrupt your body’s internal clock, and make it harder to initiate sleep.
  5. Cutting back on large meals before bed. Gaining the “COVID-19” has become a common joke because so many people are stress-eating or snacking more during the pandemic. If you’re indulging in comfort food, just make sure it’s earlier in the day.
  6. Abstaining from alcohol in the evening. Stress increases your chance of alcohol misuse, and a SingleCare survey found that 10% of respondents were drinking more since COVID-19 started spreading across the U.S. It may make you feel tired and relaxed, but it disrupts quality sleep.

If these lifestyle modifications don’t help with sleep problems, Dr. Riggins recommends cognitive behavioral therapy (CBT) for coronavirus anxiety or a melatonin supplement as a sleep aid. 

  • CBT is a form of psychological treatment that studies show is an effective treatment for insomnia. It focuses on improving your quality of life through changing your thoughts, attitudes, and beliefs. A variety of studies show that Cognitive Behavioral Therapy is an effective treatment for insomnia.
  • Melatonin occurs naturally in your body, but a melatonin supplement taken a couple of hours before bed can help when you’re dealing with insomnia or trouble falling asleep. “Melatonin can be helpful for both sleep and headache,” explains Dr. Riggins. “Melatonin has multiple functions, one of its important functions is regulating the timing of sleep.”

RELATED: How to find the right melatonin dosage

If you’ve tried all these strategies, and are still having trouble falling asleep, staying asleep, or are waking up unrefreshed, it’s time to talk to your healthcare provider. Even if you can’t make it into the office, “telehealth allows [the medical practitioner] to get an excellent sleep history, and address contributing and precipitating factors,” says Dr. Riggins, who also recommends keeping a sleep diary.

Whether it’s in-person or online, get the help you need to rest, before it starts affecting your health.