Health

How To Sleep Better In High Stress Times

From nightmares to 2 a.m. wakings, pandemic stress is ruining our sleep when we need it most. But experts say it’s possible to get it back, even under lockdown.

A photo illustration of a pink pillow floating through the clouds

(Photo: Getty Images)

Imagine your house is on fire—but as you run through it trying to call 911, the rooms are barely recognizable. Your purse, keys and phone are nowhere to be found.

This is the nightmare that jolted 54-year-old Jodie Schnurr awake in late April. Her sleep has not been good since. Every night between 1:30 a.m. and 4 a.m., she wakes up, her brain alert. She has to reach for her Kindle or a meditation app until she’s able to drift off again. Before the pandemic, she’d fine-tuned a routine to combat the havoc menopause wreaked on her usual six to seven hours of sleep. These days, Schnurr estimates it’s closer to four or five.

The lack of sleep has left her feeling scattered during the day: needing to make to-do lists because she’s forgetful, feeling tired and irritable by the afternoon, and unmotivated to do things she knows would make her feel better, like work out. “By the end of the day, there’s nothing left in the tank.”

On the surface, Schnurr doesn’t feel more stressed. While her husband and 24-year-old son lost their jobs as a result of the pandemic, she still has hers as a high school guidance counsellor near Burlington, Ont., and is financially stable. But she suspects her new day-to-day since the COVID-19 lockdown has created a background hum of stress that follows her into the night.

Ever since pandemic-related measures began across Canada in March, many people have reported sleep disturbances, from visceral nightmares to frequent wakings to an inability to fall sleep until the early hours of the morning. While the usual measures—restricting caffeine, pulling out your blackout blinds—may not be having the impact you’re hoping for, experts say there are more advanced strategies to try during periods of great anxiety.

“Sleep is a very fragile component in our life. Sometimes it’s the first thing that gets worse when we are stressed,” says Michele Ferrara, a professor at the University of L’Aquila in Italy, who studies the effects of sleep deprivation on cognitive and emotional states. Epidemics in particular, Ferrara says, are associated with a wide range of psychiatric and psychological conditions, such as anxiety, depression and other trauma-related disorders. Being in quarantine—with the financial losses, uncertainty and sheer boredom—can add an additional layer of stress.

In 2013, Ferrara co-authored a study on how sleep was affected after a 6.3-magnitude earthquake hit the central Italian region surrounding L’Aquila in 2009. The researchers compared data on sleep quality from residents before and after the quake and found that it remained poor even two years later.

Ferrara is now studying how COVID-19 is affecting sleep across Italy, a country hit particularly hard by the virus. An online survey of 14,000 asked participants about their last two weeks of sleep, including how long it took to fall asleep and how long they slept for. Even early in the research process, he’s seeing a few patterns. People are reporting fragmented sleep, and there’s a strong relationship between stress, anxiety, depression and sleep quality.

Katie Jensen, a 31-year-old podcast producer in Toronto, says the pandemic has definitely disrupted her sleep patterns, but she thinks she’s actually oversleeping. Jensen has always had “crazy dreams,” but lately they’ve taken on pandemic themes. In a recent one, she walked into a clinic after being exposed to COVID-19. There, she was greeted by a woman with red-rimmed blue eyes, her face covered in a rash. “I remember having to strip down to my underwear and go through this decontamination shower just to be presented to the clinic staff.”

Deirdre Barrett, author of The Committee of Sleep and a dream researcher who teaches psychology at Harvard Medical School, is conducting online surveys on the current state of people’s pandemic-related dreams. She says COVID anxiety is definitely a common theme—and that strange dreams are likely the result of people sleeping more. Longer sleep lends itself to deeper sleep, she says, which makes people more likely to dream and remember the dreams they have. The pandemic dreams she’s heard about are often literal: fevers, trouble breathing, forgetting to wear a mask. But since the virus itself is invisible, metaphors are also common—swarms of bugs attacking the dreamer, for instance.

Once the pandemic ends, says Barrett, likely so will most people’s COVID-tainted dreams. But there are two groups of people who may remain haunted: those experiencing acute COVID-19 trauma, such as health care workers, and those with pre-existing histories of trauma and anxiety.

Janelle Spiess, a registered nurse at the HOpe Centre in Lions Gate Hospital in North Vancouver, has witnessed traumatic events in her career, including during the 14 years she worked at a Calgary correctional facility. While she isn’t treating COVID-19 patients right now, the sudden temporary closing of the youth mental health program she works at, and the two-month lockdown of the hospital, was triggering: “It felt like a dystopian novel.”

Chronic recurring nightmares coupled with a career of shift work has meant Spiess, 37, has never slept well. She learned to master her nightmares through lucid dreaming, and they had tapered off—until now. “I have nightmares about not having things completed, missing courses, or it’s exam week and I haven’t been to a single lecture.”

When her son was born in 2017, many people commented on how bad her sleep would become, but she didn’t get what the big deal was. She’s feeling it now, though: The toddler was up multiple times a night in the first weeks of lockdown, which compounded Spiess’ own sleep issues. She’s trying to go to bed at the same time each night and relaxes with yoga in the evenings—but she also winds down with Netflix and other habits she thinks may be sabotaging her sleep. That’s leaving her with six to seven hours of fragmented sleep a night and low energy during the day.

A recent study in Nature Human Behaviour by Eti Ben Simon and Matthew Walker from UC Berkeley shows that as little as a single night of sleep loss can make us more anxious, even for those without a pre-existing anxiety disorder. When Ben Simon studied participants who had been asked to stay up for 24 hours, she observed anxiety “ramping up” by 4 a.m. or 5 a.m. the following morning.

This is how lack of sleep becomes cyclical: Stress and anxiety steal good sleep from us when we need it most. There’s evidence deep sleep helps us manage anxiety and REM sleep helps us consolidate memories and process trauma. And while much remains unknown about the consequences of long-term chronic sleep loss, we do know, as Ferrara puts it, that “sleep is a kind of emotional therapy in the night.”

So, how do you break this cycle? Research shows that reducing your anxiety, most obviously, can help—but so can taking steps to improve your sleep quality. “Sometimes [the latter] is easier to do if you don’t have access to other techniques to reduce anxiety at the moment,” says Ben Simon.

There’s no exact formula for measuring what “good sleep” is. You know it when you feel it, and you feel it by waking up rested. Getting sufficient hours of sleep and staying asleep for enough periods to go through necessary sleep cycles helps. There are also established guidelines on how to achieve this: sleep in a dark room, limit caffeine consumption late in the day, exercise, keep screens away from the bed. If these measures aren’t cutting it these days—there is only so much screen time you can avoid under quarantine—there are a few steps experts say can help under extraordinary circumstances.

To quell anxiety dreams, Barrett suggests thinking about a person or place you want to visit after this is all over, right before bed. If you’re having a recurring nightmare, she suggests a choose-your-own-adventure visualization technique used for PTSD-related nightmares: “You would picture, if the nightmare starts, how you take a path to an alternative ending.” Ferrara, meanwhile, recommends exercising in the morning, preferably outside in the sun.

You can also schedule something else in the morning: your angst. The European Academy for Cognitive Behavioural Therapy for Insomnia recommends setting aside time “to stress and reflect upon the situation.” Whether it’s journalling or talking with a friend, giving yourself time to think anxious thoughts makes them less likely to bombard you later.

And finally, stretch out your wind-down before bed. “That helps the body produce the melatonin that you need in order to initiate sleep,” says Ben Simon. She suggests setting an alarm one to 1.5 hours before bed to dim the lights, put away screens and do something relaxing. It may sound like a time-consuming routine—but these days, all we’ve got is time.


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