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10 common mistakes in fighting 'coronasomnia' -- the inability to fall and stay asleep

Covid-19 has spawned another global health crisis some have dubbed "coronasomnia" -- an inability to fall asleep or get good quality slumber during the pande...

Posted: Mar 14, 2021 9:18 AM

Covid-19 has spawned another global health crisis some have dubbed "coronasomnia" -- an inability to fall asleep or get good quality slumber during the pandemic.

Oh, you know it well?

"You're not alone, the novel coronavirus is making sleep more difficult for much of the world," said sleep specialist Dr. Raj Dasgupta, an assistant professor of clinical medicine at the Keck School of Medicine at the University of Southern California.

We humans weren't doing a good job of getting enough shut-eye even before the arrival of a deadly new virus that shook us to our core.

"Sleep problems constitute a global epidemic that threatens health and quality of life for up to 45% of the world's population," according to the World Sleep Society, a nonprofit organization of sleep professionals dedicated to advancing "sleep health worldwide."

Now, "there are multiple stresses with the pandemic -- financial, health care related, social isolation -- all of which can impact sleep," said Dr. Bhanu Prakash Kolla, a sleep medicine specialist in the Center for Sleep Medicine at the Mayo Clinic in Rochester, Minnesota.

Unfortunately, experts say, people may turn to activities during the pandemic that seem to help, but actually hinder their ability to fall and stay asleep.

Here are 10 of the top sleep mistakes you might be making -- and how to fix them.

1) Too much screen time

It's a bad habit no one can resist: Just a quick peek at your phone, tablet or laptop before bed to see the latest posts by friends and family. Minutes speed by, and before you know it, you've subjected your eyes to a huge dose of sleep-disrupting LED spectrum blue light.

"The bright light of a TV, computer or smartphone can affect your sleep patterns and keep you alert when you should be getting sleepy," USC's Dasgupta said.

Blue light suppresses melatonin levels in the body, which are secreted in a daily 24-hour circadian rhythm typically beginning after dark and peaking between 2 and 4 a.m. Melatonin is often referred to as a "sleep hormone" because we sleep better during the night when levels peak.

To avoid the negative impact of blue light, the number one rule is "no computers, cell phones and PDAs in bed and at least one hour prior to bedtime, preferably two," Dr. Vsevolod Polotsky, who directs sleep basic research in the division of pulmonary and critical care medicine at Johns Hopkins University School of Medicine, told CNN.

It's best to keep yourself in the dark as much as possible while you sleep, experts say. To eliminate all bright light, charge your cell phones and laptops outside the bedroom. Consider using eye shades and blackout curtains to keep the room dark.

2) You're becoming a night owl

With the blending of day and night that can come with working from home, a lack of typical structure and spending too much time on screens, many people are "delaying their bedtimes and waking up much later in the morning," Dasgupta said.

"This shift in the circadian rhythm is known as delayed sleep phase syndrome or simply as the 'night owl,'" he said.

That's a problem because the circadian rhythm, or the body's biological clock, controls all the hormones of the body, body temperature, eating and digestion, and sleep-wake cycles. Messing with it can be unhealthy.

Studies of shift workers, who work unusual hours and live out of sync with their normal biological rhythm, show that they are at increased risk for heart disease, ulcers, depression, obesity and certain cancers, as well as a higher rate of workplace accidents and injuries due to a slower reaction rate and poor decision-making.

Another study found changing your regular sleep-wake time by 90 minutes in either direction, which many of us do on the weekends, doubled the risk of cardiovascular disease over a five-year period. The more days you sleep irregularly, the higher the risk, the study found.

Teens often develop delayed sleep phase syndrome as they stay up to check email and social media. But during the pandemic, even "larks," or people who enjoy waking up early, are finding themselves struggling to keep their typical routine. Yet it's critical for good sleep to have a habitual time to go to bed and rise, experts say.

"The best sleep requires a set bedtime even on weekends and holidays," Dasgupta said.

3) You're hitting the snooze button

This is the flip side of staying up late. Don't do it. Why not? First, a quick refresher:

Your body needs to move through four distinct phases of sleep several times each night to generate new neurons, repair muscle and restore the immune system. (Pretty important during a pandemic, right?) The two most important phases for restoration are the dreamy state of REM, or rapid eye movement sleep, and delta, or slow-wave, sleep, according to Rebecca Robbins, an associate scientist at Brigham & Women's Hospital who studies sleep.

As you near the end of your slumber, your body is likely nearing the end of its last REM cycle. Hit that snooze button, and "unfortunately, your body will go back to sleep -- a very light, low-quality sleep," said Rebecca Robbins, who is an instructor in medicine at Harvard Medical School.

Now, when the alarm goes off a few minutes later, you'll be in the middle, not the end, of that sleep cycle, and you'll wake up groggy and stay that way longer, Robbins said. That sets you up for a less than stellar day -- and possibly another poor night's sleep.

If you're having trouble kicking the snooze button habit, try putting the alarm on the other side of the room, Robbins suggested. That way, you'll have to get out of bed to turn it off.

4) You're napping

We get it, you're tired! But while an occasional short snooze can be healthy, the World Sleep Society's second commandment warns: "If you are in the habit of taking siestas, do not exceed 45 minutes of daytime sleep."

One reason for the caution on timing is that we typically enter a "deep sleep" cycle about 30 to 40 minutes into a nap. Waking up from deep sleep produces that "Where am I?" grogginess that is worse than no nap at all. A long nap can also interfere with your body clock, making it more difficult to fall asleep later that night, Dasgupta said.

Generally, catnaps that are approximately 15 to 20 minutes are fine, experts say, and may reduce fatigue; boost creativity; increase alertness; jump-start cognitive performance; and improve mood. But try to do them earlier in the day -- between noon and 2 p.m. -- to avoid affecting that night's full sleep cycle, Dasgupta said.

5) You're staring at the ceiling

It makes sense on the surface: You can't fall asleep if you're not in the bed trying, right? Yet sleep experts say that continuing to count sheep for more than 20 minutes isn't the smartest move.

"If we stay in bed, we'll start to associate the bed with insomnia," Robbins said. She equates it to "going to the gym and standing on a treadmill and not doing anything."

If you can't fall asleep after 20 minutes, get out of bed and go into another room where there is dim light and do something calming until you feel drowsy again. The same applies when you wake in the night and can't fall back asleep.

Some people believe that it's just as refreshing to your body to lie in bed with eyes closed but not sleeping. No, that's just a pipe dream, according to Robbins.

6) You're checking the time

Another no-no: Checking the clock during the night to see what time it is.

"You usually end up trying to determine how much time you have left to sleep and worrying about whether you will fall back to sleep in a reasonable amount of time," Kolla said. "This can in fact make the process of returning to sleep more difficult."

Don't grab a sneak peek when you go back to bed, either. Seeing the time may only rev you up again.

"It's important not to get worked up about one bad night's sleep because anxiety itself makes it difficult to fall back asleep," Dasgupta said.

7. You're taking a tipple

It might make you sleepy, yes, but drinking beer, wine or liquor before bed is a guaranteed buzzkill for good sleep.

"As alcohol is metabolized it forms acetaldehyde, which is stimulating," said Kolla, who studies the interaction between sleep disturbances and addictive disorders.

"Therefore if you drink too much alcohol right before going to bed, in about four hours it is converted to aldehyde which can disrupt sleep and wake you up."

In addition to awakenings during the night, alcohol can cause "frequent trips to the bathroom because it inhibits a hormone called anti-diuretic hormone (ADH), resulting in increased urination," Dasgupta added.

8) You're not getting exercise (or exercising at the wrong times)

You'd think we'd all have more time for things that are good for us when we're stuck at home. Yet many people find themselves working longer hours during the pandemic, or juggling kids, school, work and worry. Exercise? Forget it.

When it comes to sleep (and frankly your overall health), skipping exercise is one of the worst things you can do.

Surveys of vigorous exercisers by the National Sleep Foundation show they are almost twice as likely to report high-quality, regular sleep compared to non-exercisers. Sitting for long periods of time is thought to be connected to poor sleep.

While studies haven't proven that exercise just before bed will harm sleep, many experts -- like those at the World Sleep Society -- recommend avoiding it. Why? Because moderate exercise heats up your core temperature, signaling to the body that it's time to be awake, while the release of endorphins is thought to keep some of us alert.

Of course if you're a night owl, that may not apply to you -- so listen to your body clock. For any of us, however, doing some yoga, tai chi or light stretching before bed could help with relaxation. A 2019 study of people with insomnia found those who stretched before bed showed improvement in their sleep quality.

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You can also try progressive muscle relaxation, a stretching technique in which you flex and tense each muscle group in the body, holding the tension for up to 20 seconds. Then release the tension quickly, and imagine breathing through that part of the body. Start with your toes, then feet, then calves -- you get the idea.

9) You're relying on sleeping aids

A study found a 20% increase in self-reported sleeping pill consumption between March and April last year. But popping pills is not the best choice to fix poor sleep, experts say. Prescription sleeping aids can be addictive, and some have been linked to memory loss, aggression, depression and suicidal thoughts.

Even melatonin can be misused, says Dasgupta.

"Melatonin is a natural compound released by the body, usually at night, and throwing off that balance by adding more of it to your system can cause additional sleep issues," Dasgupta said.

"If you decide to take it, remember it's all about the timing of the melatonin, not the amount of melatonin. The general rule of thumb is taking the melatonin two hours before your desired bedtime, because if you take it too late, it can throw off your sleep schedule."

10) You lack 'sleep hygiene'

"Sleep hygiene" is sleep expert-speak for ways to train your brain to sleep. In the midst of a pandemic, it's all too easy to let these habits slide.

Develop a routine. Set up a bedtime ritual by taking a warm bath or shower, reading a book, listening to soothing music, or doing deep breathing, yoga, meditation or light stretches. You're teaching your brain to wind down.

Strive for cooler temperatures. Make sure your bed and pillows are comfortable, and the room is cool: Between 60 and 67 degrees Fahrenheit is best.

Don't watch TV or work in your bedroom. You want your brain to think of the room as only for sleep.

Avoid certain food and drink. Avoid stimulants such as nicotine, coffee, black or green tea, and sodas after midafternoon, especially if you have insomnia. Spicy foods may also disrupt your tummy -- and your sleep. Chamomile tea, however, is a good option before bed because the herb can help with relaxation.

If you try these tips and can't seem to relax, or your sleep continues to worsen, be sure to reach out to a mental health professional. We can all use a bit of extra support and advice at this time, as we all struggle to manage anxiety in the face of this pandemic.

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