We have all heard that we need to get 8 hours of sleep a night. But, have you had 8 hours of sleep during Covid?  If so, you may be in the minority!

Why do we need sleep anyway?

Sleep is actually a critical biologic function that helps us in the following ways:

  • Sleep empowers our immune system strengthening our bodies immune system
  • Sleep improves our brain function; our mind works better after a good night’s rest
  • Sleep improves our mental health. Lack of sleep can cause feelings of depression. Studies have linked lack of sleep with anxiety, bi-polar, and PTSD (Post traumatic Stress Disorder)

Sleep During COVID

In this year while we have been in lockdown, schedules have been drastically altered. Some of our homes, especially those with low levels of natural light, may reduce light-based cues for wakefulness and sleep, known as zeitgebers, which are crucial to our circadian rhythm.

Worries about where to go, who to see, and what to do have exacerbated sleep. The uncertainty of the virus, having friends or family who have experienced physical and/or financial hardships has affected many folks along with feelings of isolation and depression.

Think of it this way: for a year we have been hyper vigilant about who to see, where to dine, how are food and sanitary supplies are stocked. We have covered our face with masks so only our eyes are seen. We avoided others. Now the stats are in and anxiety and depression are up.

We have all had greater work stress and our communication has often been reduced to zoom squares and we have all seen our screen time climb.

Stress-Related Fatigue and the chronic stress of living through the uncertainty of a pandemic can lead to a host of physical symptoms, including persistent headaches, memory lapses, and digestive problems. Stress-related fatigue is another common side effect. The Mayo Clinic defines fatigue as “a nearly constant state of weariness that develops over time and reduces your energy, motivation and concentration.”

Even if you receive an adequate amount of sleep at night, fatigue can still leave you feeling tired and unmotivated in the morning.

So what can you do?

How To Get Back on Track With Sleep

Set A Schedule and Routine

Establishing a routine can facilitate a sense of normalcy even in abnormal times. It’s easier for your mind and body to acclimate to a consistent sleep schedule, which is why health experts have long recommended avoiding major variation in your daily sleep times.

Sleep-specific aspects of your daily schedule should include:

Wake-Up Time: Set your alarm, bypass the snooze button, and have a fixed time to get every day started.

Wind-Down Time: This is an important time to relax and get ready for bed. It can involve things like light reading, stretching, and meditating along with preparations for bed like putting on pajamas and brushing your teeth. Given the stress of the coronavirus pandemic, it’s wise to give yourself extra wind-down time each night.

Bedtime: Pick a consistent time to actually turn out the lights and try to fall asleep.

No Screen time an hour before bed. Be careful with screen blue light hue

Incorporate Steady Routines Throughout The Day

Showering and getting dressed even if you aren’t leaving the house.

Eating meals at the same time each day.

Blocking off specific time periods for work and exercise.

Change your sheets often

See the Light

Exposure to light plays a crucial role in helping our bodies regulate sleep in a healthy way. As you deal with disruptions to daily life, you may need to take steps so that light-based cues have a positive effect on your circadian rhythm.

Practice Kindness and Foster Connection

It might not seem critical to your sleep, but kindness and connection can reduce stress and its harmful effects on mood and sleep.

Stay Active

It’s easy to overlook exercise with everything happening in the world, but regular daily activity has numerous important benefits, including for sleep. Excessive activity right before bedtime can adversely affect sleep.If you can go for a walk while maintaining a safe distance from other people, that’s a great option. If not, there is a wealth of resources online for all types and levels of exercise.

Sleep and Substance Use Disorders -Cocaine- Marijuana – Opioids and Stimulants

Substance use causes sleep problems; yet insomnia and insufficient sleep may also be a factor raising the risk of drug use and addiction. Recognizing the importance of this once-overlooked factor, addiction researchers are paying increased attention to sleep and sleep disturbances, and even thinking about ways to target sleep disruption in substance use disorder treatment and prevention.

Most kinds of substance use acutely disrupts regulatory systems in the brain affecting the time it takes to fall asleep and the quality of sleep. folks who use mind altering substances have difficulty sleeping as they titrate off of drugs, which can lead to cravings which sadly can lead to relapse.

“The neurobiological mechanisms linking many forms of drug use and sleep disturbances are increasingly well understood. Dopamine is a neurochemical crucial for understanding the relationship between substance use disorders and sleep, for example. Drugs’ direct or indirect stimulation of dopamine reward pathways accounts for their addictive properties; but dopamine also modulates alertness and is implicated in the sleep-wake cycle. Dopaminergic drugs are used to treat disorders of alertness and arousal such as narcolepsy. Cocaine and amphetamine-like drugs (such as methamphetamine) are among the most potent dopamine-increasing drugs, and their repeated misuse can lead to severe sleep deprivation. Sleep deprivation in turn down-regulates dopamine receptors, which makes people more impulsive and vulnerable to drug taking.

In addition to their effects on dopamine, drugs also affect sleep through their main pharmacological targets. For instance, marijuana interacts with the body’s endocannabinoid system by binding to cannabinoid receptors; this system is involved in regulating the sleep-wake cycle (among many other roles).

Trouble sleeping is a very common symptom of marijuana withdrawal, reported by over 40 percent of those trying to quit the drug; and sleep difficulty is reported as the most distressing symptom. (Nightmares and strange dreams are also reported.)

Opioid drugs such as heroin interact with the body’s endogenous opioid system by binding to mu-opioid receptors; this system also plays a role in regulating sleep. Morpheus, the Greek god of sleep and dreams, gave his name to morphia or morphine, the medicinal derivative of opium. Natural and synthetic opioid drugs can produce profound sleepiness, but they also can disrupt sleep by increasing transitions between different stages of sleep (known as disruptions in sleep architecture), and people undergoing withdrawal can experience terrible insomnia. Opioids in brainstem regions also control respiration, and when they are taken at high doses they can dangerously inhibit breathing during sleep.

The causal relationship between impaired sleep and drug misuse/addiction can also go in the other direction. People who suffer insomnia may be at increased risk for substance use, because sufferers may self-medicate their sleep problems using alcohol or other drugs such as benzodiazepines that they may perceive as relaxing. Or, they may use stimulant drugs to compensate for daytime fatigue caused by lost sleep. Impaired sleep may also increase risk of drug use through other avenues, for instance by impairing cognition. Consequently, sleep disorders and other barriers to getting sufficient sleep are important factors to target in prevention.

With teens and young adults there is some concerns na literature as well which debates the efficacy of early school time starts as teenagers maybe particularly vulnerable to the effects of sleep deprivation which correlate with increased risk of substance use and other behavior problems in teens. In this age group, tobacco, alcohol, and marijuana use are all associated with poorer sleep health, including lower sleep duration, again with possible bidirectionality of causation.

In creating a toolbox for health it is good to monitor sleep habits and make adjustments that allow for a regular schedule in this world of “ nothing is regular “ !