Zyma Islam noticed her sleep began to change soon after the lockdown began.
Islam is in Dhaka, Bangladesh, which has been under a strict lockdown for over three weeks. All forms of public transport are suspended. That means scores of daily wage earners—domestic helpers, rickshaw pullers, construction workers, and garment workers—have lost wages, and are now battling hunger.
Islam is typically an early riser, but she had to adapt to a new routine of working during the night. “All day long there are queues of hungry people outside my house begging and crying for food,” Islam said. The streets get quieter after 11pm, which is when Islam now gets most of her office work done. She gets to bed around 7am—and most days, she’s barely able to sleep for four hours.
“I don’t have control over whether these people actually end up getting food or relief,” says Islam, which has left her in a constant state of anxiety. “As a result of this, I’m aways sleep-deprived in spite of constantly actually being home.”
Islam isn’t alone. “Everything about this situation is dreadful. It’s full of dread all the time,” says Orfeu M. Buxton, who directs the Sleep, Health, and Society Collaboratory at Pennsylvania State University. All around the world, people’s lives are being impacted by the Covid-19 pandemic—along with their typical sleep patterns.
Whether it’s insomnia, strange dreams, or even sleeping too much, sleep disturbances are part of our body’s response to trauma and anxiety. Everyone will react to these situations differently—but experts have helpful information to share about ways to improve your rest.
“We are in the midst of collective trauma,” says Christy Beck, a therapist based in State College, Pennsylvania. “Something none of us have experienced in our lifetime. And sleep disturbance is a common trauma response, along with anxiety and depression.” Beck says that stress can cause a variety of sleep disorders, including insomnia—not being able to fall asleep—and its opposite, hypersomnia.
Anecdotal evidence seems to agree. Google searches for the term “insomnia” hit an all-time high recently. Hailey Meaklim, a psychologist and research scientist who is investigating the impact of the pandemic on insomnia symptoms, says that it is the most common sleep problem.
The pandemic is an invisible threat, Meaklim explains, “one that we can’t fight or run away from like we would from a sabre-tooth tiger.” But it still puts our bodies on high alert. “When you can’t actively do anything about these concerns, that still elicits a stress response. You want to sleep, but the rest of your physiology is actually telling you to mobilize, and that can put you at odds,” says Tony Cunningham, a postdoctoral research fellow at the Harvard Medical School.
“This may be due to the physiological arousal of the “fight or flight” system that accompanies anxiety that is in opposition with the “rest and digest” system needed to sleep,” says Courtney Bolstad, a doctoral student at the Mississippi State University. “This arousal may also cause difficulty returning to sleep in the middle of the night.”
There’s one more reason for trouble sleeping: People may also be staying up later to be on their phones, as they don’t have to get up early for work. “The light emitted from phones signals to our “clocks” that it is still daytime,” says Meaklim, which can lead to disruptions to our circadian rhythms and ultimately our sleep.
While difficulty falling asleep has been one shared experience across regions, several people have also reported an increase in vivid dreams and nightmares associated with the pandemic. The Google query for “Why am I having weird dreams” has shot up in recent weeks, along with searches for “Covid-19 dreams” and “coronavirus dreams.”
Abhinav Chugh hasn’t had a full night’s sleep in a month. The disturbances started several weeks ago, with the sound of blaring ambulance sirens passing by his window every 15 minutes. Then, he began waking up every two hours—each time from a vivid dream. The 25-year-old lives in Geneva, Switzerland, where lockdowns have been instated to prevent the spread of coronavirus. Residents can walk out on the streets, but “the loss of normalcy and the sense of human connection and sociality,” he says, has heightened his anxiety.
In times of stress, our brains release a range of neurochemicals which can trigger vivid dreams and nightmares for some people, explains Meaklim. “Also, dreams are thought to be our brain’s way to try to process emotions and make sense of what is happening to us.”
The rapid eye movement (REM) stage of sleep is when we typically dream. ”During REM sleep, our brains go through a cleaning process where memories from the previous day are consolidated into long-term memory,” explains Bolstad. “The addition of anxiety-laden memories with the already active amygdala—the brain’s fear center—may cause more distressing dreams.”
Other changes to our routines could increase the odds of experiencing and remembering dreams. Our likelihood of experiencing REM sleep is highest when we are about to wake up—so if you’re letting yourself sleeping a bit longer, your potential dream intervals may have increased. And dreams tend to be better remembered when one wakes up spontaneously rather than being jarred awake by an alarm, says Buxton.
Deirdre Leigh Barrett, an assistant professor of psychology at Harvard Medical School and the author of The Committee of Sleep has been conducting a “dream survey” where people have reported “quite explicit dreams.”
The healthcare providers in her sample are all reporting “full-on nightmares,” Barrett says, “mostly very realistic about trying to save a patient’s life and failing; a few about getting infected by patients and realizing they themselves are dying.”
Everyone handles trauma differently
But what explains these wide spectra of experiences, from sleepless nights to consistent nightmares?
“People’s varied daytime reactions to the current situation determine how it influences their sleep,” says Barrett. “Some people are much more anxious than others. Some are mainly afraid of themselves or loved ones catching the virus. Others are more stressed by the loss of a job or unpaid furloughs. Some are more sad or depressed about their diminished social contact.”
Some people might even find themselves sleeping better for the moment. “If you haven’t had Covid-19 directly impact you, and are not stressing about things on a larger scale, then you’re mostly just at home more and are able to get to bed at a better time,” Cunningham says. “So a lot of the changes might actually benefit your sleep.”
All these variations should be heartening, though: They mean it’s normal to experience some disturbances to your sleep during this time. Being accepting of changing sleep patterns for a short while and not getting too stressed out can allow them to pass more quickly.
Then, maybe you can even begin to make progress. “I think some of the variations are differences we see in coping styles, strategies, and abilities,” says Michael R. Nadorff, an associate professor of psychology at the Mississippi State University. Here are some of the strategies that may help you get a better rest:
Keep a regular schedule. “Go to sleep and wake up at the same times each day,” Beck advises. Cunningham puts extra emphasis on a regular wake time. “Eat breakfast, lunch, and dinner around the same times each day,” he says. “This structure should also help ease anxiety and depressive symptoms, by having something in your life you can control and knowing what will come next in your day-to-day life, as opposed to having the hours and days run together,” Beck adds.
Exercise regularly. Incorporate some form of physical activity into your routine, such as yoga. Do this at least three hours prior to your bedtime.
Self-care. “Spend more time on mindfulness, coping, and taking care of yourself than you might usually. We need more care right now as individuals,” Buxton says.
Avoid stressors. Limit the amount of Covid-19 news you are consuming, especially before bed. Taking in too much information about the pandemic can be overwhelming, and articles about the number of cases and deaths can increase anxiety.
Assign spaces. If possible, keep the bedroom space for sleeping. Try not to use it for work, eating, socializing, and looking at social media in particular. “The only activities that should occur in bed are sleep and sex. Otherwise, you may associate your bed with activities other than sleeping when you are wanting to sleep,” says Bolstad.
Be easy on yourself. Doing deep abdominal breathing, progressive muscle relaxation, or thinking of soothing imagery as you fall asleep—just on your own or with a tape—helps insomnia, says Barrett. Specifically to lessen anxious dreams, “one can suggest to oneself as you are falling asleep that you’d like to have a positive dream: about a loved one you’d like to see in your dream.”