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Sleeping better or worse since the pandemic? Sleep expert says you’re not alone

December 15, 2020

By Anne Christiansen-Bullers

Older man sits awake at edge of bed while woman sleeps
People with high anxiety can experience insomnia when under heightened stress, one KU Medical Center sleep expert says. The heightened anxiety of the COVID-19 pandemic has adversely affected their sleep.

Having trouble sleeping? You're not the only one. Three in ten Americans have sleep difficulties under normal circumstances, according to the National Institutes of Health, and the stress and uncertainty of the COVID-19 pandemic only adds to those numbers.

In fact, one study showed a 37% increase in insomnia rates from before the pandemic.

Catherine F. Siengsukon, Ph.D., lab director of the SleepWell Lab at the University of Kansas Medical Center, said the pandemic has upended sleep patterns.

Photo of Dr. Siengsukon

Catherine F. Siengsukon, Ph.D.

"I think it's not terribly surprising that sleep is disrupted for a lot of people during COVID," Siengsukon said. "The stress, the worry, the anxiety that a lot of people are experiencing - if people have lost their jobs, if people are not able to be connected with their friends and family - the stress can be very disruptive to sleep."

Siengsukon, who is also an associate professor of physical therapy and rehabilitation science at KU Medical Center, studies how disrupted sleep impacts health as well as how behavioral interventions can improve sleep. The Sleep, Health, and Wellness lab, commonly known as the SleepWell Lab, is part of the School of Health Professions.

Some get better sleep

Since March 2020, when the COVID-19 pandemic changed daily routines, Siengsukon said she's seen two effects on sleep. One, perhaps surprisingly, is that people are getting more and better sleep than they did before the pandemic.

      9 tips for better sleep

     Here are some of the behaviors                 Siengsukon suggests for a better night's sleep:

  1. Maintain a fairly regular sleep schedule. Plan to wake up at the same time every day. Go to bed around the same time, but don't go to bed until you are reasonably sure you will fall asleep easily.
  2. Avoid lying in bed for more than 15-20 minutes if you are not able to fall asleep. Get out of bed if you are safely able to and do something relaxing.
  3. Increase your "sleep drive." Your natural urge to want to fall asleep is heightened by physical activity during the day and lowered by taking naps.
  4. Darken your room. Our brain responds to light as a signal to awaken and dark as a signal to sleep.
  5. Avoid alcohol, caffeine and smoking a few hours before bedtime.
  6. Consider limiting your fluid intake a few hours before bed so a needed trip to the bathroom doesn't wake you prematurely.
  7. Avoid a large meal before bedtime. A light snack might be helpful to reduce nighttime stomach rumblings.
  8. Learn relaxation techniques that involve controlled breathing and muscle relaxation. Siengsukon and associates teach specific skills to their clinical trial participants, but many relaxation techniques are available online or in relaxation apps.
  9. Talk with your doctor if you are having difficulty sleeping to determine what might be causing it and what might be helpful for you specifically.

"Some people are working from home. They have a more flexible work schedule, so they can sleep more," she said. "Others have been able to adjust their hours so they're sleeping on what would be considered their natural sleep schedule. I hadn't really anticipated that happening, but it has been the case for some people."

Siengsukon explained that all humans have a natural circadian rhythm set on a 24-hour schedule, but not everyone has the same schedule. Early birds and night owls have different times when they prefer to sleep, she said, and the pandemic has allowed some of them to adjust their schedule to their own rhythm.

"For evening-type persons, the schedule changes brought on by the pandemic have been a benefit," she said. "Their nighttime sleep is based on their circadian rhythm rather than what's been forced on them based on their role in society."

Some suffer under stress

For another portion of the population, the COVID-19 pandemic has done just the opposite: stress and anxiety have caused sleep disturbances such as insomnia, nightmares and nonrestorative sleep.

If a person had insomnia prior to the pandemic, it now may be worse. "People who have sleep issues are oftentimes the type to worry more," Siengsukon said. "They're already worried about their sleep, and now we have worries of a pandemic on top of it."

Take, for example, a participant in Siengsukon's sleep study for older adults, which goes by the acronym SIESTA. SIESTA is an ongoing, five-year study to see if a behavioral intervention for insomnia can affect the prevention of Alzheimer's disease. Study participants must be age 60-85 and have difficulty falling asleep or staying asleep three or more nights a week.

The woman signed up for SIESTA before the pandemic, and for a few initial visits, she met researchers in the SleepWell Lab on the Kansas City campus. Due to stay-at-home orders brought about by the pandemic, the meetings switched to telehealth appointments.

The woman's anxiety levels increased for several reasons, Siengsukon said. "She was isolated from her family and friends, and she lived alone. She wasn't getting out, and since she was home more often, she was watching more news. Being in the pandemic heightened her sense of anxiety, which then translated to disrupting her sleep" even more than before the pandemic.

Some find success

Enroll in a sleep study for older adults

Siengsukon is currently seeking additional SIESTA participants. Information on how to apply for the SIESTA study is available online. 

"I think it's a very timely study," Siengsukon said," given that so many people have insomnia right now."

It was a different story for Andrea Whitmore, who was referred to SIESTA by her doctor. Insomnia had long been her problem, even before COVID-19. "You lay in bed and you think, ‘Oh, dear, look at that clock.' You wish you could go to sleep, and you don't."

After an initial series of tests, she began face-to-face meetings with a research assistant trained in Cognitive Behavioral Therapy (CBT), which is a series of behaviors a person can learn to get a more restful night's sleep.

When the pandemic hit, that same counselor phoned her monthly instead of meeting face-to-face. The monthly check-in calls, part of the protocol for the yearlong study, helped her stay accountable to what the research assistant had taught her. "Besides, we made a good connection, and I enjoyed talking to her," Whitmore said.

Whitmore now follows CBT behaviors to get to sleep each night. With the CBT training, she's been less dependent on prescription and over-the-counter sleep-aid medication.

"Because of the potential side effects of long-term use of those medications, I knew that I didn't want to use them regularly, but I wasn't sure I'd be able to give them up," Whitmore said."It does take time for the behavior therapy to work, because you find yourself resistant even if you think you're not." 

Group photo of lab staff

The SleepWell Lab staff, pictured June 2019.

Last modified: Jan 11, 2021
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