Pandemic amplifies sleep loss

Illustration by Cathryn Cunningham/Journal

Copyright © 2021 Albuquerque Journal

Dr. Shanna Diaz, medical director of the Sleep Disorder Centers at of the University of New Mexico Hospital, says the COVID-19 pandemic has more people experiencing insomnia and increasing numbers taking sleep medications.

Roxroy Reid of Bosque Mental Health recommends cognitive behavioral therapy for insomnia: “Change your thinking, change your behavior.”

People are losing sleep over the COVID-19 pandemic – literally.

That’s certainly true for Ron Kron of Rio Rancho, who works as a salesman at one of the big box home improvement stores.

Kron believes he had COVID-19 last January, long before testing was readily available.

“I had a temperature for weeks, peaking at around 103 degrees, and was diagnosed with an upper respiratory infection,” the 54-year-old said.

Dr. Shanna Diaz

Kron now battles insomnia, getting up two or three times during the night, often jolted awake by nightmares.

“Before COVID, I’d get up maybe once during the night and had little problem going back to sleep,” he said. “I went for years and never dreamed – or maybe I had dreams and couldn’t remember them. But now, I have these intense dreams and remember them all day long, so it’s kind of like reliving them.”

Kron, who has been taking medication for high blood pressure, has also seen his numbers rise during the pandemic, but has been reluctant to return to the doctor’s office for fear of being exposed to someone who might be ill with the virus.

He has plenty of sleep-deprived company. Americans were already sleepy before COVID-19, but concerns about the virus have amplified their inability to get extended and refreshing repose, making a large chunk of the population chronically sluggish and on edge, and often compromising their overall health.

Ron and April Kron of Rio Rancho have experienced the pandemic differently. Ron, a salesman at a big box home improvement store, now has insomnia, nightmares and a spike in his blood pressure; April, a schoolteacher working from home via the internet, saves commute time, sleeps later and is more relaxed. ( Rick Nathanson/Journal)

With a vaccine now being slowly distributed, something to surely ease people’s pandemic anxiety, sleep experts have a number of suggestions on how people can change their daily routines to get better nighttime slumber.

Dr. Shanna Diaz,medical director of the Sleep Disorder Centers of the University of New Mexico, points to a sleep study done in the U.S. and 49 countries last March and April, with the results published recently in the Journal of Clinical Sleep Medicine.

Of nearly 4,000 respondents, about 60% said they were not satisfied with their sleep and 40% of respondents said their sleep quality is worse than it was before the pandemic.

Those with worsening sleep said they fell asleep later, had a harder time falling asleep, woke up more during the night and had difficulty falling back to sleep.

“Even when they did sleep,” Diaz said, “they woke up feeling unrefreshed.”

Because the pandemic has continued and worsened, Diaz said, the trends tracked in the survey have no doubt “persisted, deepened and become more entrenched.”

For Kron, the biggest concern is that he might be asymptomatic but still harbor the virus and be able to transmit it to someone else, including his elderly father who visits him weekly.

Roxroy Reid

“It weighs heavily on my mind. I think that’s what I worry about the most,” he said.

His wife, April Kron, 52, teaches third grade at an Albuquerque charter school and has found something of a bright spot in the darkness of the pandemic.

Teaching her kids through an online audio-video portal from home, she is able to avoid the twice daily, 30-minute commute to work.

While acknowledging that an hour-long daily commute may not be particularly taxing, “I can stay up a little later at night and sleep in a little later most mornings,” she said. “I miss the hugs from the kids and the kids interacting with each other, and would rather be in the classroom any day, but I do feel more relaxed. I can even teach in my pajamas if I want to. I did one day.”

The anxiety about getting or transmitting COVID-19 is heightened by the isolation of social distancing and “the worry many have about the financial impact to their livelihoods,” Diaz said, particularly if their hours have been cut, their workplaces shuttered, “or if they’ve been going to work but feel endangered,” as with health care workers, teachers or grocery store workers.

The sleep study also showed that during the pandemic there has been an increase of about 20% in the use of sleeping pills. There are more refill requests, more frequency of use, and higher doses prescribed, Diaz said.

“People are desperate to sleep and it may be reasonable to take sleeping pills because it’s important to get enough sleep, and if you don’t, then that’s a health risk, too. It’s always about risk-to-benefit ratio,” she said.

According to the American Sleep Association, up to 70 million U.S. adults have some type of sleep disorder, insomnia being the most common.

The incidence of insomnia increases with age, and affects about 40% of women and 30% of men.

While everybody has different sleep duration needs, the ASA recommends that adults get seven to nine hours nightly; teenagers eight to 10 hours; children 3 to 5 from 10 to 12 hours.

According to research published by the National Institutes of Health, sleep has important physiological and psychological roles in the healing and repair of heart and blood vessels, nerve cells and the immune system and is integral to reorganizing brain patterns for learning and memory.

Lack of sleep is linked to an increased risk of heart disease, kidney disease, high blood pressure, diabetes and stroke.

In addition, sleeplessness is often a symptom of mood disorders, such as anxiety and depression, said Roxroy Reid, a licensed clinical social worker at Bosque Mental Health in Albuquerque.

“Most of my clients were already dealing with anxiety or depression, two maladies that in and of themselves can cause insomnia. Those underlying sleep issues are now exacerbated by COVID,” he said.

A number of his clients who did not have underlying sleep issues associated with their mental health issues, now have insomnia because of COVID-19.

The common therapeutic intervention is cognitive behavioral therapy, “which in the nutshell is change your thinking, change your behavior,” Reid said.

Much of COVID-related insomnia has to do with people’s perception of danger and threats to their life and existence.

Getting his clients to rethink or recognize that this is “a passing storm that will eventually dissipate,” goes a long way toward helping them deal with the anxiety, said Reid.

In the meantime, practicing good “sleep hygiene” will go a long way toward dealing with the more immediate problem of sleeplessness.

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