The world is still reeling from the Coronavirus pandemic. Here in Oregon, we are a few weeks into social distancing and shelter-in-place. Businesses big and small have shut down, families are struggling with unemployment and an uncertain future. Couples and families are strained with living in close quarters while at the same time people are feeling isolated and disconnected from friends, church and other activities.
Parents and teachers are scrambling to learn how to do online school from home. Medical providers are racing to prepare for a surge of patients with a shortage of available beds and personal protection devices.
I’ve been working in the field of sleep for the past 24 years, working for the sleep labs at OHSU and Kaiser Permanente. The past two weeks reminded me of the morning of 9/11 when I drove into work with my coworker at the sleep lab and we listen to the radio report of the planes hitting the towers. Later that morning we sat with a group of patients after their overnight sleep studies and we set them up with CPAP machines and watched the towers fall together.
This pandemic may not be as sudden as the terrorist attacks of 9/11 but it is wreaking havoc on our lives in many ways.
We’re under a tremendous amount of stress because of the disruption to our normal rhythms and routine. It’s not only taking a toll on relationships and our emotional health, it’s also stealing our sleep.
Here are a few resources to help you, those you work with or your family get your sleep back on track and to manage the stress you may be experiencing.
The first is the CBT- Coach App by the US Dept of Veteran Affairs
I recently had a client increased their total sleep time from just under 5 hrs sleep to 7.5 hrs sleep per night in the last three weeks.
There are other apps that can help with stress and sleep at the VA site:
Mindfulness Coach, Mood Coach as well as apps for Acceptance and Commitment Therapy and Anger & Irritability Management Skills.
The second resource is the book the Insomnia Answer.
In this book, Paul Glovinsky and Dr. Arthur Spielman teach the Spielman 3-P Model of Insomnia.
The three P factors that can disrupt sleep are Predisposing, Precipitating and Perpetuating Factors. The Predisposing Factors are our tendency to having Insomnia. If you have a low predisposition you probably have always slept well, if you have a high predisposition you are sensitive or vulnerable to disrupted sleep. You may be sensitive to noise and light, struggle with worry or anxiety or have struggled with sleep since childhood.
Whether you have a low predisposition or high predisposition for insomnia at some point Life can happen to your sleep. The Precipitating Factors are changes in life that disrupt your sleep. They can be negative stressful changes like conflict and stress at work, divorce, unemployment or a 20 page term paper that you’ve waited till the last weekend to start. They can also be positive changes like a job promotion, moving to a new house, a vacation,
The impact of Covid 19 is a huge Precipitating Factor on the sleep of many people, even folks who usually have no problems sleeping.
The Perpetuating Factors are ways of coping with being sleep deprived that may help short-term but end up perpetuating the problem. Things like caffeine, napping, watching Netflix or scrolling through Instagram till 1am. It can also include eating in the middle of the night or sleeping in for hours on the weekend to try to catch up on sleep. These are the the things that get us caught in a viscious downward spiral; for example, “I didn’t sleep so I drink coffee. But I can’t sleep because I drank coffee.” Or “I didn’t sleep so I end up falling asleep on the couch but then I can’t sleep because I took a 2 hr nap after dinner.”
The 3rd resource is especially helpful if you have trouble turning your brain off at bedtime and struggle to get to sleep or in the middle of the night and have trouble getting back to sleep is Say Goodnight To Insomnia by Gregg Jacobs.
Dr. Jacobs uses the phrase Negative Sleep Thoughts or NSTs to describe thoughts that trigger more stress and physiologic arousal, squirt your brain with the stress hormones adrenaline and cortisol. Some authors call these “hot thoughts”. He teaches you how to reframe your Negative Sleep Thoughts into quieter or cooler thoughts that are soothing, calming and less alerting.
Besides sleeping better right now after a few weeks of Insomnia. These resources will help prevent this acute or situational Insomnia from becoming the start of a chronic problem. Psychophysiogic or “conditioned” insomnia is the type of insomnia that becomes like a bad habit. It’s when you are exhausted and tired and maybe feel drowsy or sleep in the living room or on the computer but as soon as you brush your teeth, put your pjs on, get in bed and turn out the lights you feel more wide awake. When you start to struggle with getting sleep or staying asleep your bed, bedroom and bedtime can start to become associated with frustration and trigger a stress reaction. It can get to the point where folks have a mini-stress attack and start to avoid going to bed, staying later and later because they start to believe that sleep just doesn’t work for them.
One more note on improving sleep at this time, good sleep habits or sleep hygiene doesn’t just start with your evening or bedtime routine. Good sleep hygiene starts with your morning routine and can be practiced throughout the day because one keep to sleep is managing your mental, emotional and physical arousal during the day. Starting out the day well, eating healthy, getting some physical activity during the day, practicing mindfulness or other spiritual disciples all contribute to keeping your stress level down. For a lot of us right now, we are both bored or idle at times or extremely busy and scrambling around figuring out how to respond and adapt to new realities. Deciding on a structure and schedule for the day is helpful, especially for kids home from school.
My next blog post will be of some resources to help with homeschool and time together as a family, working from home, exercise and routine.
(I wanted to include it in this post but it’s getting late and I need to get ready for bed a good night’s sleep.)
For more info here’s a video I did on sleep and stress on Facebook.
Feel free to let me know if you have any questions about sleep.
