How the Pandemic Has Impacted Sleep

By: Tana Mardian

You might remember the hallmarks of early 2020: virtual classes, Zoom get-togethers with friends, or neighborhood walks as our only freedom from the indoors. As a result, you might’ve started to stay up later and then sleep in later, not bound by a strict class or work schedule. The stress and anxiety around the pandemic may have caused you to stay up later than you normally would have, making it especially hard for you to fall asleep. The simple disruption in your normal routine may have thrown off your sleep regimen. These are real difficulties that many of us have faced during the pandemic and during stressful times in general, and scientists are gathering data to look into just how much the pandemic has disrupted our lives, and, more specifically, our sleep. 

Before discussing the consequences of the pandemic on sleep, it’s important to highlight the significance of getting adequate sleep. Insufficient sleep can have serious negative implications on health; it can increase the risk of obesity, cardiovascular and metabolic disease, and mood and cognitive disorders, as well as accelerate aging. Issues with sleep weren’t uncommon before the pandemic, however, as a study in 2019 found a 15-25% prevalence rate in the United States. While total hours of sleep is important, an individual’s feelings about their sleep quality also carries its own implications. Deficient sleep quality is linked to cardiovascular and coronary heart disease, obesity, chronic kidney disease, and decreased mental health (Mandelkorn et al., 2021). Additionally, sleep has essential functions in immune response, which hold great importance in  preventing viral infection (Jahrami et al., 2021).

While some individuals may already have sleep disturbances, stressful events like the pandemic can further exacerbate these disturbances or even bring about new ones. While this area of research is still growing as the pandemic continues, a few articles have looked into the consequences on sleep that may have arisen from the current state of the world. In a systematic review and meta-analysis, Jahrami et al note that the prevalence of sleep disturbances is high at close to 40% for both the general and healthcare population. This percentage rises to about 75% in patients who have tested positive for COVID-19. The study also found an overlap of prevalence rates between psychological distress symptoms (such as stress, anxiety symptoms, and depressive symptoms) and sleep problems; there also may be a potential bidirectional relationship between the two. Female nurses appear to struggle more with sleep when compared to other healthcare workers, as researchers found a prevalence rate of 60% in this population. This study only looked at the first 8 months of the pandemic, meaning it’s essential that we continue to investigate the effects of the pandemic on sleep (Jahrami et al., 2021).

In two online, large-scale surveys of adults in March and April of 2020, researchers found that there was a significant increase in sleep disturbances. They did not see changes in sleep duration, but individuals reported new insomnia, altered circadian rhythm, daytime dysfunction, and an increased usage of pharmacological sleeping aids. The article points out that insomnia could be a consequence of stress and sleep quality, and the circadian misalignment is often a negative implication of social isolation. These issues were also particularly prevalent in women, people aged 31-45 as well as individuals who were less physically active, in quarantine, and whose livelihood was negatively impacted (Mandelkorn et al., 2021).

Another meta-analysis found similar findings to Jahrami et al and Mandelkorn et al. They remark that the high prevalence of sleep disturbances is likely explained by the fear surrounding COVID-19 and changes of sleep patterns like sleep-wake habits, lights off time, and sleep onset. Due to the onslaught of concerning news that dominates cable news and social media, there have been higher levels of psychological distress and symptoms of mental illness since the start of the pandemic. This study found a higher prevalence of sleep problems in healthcare workers, which is attributed to their higher risk of infection and irregular work schedules for those behind the frontline. The researchers of this study point out that we need support during this time; cognitive behavioral therapy, which is particularly effective for insomnia, should be offered in smartphone apps and healthcare professional training to help combat sleep problems. Healthcare providers must also be aware of the link between sleep issues and psychological distress and provide care for both, as psychological distress may decrease with improved sleep and vice versa (Alimoradi et al., 2021).

As we enter into another potentially stressful time with the Omicron variant on the rise, it’s important to keep this information in mind. Given the consequences of insufficient sleep and the significant role of sleep in our health and immune system, the impact of the pandemic on our sleep habits could have negative implications, but we can work to combat sleep disturbances by keeping a consistent and sufficient sleep schedule. Prioritizing self-care is of the utmost importance at this time, and that includes prioritizing sleep. Adequate sleep will not only support the immune system, but it can also help with the stress and anxiety we might feel as a result of the pandemic. If you do experience serious sleep disturbances or symptoms of mental illness, be sure to reach out to a healthcare provider. Otherwise, as we enter into another uncertain time, this is the perfect opportunity to stay connected with friends and loved ones, get involved in hobbies and activities that keep you safe and happy, and give yourself time to process and recharge (and get a good night of sleep!).

Reference List:

Alimoradi, Zainab, Anders Broström, Hector W. H. Tsang, Mark D. Griffiths, Shahab Haghayegh, Maurice M. Ohayon, Chung-Ying Lin, and Amir H. Pakpour. “Sleep Problems during COVID-19 Pandemic and Its’ Association to Psychological Distress: A Systematic Review and Meta-Analysis.” EClinicalMedicine 36 (June 1, 2021). https://doi.org/10.1016/j.eclinm.2021.100916.

CDC. “Omicron Variant: What You Need to Know.” Centers for Disease Control and Prevention, December 20, 2021. https://www.cdc.gov/coronavirus/2019-ncov/variants/omicron-variant.html.

Jahrami, Haitham, Ahmed S. BaHammam, Nicola Luigi Bragazzi, Zahra Saif, MoezAlIslam Faris, and Michael V. Vitiello. “Sleep Problems during the COVID-19 Pandemic by Population: A Systematic Review and Meta-Analysis.” Journal of Clinical Sleep Medicine 17, no. 2 (n.d.): 299–313. https://doi.org/10.5664/jcsm.8930.

Mandelkorn, Uri, Shir Genzer, -Hillel Shoham Choshen, Joel Reiter, e Cruz Miguel Meira, Hagit Hochner, -Gozal Leila Kheirandish, David Gozal, and -Hillel Alex Gileles. “Escalation of Sleep Disturbances amid the COVID-19 Pandemic: A Cross-Sectional International Study.” Journal of Clinical Sleep Medicine 17, no. 1 (n.d.): 45–53. https://doi.org/10.5664/jcsm.8800.