Updated: May 9
Since the start of the COVID-19 epidemic, and the societal consequences of home confinement, we have been more exposed to stress, worry, fear and even depression. Being forced to stay at home, to work at home in the presence of our children, to considerably reduce our outings, our social interactions or to work more in stressful circumstances, and in parallel to manage the health risks associated with the epidemic, can have a major impact on our daily mental, and obviously the quality of our sleep. However, in this period of uncertainty, sleep is our ally and it is essential to pay increased attention to it.
It's normal to have sleep disturbances in times of great stress
Stress-related sleep problems are common and those who are sensitive to these sleep disturbances are more likely to develop chronic insomnia during the confinement period. Pre-existing insomnia is also a risk factor for developing post-traumatic stress disorder when it is associated with major stress.
The negative impact of confinement on our sleeping habits
The circadian rhythm, governed by daylight, mealtimes and exercise, keeps us awake during the day and makes us sleepy at night. Exposure to light affects the release of melatonin, a hormone that plays a key role in inducing drowsiness. Exposure to bright light during the day therefore promotes the release of melatonin at night. Activity levels during the day also affect sleep the following night. Indeed, low activity levels (due to low morale, for example) negatively affect sleep, as well as excessively high activity levels (due, for example, to stress or overwork). Conversely, physical activity during the day (but not late at night) improves the quality of sleep (Potter et al., 2016).
Adapt your sleeping habits during home confinement
Here are some tips to protect your sleep during this difficult time:
Take advantage of this period to closely follow your natural sleep rhythm (at least 7 to 8 hours per night). It is also an opportunity to adapt your sleep to your natural circadian preferences (for example, a sleep-wake rhythm earlier or later than usual, especially for adolescents and elderly).
Keep regular bedtime and wake-up times to bring structure to the day, especially for children.
Establish a routine before bedtime, such as familiar and relaxing activities (reading, meditation, relaxing music, yoga, ...).
Avoid consulting the various media, especially information related to the epidemic, at bedtime.
Expose yourself to maximum natural light during the day, especially in the morning. If this is not possible, have your house lit during the day by opening the curtains and blinds, or by turning on the lights in your home.
For quality sleep, adopt or maintain a healthy lifestyle. If you are less active during the day than usual, eat less, at fixed times, and no later than two hours before going to bed, to avoid sleep disturbance. Avoid or limit the consumption of alcohol, stimulants (coffee, tea, energy drinks and nicotine), exposure to anxiety-inducing contents and large, fatty or spicy meals before going to sleep. Finally, avoid planning your next day's activities just before bedtime.
Make your home and in particular your bedroom a safe and comfortable environment: calm, freshness and subdued light, even dark for the evening. Avoid phone or tablet in your bedroom; if possible, turn them off before going to bed to reduce sleep disturbances from exposure to light, notifications, and the need to respond to requests and messages. Finally, consider your bed only for sleeping or having sex.
Exercise regularly, preferably in broad daylight. Find useful distractions (tidying up, DIY, ...) or activities that you know and enjoy doing.
Allow short periods (10-15 minutes) during the day to feel things, insist and reflect on the situation: write down your thoughts, talk about stress, etc.
Feel free to use social media to share your fears with family and friends, but also to share positive, entertaining and funny information, possibly unrelated to the epidemic.
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Akerstedt, T., Knutsson, A., Westerholm, P., Theorell, T., Alfredsson, L. and Kecklund, G. Sleep disturbances, work stress and work hours: a cross-sectional study. J Psychosom Res, 2002, 53: 741-8.
Altena, E., Micoulaud-Franchi, J. A., Geoffroy, P. A., Sanz-Arigita, E., Bioulac, S. and Philip, P. The bidirectional relation between emotional reactivity and sleep: From disruption to recovery. Behav Neurosci, 2016, 130:336-50.
Altena, E., Baglioni, C., Espie, C.A., Ellis, J., Gavriloff, D., Holzinger, B. Dealing with sleep problems during home confinement due to the COVID-19 outbreak: practical recommendations from a task force of the European CBT-I Academy. J Sleep Res, 2020, in press.
Gehrman, P., Seelig, A. D., Jacobson, I. G. et al. Predeployment Sleep Duration and Insomnia Symptoms as Risk Factors for New-Onset Mental Health Disorders Following Military Deployment. Sleep, 2013, 36: 1009-18.
Potter, G. D., Skene, D. J., Arendt, J., Cade, J. E., Grant, P. J. and Hardie, L. J. Circadian Rhythm and Sleep Disruption: Causes, Metabolic Consequences, and Countermeasures. Endocr Rev, 2016, 37: 584-608.