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October 5, 2020

Counting Sheep When You Can’t Sleep during COVID-19

The beginning of the year 2020 was expected to be a time to thrive, but the novel Coronavirus swept in, bringing death and demise with it. Information on COVID-19 symptoms and general updates have been constant reminders for us all, but what lies beneath the physical and psychological tolls is a foundation for maintaining our health: proper sleep. Sleep functions in restoration, regeneration, and memory consolidation. Through the secretion of hormones during sleep, our bodies are able to repair damaged cells and clear out toxic debris from our brains. Our memories are also sorted from short term memory into long term, as the information is processed. Sleep is necessary, especially in times like these. A good night’s sleep gives us strong immune systems, keeping us healthy and giving us more fulfilling lives. Investigating sleep issues amidst the ongoing pandemic is therefore critical for our health. Dr. Phillip Cheng argues that sleep maladies due to the presence of the coronavirus are rampant: “Everything going on right now can make people more vulnerable to insomnia.”1 However, sleep deprivation isn’t a new issue according to the CDC, and sleep expert Dr. Neil Stanley has stated that sleeping in due to COVID confinement is beneficial to stabilizing sleep.2 But has the quality of sleep actually increased due to COVID-19, as Dr. Stanley suggests, or worsened, as Dr. Cheng suggests? While sleep quality can be manipulated by a number of different factors, an analysis of the data suggests that indeed the ongoing pandemic has been generally responsible for critical sleep problems affecting health.

The environment presented by COVID-19 has brought radical change. With the constant news reports, the rise of COVID-19 cases, the fear of losing a loved one, and the fear of missing out of our own lives have played major roles in inducing anxiety. Missing out on normal events such as graduations, weddings, family visits, and more lead many to experience isolation and loneliness, leading to increasing stress and anxiety. While feeling anxious is a natural response the body sends out when it is under stress, those with severe anxiety disorders are suffering, and it’s affecting daily function. Anxiety has also been a main contributor to sleep disturbances like insomnia. Insomnia is one of the most common sleeping disorders, characterized by trouble falling and staying asleep, and it is in a toxic cycle with anxiety.3 As a result of the new world created by this ongoing pandemic, immense stress from anxiety over the disease have made it harder to sleep (insomnia), which has led experts to call this new condition Coronasomnia. At the onset of the viral outbreak, a study was conducted in China to see how sleep was being affected using several tests: the Insomnia Severity Index, Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and Acute Stress Disorder Scale. Experts found that insomnia had increased by 20%, supporting the view that COVID-19 has impacted sleep through anxiety.4 Dr. Donn Posner adds that the pandemic allows for a “perfect storm of sleep problems.”5 

While these studies show that this new era with COVID-19 has made sleep issues rampant, sleep as a whole is an extremely fragile state that can be affected by many factors. Before listing off such factors, it is important to understand the science behind sleep. Composed of five stages, this complex activity works rigorously to maintain balance within our body and brain. These stages are divided into non-REM and REM (or Rapid Eye Movement) cycles, where dreaming occurs, and one cycle is about 90 minutes.6 Contrary to the saying that “sleep is for the weak,” it is one of the most productivity-fueled events of our lives. Such productivity slows as we age, which explains why infants need seventeen hours of sleep, young adults need eight, and so on. Professor Alice Gregory states that sleep changes throughout our lifetime, and that disturbances are also normal in different stages of our lives.7 And so, the major factors affecting sleep include stress, medications, substance abuse, and light exposure. When these factors get in the way of proper sleep, a range of issues can occur affecting memory, heart health, and cognitive function.8 Sleep deprivation as a whole has been a problem growing in the dark, with the first National Sleep Alert being issued in 1993, and in 2014, the CDC declared that insufficient sleep was becoming an epidemic.9 Another problem arising in recent years has been the so-called “blue light fatigue,” promoted by our modern age of technology, which has increased everyone’s computer screen time. Therefore, it would be premature to directly link current sleeping problems alone with COVID-19.

Sleep Stages Simplified | Courtesy of Wikimedia Commons

However, since the onset of COVID-19, researchers have worked strenuously to find out as much as possible about the virus, and in doing so, we know that fatigue plagues patients inflicted with the virus. The immune system and respiratory tract are known as the main points of attack by Coronavirus, and disruptions of the respiratory tract also disrupts sleep. Like the vicious cycle of anxiety and insomnia, breathing problems make sleeping difficult. Persistent breathing issues may cause long term breathing-related sleep disorders.10

Symptoms of Coronavirus | Courtesy of Wikimedia Commons

While COVID patients cycle with poor sleep, quarantine confinement has affected the mental health of the general population, also resulting in reports of poor sleep. Humans are social animals, so it is no surprise that isolation from society causes disruptions in mental stability. With lots of free time in isolation, and lacking normal social interactions, we are left alone with our thoughts—thoughts that can quickly become intrusive and spur anxiety as well as depressive episodes. Studies have shown that anxiety as well as sleep issues were present in high levels for those isolated just for 14 days.11 However, when able to socialize, these factors became significantly reduced. Along with these findings, prescriptions for anxiety and depression have spiked in recent months, revealing the heavy toll COVID-19 has taken on mental health, and in turn, on sleep.12 Those staying home and away from the outdoors as a whole are unfortunately messing with their internal clocks. As this occurs, our brains begin to confuse when the day ends and the night begins, which can explain daytime drowsiness and nighttime insomnia. Not only have the consequences of physical isolation impacted mental health, but they have also impacted biological deficiencies, compromising mentality and sleep. Stress initiates a part of the brain called the amygdala, a crucial piece that regulates our emotional responses, and is associated with insomnia.13 

Enough of the negatives. There’s always brightness to contrast the darkness, even in this situation. Several scholars support that COVID-19 has been improving sleep through its new rules for society: less morning hassle, flexible schedules, and the free time that people have long been wishing for. Dr. Ellemarije Altena and other experts discuss several positives coming from COVID-19 that actually benefit sleep, such as the opportunity to sleep in, exposure to daylight, and increased productivity. Being able to sleep in permits people to pay off their sleep debt, which balances out our circadian rhythms, or internal clock. As for exposure to natural light, this also helps our circadian rhythm differentiate between day and night, allowing for faster metabolism while sleeping. Virtual working and school gives us the ability to create our own schedules, increasing work satisfaction and productivity.14

However, our desire to fill in our free time is also confusing our bodies. That spike in productivity is our coping mechanism to keep busy. In our seeking mental health stability, we are causing what experts call hyperarousal. Hyperarousal initiates our fight or flight response as we encounter heavy stressors that affect our survival, like battling COVID-19, and it is correlated to insomnia.15 This extra energy we have is overworking our brains as we sleep, causing strange dreams to occur as we try making sense of our activities from earlier in the day. Additionally, while our stay-at-home lives have given us opportunities to improve sleep, alterations in lifestyles have done the opposite. We have all learned to be busy, and we have had our socialization to hard work balanced with other personal aspects of our lives. Therefore, this resocialization effect of staying at home and building our entire lives around that has possibly caused further exhaustion as well as changes in our circadian rhythms. Essentially, our bodies are very confused right now. As we stay at home, living sedentary lifestyles is becoming a norm. The lack of exercise is hindering oxygen to pump out energy, which causes states of fatigue. All these factors contribute to daytime drowsiness and feeling tired, despite having done nothing throughout the day but stare at a screen. So, even if someone sleeps for ten hours, they will still feel tired due to sedentary living, changes in schedule affecting the internal clock, stress, and many more factors being seen as a result of COVID-19.16

Insufficient sleep and its impact on the pathophysiology of the body | Courtesy of Healthcare Journal

While sleep probably isn’t the first concern when considering the pandemic, it has affected many, even those reading this. We are living through a transformative period, in which every aspect of our lives is being affected. It is imperative to be aware of the sleep issues being presented to us, as our health depends on it. Getting proper rest in these times gives us a better chance at living. COVID-19 has drastically decreased sleep quality through its attacks on mental health, immune and respiratory systems, and overall cornering the population into uncertainty. We will be wrestling with sleep for a while, and our dreams may only get stranger.

I would like to thank my parents for supporting me throughout this writing process, for lending their ear and radiating positivity. I’d also like to thank Dr. Heather Hill and Daniela Duran for engaging with my ideas and providing me with their own amazing experiences. Lastly, I’d like to thank Dr. Whitener for this opportunity to grow and explore my passion for writing. 

  1. “Coronasomnia: 9 Tips For Coronavirus-Related Insomnia,” March 19, 2020, Henry Ford Health System (blog), https://www.henryford.com/blog/2020/03/coronasomnia-9-tips-for-coronavirus-related-insomnia.
  2. Neil Stanley, “Is there an Upside to Lockdown?,” April 2020, Sleep Station (website), https://www.sleepstation.org.uk/articles/health/free-sleep-guide/.
  3. “Sleep and Sleep Disorders,” April 2020, Centers for Disease Control and Prevention (website), https://www.cdc.gov/sleep/index.html.
  4. Li-Yu Lin, et al., “The Immediate Impact of the 2019 Novel Coronavirus (COVID-19) Outbreak on Subjective Sleep Status,” Sleep Medicine (2020): https://doi.org/10.1016/j.sleep.2020.05.018.
  5. Clea Simon, “Insomnia in a Pandemic,” April 2020, The Harvard Gazette (website), https://news.harvard.edu/gazette/story/2020/04/sleep-problems-becoming-risk-factor-as-pandemic-continues/.
  6. Encyclopedia of the Life Course and Human Development, 2009, s.v. “Sleep Patterns and Behavior,” by Christina McCrae and Pamela Dubyak.
  7. Alice Gregory, Nodding Off: the Science of Sleep from Cradle to Grave (London ; New York: Bloomsbury Sigma, 2018), 135, 163.
  8. Renata L. Riha, Sleep: Your Questions Answered (London: DK, 2007), 84, 90.
  9. Vijay Kumar Chattu et al., “Insufficient Sleep Syndrome: Is it time to classify it as a major noncommunicable disease?,” Sleep Science 11, no. 2 (2018): 57.
  10. Vipin Malik et al., “Respiratory Physiology During Sleep,” Sleep Medicine Clinics 5, no. 2 (2012): 497.
  11. Han Xiao, et al., “Social Capital and Sleep Quality in Individuals Who Self-Isolated for 14 Days During the Coronavirus Disease 2019 (COVID-19) Outbreak in January 2020 in China,” International Medical Journal of Experimental and Clinical Research 26, no. e923921 (2020): 1, https://dx.doi.org/10.12659%2FMSM.923921.
  12. Sofia Pappa, et al., “Prevalence of Depression, Anxiety, and Insomnia Among Healthcare Workers during the COVID-19 Pandemic: A Systematic Review and Meta-analysis,” Brain, Behavior, and Immunity 88 (2020): 901, https://doi.org/10.1016/j.bbi.2020.05.026.
  13. Sleep Disorders Perspectives on Diseases and Disorders, 2011, s.v. “Poor Sleep has a Significant Impact on Health and Quality of Life,” by Sylvia Engdahl.
  14. Ellemarije Altena et al., “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,” Journal of Sleep Research 29, no. 4 (2020) https://doi.org/10.1111/jsr.13052.
  15. David A. Kalmbach, et al., “Hyperarousal and Sleep Reactivity in Insomnia: Current Insights,” Nature and Science of Sleep 10, (2018): 193, https://doi.org/10.2147/NSS.S138823.
  16. Charles M. Morin, et al., “Sleep and circadian rhythm in response to the COVID-19 pandemic,” Canadian Journal of Public Health 111, no. 5 (2020): 655, https://doi.org/10.17269/s41997-020-00382-7.

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Elizabeth Santos

Class of 2024, Psychology and Criminal Justice double major. Passionate about mental health advocacy, criminal justice reform, and social issues.

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Recent Comments

112 comments

  • Aaron Onofre

    A great article! The amount of sleep we get heavily affects our day to day lives, as well as the quality of that sleep. Sleep is often overlooked in our society now, promoting working nonstop and working long days so that you can “optimize” your workday. This article shows the importance of sleep especially in a time where the whole word has changed. You can deny but it is necessary that everyone has good sleep if they expect to achieve anything.

  • Jacqueline Galvan

    This article was enlightening to me because I had always had poor sleep during the lockdown and did not know why, and I was happy to find some of the answers. I was shocked to find how much anxiety has an effect on our sleep, as this was something I unknowingly developed around that time, as well as the blue light fatigue from spending so much time inside and online.

  • Estefania Walther

    This article was not only informative but very relatable as well. I greatly believe that many people during COVID suffered quite a bit not only because of the virus and the unfortunate consequences, but just the actual stress of not being able to leave your home and see your loved ones, affected us even more than we would’ve every imagined. COVID really did mess up my sleep schedule because that was the only thing I would really do during that time and it also was mostly during the day and I would be awake at night. I like how this article highlights the importance of mental health and how it is an epidemic in our generation and COVID not only rose these cases but also helped bring more awareness to mental health and anxiety and the physical symptoms that manifest due to it.

  • Sudura Zakir

    Awesome article context. I really enjoyed reading it. This is mainly reflecting the consequences of how people suffered in the pandemic and having sleeping issues and how their brains got affected. Mostly isolation and loneliness made people indifferent a lot. They even got mental break down and sickness for staying like that. Sleep disruption is kind of an issue too which leads to anxiety, depression, poor motivation, and attention. Great research work!!!

  • Olivia Flores

    This was an astonishing article that highlights many great points about what humans are going through with the pandemic. It was eye opening as I feel honestly re assured after reading this. Personally I have had Covid 4 times since 2020 and each time was anew experience in itself. The sleep anxiety was very real as you know when you are sick that sleep is the most important thing yet I could not find myself able to. Riddled with anxiety and fear it was hard to get that rest, and even when I did sleep it felt as though it wasn’t for long. I thoroughly enjoyed this article as it was informative yet relatable.

  • Xavier Bohorquez

    This article was very interesting especially since it correlates with the pandemic and highlights the effects it has on certain communities. I really enjoyed how you provide a newer side about how Covid-19 and its effects on the sleep cycle and what’s associated with it. I also enjoyed how there were two ideas in this article, from Dr. Cheng to Dr. Stanley, this was a well thought and planned article.

  • Karah Renfroe

    This was very interesting and timely article. I experienced sleep disruptions during the peak of the COVID-19 pandemic, particularly the period from when I was sent home from university in late March through the summer. The uncertainty, stress and lack of routine made out difficult to sleep in a way that was in alignment with natural REM and Non-Rem seep patterns. I like that the article discusses this implication on mental health. There was a general decline in mental health during 2020, and although it is difficult to attribute a single factor to this phenomena, sleep is definitely a likely contributor as the article discusses. I am interested in learning more about this topic and permeant effects that the virus and pandemic as a whole had on the global community.

  • Fernando Milian Leyva

    As the author of this article remarks, there is no doubt that the pandemic changed the world in so many ways. All of us, in one way or another, could experience that. But before reading this text, I never really considered how my own sleep has been affected by this period of lockdown. This article explains in a clear way many of the symptoms that not getting sufficient sleep can cause, some of which I recognized in myself. I want to point out that the combination of text and visual elements in this essay is remarkable, making the consumption of the information so much easier to digest. Congratulations to the writer on this excellent article and her award. It is so well deserved.

  • Aaron Astudillo

    Such an interesting read! I knew that the covid-19 pandemic had a psychological impact on humanity, but I never would have imagined that it would affect our sleep. Sleep cycles are important to maintaining our health, and the integration of psychological concepts allows for this paper to really excel. Thus, while the covid-10 pandemic did have a tremendous impact, research like this is able to help in discovering the functions of the body and brain.

  • Osondra Fournier-Colon

    This article is fascinating, tackling an activity we as people have neglected and understanding how covid affected it and how we get back on track. The article does a great job taking two ideas of how people react to sleep during the pandemic, and the graphic supports those ideas. The mentioning of mental health is great since the pandemic has left so many people dealing with broken health. I struggle majorly with my sleep schedule, so reading this has given me ideas to get a schedule that will benefit me and explore why sometimes it’s hard for me to sleep. Great article! Informative and helpful.

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