Eyes wide shut?

Experts are calling it the "perfect storm of sleep problems". With circadian rhythms disrupted, we explores if sleep is the latest casualty of the pandemic

A good night’s sleep is the holy grail of health, a much-needed reset button that helps you take on a new day all over again. And yet, it can be so elusive. More so now, when we are in the middle of a global pandemic that has turned lives upside down in unimaginable ways.

Noted theatre personality Atul Kumar of The Company Theatre fame likens his messed up sleep cycle during the lockdown to being in “a constant jet-lag mode.”

There have been times when he hasn’t slept for a straight 36 to 48 hours, the Mumbai-based actor says. He isn’t the only one. Explains Joyce L, once Bangalorean and now a longtime resident of Atlanta, USA, “I toss and turn, pretty much worrying about everything.” She has been sleeping around 1.30 am only to wake up by 6.00 am. For her, the worry is not so much about “contracting coronavirus, but more about the test itself and our finances.”

It was anecdotes such as these that led Dr Sukriti Banthiya and a group of doctors to start an anonymous online survey on sleep patterns during the pandemic.

“I wondered if there could be a sleep crisis looming amidst this pandemic,” she notes. Sukriti, who recently completed her MBBS in Bangalore, says the survey has seen over 800 responses and expects to release results soon.

Senior Consultant in Sleep Medicine Dr N Ramakrishnan attributes the disruption in sleep patterns to “reduced activity, changes in work pattern (work from home), reduced exposure to sunlight as well as fear and anxiety relating to the disease and uncertainty about the future.” The expert, who is also the Director of Nithra Institute of Sleep Sciences, Chennai, has noticed an increase in the number of people without prior sleep problems who have developed insomnia or change in their sleep patterns. He also noticed that those with prior sleep problems have seen a worsening of symptoms.

Surrendering to binge-watching

What are those who can’t sleep doing then? Counting sheep? Nah, there’s online streaming for that! Netflix CEO Reed Hastings once famously remarked that the streaming company’s biggest rival was sleep.

He and indeed other OTT (Over-The-Top) streaming companies needn’t worry, because people seem to be binge-watching like never before during this pandemic.

Bangalorean Niju Vinay says that amidst the anxiety, uncertainty over finances and skewed routines, she has found it really hard to kick the habit of binge-watching.

“Over the past few days, I’ve been sleeping for only three or four hours,” Niju observes. Prafulla Gandhi, a freelance counsellor based out of Bangalore, says: “The lockdown and the uncertainty that followed initially meant late night bingeing on movies and shows. There was really no motivation to maintain a routine.”

Rise of the owls

Sleep solutions company Wakefit.co conducted a pan-India survey of over 1,500 respondents and found that 50 per cent of those who were working from home felt they were “sleepier during work hours.” The study showed a 40 per cent rise in late-night sleepers since the lockdown.

Explains Chaitanya Ramalingegowda, Co-founder and Director, Wakefit.co, “the constant exposure to blue-screen devices for work as well as entertainment is a major cause for disrupted lifestyle routines.”

Global studies have shown how exposure to constant screen time can negatively impact our circadian rhythm.

“Unfortunately, the current upturned lifestyle has opened up endless avenues for people to consume digital content on various screens,” he adds.

A major consequence of this increase in consumption of content on smart devices has been the uptick in sleep tech, including sleep tracking apps and innovative smart mattresses.

So, why this sudden focus on sleep, we ask Chaitanya Ramalingegowda. “The trend towards practicing and living a healthy lifestyle gained popularity the last decade or so, but until recently, sleep was a much ignored part of wellness,” he explains and adds, “celebrities like Ariana Huffington (author and founder of The Huffington Post), LeBron James (basketball great) and Roger Federer (tennis icon) have been instrumental in heralding a sleep revolution across the world and have led by example with a lifestyle that places great importance on regular and quality sleep.”

Thanks to advanced technology, brands are encouraging people to take actionable steps, he says, and adds that a “revolutionary change in behavioural patterns towards better sleep routines is yet to gain mass popularity.”

Is everyone losing sleep?

“There are also people who sleep better now than before the pandemic. Working from home allows them to maintain a more balanced life and hence less stress and better sleep. For example, they may be taking more breaks and having more interactions with the people they live with,” explains Sukriti, who is surveying sleep patterns online, along with a group of doctors in India.

Sleep solutions start-up Wakefit was in the news last year when it offered interns Rs 1 lakh as a stipend to sleep for nine hours every night, over 100 nights.

How is the sleep internship going during the pandemic and are interns getting enough sleep, we ask Chaitanya.

He explains that while some report disruption in sleep cycles, all of them say that their sleep quality has not been compromised because of the lockdown and the anxiety around Covid-19. The interns have been interacting with sleep experts and taking up ‘yoga nidra’ (yogic sleep) sessions to improve the quality of sleep and their lives, he adds.

At a time when the robustness of your immune system seems to hold the key to battling the virus, it helps to remember that lack of sleep can impair your immunity. Research shows that sleep helps your T cells stave off infections.

As ‘Why We Sleep’ author Mathew Walker puts it, “when it comes to sleep, there is no such thing as
burning the candle at both ends — or even at one end — and getting away with it.”

I have a dream

Theatre person Atul Kumar shared this dream on his Facebook wall:
I am, once again, in a spotlight at Prithvi Theatre, alone on stage, with my back to the empty auditorium. I am old, very old. A large video image on the cyclorama. A man, even older than me, about (to be) dying, is directing me from the audience...I am pulling my hair out and screaming these lines:

“...I will not trouble thee, my child; farewell.
We’ll no more meet, no more see one another.
But yet, thou art my flesh, my blood, my daughter — or rather a disease that’s in my flesh, which I must needs call mine.
Thou art a boil, a plague-sore or embossed carbuncle in my corrupted blood.
But I’ll not chide thee.
Let shame come when it will.
I do not call it…”

He is not alone. Just browse through idreamofcovid,com and you will see dreams of people from across the world. On Twitter, a coronavirus dreams bot with the handle @CovidDreams regularly retweets people’s vivid dreams related to the pandemic. Coronavirus dreams seem to be taking over the Internet just as collective fear and angst seems to have taken over our lives, while we navigate our way through the pandemic.

A pandemic dreamcatcher anyone?

Dream specialist and Harvard psychologist Deirdre Barrett is known for her extensive work on dreams. She is the author of works such as ‘The Committee of Sleep’ and ‘Trauma and Dreams’.

Deirdre, who collected people’s vivid dreams post 9/11, is now conducting an online survey of dreams during the pandemic. (https://www.surveymonkey.com/r/B8S75CN )

She has collected over 8,000 dreams so far from across the globe, including India.

Are there specific patterns to the dreams, we ask her in an email interview. Deirdre says, while some people have explicit dreams of the virus, others report more metaphoric ones, bug dreams being the most common metaphor so far.

Deirdre cites a particular bug-invasion dream in which a person is taken to a remote part of the woods where there are mounds of snow on the ground. There are bunkers and many young people come out with the dreamer to form a relay line and pass on supplies down the line.

The dreamer experiences a pain in the shoulder and sees a huge grasshopper-like insect that has chewed through their sweater and is gouging flesh.

The other category of dreams involve people dreaming about things going wrong with their masks.

“Any big life change tends to stir up one’s dream life and result in more vivid depictions. The shelter-at-home situation is a big life change. Also, one of the biggest variables in number of dreams, vividness of dreams, length of recalled dreams, etc., is the hours of sleep. Many who are sleep deprived due to working long hours and/or an intense social life may be catching up on sleep about now. We go into REM (Rapid Eye Movement) every 90 minutes, but each REM period lasts longer than the one before it. If you sleep four hours instead of eight, you aren’t getting half your sleep time, you are getting a quarter of it. Likewise, when you do catch-up sleeping, you are especially catching up on dreaming and have some of the longest REM periods ever,” she explains.

Sleep hygiene tips

Schedule work and sleep time. This is particularly important during the lockdown.

Earmark work space in the house and take only specific breaks (lunch, tea) and do not nap in between or shift your attention (such as watching TV/video) during work hours.

Get regular exercise such as yoga. If possible, walk in the terrace or just inside your residential complex/community (wearing a face mask and complying with social distancing norms).

Get some exposure to sunlight; sit in a balcony or walk in the terrace. Dim lights after about 9 pm and avoid exposure to bright light emanating from screens close to bedtime.

Eat healthy and on time. In particular, eat a light dinner 1.5 to 2 hours before bedtime.

Avoid coffee, tea or any caffeinated drinks after 5 pm.

(Inputs from Dr N Ramakrishnan)