Shut-eye hunting

The pandemic might be on the wane but its many repercussions are still going strong. Perhaps the biggest blow has been dealt to sleep (or the lack of it). Our collective sleep deprivation is a big cause for concern.

For Reshma K Ranjith*, a freelance content writer from Bengaluru, staying awake till 4 am, despite lying in bed for hours, is the new normal. She’s got health checkups done and seems to have no health problems.

What worries her often are the fears of a possible third wave and how her career will pan out. A consultation with a somnologist recently revealed more.

After A Sudhakar*, businessman, found out that his stock of leather goods got spoilt in his retail shop, which was closed due to lockdowns, he has been worried. Sleepless nights led to drowsy, irritated mornings and non-productive days.

Two months after, he visited a sleep therapist and was told that he was suffering from Covid-related stress, leading to Covid or Corona insomnia, popularly known as Coronasomnia.

Many of us are like Reshma and Sudhakar.

In year two of the pandemic, wellness and health scholars have observed the extent of damage it has caused to people’s sleep patterns. If not treated, this could lead to serious ramifications like increased high blood pressure, depression, and other related problems, they say. Given that insufficient sleep has an adverse effect on health as well as productivity, it evidently also has long-term economic consequences; which, simply put, is a dent in working hours, hike in health budgets and spike in mortality risks.

Wellness coach Gitanjali Padhi observed that not sleeping enough or at all was becoming common among her clients. “Those who used to sleep peacefully for eight to nine hours, many of them are not able to sleep even for a few hours now. Surprisingly, these are people who were neither affected directly nor were their families infected with Covid-19,” she reveals.

In a video on WhatsApp and other social media, she addressed the reasons and how to combat ‘Coronasomnia’.

Children (aged between three and 15) form a majority of the sleep-deprived section, she says. “Their studies happen over laptops and their recreation and other activities are also often on the same device. The impact of overexposure to blue light and lack of exercise has aggravated the situation,” she adds.

During the pandemic, everyone has become undisciplined. “Mothers who used to wake up, finish chores and complete cooking breakfast by 7 am, now wake up around that time,” she says.

Increased irritability, craving for junk food and weight irregularity, become end results of lost sleep.

Gitanjali recalls speaking to elderly people about World War II. “Many spoke about how they lived in dark rooms and faced scarcity of food, but still lived life with hope. People now are also panicking because of excess information,” she says.

IT and other desktop professionals, who used to spend a few hours travelling to office, now spend that extra time at home. “Since people are more worried about their jobs now, they put in as many extra work hours as possible,” she adds.

Disturbance in time anchors

Dr Chethan B, assistant professor, department of psychiatry, National Institute of Mental Health and Neurosciences, agrees that disturbance of time anchors has led to sleep loss. “There is a disruption in our schedules and many of us have shifted from the 9 am to 5 pm routine. Work from home has led to lesser exposure to natural light too, which affects sleep cycles,” he adds.

He observes that insomnia has increased significantly in recent times. “It is more frequently prevalent in persons with mental illness and neurological disorders. Almost 40 per cent of such individuals have some sleep issues. This percentage has increased as well,” he says.

Now, almost 75 per cent of the specified population is affected. “Many of our patients with anxiety disorders, who had handled their insomnia with counselling, are now complaining of disturbed sleep.”

Anxiety connected to health-related fears like being infected, getting hospital beds or death is one of the primary reasons for sleeplessness. “In early 2020, these concerns were more, as the public and even doctors were not aware about Covid-19. Increased awareness has helped us handle the situation better now,” says Dr Chethan.

In 2020, Nimhans set up a telehelp service, which received 1.5 lakh calls, where a majority of them complained about sleep disturbances. While anxiety continues in 2021, sleep and appetite issues are not as much in the forefront now, he adds. “Increased awareness about Covid-19 treatments has helped,” he adds.

From children to the elderly, everyone was affected. “However, female healthcare professionals were more affected; the possible two-fold increase in responsibilities being the reason.”

Anxiety levels are different in different segments. “Those who are admitted have significant guilt and anxiety connected to their situation. They worry about preparing a will, about who will care for their family, etc. Some medications used in Covid-19 treatment can also deprive one of sleep,” adds Dr Chethan.

Those infected and quarantined at home worry about their families getting infected and if they are getting adequate treatment, which can keep them awake. “The third segment, general public, often worries about the financial implications of the pandemic and the persisting uncertainty,” he adds.

A sleep-deprived generation

C A Mathew, clinical head of a sleep lab in Bengaluru, says that this is a sleep-deprived generation.

“Anxiety and worry about the future and economic concerns, feelings of isolation and depression, cancelled trips and plans, isolation from family and friends, an abundance of time spent at home, can all lead to coronasomnia. Excess screentime, especially towards late evening, can have a detrimental impact on sleep. Checking for news updates at regular intervals is another trigger,” he adds.

“Last year’s lockdown was a welcome break for many to catch up on their sleep. But as time passed, the lockdowns got extended and things changed. Inactivity as well as altered work patterns led to changes in sleep,” he says.

With increased calls about sleep issues, coronasomnia has been observed in 25 to 30 per cent of the population. “These numbers could go up with time. Education and counselling are needed to reduce these numbers,” adds Mathew.

However, stress-related insomnia has been observed earlier too. “Covid-19 is an unprecedented era. Spanish flu was said to have had similar issues. Natural disasters like tsunamis, floods or even manmade ones like terrorism or wars can also contribute to insomnia,” says Dr Chethan.

Being social beings, the pandemic has kept us away from extended family members, friends, coworkers, etc.

“Children are not able to play with friends, older and retired people cannot socialise, home makers are not able to meet neighbours or attend and organise big social functions. Health workers have been tirelessly working to tackle the pandemic. With increased stress and anxiety, there has been a definite impact on sleep and mental health. The working-age groups of 40 plus and the elderly seem to be more affected,” he adds.

Information overload

Insomnia — often differentiated as acute and chronic — is a concern. Any sleep disorder that affects one for more than six weeks needs treatment, says Dr Hirennappa Udnur, consultant pulmonologist and sleep specialist at a leading hospital in Bengaluru.

“The pandemic has been stressful, with misinformation and too much information available all across media. Often in those who have seen death closely or were infected, psychosomatic symptoms like suicidal tendencies or feelings of hatred or frustration can occur,” he observes.

For those who were infected, during quarantine, their appetite and sleep will be minimal. “Even after they turn Covid-negative, when back home, excessive worry keeps them up and their circadian rhythm is often disturbed. Memories of having seen bodies being moved out, during admission, can be distressing,” he says.

Covid-triggered sleep disorders need counselling. “Sensationalising of news is a big trigger and can cause paranoia. As a medical professional, after seeing positive cases drop at the hospital, I feel relaxed and head home. As soon as I switch on the TV, there are screaming headlines saying ‘Delta variant is here’, which can depress anyone,” he adds.

Will this affect us in the long run? “Time is the biggest healer. Our ways of dealing with the pandemic will change and so will the paranoia around it. Those who are oversensitive and are Type-A personalities get affected more,” Dr Hirennappa Udnur adds.

Those who have lost zeal in life or were affected deeply by the pandemic, will need counselling and psychiatric help.

A sedentary lifestyle, not going outside, not being tired enough, binge-watching, consuming coffee at night, can all affect sleep and it is ultimately up to us to maintain sleep hygiene.

(*Names changed on request)

Dealing with Coronasomnia

* First rule out: Check for any pathological reasons like sleep apnea. Do specific sleep studies to rule out any health issues.

* Fix a routine: Wake up at the same time, complete your chores, chalk out work meetings etc., and continue everything like you would, when you used to step out. Even if you're tired, motivate yourself to wake up on time. It will help get your circadian rhythm back on track. Shower and get dressed, even if you aren’t leaving the house. Eat meals at the same time each day.

* Regulate naps: Being home all day can tempt one to quick and more naps. Avoid this and stick to your schedule.

* Get your sunlight: Get your daily dose of sunlight. Exposure to sun’s rays will have a positive effect on one’s circadian rhythm. Keeping windows open for natural light to come in is a good method.

* Wind down: Just before going to bed, take 45 minutes to an hour to settle down. Read a book or listen to meditative music. You could also try doing crossword puzzles. Avoid reading newspapers, especially death news and Covid updates at night.

* Avoid gadgets: Don't mindlessly scroll on your phone or watch shows on the laptop. The blue light from these gadgets will keep you awake. If you have to use them at night, make sure to switch to nighttime functions/mode.

* Keep it cozy: Make sure your bedroom is perfectly dark, when lights are off. Maintain a good room temperature or have enough ventilation/blankets, according to how warm or cold it is.

* Exercise: This is a must. Make sure to work out or do yoga, for 45 minutes to an hour. Brisk walking for 30 minutes is good too. Excessive activity right before bedtime can adversely affect sleep, so time it well.

* Avoid these foods: Limit intake of alcohol and caffeine, as both can disrupt the quantity and quality of your sleep. A healthy diet can promote good sleep.

* Say no to the midnight binge: If you wake up in the middle of the night, do not start watching videos on the phone. Repeat wind-down measures — try reading a book. After setting the alarm to wake up, turn the clock around, so that you don't stay in bed looking at the time passing by.

* Make space: Assign a space in your home for your office work. Have breaks in between and complete tasks at given times, just as you would at work.

* Seek help: Counselling can help one gain positivity and gives one a platform to raise their concerns. Scientific facts from professionals also help settle anxiety and correct sleep patterns.

If there is a severity or worsening of sleep or other health problems, it is best to reach out to your doctor. If not a physical consultation, seek a teleconsultation.

Apps for better sleep

* Headspace: This app promises to teach you to breathe, meditate and live mindfully. It includes classic meditation and relaxation techniques. Its collection of soundtracks are said to be sleep inducing.

* The Mindfulness App: With over 300 guided meditations and courses from experts across the world in more than 10 languages, the app has every reason to leave you relaxed. There are also different background sounds such as forest, rain, waves and more for that soothing sleep.

* Calm: Guided meditation sessions — from three to 25 minutes — are available here to fit your schedule. The topics include calming anxiety and deep sleep, among others. It also features adult bedtime stories and soothing nature sounds and scenes to help you sleep.

* Serenity: This app will help you fine-tune your skills and learn about mindfulness, self-awareness and goals. Sleep better using relaxation techniques, peaceful music and tranquil sounds available here. Quick and short meditation sessions and daily meditations are an add-on.

Counting sheep

* In a 2019 global sleep survey of over 11,000 adults from 12 countries, around 62 per cent of respondents said they don't sleep well when they go to bed.

* The size of the global 'sleep assistance' market in 2019? Around 78.7 billion dollars. Certainly something to lose sleep over!

* A MetroNap Energy Pod (designed for power naps at workstations) costs a cool wallet-emptying $12,985.

* NASA found that a 40-minute nap improved performance by 34 per cent in military pilots and astronauts — and improved alertness by a full 100 per cent.

Snooze with a twist

There are several well-known anecdotes about famous personalities and their unusual sleep habits. Here are a few:

* Leonardo da Vinci apparently slept for 15 minutes every four hours.

* Thomas Edison believed sleeping was a waste of time and slept for four hours or so.

* So did Salvador Dali. According to the Smithsonian Magazine, he would sit with a key in one hand, poised above a metal plate on the floor and nod off. As soon as he would go into deep sleep, the key would slip from his fingers onto the metal plate — the resulting clang would wake him up. (Err... do not try this at home).