Exhausted nurse takes a nap while sitting on hospital floor.

COVID and Sleep: Better Slumber During the Pandemic May Help Protect Your Health

As the coronavirus pandemic continues to disrupt daily living, researchers are taking a closer look at one requirement for health that many people take for granted: sleep.  And they’ve concluded, perhaps not surprisingly, that improving our sleep schedule and quality is an important part of coping with these stressful times and defending against COVID-19. “We’re all affected by the pandemic in different ways,” said Chandra L. Jackson, Ph.D., a research investigator with the National Institute of Environmental Health Sciences and an adjunct investigator with the National Institute of Minority Health and Health Disparities. “Many people are sleeping less or longer than they need to, which can make people feel groggy, unfocused, and even irritable throughout the day.  Some are sleeping at different times or getting a lower quality sleep than before the pandemic.” 

The pandemic has led to disruptions in our work, home, and family life that has subsequently impacted sleep, Jackson said during a recent NIH-hosted Facebook/Twitter live event.  Financial strain, illness, housing insecurity, and being an essential worker on the pandemic’s frontline, all induce anxiety that negatively affects sleep, she explained.  Even staying at home all day can affect sleep in some people, especially those managing a house with children who are normally at school.

Of course, poor sleep is hardly new for Americans, said Marishka Brown, Ph.D., program director for Sleep Disorders Medicine at the National Heart, Lung, and Blood Institute (NHLBI).  Before the pandemic, national data from the Centers for Disease Control indicated that a third of U.S. adults were not getting the minimum of 7 hours of sleep per night recommended by the American Academy of Sleep Medicine.

The pandemic has exacerbated sleeping difficulties, Brown said. Like many others, she personally experienced sleep problems during the early months of the pandemic.  “I wasn’t sleeping through the night,” she said.  Consuming anxiety-producing news, social media, and sunlight-depriving indoor isolation were probably to blame, she concluded. So, she started limiting media usage and getting more sunshine, as she knows consistently poor sleep spells bad news.

At the molecular level, studies show that poor sleep disrupts the immune system by interfering with disease-fighting factors, including certain proteins called cytokines. That means that if you are sleep deficient, you may have more trouble coping with the lifestyles imposed by the pandemic and fighting infections, such as the novel coronavirus that causes COVID-19.

“If you’re actually sick, resting your body seems to help you recover faster,” Jackson said. She points out that poor sleep has also been shown to make vaccines less effective by reducing the body’s ability to respond. Many studies throughout the years have linked poor sleep to an increased risk of heart disease, cancer, kidney disease, high blood pressure, diabetes, stroke, and obesity.  By contrast, getting enough good quality sleep at the right time of day improves energy levels, emotional wellness and mental health, and builds a stronger immune system.  

While poor sleep is common for many, minority groups are disproportionately burdened by it, Jackson noted.  For example, African Americans are less likely to get the recommended 7 hours or more per night. This group also suffers preventable higher rates of sleep apnea and other sleep problems.

“Preexisting sleep disparities are clearly relevant to the pandemic, as poorer sleep contributes to health disparities and immunocompromising outcomes like diabetes and cardiovascular disease,” Jackson said. “These are conditions that we know increase susceptibility to poor outcomes related to COVID-19.”

Even those fortunate enough to have survived a COVID infection can suffer its effects on sleep, in addition to its lingering effects on the lungs and heart. These survivors—including those who had only mild cases of the disease—reportedly experience insomnia and other sleep problems that they did not have before their illness, Brown said. These findings also underscore the importance of prioritizing sleep, she noted.

Michael Twery, Ph.D., director of the NHLBI’s National Center on Sleep Disorders Research, agrees.  He acknowledges that while NIH researchers have long been studying the biological underpinnings of sleep and exploring ways to prevent and resolve sleep problems, they are only now beginning to study the effects of COVID-19 on sleep.

“Getting a good night’s sleep during the pandemic helps boost the immune system and should be an important part of your daily routine, along with healthy eating and staying physically active,” Twery said.

“Everyone has trouble sleeping from time to time,” he added, “but it’s important to work on optimizing you and your family’s sleep—especially now.”  

The following tips may help improve your sleep habits:

  • Make sleep a priority, just as you would for physical activity and healthy eating.
  • Try to go to bed and wake up at the same time every day, especially during the pandemic, when daily routines have been upended.
  • Practice a relaxing bedtime ritual such as meditating, taking a bath, listening to soothing music, or reading a book. But avoid tablets or computers that lack a blue-light filter, as using these items before bedtime can interfere with sleep.
  • Consider whether reducing caffeine, nicotine, and alcohol before bed are useful for you as they can interrupt sleep.
  • Spend some time outside every day (when possible), particularly getting early morning light. Stay physically active but continue to practice social distancing during the pandemic.
  • If you’re tired, take a nap but avoid long naps and avoid taking them later in the day because that can hinder your nighttime sleep.
  • If you’re in bed and can’t fall sleep, get up and do some relaxing activity until you feel sleepy. 
  • If you experience frequent sleep loss or excessive daytime sleepiness, consider discussing your symptoms with a physician.