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May 18, 2020

Ask the expert: Sleep and stress during a crisis

Stress — and how it affects sleep cycles — is taking its toll during the COVID-19 health pandemic. Not everyone has the early morning wake-up calls to get to the office on time but regardless of schedules, people are sleeping less and stressing more.

Kimberly Fenn, professor of psychology at Michigan State University, says that lighter sleep, unusual and vivid dreams and insomnia symptoms are results of stress — and, unsurprisingly, what many people are experiencing. Beyond feeling fatigued, a lack of sleep can hinder the immune system — which no one can afford in a health crisis.

Fenn, also the director of MSU’s Sleep and Learning Lab, answers questions about sleep under stress and offers her tips to getting a better night’s rest.

How does stress affect sleep?
Stress can have profound effects on sleep. Notably, stress can exacerbate insomnia symptoms and disrupt an individual’s ability to fall asleep or maintain sleep throughout the night. There is also evidence that stress impacts the quality of sleep, making it more likely to spend time in lighter stages of sleep. Finally, stress has a severe impact on cardiovascular function both during waking and sleep. Individuals who are experiencing high levels of stress tend to have a higher heart rate during waking and sleep and a lower heart rate variability during sleep.

How might social distancing and the state of the world cause unusual dreams for people?
Social distancing, per se, is likely not affecting dreams. However, this is a period of time in which many — or perhaps, most — people are experiencing high levels of stress.

One consequence of extreme stress is that during sleep, individuals are more likely to stay in lighter stages and more likely to wake up in the middle of the night. Vivid or unusual dreams are most likely to occur during rapid eye movement sleep. Although people have vivid dreams in this sleep stage on a normal night, they may be having more of these dreams right now and may simply be more likely to wake up in the middle of a dream and therefore more likely to remember it.

Why is sleep important during a pandemic?
Sleep is important during a pandemic primarily because it is critical to overall health. Most importantly, sleep deprivation can directly impair health and immune function. That is, when individuals are not obtaining sufficient nightly sleep, their ability to fight off a viral infection is reduced. This means that if individuals are exposed to COVID-19, their bodies may be less able to fight against it if they are sleep deprived. In some cases sleep deprivation does affect the severity of the virus.”

There are reports of people having more vivid, odd dreams during the pandemic. What are dreams, and what does it mean to process emotions and thoughts through your dreams?
Dreams are a unique state of consciousness in which individuals experience vivid perceptual images, emotions and other sensory content. Dreams that occur during REM sleep tend to be highly emotional and often bizarre. The reason that they are emotional is due to neural function during REM dreams. There is an area of the brain called the amygdala that in the waking state, responds to emotional stimuli (particularly fearful stimuli). The amygdala is highly active during REM dreams which can explain the emotional content of the dreams.

Vivid dreams are likely not the sole cause of unrestorative sleep right now. It is highly likely that extreme stress is causing sleep to be less fulfilling right now.

What might some remedies be for getting a better night of sleep?
Unfortunately, there are no magical ways to improve sleep but there are some basic recommendations for optimal sleep hygiene that many people do not observe and that can improve the ability to fall asleep, maintain sleep and improve sleep.

First, it is important to recognize that the root cause of insufficient or unrestorative sleep is likely stress, anxiety or worry during this pandemic. Targeting this anxiety will likely have strong downstream benefits to sleep. I would first recommend that individuals engage in activities that reduce this stress. Exercise can be extraordinarily beneficial in reducing stress and improving sleep. Starting or continuing a meditation practice can also help calm the mind, reduce rumination and help initiate sleep.

In addition, there are several recommendations we have for obtaining optimal sleep at all times:

1. Cool. Temperature has a profound effect on sleep. Ambient temperature should be no more than 67 degrees during the night. Temperatures between 60 to 67 degrees are optimal.

2. Comfortable. Remember to pay attention to your sleeping environment. This means everything from your mattress and pillow to your sheets to the clothes you wear during the night. At the extreme level, if your mattress or pillow puts stress on your body or even causes pain, this will lead to more nightly arousals and less restorative sleep.

3. Quiet. We sleep better in quiet environments and environmental noise can obstruct sleep. Often, we cannot control the noise in our environment. For example, individuals who live in large cities may be subject to daily environmental noise. However, we can work with our environment. If your environment is noisy, you may want to try ear plugs. I would also recommend using a white noise machine that will mask some of the noise and help to maintain sleep.

4. Dark. Light is the primary cue to your body that it is time to be waking so you want to minimize the amount of light in your sleeping environment. If your environment has a lot of light due to factors that you cannot control, you might want to consider a sleep mask.

5. Prepare your body for sleep. This is a broad category, but we engage in a lot of behaviors that disrupt our sleep.
a. Avoid drugs or alcohol for at least four to six hours before sleep
b. Stay off devices for an hour before sleep (30 minutes at the bare minimum). All light can suppress melatonin, which is your body’s signal that it is time for sleep but devices such as phones or tablets emit blue light which suppress melatonin even more than regular light
c. Avoid work or any stress-inducing activities for at least two hours before bed.

6. Maintain a consistent sleep schedule. Your sleep will be optimized if you go to bed and wake up at the same time each night. In times like this when individuals do not have strict schedules, it may be easy to stay up very late one night and then go to sleep earlier the next. One way to keep a consistent schedule is to set an alarm for sleep as well as for wake.

By: Caroline Brooks

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