Pandemic Insomnia: Five Tips to Get Your Sleep Back on Track

As the COVID-19 pandemic has moved into its second year, it is no surprise that many teens and adults are continuing to struggle with insomnia and other sleep problems. Increased stressors related to finances, employment, and grief are likely worsening anxiety and sleep issues. For many, remote work and virtual learning have drastically changed the ways we use different spaces in our home, including our bedrooms.

What is insomnia and how do you know if you have it? According to the DSM-5 [1], insomnia is described as having dissatisfaction with sleep quantity or quality (difficulty falling asleep, staying asleep, and/or early-morning awakenings with the inability to return to sleep). Other criteria include the following:

• The sleep disturbance causes distress or impairments in social, occupational, educational, academic, behavioral, or other important areas of functioning

• The sleep difficulty occurs at least 3 nights per week

• The sleep difficulty is present for at least 3 months

• The sleep difficulty occurs despite adequate opportunity for sleep

Many individuals will experience sleep problems periodically throughout their lifetime; however, some will go on to have sleep problems that last longer than 3-months and require specialized treatment (between 10 to 30 % of adults struggle with chronic insomnia) [2]. People often turn to sleep aids and other medications (over-the-counter or prescribed by their primary care provider) when they first start to have sleep problems. Medications can be helpful for some (not all) in the short-term; however, they can lead to a number of problems in the long-term [3]. The good news is there are several important changes you can make to improve your overall sleep quality whether you just started having sleep problems during the pandemic or have had them for a long period of time. Below are five tips to get your sleep back on track:

 1.     If I could only share one tip to help you improve your sleep, it would be to wake up at the same time each day (including weekends or on your days off). I know, I know— this can be very hard to do. My patients often tell me they like to sleep longer on the weekends or their days off to “catch up” on their sleep. Unfortunately, there is no such thing as “catching up” on your sleep. You can never get that sleep back, which is why working on improving your sleep overall can be so important. Set the alarm for the same time every day (I use the iPhone sleep function that allows you to set a daily alarm and also tracks when you go to sleep). If you have children, you might have a “natural alarm clock” that wakes you up at the same time each day whether you like it or not (one positive aspect of early-rising toddlers).

2.   Avoid doing work, watching TV, reading, or being on your phone while in bed. This is especially important as so many people are working or attending virtual school from home. Some people have converted parts of their bedroom as a home office, so it can be so tempting to lay in bed and do work or to be on your phone as you wind down for the day. We want to associate our beds with the two S’s: Sleep and Sex. Our beds should induce relaxation and bring on sleep. When we start to do other more stimulating activities, we no longer associate our beds with sleep and relaxation. This can be a major contributing factor to the development of insomnia and sleep issues.

3. Get out of bed if you cannot fall asleep after 15 minutes. This one seems counterintuitive, as we often think that we can force sleep to happen if we just stay in bed long enough. Building on the previous point, we do not want to associate our bed with tossing and turning. It is much more beneficial to get out of bed and do something non-alerting (sort mail, fold laundry, or another “boring” activity) until you start to notice you are getting drowsy. That is when you will want to return to your bed.

4.     The pandemic has led to an increase in alcohol use for many people. I have heard many patients say, “but alcohol helps me sleep!” This is partially true as alcohol can cause drowsiness to help you initially fall asleep; however, it also can cause more interruptions in sleep due to an increased need for urination and more awakenings when your body has processed the alcohol. If you choose to drink, limit the quantity and make sure it is several hours before bedtime to ensure that it does not interrupt your sleep.

5.     Stress! This is a huge contributor to poor sleep and insomnia. Unfortunately, our stressful thoughts wait to pop into our minds right as we lay down to go to sleep. For many that are busy during the day, bedtime is one of the few times that we can truly be alone with our thoughts. These thoughts can range from thinking about all the to-do’s for tomorrow to troublesome ruminations about the day (e.g., “Why did she say that to me? How am I going to fix that?”). If this is you, start by spending as little as 5-10 minutes (30-minutes on more stressful days) completing relaxation exercises (e.g., deep-breathing, meditation, or mindfulness activities) right before bedtime. We call this our “buffer zone” in Cognitive-Behavioral Therapy for Insomnia [3]. Other activities like taking a hot shower or bath, lighting scented candles, or using other calming aromas, can be helpful in preparing you for sleep. If you are a parent, think about ALL of the steps needed to help our children fall asleep (bath time, reading a book, singing songs, rocking, etc). We do not just plop our babies in the crib and walk away. This is a good reminder that adults also need regular bedtime routines, just like children.

For some, once the stressful event that caused the sleep problem is gone (i.e., divorce, job loss, health problem, etc), their sleep returns to normal. However, other individuals continue to have trouble falling and staying asleep long after the stressful event has ended. If this is you, Cognitive-Behavioral Therapy for Insomnia can be an effective first-line treatment and typically only requires 4-6 therapy sessions. It has been found to be an effective treatment in the short-term, and more effective than sleep medication in the long-term [4].

We all know what a positive effect sleep satisfaction can have on our quality of life. Improving sleep has been shown to reduce emotional vulnerability and limit the emergence of other psychological problems, like anxiety and depression [3,4]. I am passionate about helping others improve their quality of sleep. If you or your loved one are interested in giving CBT-Insomnia a try, schedule a free phone consultation today.

 1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.

2. Bhaskar, S., Hemavathy, D., & Prasad, S. (2016). Prevalence of chronic insomnia in adult patients and its correlation with medical comorbidities. Journal of family medicine and primary care, 5(4), 780–784. https://doi.org/10.4103/2249-4863.201153

3. Manber, R., Friedman, L., Siebern, A.T., Carney, C., Edinger, J., Epstein, D., Haynes, P., Pigeon, W., & Karlin, B. E., (2014). Cognitive Behavioral Therapy for insomnia in Veterans: Therapist manual. Washington, DC: U.S. Department of Veterans Affairs.

4. Mitchell, M. D., Gehrman, P., Perlis, M., & Umscheid, C. A. (2012). Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review. BMC family practice, 13, 40.

**This blog is not intended as medical advice or provision of a diagnosis, and should in no way replace consultation with a medical or mental health professional. This is only my opinion, based on my background, training, and experience as a Licensed Psychologist.