Elizabeth Renzetti is a Globe and Mail columnist. Her latest book is Shrewed: A Wry and Closely Observed Look at the Lives of Women and Girls.
I have fond memories of being a good sleeper. A champion sleeper. A person who slept through fire alarms and babies screaming, on buses and airplanes. I was the jerk who asked for after-dinner espresso. Once, during a very boring documentary at the Toronto International Film Festival, I fell asleep on a stranger’s shoulder and may even have left a tiny bit of drool behind. I used to joke that I had trouble staying awake, not falling asleep.
Well, the joke’s on me. What a very funny pandemic joke it is, too. For eight years – sorry, I mean eight months – I’ve joined the glassy-eyed company of the country’s insomniacs. It’s either impossible to fall asleep, or when sleep does come I’m jerked awake in the dead of night, the time that Ingmar Bergman called the hour of the wolf, “the hour when the sleepless are haunted by their worst anguish, when ghosts and demons are most powerful.”
If it’s any consolation, there are a lot of us staring panic-stricken into the darkness right now, conjuring ghosts and demons. In a normal year, according to experts, one-quarter of the population might experience temporary insomnia, with between 10 per cent and 15 per cent experiencing chronic insomnia (defined as difficulty getting to sleep or maintaining sleep, at least three nights a week, for at least three months).
But this, as you may have noticed, is no normal year. The pandemic crisis is playing havoc with our sleep, and our dreams – not everyone’s sleep, but enough that researchers are worried that a temporary crisis could turn into a chronic one, if pandemic coping habits persist once the danger is past (yes, I’m looking at you, seductive glass of scotch).
When sleep researcher Rébecca Robillard sat down to analyze the results of a COVID-19 study she had led, she expected to find an increased level of sleep disturbance. But what she found stunned her and the study’s other researchers. More than half of the 5,525 Canadians responding to their online survey, conducted between April 3 and June 24 of this year, reported trouble sleeping.
“I kept rechecking the numbers because that was really high. We were really surprised,” Dr. Robillard, director of clinical sleep research at the Royal Ottawa Institute of Mental Health Research, said in an interview. “We were kind of expecting sleep to be affected because we’re facing an unusual challenge with a lot of consequences for different people. Sleep is a bit of barometer of how people are feeling and how they’re coping with new situations. But one out of two? I certainly did not expect that.”
Some of the factors tied to an emergence of sleep disturbance included being female, having family responsibilities, having a chronic or mental illness, and reliance on alcohol. About 36 per cent of people in the study, published this month in the Journal of Sleep Research, reported having sleep troubles prior to the pandemic. But as Dr. Robillard noted, “even then, 36 to 50 per cent, that’s a big increase.”
Interestingly, Dr. Robillard’s study echoes other research showing that for some people, sleep is actually improving during the pandemic (more on that in a bit). But those who are suffering are really suffering. That’s because of the bidirectional nature of sleep disturbance, or what Dr. Robillard calls “the vicious cycle that builds up with time.” After a sleepless night, you may feel stressed, anxious or unhappy during the day – states of mind that prevent the next night’s deep and inky sleep.
As humans, we’re pretty good at compensating for short-term sleeplessness: Our bodies metabolic and adrenal systems rise to the job of keeping us awake during disasters and emergencies. The effects of long-term untreated insomnia can be devastating, though: It is associated with major depressive disorder, heart disease and type 2 diabetes.
This is why sleep researchers are so keen to educate people about the particular ways that the pandemic is trashing their shut-eye, and the steps we should take now to head off bad habits before they become irreversible. Disasters such as wildfires are known to increase rates of insomnia in the communities that are affected, but the coronavirus is a uniquely designed sleep-stealer. By its very nature, it creates stress and anxiety. By imposing physical restrictions, it keeps people from the daylight and physical activity that help promote deep sleep. We are hooked on the late-night updates delivered by our phones, which is the equivalent of singing our brain a Sex Pistols song when we should be singing it a lullaby. Working from home messes with the daily schedules that help regulate sleep. Finally, there are booze and drugs, which may seem like our friends at bedtime but are the enemies of the deep sleep our bodies and minds need in order to repair.
“I don’t know about you, but I work from home and I have a great deal more freedom in organizing my time,” says Charles Morin, Canada Research Chair in Sleeping Disorders and professor of psychology at Laval University. “Typically, we’re quite regulated. With this COVID-19 and confinement we kind of lose our markers for going to bed or for eating. We know that daylight is very important for regulating sleep-wake schedules. So if you just stay indoors and you have dim light all day long, your sleep-wake schedule becomes very disrupted.”
Dr. Morin is leading a study of the effects of COVID-19 and confinement on sleep, in collaboration with researchers in 15 countries. That data isn’t available yet, but he has conducted other research that suggests the pandemic is having deleterious effects on people’s sleep and mental health. Dr. Morin went back to a sleep study of 4,000 people that had wrapped in 2018 to ask some of the subjects how they were sleeping now. “I guess as you might expect a lot of people who didn’t have sleep problems before developed sleep disturbances during the pandemic … and of those that had sleep problems in 2018, more than 80 per cent had persistent sleep problems now.”
It’s not just disordered sleep. It’s also that our dreams have become deeply weird. A team of Finnish researchers discovered that virus content, including accidental hugging and failure to social distance, was infecting the nightmares of its study subjects. “The research is telling us that what we dream about at night is not independent from our daytime experience,” Dr. Morin says. “It’s been shown many times in research that people going through a tough life situation are more likely to have very negative dreams.”
Ask your friends about their weird dreams on your next Zoom call. You’re bound to get an earful. When I asked, I heard about people dreaming in Martin Scorsese level detail about trying to escape large crowds of unmasked strangers, or being chased through desolate airports. One novelist, who rarely remembered her dreams before COVID-19, was thrilled with brilliantly vivid new dreams, which felt like a gift from her imagination.
At least her dream-fridges hadn’t turned on her, which was the unfortunate fate of British writer Marina Benjamin one recent night: “Yes, the fridge went rogue and it started spewing out ice cubes in the strangest shapes, and then it kind of grew arms and became more humanoid and chased me around the house,” she said, even managing to laugh about it. I had called Ms. Benjamin, author of the piercing memoir Insomnia, to ask about her experience of sleeplessness, and also to talk about Charlotte Beradt, a young journalist in Berlin in the 1930s who collected the anxiety dreams of her neighbours, a society facing rising fascism.
“She noticed and started collecting dreams from people who were kind of internalizing the fascist regime and were finding that they were having very paranoid dreams. They were reinterpreting events and making almost horror fictions of the totalitarian experience they were living through,” Ms. Benjamin says. Ms. Beradt recorded her neighbours’ nightmares in code and hid them from the authorities. She smuggled her dream notes out of Berlin and published a book, The Third Reich of Dreams, in exile in 1966. Could the COVID-19 world be experiencing a similar collective anxiety that’s filling the gaps in our broken sleep?
If so, perhaps the chaotic dreams are a way of grappling with collective trauma, an upside to a moment that seems almost entirely downside. There is another upside: Ms. Benjamin says she’s sleeping more soundly at the moment than she has in a long time (she credits writing about insomnia with helping manage her anxiety around it). It turns out that she is not alone. There is a significant portion of people who benefit from the upheaval provided by COVID. First is the group that researchers colloquially call “owls,” who are genetically predisposed to staying up late and do not enjoy rising for work in the morning. And the other group is – well, have you seen a blue light coming from under your teenager’s door at 3 a.m.?
“With teens, I was thinking why would they get better?” asks Dr. Colleen Carney, director of the Sleep and Depression Laboratory at Ryerson University and co-author of the sleep-help book Goodnight Mind. “It’s because they don’t have to get up so early for school. In puberty there’s a shift towards nightness, a biological shift, and schools don’t accommodate that. They still want them to get up early.”
In fact, research done on schools that move back their start times shows what a profound effect it has on adolescent health, Dr. Carney says: “They had more sleep, more time in bed, later bed time and later waking time, better depression and anxiety, less insomnia and less need for a nap.” Research is showing some of these benefits accruing to teens in lockdown. Another upside: COVID-19 is providing a vast laboratory to study the teen in her bedroom, her natural habitat.
Not everybody has the luxury of staying up all night making a TikTok. What about those of us staring at the ceiling, worried about disease, bankruptcy, that weird sound in the basement? Well, the recommended line of treatment is cognitive behavioural therapy for insomnia, or CBTI. It is the therapy Dr. Carney practices at Ryerson, and which can be accessed virtually through a session with a practitioner, or through an app or a book.
The only problem with CBTI? “Not enough people know about it,” says Judith Davidson, author of the book Sink Into Sleep and a professor of psychology at Queen’s University in Kingston. Dr. Davidson provides CBTI therapy to patients and works with family doctors and medical students to educate them, in the hopes that it becomes a first-line therapy instead of medication (the use of which has risen during the pandemic).
CBTI can be taught in a few sessions, and involves sleep scheduling, stimulus control therapy and learning how to redirect panicky thoughts about insomnia (“I’m not going to fall asleep. I’m never going to fall asleep. I’m going to pass out at work and get fired”). As Dr. Davidson says, “we try to make those thoughts less catastrophic and more boring so people can fall asleep.”
It may be that catastrophic thoughts are all you can manage, possibly because you go to bed clutching your tiny, blue-lit comfort totem. Except, as sleep researchers will tell you, it is a false sense of comfort that the phone provides. Both for the stimulating content, which spurs a racing mind, and for the blue light, which also acts as a stimulant, your phone should be banished from your bedroom at least an hour before bedtime. The New York Times will still be there in the morning. The world will too, in all likelihood.
The banishing of electronic devices is just one piece of advice that Canadian sleep researchers have collected on a website called sleeponitcanada.ca. It contains a whole suite of recommendations for those unable to sleep through the pandemic: Maintain regular rising and sleeping times. Make sure you get daylight every day. Have a sleep routine for winding down before bed. Exercise. Avoid alcohol and drugs.
And, in the immortal words of Douglas Adams: Don’t panic. That’s not actually on the official advice list, at least not in so many words, but it’s definitely the underlying message. Don’t panic about some missed sleep, because most of us are in the same boat, staring at different ceilings but thinking the same thoughts: When will this end?
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