It’s 3.45 pm here in Chennai, so I am surprised to receive a panic-filled text from a friend in Atlanta, USA. It’s 6.15 am there and it is unlike her to wake up so early. “I had such a bad dream,” the text read. “In my dream, there was a lockdown due to COVID-19 and nobody could step out of their homes. I slept on the terrace, and I was warned, but eventually shot in the head,” she writes from her bed, trying her best to stay calm.
What lies beneath
Anxiety spurred on by the pandemic, seeping into dreams, and messing up sleep patterns is a common occurrence, according to pulmonologist and sleep expert Dr MS Kanwar, who is also the Director of Advanced Sleep Disorder Institute, New Delhi.
Dr Kanwar has just wrapped up a tele-consultation session. “Ever since the lockdown, we have been getting a lot of phone calls about irregular sleep. Not just from people who already have sleep disorders, but also from those who have other lung-related issues.” Anxiety, he says is the main cause.
“There is a common association between anxiety and sleep disturbances,” he says. Uncertainty about the future is a recurring theme he is seeing right now. “People are worried about their job security, their savings, their loved ones in different cities…” And then there are people who are ‘hooked’ to COVID-19 news alerts — the constant stream of statistics.
- Write down all the things that keep you awake at night, and next to it, list the possible solutions of the concerns. Spending half-an-hour during the day on this will reduce chances of these thoughts coming back to your mind at night. It takes a couple of weeks before it shows results.
The stress from thinking about all this reflects in our quality of sleep. You could either have a problem with sleep onset — no amount of counting sheep is enough — or you could have a problem with sleep maintenance, the frequent fracturing of sleep.
“When you have an anxiety overlay, the kind of sleep that gets most disturbed is N3 sleep,” he says, referring to the third phase of Non-Rapid Eye Movement sleep.
Tech specs
Your sleep period is divided into three stages preceding REM sleep, which you cycle through every 90 minutes or so. Stage N1 is when you transition from wakefulness to sleep, to Stage N2, when your breathing and heart rate begin to slow down. Stage N3 is when your body regenerates itself.
“It is the deepest, most refreshing stage of sleep. When you are anxious, N1 and N2 sleep, which are the lighter phases increase, at the cost of N3 sleep,” he says. Post N3, you move into the REM phase, where you have dreams that you can remember post waking up.
Having vivid dreams by itself is not an indicator of poor sleep, clarifies Dr N Ramakrishnan, founder of Nithra Institute of Sleep Sciences, Chennai. “But if the dreams have a pattern of making you worried or anxious while waking up, that needs to be addressed,” he says.
At the other end of the irregular sleep spectrum are those of us who are oversleeping. “One reason could be sheer boredom. For people working from home, it is best to mimic your earlier routine by establishing defined work hours and work space,” he says. “The other reason could be depression, in which case, you would need to consult a professional.”
Sweat more, sleep better
Anxiety is just one side of the coin. The lockdown has changed our very bodily rhythms, right down to our dietary patterns. As we juggle between work and domestic chores, for example, breakfast could become brunch and lunch an afternoon snack. This too affects our sleep.
“If you are eating late at night, we advise a minimum of two hours break before you go to bed, during which you should not be lying down. It may cause digestive disorders like gastroesophageal reflux disease, which aggravates insomnia,” says Dr Kanwar.
Couple this with not enough physical exertion to tire you out, and you will have a case of delayed sleep. Dr Ramakrishnan advises deep stretch exercises and yoga. Strength training too aids a deeper sleep.
Low angle of slim woman exercising on open terrace under lovely sky. She is doing side lunges and preparing for training with dumbbells. Doing fitness in open air concept
However, the timing of these exercises is also important. Traditionally, experts have recommended AM workouts, but a newer study from 2018, published in Sports Medicine , claimed that you can exercise in the evening as long as you avoid vigorous activity for at least one hour before bedtime.
Despite this, in the current scenario, it is best we stick to traditional advice for a reason simple enough: sunlight.
Night and day
“Normally, we have an internal clock, a circadian rhythm that the body follows. The stimulus for maintaining that rhythm is light and darkness,” says Dr Ramakrishnan.
“At night, our body starts generating the hormone melatonin. When we are exposed to sunlight the melatonin level falls. Therefore, having darkness at night and being exposed to sunlight in the daytime is essential for maintaining this cycle.”
As we are cooped up in our homes, the level of sunlight we receive has gone down, affecting not only Vitamin D levels, but also our ability to generate melatonin at the right time. “That is the reason we specifically ask people to work out in the morning. Many do work out, but they end up doing so indoors, in the late evenings or nights,” he says.
Similarly, at night, refrain from any kind of exposure to light as it will “stimulate the rods and cones in your retina, impacting sleep.” So scrolling through bottomless pits of social media until it lulls you to sleep is not the best idea. With no downtime, your mind will constantly be awake, and this behaviour exists under normal circumstances as well.
“If you are going to look at your screen even if it is in your bedroom, sit away from the bed on a chair,” he says, asking us to be careful of the associations we form with the bed. “Daytime or night-time, do not use your phone, or laptops or even read books in the bed. Remember that the bed is for sleep and sex only.”
