Under normal circumstances, healthy sleep is vital for optimal health and human performance. Sleep impacts virtually every function in the body and brain. Poor sleep is a well-documented risk factor for potentially severe adverse health consequences, including heart attack, stroke, diabetes, dementia and premature death, as well as depression, anxiety, addiction and post-traumatic stress disorder (PTSD). By contrast, healthy sleep protects against disease and enhances quality of life.
But today, living during the COVID-19 pandemic is not a normal circumstance. To be alive today is to inhale a certain kind of anxious uncertainty. Work and family schedules have been upended, social support has been dramatically reduced, and a great portion of waking life is now spent in front of electronic devices. Each of these effects can worsen sleep.
Despite these changes to our daily lives, healthy sleep matters more now than ever. Multiple studies in the field of psychoneuroimmunology have demonstrated a link between poor sleep and impaired immune function. Poor sleep has been shown to lessen the effectiveness of several vaccines (including influenza vaccine), a critical issue as we will one day likely rely on this important protection from COVID-19.
In addition to supporting immune function, healthy sleep is a foundational pillar of our mental health and well-being. Each night, healthy sleep clears our minds and lifts our moods. But when sleep goes wrong, consequences can be dramatic. As evidence, consider the impact of sleep among high-performing individuals, our courageous men and women in uniform.
Over the past two decades, the longitudinal Millennium Cohort studies have assessed symptoms among over 200,000 active duty service members, veterans and reservists. One of the most notable findings has been that poor sleep prior to deployment is a reliable predictor of subsequent mental health problems including depression, anxiety and PTSD. In fact, poor sleep prior to deployment has been found to be the most common symptom and strongly predictive of subsequent PTSD following deployment.
Of course, life during COVID-19 is not military combat. No one is shooting at us, and the world seems united in the fight against the virus. Even so, it is illustrative that military leaders recognize and support healthy sleep as a core component of physiological and psychological resilience. In addition to providing high quality sleep medicine care and seeking to optimize sleep in the field, the Department of Defense supports a focused program of sleep-related research, including our own research at the University of Maryland School of Medicine, to support service members and veterans alike.
So, what lessons from sleep science can be applied to enhance self-care and resilience during the COVID-19 pandemic? First, sleep needs to be prioritized, especially during COVID-19. The restorative power of sleep is particularly evident during times of heightened stress. Second, sleep should be protected in time and space, with no daytime activities such as electronics, planning, worry or work. Third, sleep can be enjoyed as a pleasant daily respite, a welcome break from daytime concerns. Additional suggestions for healthy sleep are listed below:
- Allow enough time for uninterrupted sleep. Adults need a minimum of 7 to 8 hours of quality sleep per day for optimal health and performance.
- Maintain a consistent sleep/wake schedule every day. Your internal body clock thrives on consistency.
- Establish a sacred space for sleep. Your bedroom should be cool, dark, quiet and uncluttered.
- Develop a soothing pre-sleep wind-down ritual. This routine should include soothing activities and be devoid of cues for daytime stress.
- Reduce electronic devices and eliminate electronic devices one hour or more before bed. Electronic devices emit blue light, a powerful melatonin suppressant.
- Choose news sources wisely. Media pundits are paid very well to engage and enrage. Seek information only from highly trusted sources, and block the rest.
Emerson M. Wickwire (firstname.lastname@example.org) is associate professor of psychiatry and medicine at the University of Maryland School of Medicine and director of the Insomnia Program at the University of Maryland Medical Center — Midtown Campus.