Dealing with sleep problems during home confinement
Ellemarije Altena is Assistant Professor (Maître de Conférences) of the University of Bordeaux at INCIA* and a sleep disorders specialist. As member of a European researcher task force, she recently published a set of recommendations to improve sleep quality during home confinement due to the Covid-19 pandemic.
What is the current context as these recommendations are published?
The European CBT-I Academy was founded in 2019 to make short-term effective treatment for insomnia more accessible throughout Europe. With the coronavirus outbreak, we thought it was urgent to publish sleep advice for all those suffering from sleep problems due to this fast-changing situation. We wrote this paper with a task force from within the academy which is representative of numerous affected countries. The recommendations are for people with and without children, couples and singles, as well as medical staff and those currently experiencing a greatly increased workload.
Why is it important to try to get good quality sleep in this period of Covid-19-related confinement?
Sleep is important for a healthy immune system, but also for handling stressful situations and making the right decisions during the day. In the current situation, sleep can be affected not only by direct health hazards but also by having to combine work with home-schooling, having limited options for social contact, exercise and relaxation, facing an increased workload and experiencing elevated anxiety and insecurity. By improving sleep even slightly, it becomes more feasible to face these problems during the day and sleep better again the next night.
What are the impacts of confinement on sleep?
Most people will be less exposed to daylight, get less exercise, and eat more as well as less regularly. These factors may all negatively affect sleep, since for instance bright light suppresses melatonin, needed to fall asleep. Heavy meals late at night and lack of exercise also have a negative effect on sleep. Of course, constant stress and anxiety about this insecure situation can cause sleep problems, in particular through frequent awakenings. Some people may use their telephone and tablet more at bedtime, again with bright light suppressing melatonin needed to fall asleep.
However, being able to go to bed a bit later at night, and sleep in the next morning, benefits the 'night owls' and adolescents. The elimination of time spent commuting to work and the reduction of outside noise can also benefit sleep for some, as well as increased time spent with family.
What are your main recommendations to better manage sleep disorders?
Keep a regular schedule of when you go to bed and get up, even if it is a bit of a different schedule than your regular one. Get bright light in the morning and exercise during the day. Plan a moment during the day to address and express emotions and thoughts about the situation, and try to limit rumination during that time slot. Share your emotions and thoughts with others during the day. We are not made to only feel negative emotions, so try to share humorous information and strongly control and limit exposure to news about the coronavirus outbreak, particularly at night. Instead, find relaxing, pleasant and distracting activities. Limit light exposure during the evening and night as much as possible.
We recommend that parents keep fairly regular schedules during daytime for their children, talk about their feelings and thoughts about the situation during the day, and provide comfort during the evening through a constant ritual when going to bed. We also advise healthcare workers to limit bright light before going to sleep, try to eat light meals as regularly as possible and find short moments to confide in colleagues and family about their worries and thoughts during the day if possible.
* INCIA – Aquitaine Institute for Cognitive and Integrative Neuroscience (CNRS, EPHE and University of Bordeaux – Bordeaux Neurocampus)
Dealing with sleep problems during home confinement due to the COVID‐19 outbreak: practical recommendations from a task force of the European CBT‐I Academy. Altena et al.
Assistant professor at INCIA