Seniors, Insomnia and The Pandemic

Sleep disorders are highly prevalent as one ages, and even more so during this crisis. 

We hear from  YEI members who are having a tough time
with insomnia during this pandemic

 

 

50% of seniors suffer from some kind of insomnia – in non-pandemic times.  Dr Philip Cheng, Clinical Psychologist and Research Scientist at the Sleep Disorders Centre at the Henry Ford Health System says that “Everything that is going on right now, can make people more vulnerable to insomnia”.

Kathy from Cape Town is having a particularly tough time.  She has been slammed with Covid-19 issues left, right and centre, and no wonder, insomnia has become a direct result.  Kathy is an Essential Worker, working on the frontline.  Some of her staff members have become infected with Covid-19, which has led to much stress and concern amongst the remaining staff members at work.  Kathy’s husband has taken a paycut.  Kathy’s son-in-law has been let go from work.  Kathy’s daughter has taken a pay cut.  All this at once.  Kathy is the recipient of coronavirus anxiety which leads to fragmented sleep, nighttime awakenings, disturbing dreams and even nightmares, which sadly have become common during this time.

Llynne is 74 and from East London.  “I am unable to fall asleep quickly and when I do, I sleep for an hour or two and am unable to go back to sleep till 5 or 6am. It upsets my day as I haven’t had sufficient rest and struggle with no energy during the day and doze off in the chair at the drop of a hat. I’m 74 next month, live alone – I’m a widow and am diabetic and my fasting reading in the morning is climbing. Lack of sleep affects all aspects of my daily life.  My insomnia has most definitely worsened since the start of the pandemic”.

“I haven’t been the best sleeper for about 10 years, but definitely worse in this crisis”, says Mandy, 67, from Cape Town.  “I fall asleep, but then wake a few hours later and my brain is lit up, worrying about surviving in the current economy; how long will our investments last; will my son (married with 2 kids) manage to keep his job; if he doesn’t keep his job, what next; what will happen if we get the virus; such longings to hug my grandchildren, etc. The uncertainties of the future weigh heavily! I try to relax, get rid of the thoughts and focus on good memories, etc but it doesn’t seem to help. Knowing that sleep deprivation affects one’s health and immune system adds to the concerns! I pray for serenity to accept the situations that I cannot control, have courage to deal with that which I can control, and the wisdom to know the difference!”

Val, 70, from Grahamstown has had sleeping problems all her life. But now it is worse than ever.  “Very erratic, wake at all odd hours, my dreams are weird, unreal, nightmares, I wake up having a conversation with myself. I have to take a sleeping tablet occasionally to get a good night’s sleep”.

 

 

Right now, in the midst of this pandemic, heightened anxiety and unstructured time can cause insomnia, even to those who are accustomed to a good night’s sleep.  Many are struggling to get a good 7/8 hours.  It has been reported that there has been a spike in the use of anti-insomnia, anti-anxiety and anti-depressant medications.

Dr Alison Bentley, Sleep Physician and Researcher says:  “There are immediate consequences to a lack of sleep”.  She says if people don’t sleep well at night they won’t function well during the day; their executive functions are affected by lack of sleep.  Other than a general tiredness during the day, memory and concentration are affected, as is one’s thinking ability, and you become moody and unhappy. These consequences of poor sleep can make the anxiety worse or trigger an underlying depression.

A number of factors have conspired to increase sleep problems during COVID and particularly lockdown. The anxiety of financial worries and catching this new disease are good reasons to battle to fall sleep at night. If we combine that with the lockdown restrictions, we have found that people are either going to bed earlier or waking up later in the morning and finding it difficult to fall asleep at night. Other people are sleeping longer and experiencing lots of vivid dreams. The anxieties are real and cannot be ignored but creating poor sleep habits is not the best way to handle this scenario.

It is important to understand that there is a real biology to sleep and you cannot override this. For example, you have a prescribed amount of sleep that is correct for you – you cannot get more. Trying to get more will lead to frustration and lots of time lying in bed awake. You are also built as a lark or an owl – a lark is someone who goes to bed early and gets up early – you can’t change. The two biological factors that determine sleep are the homeostatic force which is easy – the longer you stay awake the sleepier you get. Napping during the day destroys the ability of this force to get you to fall asleep at night. Then melatonin secretion at night helps us with the timing of sleep and making us feel very sleepy at the correct time. Over the age of 55 years, unfortunately melatonin levels are very low so we need to use the other forces to assist.

Overall, if you try to change your sleep patterns beyond what you are designed to sleep, you will present with sleep that looks like you have insomnia.

Dr Melinda Jackson and her team from the Turner Institute for Brain and Mental Health at Monash University in Australia, are running a study specifically about insomnia symptoms during a pandemic.  They are finding that the impact of the pandemic has huge economic, health and social impacts – all of which influence the way we sleep.  Early results show that heightened anxiety associated with concern about the health of ourselves, our loved ones and our colleagues, coupled with financial distress and job loss are major factors in sleep deprivation.

 

So, what to do….

Sleep is always vital for good health and comes hand in hand with a long list of health benefits.    Sleep helps the body repair itself, it wards off illness, it reduces stress and inflammation and even the risk of depression.  In this time of crisis, it’s important to note that sleep plays a big role in strengthening the immune system and its response to infection.

• Try and keep a regular sleep-wake schedule – preferably the schedule that you had before we had lockdown
• Create the ideal sleeping environment – a dark room and more on the cooler side, temperature-wise!
• Stick to a regular routine during the day as disruption in routine can lead to difficulty in sleeping.
• Schedule in a half-hour wind-down time before bed, specifically to relax and read a book. Deep breathing exercises and guided meditation are great wind-down “activities”.  Stay away from “electronics” – laptop and phone.
• Try and go to bed sleepy, and schedule the correct number of hours in bed. In order to feel sleepy, you may have to go to bed later when you are feeling anxious in order to relax a little.  Don’t worry about the sleep loss.  You’ll likely catch it up the next night.
• Try to get 15-30 minutes of sunlight when you wake up.
• Try to avoid naps.
• Avoid consumption of caffeine and alcohol in the evening, and don’t have a large meal just before bedtime.
• Exercise in the afternoon, if possible. Regular exercise and a daily walk can promote sleep.  Try to move every hour.
• Set aside a “worry hour” to address anxieties. Speak about your fears with a friend or write them down – this gives those fears an outlet.

 

Article by You’ve Earned It – the online retirement platform

 

Have your daily routines been affected by lockdown?
A South African research team have launched an anonymous online survey to hear about your experiences.  They would love your input
– the survey will take 20-25 minutes.
If you are 18 & over, live in SA and would like to participate, click here:

https://forms.gle/ZoHE7e6VMzfsHFjU6 

#COVIDSleepSA

 

Thanks to:

Dr Alison Bentley, Sleep Physician and Researcher, for her contribution to this article, and The Sleep Researchers of South Africa

 

You’ve Earned It / YEI (https://youve-earned-it.co.za/),
the online retirement platform
for South African over-60s

 

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Relevant articles:

Lockdown Level 4 and what it means to SA seniors

How to reduce your risk of catching the COVID-19 virus while shopping

Time for seniors to mask up

Why it’s still important to get your flu vaccine during the COVID-19 outbreak

How seniors can cope with coronavirus anxiety