By Libby Pellegrini MMS, PA-C
If you are struggling to get a good night’s sleep during the current pandemic, you are not alone. According to the Sleep Foundation, millions of Americans suffered from insomnia prior to the onset of the pandemic, and the current climate is likely increasing the number of people who are having difficulty sleeping. This may be due to a multitude of factors, such as altered routines, decreased access to exercise facilities, decreased exposure to natural light, increased screen time, and excessive worry.
However, quality sleep is critical, now more than ever. Sleep is connected to improved immunity, better mental health, and higher stress resilience. Read on to learn more about how to improve your sleep during these uncertain and anxiety-ridden times.
The concept of “sleep hygiene” refers to the rituals that impact your nightly sleep routine, some of which occur long before your actual bedtime. If you have changed your schedule during the pandemic, it is quite possible that the comfortable circadian rhythm that previously drove your sleep schedule has been rudely disrupted. In order to get back on track, you can give yourself a sleep hygiene makeover by doing the following.
- Reduce or eliminate your evening alcohol consumption, as booze can wreak havoc on your sleep quality, and lead to increased awakenings during the night.
- Reduce your caffeine intake, particularly if you are in the habit of having an afternoon pick-me-up dose.
- Remove any screens from your bedroom, and try your best not to engage with screens for at least 30 minutes prior to bedtime.
- Expose yourself to more natural light during the day to increase your production of melatonin (a naturally occurring hormone involved in regulating the sleep cycle) and therefore recalibrate your circadian rhythm.
- Try a calming activity before bed, such as a bath, aromatherapy, soothing music, or even a sleep meditation.
- Try to stick to a consistent bedtime and wake time, preferably without too much variation from your normal pre-COVID routine.
- Try to avoid naps; it is easy to pass out on the couch during the mid-afternoon when you are not otherwise occupied, but snoozing during the day can reduce your “sleep debt” and sabotage your attempts to fall asleep at night.
A daily bout of exercise can go a long way toward improving your sleep. Exercise boosts your endorphins, giving you a more optimistic outlook and more energy, and it also helps you “tire yourself out” so that you can sleep better at night. However, if you exercise too late in the day, your body and brain may be too activated to fall asleep. If you feel that a nighttime exercise session is causing you to have difficulty falling asleep, trying shifting your workout to the morning.
Certain eating behaviors–such as ingesting a large meal right before bedtime, or eating spicy or acidic foods—can definitely disrupt your sleep. However, the following foods are notorious for improving your sleep.
- Foods containing tryptophan can make you drowsy after ingesting them. Tryptophan is an amino acid that boosts serotonin and melatonin production. High tryptophan content foods include poultry (post-Thanksgiving turkey nap, anyone?), dairy, and eggs.
- Foods that have a natural melatonin content can also help improve your sleep, as higher melatonin levels give your brain a stronger “sleep cue.” High melatonin foods include cherries, grains, and nuts.
- Foods that contain high levels of potassium, calcium, and magnesium, in particular, can improve your sleep quality, increasing your ability to get to sleep and stay asleep. Try a banana, dark leafy greens, or a handful of pumpkin seeds before bed to improve your snooze.
To reduce your nocturnal angst, a sleep supplement may be helpful as well. Research has shown that supplementation with melatonin can decrease the amount of time it takes to fall asleep, increase your amount of total sleep, and improve your quality of sleep. Many different formulations of melatonin are available over the counter. Check in with your healthcare provider about what regimen is right for you.
Despite the above tips and tricks, it can still be difficult to manage insomnia on your own. If your attempts at troubleshooting your sleep woes have failed, it may be time to check in with your healthcare provider about other medications that can be helpful for sleep. After a review of your medical history and current medical conditions, your provider may recommend a trial of one the following sleep medications.
- A short-term benzodiazepine, which can have a sedative effect. Examples include Lorazepam (Ativan) and Temazepam (Restoril)
- A non-benzodiazepine sedative, such as Eszopiclone (Lunesta) or Zolpidem (Ambien)
- An antihistamine, such as Doxepin
- A melatonin receptor agonist, such as Ramelteon (Rozerem)
- An oxerin receptor antagonist, such as Suvorexant (Belsomra)
- A combination serotonin and histamine antagonist, such as Trazodone
If your healthcare provider prescribes you a sleep medication, make sure to use a ScriptSave WellRx savings card to find the lowest price. After initiating a prescription for sleep, your provider will likely recommend reevaluation within a few weeks to see how your sleep is progressing. If you continue to struggle with insomnia, your doctor may recommend cognitive behavioral therapy (CBT) for further improvement.
Libby Pellegrini is a nationally certified physician assistant. She currently works in emergency medicine where she sees and treats a broad spectrum of illnesses across all age ranges. She holds a journalism degree from Northwestern University.