Illustration by Victoria Borges
Feeling moody or cranky? Having trouble concentrating or recalling something from earlier in the day? Spinning your wheels on a project? You might need to work on your sleep.
Certainly, the events of 2020 — a global pandemic, a national reckoning with racial injustice, a polarizing election cycle — brought added stress to our lives. While a good night’s sleep goes a long way toward managing stress, anxiety is one of the chief culprits behind sleep disruptions. And high-quality sleep is vital to our health, local doctors say.
“It’s still not exactly known why we need sleep, but many mechanisms in the body rely on sleep,” says Dr. Samuel A. Taylor, medical director of the VCU Health Center for Sleep Medicine, chair of the Division of Sleep Medicine and an assistant professor in the neurology department in the VCU School of Medicine. “An increase in anxiety can make it difficult to settle down into quiet and restful sleep.”
Taylor, who notes that the field of sleep study didn’t become a codified medical subspecialty until the 1970s, says sleep is “intimately intertwined” with mental health. What’s challenging, he notes, is that the most common forms of insomnia — difficulty falling or remaining asleep, waking too early, or waking without feeling rested — can be symptoms of another issue or a disorder in itself.
“A good analogy is the difference between seizures and epilepsy,” he says. “Epilepsy manifests itself through unprovoked seizures. But you can have an isolated seizure and not have epilepsy.”
In the same way, Taylor says, acute insomnia, which lasts less than three months, can be a reaction to a specific event, such as the death of a loved one or the end of a significant relationship. Insomnia becomes chronic when it persists for more than three months, which may indicate a larger issue.
Dr. Naim Bashir (Photo courtesy Bon Secours)
Dr. Naim Bashir, a sleep specialist with the Bon Secours Sleep Disorders Center, says it’s important to investigate persistent sleep disturbances, because in addition to negatively affecting quality of life, they can indicate serious health problems, such as obstructive sleep apnea, digestive issues, diabetes or even mood disorders. “Scientific data indicate most adults need seven to eight hours of sleep to function optimally during the day,” Bashir says.
Normal sleep in adults is governed by two processes, Bashir notes: the functioning of neurotransmitters in the brain to signal waking and sleeping, and circadian rhythms connected to the sun rising and setting. Disruptions to those natural triggers can include certain medications, caffeine, napping for too long or too late in the day (after 4 p.m.), and evening exercise, which leads to alertness. Even watching TV or reading on a tablet while in bed can lead to problems.
“Maladaptive mechanisms promote wakefulness and reduce our ability to fall asleep,” Bashir says. “Over time, [those behaviors] may contribute to the problem becoming chronic in nature.”
To support sleep health, Bashir says, pay attention to foods or medications that may be causing problems. Melatonin can help induce sleep but can also lead to nightmares. Some patients, Bashir says, have reported improved sleep by using weighted blankets or CBD oil, but he notes there isn’t much evidence supporting CBD use for sleep issues.
Another reason to pay attention to your sleep, Taylor says: Good sleep strengthens the immune system. He points to an often-cited study in which two groups were given the same Hepatitis B vaccine. One group was deprived of sleep prior to vaccination, while the other group’s sleep was left undisturbed. The sleep-deprived group didn’t develop the same level of antibodies to the disease as the other group. With a COVID vaccine on the horizon, Taylor says, we need our rest.
“It’s very important we’re sleeping well up to that vaccine and for several weeks after, so we can have an appropriate immune response,” he says.
Sleep Soundly
According to a fall 2020 survey from the American Academy of Sleep Medicine (AASM), roughly one-third of Americans reported difficulties with sleep during the first six months of the novel coronavirus pandemic.
Some expert tips to promote high-quality sleep:
- Keep to a schedule. If you want to wake up at 7 a.m., plan to head for the bedroom around 10 p.m. the night before. Avoid staying up later and sleeping later on the weekends, and limit naps to early afternoon and to roughly 20 minutes.
- Ditch the screens. At least 30 minutes before bedtime, turn off or put away electronic devices.
- Stay active. Exercise regularly, but not right before bedtime.
- Don’t fret. If you’re having difficulty dropping off, Dr. Naim Bashir recommends a warm shower or bath, listening to music, or winding down through meditation or prayer.
- Do fret. For those whose minds just won’t settle, Dr. Samuel A. Taylor recommends setting a “worry time” after dinner. “Process what happened during the day and plan what’s coming the next day,” he says. “When you go to bed, if your mind starts to race, you can tell yourself, ‘I don’t need to think about that; I’ve already planned that out,’ or ‘I’m going to move that to the list for tomorrow.’ ”
