As anxiety caused by the coronavirus continues to build, so have problems of restlessness for some — an often ignored problem that, in turn, can affect functionality throughout the day, a local physician explained.
Dr. Adolfo Kaplan, a physician at the McAllen Pulmonary and Sleep Center of the Valley, said the importance of sleep is not addressed enough. Before the pandemic, approximately 30% of the population suffered from insomnia.
Cases of chronic insomnia can lead to increased chances of diabetes, cardiovascular disease and several types of dementia. Insomnia also leads to obesity.
“Something that is completely disregarded is sleep,” he said. “The reality is that if you don’t sleep well, you are not going to function well.”
A critical part of mental and physical health, sleep strengthens the immune system and brain function and helps regulate moods.
The pandemic has upended the daily schedules of many people, and Kaplan explained that disrupted routines are the main cause of insomnia, a prevailing sleep disorder during this time. He noted that there has been an increase of complaints of inadequate sleep in the clinic. Additionally, he said the use of sleep promoting medication in the country has increased by 20% between the months of February and March, preceding a declining trend between 2015 and 2019.
However, Kaplan said, there is a way to use the pandemic to improve your sleep schedule.
“Don’t let a crisis go to waste, this is an opportunity to be consistent with your bedtime and follow your own circadian rhythm,” Kaplan said.
Your circadian rhythm can be described as a 24-hour internal clock running in your brain, that tells your body when to sleep, wake and eat. This rhythm is influenced by external cues, like sunlight and temperature — a method Kaplan encourages people to practice managing.
“Maintaining a steady daily schedule, a regular schedule, is key to sleeping well,” he said. “Quarantining has messed that up quite a bit, people are suddenly having trouble keeping up a daily routine. So, setting up an alarm, waking up at the same time, going to bed at the same time, having regular meals at the same time is all crucial. That sets up our internal clocks, which is incredibly important.”
Kaplan recommends taking morning walks, which on top of physical exercise, helps your brain wake.
“Because you are exposing yourself to the most important thing that helps your brain say, ‘OK, time to wake up…’” he said. “There is a reason why us human beings follow the sunlight, it helps set your internal clocks.”
Then at night, he said, designating a time before bed to relax is crucial, because “you can not force yourself into sleep.”
“We do not have a switch in the brain, you can not turn it on to wake up, then turn it off to sleep… you need to be able to relax.”
While facing high uncertainty due to the spreading disease, being able to unwind and rest can be a challenge, but following a daily schedule will help, Kaplan said.
“When we say relax, I tell everyone that it’s not just ‘OK, my muscles are relaxed.’ You need to relax your most important organ: you brain,” he added.
Part of that is to stop checking the clock; there is no use in keeping up with the time, he said.
“If you say you want to go to sleep but you are tense, then you are thinking, ‘It’s already 10 p.m. and I need to fall asleep now’ — that is the worst thing you can do for your sleep,” Kaplan said. “You need to slow down, and we all do it in different ways. You need to find your way to slow down… You can not be running around then come to bed and fall asleep. It’ll never happen.”
Your brain secretes hormones that allow your brain to sleep a couple hours before you do, and Kaplan emphasized the importance of having a relaxing routine to follow before bed. Some activities most people do include taking a shower, reading and listening to music. It could also be other daily tasks, like taking the dogs out or putting dishes away.
Kaplan mentioned that some people enjoy drinking tea. However, he noted that the actual tea is not what helps with falling asleep: it’s the action of making it.
“Making tea as part of your routine, the behavior of preparing it, is what helps you most,” he said. “The process of actually doing it is what helps you the most. Actually relaxing and disengaging, it’s not the food itself.”
He also mentioned that there have been studies of thermal remedies to fall asleep quicker. By raising your body temperature with a hot shower, cooling off afterwards in bed can help you slip into sleep.
The most important part though, Kaplan said, is to be consistent with your bedtime. Regulating your daily routine is instrumental to fighting restlessness.
Kaplan also addressed some misconceptions of sleep.
“Everyone is trying to cheat with sleep, they say, ‘Let me take one hour here, then a couple there,’” he said. “That is not how it works. You can not catch up with sleep, that does not exist. You never catch up.”
Additionally, Kaplan said that as more people are working from home, he encourages them, as tempting as it is, to not work in the bedroom — especially from their bed.
“Use your bedroom to sleep only,” he said. “If you work in your bedroom, you are there for the entire day. So, you make it much harder for your brain to see it as a place of relaxation if you are there working all day on your computer.”
“Though one of the problems of this quarantine is that not everyone has the luxury to have a bedroom for each person in the house, so if someone wants privacy, there is no other place but their bedroom. However, they should do their best to have a separate place to work during the day, and keep the bedroom for sleeping.”
Since people are spending more time in their homes, they are also taking more naps, which can be detrimental in sleeping well at night.
“People are now napping during the daytime more, since they are staying at home more,” Kaplan said. “Napping for 15 to 20 minutes is very healthy, but nothing more.”
He then reiterated the importance of abiding by a daily schedule to achieve quality sleep at night.
“Maintaining a routine is absolutely paramount,” he said. “Sleep is crucial for your ability to function, and there are a lot of things we can do without medications.”