Volume 68, Issue 6 Louisville Medicine - Page 6


, I can ’ t sleep .”
Lots of patients are telling us that - from twenty-somethings to seventy-somethings , everyone ’ s sleep is under siege . At the beginning of the pandemic , it was related to the rapid change that we had to undergo . Folks were facing a loss of their routine , of their regular circles of support . As a result , they could not sleep . Now , sleep neurologists have documented this phenomenon as COVID-somnia .
Our patients are not alone in this ; we may be suffering from poor sleep too . This is not a local phenomenon , it is nationwide . Compared to March , our sleep is now affected by the virus , financial concerns , health concerns for our loved ones , racial injustices and the effects of a tough-fought campaign season .
Waking hours for our patients are filled with the virtual world . As patients work from home , they are likely struggling with “ virtual fatigue ,” considering their work and their children ’ s schoolwork . We are all so busy during the day that our worries and concerns don ’ t get a chance to creep up on us until we are lying in bed , trying to sleep . Patients have told me that , once in bed , they begin to run their financials . They may not be working as many hours , they or their partners may have lost their jobs , yet the bills still come . Others may be grieving the loss of closeness , hugs and interactions with family members and friends . We are all worried about health .
The other ongoing concern I ’ ve heard is the “ status of our country and our world .” The uncertainties and emotions of racial injustices , plus the tumult of the election , worldwide climate change and raging forest fires , weigh heavily upon us . “ You know , it ’ s just 2020 ,” patients say , but still end up staring into the darkness .
Sleep neurologists have noted that more patients have met diagnostic criteria for “ chronic insomnia :” not being able to fall asleep within 30 minutes , occurring at least three times a week for three months in this pandemic world . Our pharmacy benefit managers have noted an increase in prescriptions to help with sleep . These medications are not ideal , and may help us fall asleep , but will not help us stay asleep . Alcohol sales have greatly increased during the pandemic , and patients who are drinking more will also harm their sleep patterns , among other parts .


We , too , may be guilty of even less sleep than before . This chronic sleep deficit can make us feel fatigued and more irritable during our waking hours . It ’ s harder to concentrate . It can also suppress our immune systems , a scary thought during this unprecedented time .
What can we do ? What can we suggest to our patients ? If this comes up , encourage your patients to get back into a routine : a daily routine , and then a bedtime routine . Building physical activity into the day will also help with falling asleep . We all should give ourselves a break , for at least an hour before bedtime , from any screen : no television , tablet , laptop or phone . Instead , we should find something relaxing to help us wind down . Read a book , take a bath , listen to something restful like music , a meditation app from Headspace to Ten Percent , or a podcast like Levar Burton Readsand Nothing Much Happens . Cuddle your people and your pets . Make something . Bake something . Play something .
The virus is not done with us yet . We are in this for the long , long haul . Regardless of what specialty we practice , we are having this conversation about sleep with our patients and ourselves . Stress affects everyone differently . Loss of sleep or insomnia causes stress , then worsens it . We have to find a way to deal with stress day to day , and it ’ s especially important to do so in this current situation .
Each of us will have to find the means to handle that stress and lessen it . It won ’ t happen immediately or even overnight . But , small steps in the right direction will put us on the path to wellness . When we have managed the stress and feel it a bit less , then at bedtime , the hamster running in our minds will show down its pace . As time goes on , the more we learn what relaxes and helps us , the hamster will stop running . Put it to sleep first - then maybe then you can nod right off . Don ’ t give up !
References : https :// journals . lww . com / neurotodayonline / fulltext / 2020 / 07090 / sleep _ neurologists _ call _ it . 1 . aspx https :// www . nhlbi . nih . gov / news / 2020 / covid-and-sleep-better-slumber-duringpandemic-may-help-protect-your-health https :// www . npr . org / local / 305 / 2020 / 09 / 17 / 913964653 / c-o-v-i-d-somnia-ismessing-with-locals-sleep-here-s-what-some-are-doing-to-fix-that
Dr . Tailor is an internal medicine physician at Norton Community Medical Associates : Barret .