Shortly after the pandemic began, Richard Leadlay noticed his bedtime slowly creeping later and later.
“I just started staying up late, and going to bed really early. And I didn’t realize that it was going to turn my life upside down,” Leadlay told CTV News from his home in London, Ont.
What started out as a few late nights in front of the television turned into an entirely new sleep schedule. Leadlay found that he constantly craved sleep.
“During the days, I just felt tired. My body was just kind of floating on the edge of wanting to shut down … and if I did go to bed, then I ended up feeling worse. It was very much a no-win situation,” he said.
“At its worst I felt like I had the flu. Just nauseous, disoriented, lethargic.”
COVID-19 has wreaked havoc on the global economy, public health systems and upended industries from tourism to summer camps. Now, doctors from around the world say they’re seeing an influx in patients with disrupted sleep patterns linked to financial anxiety, fears of the virus or a lack of daily routine.
In China, researchers surveyed 801 front-line health-care workers and found that, compared to the general population, they tested significantly high on a scale used to measure insomnia. Left untreated, insomnia could lead to lasting health repercussions, including weight gain, heart disease, hypertension and diabetic predispositions, according to Dr. Raymond Gottschalk, medical director of the sleep disorders clinic at McMaster University.
“We know that sleep restriction, sleep deprivation and/or sleep disruption can shorten lives,” Gottschalk said.
Gottschalk compared sleep to an “auto-repair mechanism” for the body, not unlike a computer when it’s dormant. When this process is disrupted, some people end up feeling sick, he said. There are several factors that may be triggering these unusual sleep patterns: increased alcohol and caffeine consumption, fewer set meals and more snacking, heightened levels of anxiety, reduced access to sunlight or even more hours spent in front of screens.
In his own practice, Gottschalk said he’s worked with patients struggling to sleep due to anxiety about losing their jobs. Canada’s unemployment rate jumped to 12.3 per cent in June, more than double the rate of 5.6 per cent in February before lockdown began.
“I’ve had many patients let me know how stressed they are because of the shutdown of their business and they’re in the entertainment business or in the food and beverage business, which has just been absolutely decimated,” he said.
“So all of these occupations and highly skilled professionals (are) essentially without work. I think impact is still to be seen fully.”
In some cases, patients are reporting chronic nightmares that prevent them from making it through the night. Gottschalk said some patients have dreamed of snakes, which are seen as representing an “unnamed fear.”
Losing Times Cues
Another factor that may be worsening sleep patterns is the fact that, for many people, lockdown has completely transformed their daily routine. Without rituals like commuting or picking up the kids from school, many people find themselves feeling unmoored, according to Dr. Andrew Lim, a neurologist at Sunnybrook Health Sciences Centre in Toronto.
“What happens is when we lose these time cues, when we lose the regular exposure to daylight, the regular social interactions, the regularly timed mealtimes and physical activities, the internal biological clock can start to drift,” Lim said.
Disrupted sleep patterns don’t look the same for everyone. Lim said it’s more common for younger people to see their bedtimes shift later, while older people may become tired earlier in the day and end up heading to bed earlier.
“If your body clock has drifted later, it may be that at twelve noon you still feel like it’s the middle of the night,” he said.
One immediate symptom of not getting enough sleep may be a person’s mood.
“You’re more irritable, you’re anxious, you might even become depressed if you’re not sleeping enough,” Lim said.
On the flip side, some patients have reported improved sleep schedules during COVID-19.
“There is a subset of the population who are actually sleeping better, because they don’t have to get up as early for work and may experience less stress from not having to commute,” said Dr. Daniel A. Barone, associate medical director of the Weill Cornell Center for Sleep Medicine, in an interview with Neurology Today.
Treating Sleep Irregularities
For Leadlay, he found himself relying on his wife to care for the kids while he tried to catch up on sleep. Eventually, he realized he needed to make a change.
“My biggest concern is being a good parent to my children, and a parent who’s lying in bed going, ‘Yeah, just please leave me alone,’ I don’t accept that from myself as a reasonable excuse,” he said.
He ended up at a sleep clinic at Sunnybrook Health Sciences, desperate for help. Now he’s working to adjust his sleep schedule gradually in 15-minute blocks, with the ultimate goal of realigning himself with a normal sleep schedule in the near future.
There are a variety of ways to treat sleep disruptions. Gottschalk recommends going to bed when you’re feeling tired, waking up at the same time each day, and getting out of bed if you’re awake more than 20 minutes.
Reading before bed can also be a helpful transition tool, but he said to avoid spending time on your phone before bed. Leadlay acknowledges that it’s going to be tough to rewire his sleeping habits, and it may take time. But he’s also optimistic.
“I really hope that others can learn from my mistakes and nighttime television isn’t worth sacrificing your daytime life,” he said.