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Don’t ignore sleep problem during COVID-19 lockdown

Recently I have noticed that I am not feeling fresh enough during the daytime and often get irritated at the small deviation of regular work. This mood alteration is new to me. Initially, I thought, might be I become boredom from the current lockdown situation, which is the new normal of COVID-19. But I become worried when this incidence has repeated frequently. I have started researching the reason behind this, and I found may my sleep cycle is not completed.  

It is true COVID-19 itself is a fatal infection. But the precautionary measures which we follow currently to save ourselves from this infectious disease can bring many abnormal physical or psychological conditions. Therefore, we should not ignore any physiological changes during this lockdown. These might be an indication of an early stage of the disease that can impact our present and future days also.

How we fall asleep?

When we sleep our internal clock is ticking continuously and regulates a definite pattern of brain wave. Normally, the sleep cycle pattern alters with age. But non-REM and REM (Rapid Eye Movement) phases are two general phases of sleep. The duration of each phase usually lasts for approximately 90 minutes. Further, the non-REM phase is divided into four stages.

  • During stage one and stage two are the phases when our body is prepared to fall asleep by reducing eye movement. Gradually brain waves start to slow down.  
  • During stages three and four, the brain has started generating delta waves to induce deeper and restorative sleep to relieve and repair our body tissues.

All our dreams come at the REM phase when our brain becomes active and cardiovascular activity is also recharged. This phase plays a role in mood swings as well as cognitive and emotional performances.

What factors negatively affect our sleep during the COVID-19 pandemic?

Most of us have experience of struggling for sleep during visiting an outstation. Even drinking alcohol consumption, noisy environment, shifting of duty and certain medication intake often hampers our sleep. Even too much stress, anxiety also negatively impact our sleep. Several researchers have already identified that the current COVID-19 epidemic has an association with anxiety, distress, depression, sleep disorders, and suicidality along with a significant reduction of positive emotions and life satisfaction. Leo Sher, an author of a recently published article in Elsevier Public Health Emergency Collection journal reported that a combination of anxiety and stress could reduce sleep quality. [1]

Before this lockdown, people do not have any idea how difficult to perform work from home job. In a lockdown, many of us used to go to bedpost midnight. We have the realization that this hampers the sleep schedule. But COVID-19 brings fear of job insecurity, financial crunch, and worry about family/friends security. All these thoughts bring sleepless nights. [2] Not only the general population but even healthcare staffs also unable to manage their psychological stress in this COVID-19 pandemic condition.

Evidential support

Chinese research was conducted on 1250 healthcare professionals to check their mental status. The result showed that the 34.0% of the study participants had insomnia. [1] Therefore, treatment of sleep disorder is a vital requirement to avoid psychiatric disorders symptoms like depression and other serious mental illnesses that aggravate suicidality. [1]

 The Times of India also reported a study result conducted by Wakefit.co on 14th April 2020. According to this report, 67% of Indians who had participated in this research used to go to the bed before 11 pm were started to sleep after 11 pm during this lockdown. [2]

Not only Asian countries but the sleep disorder due to stay-at-home orders is markedly noticed in Europe and America also. The journal Current Biology reported that lockdown might increase the duration of sleep time, but the quality of sleep had declined. [3]

One of my friends called up me a few days back and she compliant that she felt whole day sleepy, but her duration of sleep increased as compared with prior COVID insufficient sleeping hours or poor quality of sleep not only negatively affect our mental health, but increase the risk of unexplained weight gain, cardiovascular disease, stroke, obesity, and diabetes. [3]

What are the recommended lifestyle measures that can improve the sleep cycle?

List down thoughts

During our bedtime, lots of thoughts pop up in our minds. Instead of thinking this to-do list in your mind, right those in a small writing pad. We often repeatedly think the same things for remembering them. But if we write it down, then the chance of forgetfulness will be minimized. This will help you to reduce start thinking and rethinking positive and negative aspects of those thoughts at bedtime. [4]

Pleasant Room temperature

Usually, pleasant room temperature lies between 180C to 240C. Therefore, set proper cooling technique in your bedroom, because favorable room temperature helps us to fall asleep. [4]

Avoid digital device at bedtime

Currently, work home habit gives us relaxation to wake up late in the morning. 

We often spent our night hours surfing the net, chat with friends, or watching movies on Netflix or other sites. Our most common excuse to spend late-night screen time is – do not feel sleepy, then why should we go to bed early?   

But we do not realize that nocturnal screen time causes unnecessary light exposure stimulates psychological activity that delays the time to fall asleep. [5] Therefore, start to say strict ‘no’ to watch television, mobile phone, or working on a laptop before bedtime.

Revive bedtime book reading habit 

Go back to your childhood and start reading books at bedtime. Reading books at bedtime may old fashion, but ideal to feel sleepy. The added advantage of this step is to inspire other family members, especially your kids to develop the same habit also.

Breath in fresh air

After dinner, got to the terrace, or balcony for at least 10 minutes of brisk walking. This will help you to inhale fresh air which is essential for proper blood circulation in your brain and supply oxygen. This will help to reduce sleep disturbance. [4]

Join online yoga session

Gym and other fitness clubs do not get permission to open full-fledge till now. In such a situation, people can join an online yoga session to maintain the regularity of physical activity. Most of us know the benefits of yoga to alleviate different disorders, including sleep disturbance.

 In 2013, the Journal of Ayurveda and Integrative medicine published a research result to provide evidence of long term yoga practice that could impart good quality sleep in elderly individuals. Both Asana, pranayama improve sleep quality. [6] More than 15 years back, a preliminary study result also stated that simple regular yoga practice could treat chronic insomnia by correcting the delayed onset of sleep and sustaining phases of sleep. [7] The Harvard Medical School recommended some yoga postures for better sleep include Balasana, Uttanasana, Ardha Uttanasana, Supta Baddha Konasana, Viparita Karani, and Savasana. If you know these postures, then you can try these at your home. [8]

Herbal remedies to treat mild insomnia

  • GABAergic herbs like Kava root (Piper methysticum), jujube seed (Zizyphus jujube), Pine leaves (Pinus massoniana), Licorice root (Glycyrrhiza glabra), and whole plant of Lemon Balm (Melissa officinalis) increases GABA level in the brain to induce sleep. [9]
  • Griffonia seed (Griffonia Simplicifolia) is a natural supplement of 5 -Hydroxytryptophan and is used to increase the synthesis of serotonin in the brain. This herbal ingredient has many health benefits like effective treatment of uncomplicated insomnia. [10]  

Incorporation of herbs and Superfood improve the sleep cycle

  • Some available kitchen herbs and Superfoods like black pepper leaf, bulb of white radish, fenugreek seeds, almond, fennel seed, poppy seeds, sweet cherries, Grapevine fruit, Strawberry, Pomegranate are a source of melatonin. Eat rice, corn, oats meal to increase the melatonin supply in your body. [11] A Review report supported that melatonin could improve the sleep cycle by reducing the time to fall asleep. [12]
  • During this lockdown, include broad bean, chestnut, hyacinth bean in your recipes to reduce sleep problems naturally. These plant-based food are natural sources of ornithine. [13] A human trial result reported that ornithine supplement is an effective treatment to relieve stress and improve sleep quality. [14]
  • It is not new that green tea is a healthy substitute for milk tea, which we usually prefer to drink. But Green tea is a rich source of L-Theanine. Usually, tea is not a suitable beverage for those who have sleep deprivation issues. [15] L-Theanine acts as a stress reliever. Supplementation of this phytochemical for four weeks could improve the sleep quality index and reduced sleep medication intake rate. [16]
  • I recommend readers who have disturbed sleep, drink lemon balm green tea. A combination of GABA and l-theanine act synergistically to improve sleep quality by reducing sleep latency and increase sleep duration. [17]
  • To prepare this recipe, mix chopped lemon balm and green tea in a 5:1 ratio and add into boiling water. [17] Turn off the flame and cover the vessel for 10 minutes. Then enjoy your hot herbal tea. You can add one teaspoon of honey to improve its taste. But if you are a hypothyroid patient and administer any thyroid medication, then talk with your doctor before incorporating lemon balm in your diet. Lemon balm can interact with certain thyroid medications.

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195057/
  2. https://timesofindia.indiatimes.com/life-style/relationships/work/work-from-home-is-making-67-indian-suffer-from-sleep-deprivation-says-study/articleshow/75126242.cms
  3. https://www.sciencedaily.com/releases/2020/06/200610112107.htm
  4. https://www.express.co.uk/life-style/health/1270239/sleep-lockdown-how-to-fix-sleep-cycle-tips
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839336/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3667430/
  7. https://link.springer.com/article/10.1007/s10484-004-0387-0
  8. https://www.health.harvard.edu/blog/8753-201512048753
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4023459/
  10. http://www.ijplsjournal.com/issues%20PDF%20files/july2010/8..pdf
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678868/
  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273450/
  13. https://pubchem.ncbi.nlm.nih.gov/compound/L-Ornithine
  14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055948/
  15. https://www.mdpi.com/2306-5710/2/2/13/htm
  16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836118/
  17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366437/

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