Counting Sheep

I received my first Moderna shot last week and am happy to report that I had no side effects at all. My arm didn’t even hurt afterwards. I still have mixed feelings about it, including concerns about the level of efficacy I’ll have due to being immunosuppressed, the potential side effects of the second shot I’ll get in a month, and the long-term effects for all of us in this grand experiment. But life is full of unknowns and full of risk. Given the available options and focusing on my present needs which include being with family and friends again, I think I made the wisest choice possible.

Although I have concerns, it’s important that I focus on gratitude, as I do with taking corticosteroids. If I believe that these things are bad for me, I’m sending that message to my brain and body and this can definitely affect my reaction to them. So each day, as I take a pill or think about the vaccine, I use an affirmation – thank you for this tool of wellness and for my body’s healing and strength. I encourage you not to underestimate the power of thoughts.

One of the most influential factors in our thinking on a daily basis is the amount of sleep we experience. Lack of sleep leads to increased negative thoughts in addition to weakening of the body. The CDC reported pre-pandemic that overall, 35% of Americans weren’t getting the recommended 7 hours or more of sleep needed per night for optimal well-being. The picture was even worse for black Americans, with almost 46% not getting enough Z’s.

So insomnia was a major health challenge pre-Covid 19, but has increased dramatically during the pandemic. “It’s a problem everywhere, across all age groups,” according to Angela Drake, a UC Davis Health clinical professor in the Department of Psychiatry and Behavioral Sciences. A report from the National Institutes of Health highlighted a study early in the pandemic that “revealed very high rates of clinically significant insomnia” along with increased acute stress, anxiety and depression.

Studies show that since the onset of the pandemic, we have jumped to 58% of Americans struggling with sleep and a 20% increase in sleep medication use, 60% of study participants reported increased alcohol consumption and over 3 million people now follow the Sleep with Me Podcast, considered by many to be the most boring podcast available.

With the onset of the pandemic, followed by widespread shutdowns, people are worried about their jobs and finances, their families, their kids’ education, their long-term plans and of course, about becoming ill. We’ve been living under some level of constant anxiety, fear and/or depression for a year now, which all can lead to insomnia.

Now dubbed coronasomnia, the impact on our physical and emotional health can be serious. Lack of sleep has a negative impact on our emotional regulation and mood. It reduces our cognitive functions as well, so memory and decision-making can be negatively impacted by poor sleep. Insomnia can lead to decreased cardiovascular health and create metabolic issues, including increased risk of weight gain, diabetes and high blood pressure.

As if all the COVID fatigue and anxiety were not enough, however, there’s another reason for coronasomnia, which is our routines. Many stay home the majority of the time in order to stay safe, but as human beings, we need stimulation and we need connection with other people. Instead, we’ve gotten too routine, with little variation day to day. That lack of stimulation contributes to poor sleep. On top of that, the many people working from home have gotten out of their normal daily routines, which also affects sleep. If you’re working from home and can’t sleep, why not get some work done? This pattern throws our circadian rhythm out of sync and that’s critical because circadian rhythms regulate all of the cells in our body. In addition to affecting our eating, digestion and sleeping processes, perhaps most importantly, they impact our immune system.

There are several steps we can take to get our sleep cycle back on track, beyond counting sheep. If working from home, keep the same schedule as if you were leaving the house to work. Don’t sleep in or stay up late. Get up at the same time each morning, just as you did pre-pandemic, even if it means using an alarm. Be sure to take a short break mid-morning, a lunch break, and then another short break in the afternoon.

Go to bed at the same time each night. Prepare for sleep by lowering lights at least a half-hour before bedtime to signal to the brain that sleep time is coming, and avoid screens in the bedroom. The blue light from our devices signals our bodies to stay awake and not release melatonin. Melatonin is only released in the dark and is vital to the repair of our immune system while we sleep. Many televisions also have a blue light that remains on after you’ve turned the TV off. Change the settings to turn this nightlight off or cover the light with dark tape.

Don’t watch the news before bed and cut back on news and social media in general. It’s over-stimulating to be bombarded by constant breaking or negative news. If watching TV in bed, turn if off at the end of the show instead of falling asleep with it left on. Even better, read a book or magazine instead.

If possible, don’t use your bedroom, and especially your bed, as your office. The bedroom needs to be a place of rest and the brain needs to be trained to recognize this if the lines have blurred. If you have no choice but to use your bedroom as an office, keep work-related equipment and papers in one section and cover it up at night. Just throw a blanket over the whole thing so that you’re not tempted by seeing the computer or stacks of paper that need to be addressed.

Experts suggest avoiding long naps, but if needed, to take short power naps early in the afternoon to avoid throwing the sleep cycle off. Sunlight and exercise both help us sleep better at night, as does eating dinner earlier to give our bodies time to digest the food before we’re ready to sleep.

If you still wake up in the middle of the night and can’t sleep for more than half an hour, get out of bed and do something mundane or monotonous in a dimly lit room. Keep in mind that alcohol, caffeine and sleep medications affect our quality of sleep, so quantity doesn’t necessarily trump quality.

For severe cases, cognitive behavioral therapy for insomnia is a structured, evidence-based program guided by a sleep therapist that helps you relearn how to sleep. The goal is to help you replace thoughts and behaviors that hurt your sleep with new behaviors and thinking that will help you sleep well.

Meditation can improve sleep and strengthen our mind body connection. It lowers our stress hormones and relaxes our bodies, promoting better, restorative sleep. We can also benefit from the best of two worlds by combining cognitive based therapy with mindfulness and meditation.

Continuing our exploration of various types of meditation, mindfulness based cognitive therapy, or MBCT, is a well-studied practice that can provide relief from insomnia as well as many other wellness challenges. Mindfulness meditation is a main component of MBCT, a program developed to prevent the relapse of depression among individuals with recurrent major depressive disorder, which is significant when considering that at least one in three people with insomnia also suffer from depression.

Mindfulness-based cognitive therapy builds upon the principles of cognitive therapy by using techniques such as mindfulness meditation to teach people to consciously pay attention to their thoughts and feelings without placing any judgments upon them. The combination of mindfulness and cognitive therapy is what makes MBCT so effective. Mindfulness helps you observe and identify your feelings while cognitive therapy teaches you to interrupt automatic thought processes and work through feelings in a healthy way.

MBCT is an eight week program that can help overcome depression, anxiety and stress by learning new ways to respond to your own thoughts and feelings. You can join a course in person or can follow the eight-week lessons via books, online classes and/or videos. The training includes listening to recorded guided meditations and trying to cultivate mindfulness in daily living. This may mean bringing mindfulness to day-to-day activities, like brushing your teeth, showering, washing the dishes, exercising, or making your bed. By applying MBCT skills such as doing what works rather than second-guessing yourself, focusing on the moment without distraction from other ideas or events, paying close attention to what is going on around you, and taking a non-judgmental stance, stress levels decrease and mindfulness skills increase.

Other MBCT techniques include the body scan exercise, yoga, walking and sitting meditations, sitting with thoughts, sitting with sounds, and mindfulness stretching. There is an emphasis on observing one's experience, focusing on the breath and attending to the body and physical sensations. You can find a guided body scan on our You Tube Channel at Work2Live.

We’re living in very challenging times and to maintain our mental and physical health, we need as many tools and techniques at our disposal as possible. If you’re suffering from insomnia, anxiety and too much stress, any form of mindfulness and meditation can help, but it may take some experimentation to find the style that is right for you. Check them out and as always, stay open and curious to the process.

Until next time. Have a wonderful week, stay mindful and be kind to yourself and others.