Covid-19 has literally become a nightmare for many people who are suffering poor or broken sleep or having vivid or disturbing dreams.
The pandemic has brought a collective trauma to us all which has not spared our sleep: half the population has experienced bad sleep since March 2020 and according to experts at the Norfolk and Norwich University Hospital, 60 per cent of adults in the UK suffer from insomnia and 25 per cent from vivid and recurrent nightmares.
So it wasn’t just a bad ‘quarandream’ that our night-time dreaming is more vivid, weird and sometimes even downright horrifying since the start of the pandemic.
Being drained by an army of leeches. Becoming a monster who sets out to wipe out the whole street. Being chased by invisible creatures. Being in a prison cell and no one coming to deliver food or aid. Entire housing estates sinking into the ground, lost forever.
These are just a selection of the dreams a handful of people have described to me recently – and it doesn’t seem difficult to track them all back to fears about the pandemic.
Head of Sleep Medicine at the NNUH Philippe Grunstein says: “Covid is highly transmissible and associated to the fear of death.
“In addition to the consequences of the lockdown, the economic strains and the dramatic chances in our everyday life, it makes us feel so little, so vulnerable and so mortal.
“This explains the almost threefold increase in the occurrence of nightmares now affecting a quarter of the population at least one night a week compared to just nine per cent before the pandemic.
“Everything that disrupts or breaks our usual time landmarks and routines we had before the pandemic can generate insomnia.
“Anything that brings a lot of anxiety opens the doors to insomnia: financial worries, loss of physical connections with family members and close friends, tensions at home, alarming news, cancelled or delayed appointments for health conditions, working as a key worker…”
Dr Grunstein joined the hospital in 2003 and was instrumental in the creation of its sleep unit in 2004 which looks after up to 5,000 patients a year who suffer from a range of sleep issues ranging from obstructive sleep apnoea to insomnia, parasomnia and hypersomnia.
He is a man who is passionate about good sleep.
Covid-19 related nightmares, he tells me, affect more women than men (28 per cent to 17 per cent), more young people (38 per cent of those affected are under the age of 40), 50 per cent of pregnant women and 33 per cent of people living alone.
You’re more likely to suffer if you drink, sleep for five or less hours a night, take sleeping pills or have a history of certain mental health issues.
“Nightmares affect 40 per cent of healthcare professionals, which is no surprise,” he adds.
“Covid damage to sleep is the overlooked time bomb of this pandemic. The insomnia that affected between 10 to 30 per cent of the UK adult population before the pandemic has now soared to staggering figures – a new word has been coined for this condition: Covinsomnia.”
The headline news is that a good night’s sleep is harder to achieve than ever but that a solid block of shut-eye is at the very core of the robust immune system we need to go into battle with Covid-19.
Dr Grunstein said: “Any chronic insomnia impairs our immunity and makes us more vulnerable to viral infections by at least four times compared to seven to eight hours of unbroken, restorative sleep.
“It impairs our immune response to vaccines.”
Dr Grunstein praised the Sleep Clinic team at the NNUH, including Dr Prasanna Sankaran, and said the work carried out transformed people’s lives and can even add years to their life expectancy.
Sleep should never, he added, be taken for granted.
“Because I worked in intensive care, I learned to fall asleep when I had the chance to and that has stayed with me – I fall asleep easily,” he said.
“I know what works for me, and that’s to get enough sleep so that I can wake up at 5.30am and do a few hours of work. But if my wife or I ever do find it difficult to get to sleep, we talk to each other quietly before bed and it sends us drifting away…”
Below, Dr Grunstein offers his own tips for people struggling with Covinsomnia but points out that there can be no hard-and-fast rules.
“Some people were born like bats,” he laughs, “they sleep during the day and that’s what suits them. And sometimes you want to stay up late and have a drink and that’s fine – these are guidelines if you are having problems.
“Sleep isn’t just what we do at the end of our day, it’s far more important and we should all take it very seriously.”
His final advice echoes that we have heard for months with a twist of his own: “Wash your hands, respect distancing, wear your mask when required and sleep well.
“Sleep is a big immunity shield.”
Brilliant tips to help avoid Covinsomnia in the words of the Head of Sleep Medicine at the NNUH
Daytime
• Try to wake up at the same time during the week and same at weekends during lockdown
• Even if you work from home, get showered and dressed as going to work as usual
• Enjoy the morning light for at least 15 to 20 minutes: open your blinds or curtains and open windows for a blast of fresh air
• Set up fixed times for work, exercise and meals
• Exercise at least 30 minutes in the afternoon (ideally between 3pm to 4pm)
• Walk your dog, play with your cat, enjoy the garden, watch the birds, trees and skies
• Read more, watch television less
• Remain connected to the people who live outside your household, write to them, do not forget birthdays, show kindness
• Do not nap more than 20 minutes a day
• Stop all computer activity by 5.30pm and start cooking
Late afternoon, evening and bedtime
• Dinner by 7pm maximum, limit your alcohol intake
• Stop television at least 40 minutes before going to bed
• No watching the News at Ten
• Make your bed inviting: change bed linen once per week, fluff up your pillows, light candles, don’t have a TV, computer or mobile phone in the room if possible. Your bedroom should be for sleeping and sex only
• If you are in a couple, whisper a nice story to each other before you sleep
• For those who are anxious and at higher risk of insomnia, before going to bed, write down on a notebook what to do the next day. It works better than a sleeping pill
• Do not take sleeping pills, they give less deep restorative sleep, the type you need the most to consolidate memory and maintain good intellectual activity
Sleep Q&A:
What is the ideal amount of sleep? PG: “Between seven and nine hours. Less than six hours and more than nine hours is potentially problematic for adults. Older people may sleep less and wake up more frequently but are also more likely to be taking medications that interfere with sleep.”
Are nightmares bad for us? PG: “We believe that dreams and nightmares help us to process emotions. The more stress you are under, the more likely you are to have bad or frightening dreams. As long as the nightmares aren’t recurrent and don’t involve a physical reaction, we would not be too worried.”
What is the definition of insomnia? PG: “Sleep onset insomnia means that it takes at least 30 minutes at least three times a week, to fall asleep. Sleep maintenance insomnia means that you wake up for at least 30 minutes at least 3 times a week, after having fallen asleep. Chronic insomnia means that insomnia has been present for at least three months.”
Does sleep help my immune system fight illnesses? PG: “Regular sleep supports the immune system which reduces the risk of infections and can help improve outcomes for people who are fighting a virus. Sleep deprivation has the opposite effect and can make people more vulnerable.”
Why am I suddenly finding it harder to sleep during lockdown? PG: “There could be lots of reasons: stress, an overload of information that keeps the mind working, too long staring at screens close to bedtime, a lack of daytime structure, inconsistent bed and wake times, increased napping during the day.”
What should I do if I am suffering from troubling insomnia and recurrent, vivid nightmares? PG: “Alert your GP who can refer you to our sleep service at the NNUH.”
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