Pandemic Got You Stressed? How Losing Sleep Affects Your Health

LEXINGTON, Ky. (May 6, 2020) — Feeling tired? Stressed? Do you know that today ends in a 'y,' but you can't remember which day it is? If you said yes to at least one of these, know that you are not alone.

The COVID-19 pandemic is causing millions of people to lose sleep and that can come at a major cost to your overall health and well-being. UKNow is talking with Martha Rosenthal, a Sleep Medicine specialist in the Division of Pulmonary, Critical Care and Sleep Medicine, who works under the direction of Dr. Sara Pasha at the University of Kentucky Sleep Disorders Center. Rosenthal is answering questions about sleep during stressful times -- and what you can do to take back your health.

UKNow: Why is this pandemic causing sleep problems?

Rosenthal: There are a number of ways in which this pandemic has caused shifts in individual sleeping routines. We have all been forced to change our routines, including many of us who are now working from home. We're also facing increased stress and anxiety. Both of these factors may affect our ability to maintain an adequate sleep-wake cycle, develop irregular sleep schedules and shift our typical circadian rhythm patterns. Lack of social interactions during the day can also lead to more intense and dramatic dreams at night, which can be stressful for some people.

UKNow: How does lack of sleep effect a person day-to-day?

Rosenthal: Sleep deprivation, or inadequate quantity or quality of sleep, can also lead to changes in mood, performance and health. If you are experiencing poor concentration, mood irritability, poor decision-making and lack of energy, it's possible that you are suffering from sleep deprivation. A lack of sleep also puts us at a higher risk for high blood pressure, heart attack, obesity and diabetes. Excessive daytime sleepiness can lead to drowsy driving accidents and workplace injuries.

Sleep deprivation can also affect your immunity. For example, our bodies produce proteins, called cytokines. This type of protein helps in stimulating our body's immune response. When we do not receive enough sleep, our bodies are negatively affected by this -- it has even been shown that lack of sleep before receiving a vaccine may weaken the vaccine's response.

UKNow: How do you know you have a sleep issue?

Rosenthal: A key symptom of having sleep issues is frequently not feel well-rested during the day. It is important to differentiate between sleep deprivation and insomnia. Sleep deprivation happens because of poor sleep quality or a lack of opportunity to sleep. Insomnia occurs when the opportunity to sleep is present, but you are unable to fall asleep. Most people are sleep deprived and this is usually due to reduced sleep time; however, if you feel that you are getting adequate hours but are still tired and sleepy, it is important to be evaluated for conditions like obstructive sleep apnea.

If you are unable to fall asleep or stay asleep, you might have insomnia. It is important to discuss your insomnia symptoms with your primary care physician (PCP), as they can be indicative of anxiety or depression.

The most common sleep condition that we treat at the UK Sleep Clinic is obstructive sleep apnea. This condition can affect our ability to fall and stay asleep. Common symptoms include loud snoring, witnessed apneas, being overweight, frequent nighttime arousals, excessive daytime sleepiness and non-restorative sleep complaints.

UKNow: When should I seek help from a doctor?

Rosenthal: Red flag signs that a lack of sleep is affecting your daily function or work ability include excessive daytime sleepiness, drowsy driving events or sleep difficulties that are co-morbid with chronic medical problems such as heart issues, stroke or lung disease. If you're experiencing any of these symptoms, you should contact your primary care physician for further direction.

UKNow: Are there any strategies you can use at home to help mitigate sleep issues?

Rosenthal: There are a number of practices to consider changing in your day-to-day routine that could help.

• Perhaps the most important is sleep hygiene. Everybody's change in routine may make this difficult, but it is important to still reserve the bedroom for sleeping. Separate your work, children's schoolwork, meals and exercise from the bedroom.
• Keeping a consistent routine, bedtime and wake up time.
• Make sure you're getting adequate hours of sleep (typically 7-10 hours per night).
• Exercising during the day promotes good, quality sleep.
• Limit your caffeine, nicotine and alcohol intake and do not eat large meals close to bedtime.
• Limit naps during the day to no more than 30 minutes.
• Stick to a relaxing bedtime routine sans electronics.
• Create a comfortable sleep environment.

Significant sleep conditions, such as sleep apnea or restless leg syndrome, can have an effect on your quality of sleep. Please seek help from your PCP if you suspect this might be you.

UKNow: What is your advice for those who have sleep apnea and use CPAP therapy?

Rosenthal: Many individuals who are already diagnosed with obstructive sleep apnea use a common therapy called a CPAP machine. In response to the COVID-19 pandemic, many questions have come up regarding the use of CPAP machines as a ventilator or for symptom support. Patients should continue to wear their CPAP machine as directed by a sleep physician. If you develop shortness of breath or difficulty breathing, contact your healthcare provider immediately.

An important note to CPAP machine users: if you suspect you may have symptoms of COVID-19, be sure to isolate away from any bedroom partners, as your CPAP machine can aerosolize the droplet particles of the virus.

*****

UK HealthCare's Sleep Center is now offering telehealth visits, which allows patients to meet virtually with a physician. Patients can access this system from a computer or smart phone device by using Zoom. Rosenthal said this opportunity makes it easy to reach patients while they're safe at home. She's hopeful the new virtual system will ultimately allow for more access to care now and in the future.

UK HealthCare is also offering a new drive-thru station for patients to pick up and drop off home sleep study testing equipment. This is for patients who are candidates for home sleep study testing. If you qualify, drive up and park in the designated spot at Good Samaritan Hospital. A respiratory tech will bring the equipment down to you.