As the Covid-19 pandemic continues to impact Ireland, many people have reported that they are having sleep issues. TheCity.ie’s Kim O’Leary speaks to sleep physiologist Motty Varghese about how to ensure students get a good night’s rest – especially as they approach the final few weeks of assessments.
For the last four weeks, I have found myself spending the late night hours constantly tossing and turning in my bed, unable to drift off into an uninterrupted sleep. There is always a distraction of some sort.
The latest Covid-19 updates from Ireland and around the world, as well as the anxiety about final assessments at college, make it hard to ‘switch off’ and sleep through the night.
With the final few weeks of the academic year upon us, many TU Dublin students are wondering how they can get some peaceful rest, despite the troubling circumstances they are experiencing.
I interviewed Motty Varghese of The Sleep Therapy Clinic – a senior respiratory and sleep physiologist in St James’s Hospital Dublin since 2003. Mr Varghese is passionate about helping individuals with sleep disorders. He graduated as a Respiratory Therapist and is also a licensed Sleep Technologist with The Board Of Polysomnography Technologists in the United States.
I started our interview by asking Motty Varghese, how many hours of sleep each night does the average person require?
Varghese: Sleep need is variable between individuals and every individual’s sleep need is unique to themselves. The recommended sleep duration for an adult is over seven hours, and not recommended is less than six hours or over 10 hours. In sleep problems like insomnia, your sleep quantity can be compromised. In sleep disorders like obstructive sleep apnea or restless legs syndrome, you will have a tendency to sleep for a longer time. However, despite increased sleep duration, the person can still feel tired.
Teenagers or young adults would also have a tendency to go to bed very late and wake up very late. If there is an extreme delay in sleep onset, it could be symptoms of Delayed Sleep Phase Disorder (DSPD) – unfortunately, this can have an adverse impact on their academic performance. This happens due to a delay in their circadian clock, not exclusively due to poor habits alone. This warrants therapy, since regularising their sleep patterns by strategic light exposure can bring multifaceted benefits.
O’Leary: As the Covid-19 pandemic continues, do you think there has been a noticeable change or disruption in sleep patterns? If so, why?
Varghese: Yes, this has been flagged as a problem by many. If you remember, the lockdown was implemented around the same time the clocks moved by an hour for DST. With the implementation of lockdown, many people started working remotely, and with it came some flexibility in the morning as well. Our sleep patterns changed and we started sleeping in in the morning. Along with it, there is a general anxiety about COVID 19 and this has been leading to an aroused mental state or a state of hyper-alertness for people. It is needless to say when we are hyperalert, our sleep onset can be delayed and the sleep quality can be compromised along with sleep quantity.
O’Leary: What recommendations/advice would you have as a sleep expert for TU Dublin students having difficulty getting enough sleep during the pandemic, as well as preparing for their final assessments and exams?
Varghese: Your approach to protect your sleep should focus on a few factors:
1. Avoid a state of hyper-alertness
Preoccupying yourself with thoughts of what is happening around you can lead to cognitive or mental arousal. You also want to be informed at the same time. Hence avoid consumption of news via TV, social media, or other sources close to bedtime. Relying on credible sources of information will help to avoid unnecessary panic. Engaging in some relaxing activities like meditating, doing some breathing exercises etc can also help reduce anxiety.
2. Prioritize sleep
You know how important sleep is for you, yet you cannot force it. Understand that sleep is a natural process, but you can nurture it by adopting certain good habits. It may go against what your preferences are, but prioritizing sleep will pay you the dividends now, more than ever.
3. Have a routine
It would also be unrealistic to ask you to adhere to the pre-lockdown sleep schedule since you have the flexibility of working/studying from home and not commute. You may be waking up late, but ensure you still have a structure and are not sleeping in too late. On the upside, at least you are not accumulating a “sleep debt” and focus on consistency of bedtime and wake time through the week. You can gradually move to an earlier wake time when the lockdown is over.
4. Know your rhythm
Whether you are working or studying, productivity is an important factor to keep our stress levels down during lockdown. Everyone has a chronotype – evening, morning, or intermediate – based on your genetic coding. We also call them “larks” and “owls”. This would also mean you will have a preferred bedtime, wake time, and time of optimal alertness during the day. For instance, an evening type person tends to go to bed late and wake up late and a morning type person will do the exact opposite. Pay attention to this pattern of sleepiness at night and alertness during the day. You will be able to be productive and get more done by following your circadian rhythm.
Light is a powerhouse of energy. Focusing on light exposure during the day and reducing light exposure closer to bedtime indicates to our body about the day-night cycle and prepares itself for sleep at night and alertness during the day. Seek out natural daylight in the morning and avoid blue light exposure from screen devices for two hours before bed time.
O’Leary: Are there any particular food types that can help people to have a more restful night’s sleep?
Varghese: A lot of research has been done into the effect of food on sleep. Research indicated a carbohydrate-rich meal ingested four hours before bedtime in the evening reduced sleep onset latency. It is also advised not to eat any food within 2-3 hours of bedtime since this can increase the body temperature (and delay sleep), cause heartburn, etc.
Food that is rich in tryptophan is also mentioned in the proposed relation of food and sleep.
O’Leary: Is it true that less sleep may weaken the immune system and make people more susceptible to illness, such as this virus (Covid-19)?
Varghese : It is true that sleep and immunity have a mutual relationship. We have known for a very long time that there is an increased chance to catch a common cold or to have flu symptoms if you are sleeping poorly. There is also evidence that the flu vaccination was more potent in individuals who were good sleepers compared to poor sleepers.
It is also vital for us to prioritize our sleep during this time when we are constantly looking for a new line of defence against the virus. It would also be ideal if sleep becomes part of our public health messaging along with good dietary habits and exercise.
O’Leary: Do you think that more studies should be carried out to analyze sleep patterns during the Covid-19 pandemic?
Varghese: Pandemics like this are thankfully not a common occurrence and it will be useful to study how sleep patterns are affected during this period. It will help to prepare for any future pandemics if at all it happened. Sleep monitoring wearable devices (like Fitbit) will come in handy in situations like this to look at the sleep habits of a large number of people.
O’Leary: Some people are also reporting that they are having vivid dreams as of late, do you think that dreams are an important coping mechanism during this stressful time?
Varghese: Dreams occur during a specific stage of sleep called REM sleep. The functions of REM sleep are memory formation and emotion regulation. The information which we take in during the day is processed during REM sleep and converted to memory.
Unfortunately, we have an information overload now which is not very pleasant, and this may be having an effect on our dreams.
Most of the REM sleep or dream sleep happens in the second half of the night. So we may also be getting some more dreams in the extended sleep period in morning hours and these dreams are possibly influenced by the information we received the previous day.