Help with sleep during COVID-19
Managing sleep
During COVID-19
Many veterans might be struggling with their sleep, and with changes in lifestyles due to government restrictions, uncertainty about the future, and anxiety about staying healthy. You may find that you are finding it more difficult to get good quality, undisturbed sleep currently.
What is sleep and why do we need it?
Sleep is a state in which our mind and body experiences changes in our levels of consciousness, relatively inhibited sensory activity, reduced muscle activity, and reduced interaction with our surroundings.
You need sleep to stay alive; to restore the balance of hormones and chemistry within the brain and body which build up when you are awake; form or maintain the pathways in your brain that let you learn and create new memories as well as to help you concentrate and respond effectively during waking hours.
There are thought to be four main sleep stages.
Stage 1: Non-Rapid Eye Movement (REM) sleep.
- This is the changeover from wakefulness to sleep, it is a short period of relatively light sleep. Your brain and your body begin to slow and relax, your heart rate and breathing slows and your brain waves reduce from that of usual daytime wakefulness patterns.
Stage 2: Deeper Sleep.
- This is a further relaxing of muscles, slower breathing. Your core temperature drops, and eye movement stops. Your brain activity slows but there are occasional bursts of electrical activity. You spend more of your repeated sleep cycles in stage 2 than any other sleep stage.
Stage 3: Non-REM sleep.
- This is the period of deep sleep that aids you to feel refreshed in the morning. This is when your heart rate and breathing slows to the lowest level, your muscles relax so much it may be difficult to wake you and your brain waves are even slower. This stage occurs in longer periods during the first half of the night.
Stage 4: REM Sleep
- This is ‘rapid eye movement’ sleep and occurs about 90 minutes after falling asleep. It is when your eyes move rapidly, your brain waves become more active however your leg and arm muscles become temporarily paralysed to stop you acting out your dreams. You do most of your dreaming in REM sleep. Your brain waves, blood pressure and breathing become closer to that of when you are awake in this stage of sleep, your eyes move side to side quickly but with your eye lids closed.
We all pass through each of these stages at different times during the night.
What causes poor sleep?
There can be numerous contributing factors including:
- Stress
- Sensory overload
- Pain and discomfort
- Nightmares
- Caffeine
- Poor diet
- Medical condition
- Substance misuse
- Disturbed sleep pattern through shift work / care roles
Why might veterans struggle with sleep?
Many veterans struggle with sleep as they have been trained to go without it in certain situations. They may have been woken frequently during deployments under high threat or experience nightmares relating to their military experiences. However, without sleep, your ability to peak in function drops dramatically almost immediately and your risk of developing health complications increases.
Nightmares are also a contributing factor to poor sleep.
Suggested Resources:
Why is it worse at the moment?
It may be that you’re feeling out of control and your normal routine has changed. You may be working more, or less and you may also have had a change of environment both physically and socially which may be making you feel overwhelmed, particularly the dynamics on your relationship may feel more strained due to the confinement and lead to you feeling unable to relax.
This disruption can feel like a threat and leave you feeling anxious. You can learn more about coping with anxiety here.
Anxiety is a contributing factor to poor sleep for many reasons. It may cause you to feel unable to relax leading to use less helpful coping strategies to manage such as smoking, comfort food, alcohol or drugs, over exercise or under exercise and then develop use of caffeine to try to counter act the tiredness but as a stimulant caffeine only contributes to the problem.
Your usual coping strategies that may help you to ‘switch off’ of - perhaps going to the gym, seeing friends and family or being outdoors - have now been restricted which can contribute to feeling trapped or restricted. It could also leave you feeling lonely and isolated if you are living alone. If you are living with children, it is perhaps that you are prioritising their routine and neglecting your own, feeling like you lack time which leads to poor sleep hygiene practice. You may stay up later watching TV as you’ve not had a chance during the day to ‘have a break.’ This may lead to an increase in use of screen-based technology with exposure to more ‘blue light’ as well as information processing of news which can be triggering could also lead to poor sleep.
How to address poor sleep?
Improve sleep hygiene.
- Set a schedule – go to bed and wake up at the same time each day. If you work shifts try and create a routine which accommodates this.
- Exercise 20-30 minutes per day – do not do high intensity exercise close to going to bed. See here for calming sensory exercises.
- Avoid caffeine and nicotine late in the day and avoid alcoholic drinks before going to bed.
- Relax before bed – try reading, a warm bath and time away from screens.
- Keep your bedroom your bedroom. It may be especially hard at this time to find space for yourself in your environment if you’re living with others and working from home. Try and keep your bedroom the place where you sleep and not a work station.
- Create a good environment for sleep, a nice temperature, little noise and light. Purchase a black out blind if you need to sleep during the day for work.
- Try not to sleep during the day, whilst it may be tempting this could disturb your sleep routine later.
- If you take sleep medication – agree with your GP the best time to take this and ensure you stick to this schedule.
You could also try using sensory strategies to regulate your body ready for sleep – you can learn more about this with our Sensory worksheet below.
Suggested resources:
Is there someone I can call and talk to?
Our 24/7 free Helpline remains open, so please do not hesitate to call if you need someone to talk to or any guidance during this difficult time.
Combat Stress 24/7 Free Helpline 0800 138 1619.
If you feel your anger is placing you or your family at risk of serious harm – please contact the following organizations urgently: