Sleep Science Friday: Sleep in the time of corona—with Dr. Christine Blume
Sleep Science Friday
It’s the end of another week—grab a coffee/tea/beer/wine and end your week with a quick recap of Sleep Science News!
Sleep in the time of corona—with Dr. Christine Blume
20 November 2020
After nearly a year coping with a global pandemic, some positive news broke recently: Pfizer (with BioNTech) and Moderna recently announced within weeks of each other two possible COVID-19 vaccine candidates. This is especially promising as stress and uncertainty have had huge impacts on our daily lives, with (anecdotal) increases in insomnia (or “coronasomnia”), the advent of “corona dreams”, as well as decreased sleep quality. This is concerning as a well-functioning immune system is linked to getting proper sleep (de Silva et al. 2020; Irwin, 2012; Okamoto et al., 2008), with less sleep associated with a higher risk of getting sick (Cohen et al. 2009, Patel et al., 2012; Prather et al. 2015; Wilder-Smith et al., 2013), as well as decreased vaccine effectiveness (Lange et al., 2011; Prather et al., 2012).
Today we discuss sleep in the time of corona—how the coronavirus pandemic has affected our sleep—with Dr. Christine Blume. Dr. Blume is a sleep scientist at the Centre for Chronobiology in Basel, Switzerland and a member of the Early Career Researcher Network (ECRN) Committee at the ESRS. Her research focuses on circadian rhythms and cognitive processes during sleep, as well as the effects of artificial light on sleep and how the COVID–19 pandemic has affected our sleep patterns. Dr. Blume is also an active science communicator and proponent of scientific outreach.
0:00-0:33 Introduction of Dr. Christine Blume
0:34-5:19 How has our sleep changed during the COVID–19 pandemic? (Dr. Blume begins talking at 1:32)
The pandemic has affected our daily sleep-wake rhythms, which are not only determined by internal biological rhythms, but also social rhythms, such as our working schedules balanced with leisure time. Dr. Blume and her colleagues set out to investigate how the lockdown changed sleep-wake patterns and found that social jetlag (the misalignment between internal biological rhythms and external social rhythms) actually decreased and that sleep duration increased (Blume et al., 2020).
These two findings, from a chronobiological and sleep health perspective, is largely positive as individuals were able to sleep more and follow their internal biological rhythms, rather than external social cues. This may be especially more beneficial for those with later chronotypes, who are normally at a disadvantage, as normal work schedules tend to favor earlier chronotypes.
However, while sleep duration increased, sleep quality appeared to decrease and corresponded to subjective burden and decreases in mental and physical wellbeing related to the pandemic. Although, those who spent more time outside and had more physical activity were able to mitigate some of the negative effects of the lockdown on sleep quality.
While this was a retrospective study, these results have been confirmed by several other studies (Cellini et al., 2020; Leone et al., 2020; Wright et al., 2020)
5:20–8:34 Keeping a routine moving into autumn and winter months
As we move into shorter days and longer nights, Dr. Blume emphasizes the importance of getting enough natural daylight and physical activity; people who spend more time outside under the open sky also tend to sleep earlier and report improved sleep quality, as do those who get regular exercise.
Moving into winter, this may become increasingly challenging as it becomes colder and darker. Dr. Blume recommends setting a daily routine that benefits your rhythm—especially if you work from home. This includes starting your day by going for a short 20 to 30 min walk in the morning and ending your working day with another walk in the afternoon or early evening. This time will also help you prepare for and detach from work, while giving you your daily dose of natural daylight and physical exercise.
8:35-9:58 Bringing the sun inside—light therapy lamps?
Although light therapy lamps are sometimes used in the treatment of seasonal affective disorder or seasonal depression, Dr. Blume recommends trying to get enough natural light.
Although it may not feel like it, the light levels outside even on cloudy, rainy, or overcast days are orders of magnitude higher than inside, she says. And to prioritize natural daylight, which is free, over light therapy lamps. However, if you are unable to leave your home, light therapy lamps could be helpful, as well as spending more time next to a large bright window.
9:59-13:04 Supplementing with Melatonin or Vitamin D
Melatonin is a hormone that is naturally secreted by our bodies that regulates the sleep-wake cycle, with levels increasing after sunset. Therefore, taking melatonin is only effective in cases where you have a deficit. For example, melatonin can help with jetlag when your melatonin levels are high at the wrong time and may also help in older people who have melatonin deficits. However, in most healthy young adults, it should not be a problem. And while some clinical trials are investigating melatonin as a possible (adjuvant) treatment for coronavirus (Acuña‐Castroviejo et al., 2020; Anderson & Reiter, 2020; Castillo et al., 2020; Romero et al., 2020; Zhang et al., 2020), and it is associated with antioxidative and anti-inflammatory effects, it is unlikely to be a cure used by itself.
Vitamin D is also created naturally by our bodies and requires exposure to sunlight, with a lack of exposure to sunlight leading to a deficiency. Some studies have also shown that Vitamin D is effective in preventing acute respiratory infections (Hughes & Norton, 2009; Martineau et al., 2017), so supplementing may be beneficial during the winter months. However, more research on vitamin D and COVID-19 is needed (Bergman, 2020; Mohan et al., 2020). Dr. Blume also cautions that it is possible to overdose on Vitamin D and that you should discuss with your doctor on getting your Vitamin D levels measured to take proper dosages.
13:05-20:19 Are #CoronaDreams keeping you awake?
Earlier this spring in April, reports of strange pandemic-related dreams began to flood blogs and social media, with people sharing under #CoronaDreams.
“So, what people report under this hashtag and what has also now been subject to research is that people say that they dream more vividly, they dream more bizarre dreams and they also dream more and they can remember their dreams better. Now we can of course ask from a scientific perspective, why could that be the case?”
Several theories have been proposed. From an evolutionary perspective, dreams may be a way for the mind to better prepare for the future, by working through situations and how to find solutions. In the Continuity Hypothesis, our daily lives may extend into the dream world—which, unsurprisingly, could explain why we’re experiencing more corona–content in our dreams.
So why do people remember their dreams more or have more bizarre dreams?
There are several scientific explanations for this. First, several studies have already shown that we sleep a bit more during the pandemic. During sleep, we do not only dream during REM (although this is when we have more bizarre and vivid dreams), we dream throughout the night. Therefore, more sleep means we do in fact dream more.
Next, when people sleep more during the pandemic, they tend to extend sleep into the morning hours, which is when you have more REM sleep. This could mean that you do actually experience more vivid dreams and vivid dreams are easier to remember.
Another aspect is related to stress. The pandemic has led to unprecedented social distancing and lockdown measures. Stress is also linked with more bad dreams and bad dreams are remembered more easily as they have a stronger emotional tone. Stress also creates more arousal during sleep, making sleep less deep and consistent and may cause you to wake up more often. And since we tend to only remember dreams that we wake up to, if we wake up more throughout the night, this may feed into this feeling of remembering more dreams.
Lastly, focusing on dreams may prime us to remember them more. So, when you have this social influence, with media and hashtags, this can lead us to focus our attention more on dreams and may consequently lead to people remembering dreams better and talking more about “corona dreams.” However, trends on social media may overestimate this phenomenon and Dr. Blume is excited to see what the future research on this shows.
For those who are suffering from particularly stressful dreams, Dr. Blume also recommends keeping a dream diary. She suggests writing your dreams down and trying to find an active solution for what may be frightening you, and to rehearse this during wakefulness. This may then be picked up in your dream and help with your sleep.
20:20-24:00 Mental health and sleep quality
If possible, getting enough daylight and exercise are two important factors for maintaining your rhythm and for your mental health. Apart from the usual sleep hygiene recommendations, Dr. Blume encourages everyone to not get too caught up with work and shifting your sleep window and to try maintaining a regular sleep-wake cycle—especially if you already have difficulties sleeping.
If you have trouble with thoughts running through your head while lying in bed, she suggests trying some visual cognitive techniques. For example, Dr. Blume sometimes imagines a sky with large white clouds, and that every thought that comes to her mind is placed on a cloud that can drift away. This helps prevent you from engaging with your thoughts and to perhaps drift off quicker.
If sleep hygiene and cognitive techniques don’t help, Dr. Blume advises talking with your doctor. Generally, medication is not recommended as the first step, but rather Cognitive Behavioral Therapy for Insomnia (CBT-I). This can give you the tools to change your cognition about sleep, as well as your behavior, in a way that enables you to learn how to sleep better and offers a better long-term solution than medication.
CBT-I can also be done remotely—with online CBT-I shown to be as effective as in–person treatment. In the UK, the NHS offers the online sleep program, Sleepio; while German speakers may consider, GET Sleep. Similar offers exist in other European countries.
24:00-30:09 Science Communication: Let’s talk science
As public trust of science and scientists waver during the pandemic, and with a growing number of anti-vaxxers, now is an especially critical moment for scientists to communicate with the public. Dr. Blume is an active science communicator, appearing regularly on Deutschlandfunk Nova (a German public radio broadcasting station with lots of scientific content) and writing articles on sleep and sleep-related topics in print media. She actively encourages scientists to share their research outside of the academic world.
“I think the first step is to not think that your research is not interesting or not important enough to be mentioned or that the journal is not good enough…this often relates to imposter syndrome—thinking that what you do is not worth being talked about. But…when you overcome this, you will notice that actually there is always someone who is interested in what you do.”
She suggests being active online, such as on Twitter, which has a strong and active science communication community. Additionally, contacting your press office, getting involved in outreach programs, and creating a simple webpage (so that you are findable online) are all simple ways to get involved with science communication. Although this can be time consuming and challenging to include in your daily work schedules, this also offers an opportunity to expand your own knowledge.
“I always try to see it as an opportunity to really look over the rim of my teacup…and learn about topics that…I don’t usually handle in my daily work…and when you do that, you sort of buildup knowledge around your topic which can be really helpful.”
However, while engaging with the public about your work, Dr. Blume notes, “You have to know what you know, and what you don’t know.” That it is also important to convey your work clearly and that there is no shame in admitting what you or scientific research in general doesn’t know—science is about learning and science communication is about being honest.
Thank you to Dr. Blume. It was a pleasure to discuss how the pandemic has affected our sleep, how to manage our rhythms, and about scientific explanations behind corona dreams. If someone is interested in science communication or science in general, Dr. Blume would be very happy to hear from you.
“I’m always happy to receive emails from people who want to discuss science.”
To get in touch with Dr. Christine Blume, you can contact her by email at christine.blume[at]upk.ch and follow her on twitter, @christine_blume. You can learn more about her research and science communication activity on her website.
For additional reading and recent publications on COVID–19 and sleep:
- Bagci et al. (2020) Effects of altered photoperiod due to COVID-19 lockdown on pregnant women and their fetuses
- Barrett (2020) Dreams about COVID-19 versus normative dreams: Trends by gender
- Casagrande et al. (2020) The enemy who sealed the world: effects quarantine due to the COVID-19 on sleep quality, anxiety, and psychological distress in the Italian population
- Cavalli et al., (2020) Living with fibromyalgia during the COVID-19 pandemic: mixed effects of prolonged lockdown on the well-being of patients
- Erren & Lewis (2020) SARS-CoV-2/COVID-19 and physical distancing: risk for circadian rhythm dysregulation, advice to alleviate it, and natural experiment research opportunities
- Erren et al. (2020) COVID-19 and “natural” experiments arising from physical distancing: a hypothetical case study from chronobiology
- Huang et al. (2020) Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
- Kocevska et al. (2020) Sleep quality during the COVID-19 pandemic: not one size fits all
- Lee (2020) Human Circadian Rhythm and Social Distancing in the COVID-19 Crisis
- Ma et al. (2020) Mental health problems and correlates among 746 217 college students during the coronavirus disease 2019 outbreak in China
- Meira e Cruz (2020) Putative contributions of circadian clock and sleep in the context of SARS-CoV-2 infection
- Murat et al. (2020
- Partinen et al., (2020) Sleep and circadian problems during the coronavirus disease 2019 (COVID‐19) pandemic: the International COVID‐19 Sleep Study (ICOSS)
- Pesonen et al. (2020) Pandemic Dreams: Network Analysis of Dream Content During the COVID-19 Lockdown
- Schredl (2020) Dreaming and the COVID-19 Pandemic: A Survey in a U.S. Sample
- Tendal et al. (2020) Weekly updates of national living evidence-based guidelines: Methods for the Australian Living Guidelines for Care of People with COVID-19
- Taquet et al. (2020) Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA
- Zreik et al. (2020) Maternal perceptions of sleep problems among children and mothers during the coronavirus disease 2019 (COVID‐19) pandemic in Israel
Resources on managing your sleep:
- Crew et al. 2020 The Society of Behavioral Sleep Medicine (SBSM) COVID-19 Task Force: Objectives and Summary Recommendations for Managing Sleep during a Pandemic
- Simpson & Manber 2020 Treating Insomnia during the COVID-19 Pandemic: Observations and Perspectives from a Behavioral Sleep Medicine Clinic
- Sleep Advisor: Got Insomnia? 10 interesting facts about being unable to sleep
- GET Sleep
For similar ESRS articles on COVID-19 and sleep—see past Sleep Science Fridays:
- Sleep in the time of COVID (5 October 2020)
- Covid-19 and sleep (31 July 2020)
Have a great weekend everyone and remember to get your daily dose of sunshine!
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