Sleep Suffers But Also Shields [Editor’s Message]

The sleep disturbances caused by the global pandemic are far reaching—and sleep medicine professionals play a unique role.

By Sree Roy

We will likely still be identifying collateral damage from the SARS-CoV-2 pandemic years from now. Some schoolchildren will be struggling to catch up. Chain restaurants might dominate the landscape. The question of whether to place loved ones in nursing homes may become even more fraught than before.

The sleep disruption brought on by the coronavirus is likely to impact the sleep medicine subspecialty in the short- and long-term. Poor sleep is a normal reaction to stress, but the reach of coronavirus-related stress is unprecedented in both duration and geography. Already, we are seeing an uptick in the number of prescriptions being filled for insomnia.¹ These patients are in addition to those who had their sleep studies postponed or needed in-person help acclimating to therapies—who will still require sleep disorder management when the virus is under better control. Sleep professionals will eventually have their schedules fill with these patients.

For now, sleep specialists should speak out to alert the public that sleep health remains important—particularly during times of great stress.

One of the best analogies I’ve seen described sleep as a “shield” against stress. Research fellows and a professor at The University of Queensland said, “When you don’t get enough sleep the shield cracks and you are more susceptible to stress. But when you get enough sleep the shield is restored.”² And of course, cracks in the sleep shield make many aspects of life worse, from lowering immunity to raising blood pressure.

[RELATED: National Sleep Foundation Releases Position Statement on Sleep in a Time of Pandemic]

It is also important for sleep professionals to protect their own sleep, including—and perhaps especially—those who find themselves on the front lines, such as respiratory therapists reallocated to the ICU and pulmonologists who are diagnosing COVID-19 patients. (Thank you for your dedication.) Almost one in four health workers in China reported sleep problems during the pandemic, according to a study, which also noted that this percent was significantly higher than workers in other occupations.³ The study has insights applicable to the United States. “One possible reason is that many health workers are sent to the front to fight the sudden outbreak, the working intensity and time of healthcare workers will increase in the face of severe epidemic, resulting in them not having enough time to rest, and prone to chronic stress and psychological distress….In severe cases, PTSD symptoms may even occur, which is highly correlated with poor sleep.”

The authors add, “Psychological first aids could be delivered by someone who understands the basic principles, training community volunteers in the future might be an effective and sustainable way to alleviate the mental stress of the general public during times of crisis.”³

In the United States, such psychological aid is available for physicians via “Physician Support Line,” which launched March 30 and is available at 1-888-409-0141. I hope you will call as needed for assistance with your sleep and other issues. (If you are a psychiatrist who wants to volunteer your time, visit www.physiciansupportline.com.) By guarding our own health, we can take care of others.

Sree Roy is editor of Sleep Review.

References

1. Express Scripts. America’s State of Mind Report. Available at https://ift.tt/3cs9EFq.
2. Pattinson C, Rossa K, Smith S. Sleep won’t cure the coronavirus but it can help our bodies fight it. The Conversation. Available at https://ift.tt/2UERZ7l.
3. Huang Y, Zhao N. Mental health burden for the public affected by the COVID-19 outbreak in China: Who will be the high-risk group? Psychol Health Med. Available at https://ift.tt/2Ml684F.

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