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Jefferson Health

Home of Sidney Kimmel Medical College

How to Upgrade Your “Sleep Hygiene” During Coronavirus Outbreak

Sleep releases cytokines that need to increase to effectively fight infection. Here's what you can do to ensure you get the zzz's you need.

With thoughts of the coronavirus pandemic taking up space in our collective consciousness, it’s no surprise that sleep deprivation – already a serious health issue for millions of Americans – has itself become a health crisis.

Sleep deprivation was a problem long before the COVID-19 pandemic. Back in 2014, the CDC labeled sleep deprivation a public health epidemic—with over 70 million adults suffering from a sleep disorder.

“Insomnia is quite prevalent to begin with,” says Dr. Dimitri Markov, a sleep specialist with the Jefferson Sleep Disorders Center. “Now, with such a significant stressor uprooting people’s lives, people tend to lose track of the helpful behaviors that helped them function better in the past, including good sleep behaviors.”

Maintain Good Sleep Hygiene

In times of increased anxiety and stress, it can be easy to lose sight of how our daily habits influence our ability to sleep well. The concept of sleep hygiene, Dr. Markov says, focuses on how to use your habits and routines to your advantage when it comes to sleep. It also includes optimizing your sleep environment so that you can relax and rest easy when you turn in for the night. “Sleep hygiene is a series of rules, almost like a prescription, of what to do and what not to do – basically prescribed behaviors.”

There are myriad ways to upgrade your sleep hygiene, but some key examples include:

  • Avoiding caffeine or other stimulants after 1 p.m. when they could make it hard to get to sleep. [Check out our list of foods that promote sleep.]
  • Setting a consistent sleep schedule so that your body and circadian rhythm work to your benefit.
  • Following the same bedtime routine every night to help you mentally and physically wind down in preparation for sleep.
  • Making your bed comfortable and supportive and your bedroom free of excess external light or sound that might be disruptive.
  • Minimizing the use of electronic devices, including mobile phones, in the hour leading up to bedtime because they create mental stimulation and emit blue light that can suppress the body’s production of melatonin, a hormone that promotes sleep.
  • Stopping the common practice of tossing and turning. If you can’t fall asleep within about 20 minutes of going to bed, get up and do a low-key activity (like reading) in dim light until you start to feel drowsy.
  • Avoiding looking at the clock in the middle of the night.
Woman sitting in comfy bed with cup of tea
Make your bed comfortable and supportive and your bedroom free of excess external light or sound that might be disruptive.

Get Back to the Routine

Maintaining a routine, Dr. Markov says, is especially important for a good night’s sleep. With so many people working from home, that can be a challenge. If you don’t have to wake up early to catch that train, for example, maybe you stay up a little later – and sleep in a little longer. As a result, maybe you feel the need to take a brief nap in the afternoon. “All of this can lead to sleep curtailment and sleep deprivation,” Dr. Markov says. “And we do feel more stressed when we’re not in these established, familiar routines.”

Wake up at a consistent time every morning, Dr. Markov advises, take a shower, get dressed – maybe as if you are actually going to work. It will certainly help with those Zoom calls. “You need to keep up appearances,” Dr. Markov says. “If you are on a video conference, you are being watched.”

Sleep and Your Immune System

One of the best ways to protect against this virus is to boost your immune system. Since sleep is a natural immune booster, getting a good night’s rest is one way you can protect yourself. Studies show that people who don’t get quality sleep or enough sleep are more likely to get sick after being exposed to a virus, such as a common cold virus. Lack of sleep can also affect how fast you recover if you do get sick.

During sleep, your immune system releases proteins called cytokines, some of which help promote sleep. Certain cytokines need to increase when you have an infection or inflammation, or when you’re under stress. Sleep deprivation may decrease the production of these protective cytokines. In addition, infection-fighting antibodies and cells are reduced during periods when you don’t get enough sleep.

Get Some Exercise, Get Some Sun

We know. Gyms are closed. But Dr. Markov recommends maintaining at least some level of physical activity – preferably earlier in the day, or at least not close to bedtime. Many gyms are offering classes online, which, Dr. Markov says, can also provide a sense of social interaction. “If your gym is streaming classes, you know you’re exercising with your exercise buddies.”

And why not include the added benefit of sunlight. According to the National Sleep Foundation, light is a powerful guide for your body. In part through the connections between the eyes and the brain’s biological timekeeper, light rays influence chemistry and behavior and keep us in sync with the ebb and flow of the day.

“If you can get outside, without a lot of people being around of course, by all means,” Dr. Markov says. “But at least open up the curtains during the day and let some sunlight in.”

Keep in Touch

Which brings us to another important routine – staying in touch with friends and family. “We are social animals,” Dr. Markov says. “We are all stuck at home, but try not to be alone or isolated. If your family is far away, use video chats to contact family or friends. It’s important to maintain those routines as well.”

An Unstoppable Force

In the end, Dr. Markov says, sleep should prevail – as long as you’re doing all you can to counteract stress and anxiety. “Sleep is one of the three most powerful forces in nature,” he says. “Sleep, hunger and sex drive. Sleep will overpower you. Sleep cannot be stopped.”

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COVID-19, Healthy You