COVID-19 and women’s health: How to get better sleep during the pandemic

Strange dreams, insomnia, overall restlessness. While sleep problems like these have long been an issue in the United States, the impact of the coronavirus pandemic may be exacerbating pre-existing sleep disorders – especially among women, who are more likely than men to suffer from insomnia and other sleep-related issues.

How can women maintain a quality sleeping pattern? Dr. Kanta Velamuri, a sleep medicine expert at Baylor College of Medicine, discusses the importance of sleep, and shares tips for healthy sleep.

Q: What is the relationship between sleep and overall health?
A: Sleep is an integral part of health and well-being. It is a basic biological requirement along with food, water and air. As English dramatis Thomas Dekker elegantly stated: “Sleep is that golden chain that ties health and our bodies together.”

Inadequate quantity and quality of sleep due to sleep restriction or disorders lead to numerous adverse impacts, including cardiovascular, metabolic, neurologic, mental, immunologic health, as well as on human performance and mortality.

Q: What are the risk factors for sleep disorders like insomnia? Why are women disproportionately impacted?
A: Many factors account for this, including hormonal and non-hormonal factors such as presence of anxiety and depression, and social factors such as childcare responsibilities. 

Many women who suffer from pre-menstrual syndrome or pre-menstrual dysmorphic disorder report trouble sleeping with complaints of difficulty falling asleep, frequent awakenings, and non-restorative sleep. Thirty percent of pregnant women and 42% of postpartum women also report insomnia and restless sleep.

Q: How is the COVID-19 pandemic impacting our sleep patterns?
A: The pandemic has led to changes in the normal day-to-day routine for many people. There is an increased burden of balancing work and home-schooling of children. Sleep patterns have shifted with more people tending to stay awake later and waking up later.

Stress levels are increased due to uncertainty, as well as due to illness and loss. Stress is a major factor in sleep problems. For people who already had insomnia prior to COVID-19, a major stressor like the pandemic can lead to post-traumatic stress disorder (PTSD), which can then lead to worsening sleep quality.

A study of Wuhan residents showed that up to 7% of the population reported symptoms of PTSD, and women were disproportionately impacted by these symptoms. The risk was higher in those following COVID-19 news updates for more than three hours a day.

Isolation can also lead to detrimental effects. Previous studies that looked at sleep during quarantine showed younger women were more at risk for negative psychological impacts. However, these studies were of a shorter duration and the effect of this pandemic on sleep is still being studied.

Q: Are quality and quantity of sleep equally important?
A: Both the quantity and quality of sleep are important. The recommended quantity of sleep during a 24 hour period for an adult is 7-8 hours. Both inadequate sleep and excessive sleep are detrimental to health.

Good quality sleep results in sleep satisfaction, which is a subjective evaluation of how satisfied a person is with their sleep. Usually, people feel refreshed upon awakening if they have slept an adequate number of hours and have had a good quality sleep (e.g. how long it took to fall asleep, number of awakenings in the night, condition of sleep).

Q: For women who are balancing priorities, such as work and childcare, what are some things they can do to get healthier sleep?
A: The increased burden of work, childcare, and housework, which is mainly falling on women, can cause women to neglect their own sleep. Here’s some advice to keep in mind:

• It is important to have regular bedtimes and wake times, ensuring adequate quantity of sleep.
• Avoid naps during the day.
• Turn off electronics and bright lights at night. Do not work, watch TV or use devices or tablets while in bed.
• Bedtime rituals such as reading and bath time help initiate sleep.
• Exercising helps promote good sleep – but do not exercise just before bedtime.
• Avoid caffeine late in the day.

Q: Any advice for healthcare workers?
A: Many frontline healthcare workers are facing an increased amount of stress and anxiety. Additionally, many are having to work shifts that impair their usual sleep schedule. Frontline workers should:

• Use the available mental health resources to deal with anxiety and stress.
• Practice self-help activities such as meditation, yoga, and relaxation exercises. This can help improve stress levels after a shift.
• Schedule brief times during the day to de-stress and reflect. Talk to trusted colleagues about your concerns with work situations.
• Limit the time you are exposed to COVID-19 news that is not directly related to your institution.
• For those who are working unusual shifts, it is important to protect sleep during the daytime. Using ear-plugs, turning off the phone or placing it on do-not-disturb, and room-darkening shades are all strategies to ensure good daytime sleep.
• If possible, try to avoid using sleep medications to help you sleep.

Q: How can partners and loved ones help support healthier sleeping habits?
A: Take the time to help your partner de-stress by having quiet times to talk. You can also help support healthy sleeping habits by sharing in the workload of childcare, including bedtime, home-schooling, feeding and general care. Healthy sleeping patterns for the whole family are important in ensuring that women obtain healthy sleep as well.

Dr. Velamuri is an associate professor of pulmonary, critical care and sleep medicine at Baylor. Learn more about sleep medicine services at Baylor or call (713) 798-3300.

Additional Resources

See resources from the National Sleep Foundation.

Visit the CDC website to learn more about sleep disorders.

-By Nicole Blanton