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Covid-somnia messing with sleep cycles

NEW DELHI: For the past six months, Sreyashi, 39, has tried pacing up and down her terrace at midnight to tire herself out, gulped down a drink or two to calm her nerves, and even curated a playlist of guided sleep hypnosis videos to reset her circadian rhythm.
Yet every night, she finds herself restless over everything from the dismal state of rising Covid cases to the sorry shape of her love life. Even since the pandemic broke out, all Sreyashi has wanted is a proper night of shut-eye. “My routine used to be awesome. I’d hit the bed by 12am and be up by 7am because I had to go to work. Now, it’s as if my mind can’t concentrate on one single thing. Sometimes I’m up till 4am and then I have to pull my eyes open to somehow wake up,” says Sreyashi, a corporate lawyer from Santacruz.
The pandemic-induced stay-at-home order has tossed people’s schedules out of the window and along with that a good night’s sleep, creating a massive new population of chronic insomniacs. ‘Covid-somnia’ is what physicians and researchers who specialise in sleep disorders call this surge in disrupted or reduced sleep associated with Covid-19.
“There has been an increase in sleep disorders in the time of Covid — ranging from insomnia, which is lack of sleep, to hypersomnia, which is excessive sleepiness. Our body clock is governed by a day and night cycle and people follow social cues to go out for work, study, physical activities which have all been disrupted by an unpredictable virus as well as the work from home culture,” explains Dr JC Suri, pulmonologist at Fortis Hospital, Delhi and founder-president of the Indian Sleep Disorders Association. “We are witnessing around a 15% increase in complaints of sleep disturbances now. In 40% of the cases, the underlying cause is acute anxiety and stress stemming from a morbid scare of the disease, social isolation, financial insecurities, physical inactivity and constant exposure to breaking news,” he adds.
While the prevalence of Covid-somnia is being reported across all age groups, teenagers and young working adults between 25 and 45 years may have taken the biggest hit. “The elderly already had fairly a relaxed schedule. But students and young adults don’t have a fixed routine to adhere to and are hooked to their gadgets. Many have reported logging into online classes or meetings and then dozing off midway,” explains Dr Jayalakshmi T K, head of the Sleep Lab at Apollo Hospitals, Navi Mumbai.
It has other effects too.“Lockdown delayed a patient’s sleeping time to 1.30 am, which disrupted his eating cycle and led to gastroesophageal reflux disease. Another patient, despite being on multiple sleep medications, was unable to fall asleep and developed palpitations due to anxiety,” says Dr Jayalakshmi.
The somnologists at International Institute of Sleep Sciences (IISS) in Thane conducted a randomised study of 150 people this March. Nushafreen Irani, research coordinator at IISS, says 25-30% were suffering from non-restorative sleep, which is not feeling fresh even after 8 hours of sleep. “This must have gone up to 50% from what we’ve observed. Patients who already had sleep issues but were managing say that it’s unbearable now,” says Irani.
Another insomnia-inducer is the growing use of devices. “The constant beeping or vibrating of the phone keeps me on the edge, making it harder to fall asleep,” says Ashok Menon, 38, whose bedroom once an electronics-free sanctuary now serves as a makeshift office. “This is a Pavlovian response once the bed starts getting associated with work and worry instead of a place to rest and sleep,” says Irani.
An hour of screen-free time before bed could help transition to restful sleep. “Unfortunately, people try to unwind by watching TV or scrolling on their phones, which is a self-defeating exercise. Blue LED light from screens inhibits the release of melatonin, the sleep inducing hormone and tricks the brain into believing it’s daytime,” says Dr Rajesh Parikh, neuropsychiatrist at Jaslok Hospital and Research Centre, who has treated over 50 patients with sleep disorders in the past few weeks. “However, most of them approached me for anxiety and depression, not primarily for sleep disorders,” he adds, which points to the fact that most people with sleep trouble rarely seek medical advice.
“When lack of sleep starts affecting daytime functioning to an extent that one feels fatigued, cannot concentrate, and suffers from intense mood swings, it’s time to seek medical help,” advises Dr Suri, who set up the first sleep lab in the country at Delhi’s Safdarjung Hospital in 1991.
However, there has only been a glancing interest in insomnia, not a medical specialty in India, yet. “One can consult neurologists, pulmonologists and psychiatrists but certainly not the neighbourhood chemist!” signs off Dr Parikh.

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