Do you experience insomnia due to the COVID-19 pandemic? How does this affect your mental health? Is there a relationship between insomnia and mental health?
This article explores this issue by reviewing studies focused on the relationship between insomnia and mental health. It also lists the methodologies applicable to online studies. The methods mentioned can guide researchers to conduct similar studies in their respective locations.
The pandemic has greatly affected everyone because of the huge impact on people’s way of life. Some experience difficulty in meeting their basic needs during lockdowns. Suddenly, everyone has to stay indoors, in the safety of their homes, to avoid contracting the dreaded disease caused by SARS-COV2.
When will this pandemic ever end?
While some people have gradually gone out of their homes and resumed their economic activities, particularly in places where vaccines are accessible, some still struggle to surmount the challenges of being confined in their homes.
As a result, many people develop insomnia due to worries about what the future holds for them. The outlook seems bleak among the marginal families who need to work daily to make ends meet.
The inability to work and the apprehension of getting infected by COVID-19 brings sleepless nights, for days and even weeks. Long-term sleeplessness leads to insomnia or lack of sleep. A person with a sleep disorder has difficulty getting asleep, wakes up too early, and has a problem getting back to sleep. Tiredness ensues, energy levels are down, and irritability occurs. Work performance suffers as a result.
Those who could not cope tend to have chronic mental health issues leading to much more critical health conditions.
How does insomnia affect mental health? What factors cause insomnia?
I listed the methods used by the researchers in investigating the link between insomnia and mental health as reference for those who would like to study the phenomenon.
Online cross-sectional survey
A cross-sectional survey looks at data from a population at one specific point in time. The instruments used include the following:
- Insomnia Severity Index,
- UCLA Loneliness Scale,
- Athens Insomnia Scale,
- the Intolerance to Uncertainty Scale,
- the De Jong Gierveld Loneliness Scale,
- Patient Health Questionnaire-2 Depression Scale,
- Insomnia Severity Index,
- Generalized Anxiety Disorder-7,
- Patient Health Questionnaire, and
- Impact of Event Scale-Revised Questionnaire
Notice that a battery of different tests measured insomnia and mental health. Data acquisition involved self-reporting given the contagious nature of COVID-19. The respondents marked their total sleep time, bedtime, and wake-up time. Information on sociodemographics, antecedents of mental and physical health conditions, and COVID-19 related stressful events were also noted.
Some of the studies involved hundred, and even thousands of participants. The greater the number of respondents, the more reliable the results of the studies. Hence, the findings mentioned in the following list give a high degree of confidence, thereby making them handy references in dealing with insomnia and mental health-related issues.
Findings on Insomnia and Mental Health
Who are Prone to Insomnia?
According to Wang, et al. (2020), COVID-19 patients tend to be female, younger age, and with higher fatigue and anxiety severity were more likely to experience insomnia disorder. Women and people in urban areas were more vulnerable to sleep problems, while younger age showed a non-significant trend. Those uncertain about having themselves, or someone close to them contracted the coronavirus, also demonstrated elevated insomnia scores. Lastly, according to the regression analysis, higher levels of intolerance to uncertainty, COVID-19-related worry, loneliness, as well as more severe depressive symptoms, were all predictive of insomnia.
Most of those affected during the pandemic are front-line personnel like the healthcare workers and skeletal workforce. Atypical work schedules greatly affected nurses and doctors who serve the needs of the virus-infected patients in addition to a load of non-COVID-19 cases.
Causes of COVID-19 Insomnia
Based on the studies that I have reviewed, the following are the causes of COVID-19 insomnia:
1. COVID-19-Related Worries
Anything COVID-19 related can cause insomnia. We can see the ups and downs of cases each day and being too anxious about what this pandemic will do to our life subconsciously affects sleeping patterns.
Lonely people tend to get insomnia. And being more so during the pandemic because of the limited contact with other people worsens the feeling of loneliness.
Kokou-Kpolou, et al. (2020) confirmed COVID-19-related worries and loneliness as the major contributing factors to clinical insomnia. Clinical insomnia refers to the observation and treatment of actual patients rather than theoretical or laboratory studies.
3. Uncertain About Having Themselves Contracted the Virus
As we expose ourselves outside due to the necessity of supplying our daily needs during the pandemic, the possibility of contracting the virus is high. This uncertainty of having contracted the virus, especially if you know someone close to you has got it, contributes to insomnia. It may be a matter of time before you get the virus yourself.
4. Being Infected by the Virus
Once an individual gets infected by the COVID-19 virus and exhibiting the symptoms, insomnia results.
Depression has also been linked to insomnia. According to Mayo Clinic, depression refers to the mood disorder that causes those affected with a persistent feeling of sadness and loss of interest. It affects how you feel, think and behave.
When insomnia has worsened, it gives rise to a variety of emotional and physical problems. Eventually, the situation culminates in a feeling that life is not worth living.
6. Economic-related stress
For those living on a hand-to-mouth existence, economic-related stress arises due to the COVID-19 pandemic causing insomnia. Virtually everyone’s finances are affected, although some have found refuge in online work that can relieve them of this stress. Those who have difficulty doing so experience insomnia.
9. Changes in Daily Life
In general, significant changes in daily life due to constraints imposed by COVID-19 cause insomnia. The pandemic has changed the routine activities of the day such as waking up for work, meeting other people, work routines, leisure time spent outside of the home, among others.
10. Higher Levels of Intolerance to Uncertainty
As the higher the intolerance level of a person to uncertainty, the worse insomnia gets. Being too anxious of the uncertain situation imposed by COVID-19 prevents many of those involved in the study from getting adequate sleep.
Insomnia and Mental Health
Given the COVID-19 causes of insomnia, what then are the mental health effects that manifest among those affected? Here is a list of mental health issues due to COVID-19 insomnia.
- People, at their worst attack of insomnia, tend to commit suicide. Having those sleepless nights due to COVID-19 and the uncertainty it brings causes people to consider ending their life. But of course, that’s an undesirable refuge when faced with problems as there is no going back. Many other options arise if you give another shot at life.
- Findings reveal that the multivariate logistic regression model suggested that insomnia worsened during the outbreak of COVID-19. It is associated with mental health.
- The causes of insomnia listed above are precursors of psychiatric disorders. Psychiatric disorders refer to mental illnesses that greatly disturb your thinking, moods, and behavior.
Some Recommendations to Counter Insomnia and Mental Health Impacts
Apply Interventions that Work for You
I listed 25 ways on how to fight insomnia based on my experiences and readings. Identify the underlying causes and eliminate inapplicable ones if you are one of those affected.
- Sleep strengthens the immune system. It may even help stop the pandemic as melatonin, the hormone that facilitates sleep, could potentially block the COVID-19 virus. The following video explains why this is so.
Gholizadeh et al. (2021)’s mini-review on melatonin observational studies suggested the following outcomes:
- it decreases the severity of the outcomes of COVID-19 patients in their early-stage or even in their critical conditions,
- melatonin decreases pneumonia and reduces lung damage,
- it plays an important role as anti-inflammatory, anti-viral, and antioxidant activities, and
- it decreases the viral load at the molecular level.
More studies, however, are suggested to strengthen the findings.
Develop Therapeutic Strategies
Mayo Clinic lists several therapeutic strategies in lieu of sleeping pills. This strategy is called Cognitive Behavioral Therapy.
Social Policies to Support Insomniacs
The inability to sleep requires public policy that supports those who are affected in the wake of COVID-19. Creative means may be drawn from existing ones such as those recommended by Barnes and Blake (2015). Educating the public about the factors that cause insomnia during the pandemic will help them recognize the problem and find appropriate solutions.
For example, economic-related worries can be overcome by offering more jobs online. Or support strategies that make efficient the implementation of online classes and approaches, such as the Blended Website Learning System, that enable students to save on bandwidth and cost. Thus, they save money and cope up more easily with the challenges of online learning. In addition, students and teachers minimize their exposure to blue light that causes insomnia.
Regular Updates to Reduce Uncertainty
Knowing what is at hand can reduce uncertainty levels. Educating the public about the latest scientific breakthroughs that can allay fears of a worsening situation, or even relaying truthful statistics, whether positive or negative, can help a lot. The fear of the unknown will be minimized thus establishing better sleep outcomes.
We can do our share by sharing information like this to help those afflicted with insomnia due to COVID-19.
Barnes, C. M., & Drake, C. L. (2015). Prioritizing sleep health: public health policy recommendations. Perspectives on Psychological Science, 10(6), 733-737.
Gholizadeh, M., Abaj, F., Hasani, H., Mirzababaei, A., & Mirzaei, K. (2021). Does the melatonin supplementation decrease the severity of the outcomes in COVID-19 patients? A mini review of observational data in the in vivo and in vitro studies. Melatonin Research, 4(2), 348-359.
Killgore, W. D., Cloonan, S. A., Taylor, E. C., Fernandez, F., Grandner, M. A., & Dailey, N. S. (2020). Suicidal ideation during the COVID-19 pandemic: The role of insomnia. Psychiatry research, 290, 113134.
Kokou-Kpolou, C. K., Megalakaki, O., Laimou, D., & Kousouri, M. (2020). Insomnia during COVID-19 pandemic and lockdown: Prevalence, severity, and associated risk factors in French population. Psychiatry research, 290, 113128.
Li, Y., Qin, Q., Sun, Q., Sanford, L. D., Vgontzas, A. N., & Tang, X. (2020). Insomnia and psychological reactions during the COVID-19 outbreak in China. Journal of Clinical Sleep Medicine, 16(8), 1417-1418.
Morin, C. M., & Carrier, J. (2021). The acute effects of the COVID-19 pandemic on insomnia and psychological symptoms. Sleep medicine, 77, 346.
Voitsidis, P., Gliatas, I., Bairachtari, V., Papadopoulou, K., Papageorgiou, G., Parlapani, E., … & Diakogiannis, I. (2020). Insomnia during the COVID-19 pandemic in a Greek population. Psychiatry research, 289, 113076.
Wang, Y., Zhu, L. Y., Ma, Y. F., Bo, H. X., Deng, H. B., Cao, J., … & Wu, X. J. (2020). Association of insomnia disorder with sociodemographic factors and poor mental health in COVID-19 inpatients in China. Sleep Medicine, 75, 282-286.
© 2021 October 24 P. A. Regoniel