Sleeping Tips When Staying Indoors During Isolation Period

Why does getting up at the same time every day make you sleep better at night? How does the time you eat affect your sleep? How can you combat insomnia? Authorities from Australia and the United States answer these questions, and more.

This information is for people who have to stay indoors for an extended period of time. If you are sleep deprived because of lack of opportunity to sleep (e.g., frontline health professionals, support workers, caregivers), please prioritize sleep and rest as much as you are able to.

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Part 1: Support our body clock and daily rhythms
Sleep is controlled by biological, social, and environmental time-keepers. These include the light we are exposed to, time-of-the-day when we eat our meals, exercise, interact with others, and many more. When we stay indoors for a long period of time, we lose many of these cues. This can be challenging for a good night’s sleep and regular daily routines. Here are some strategies to support our daily rhythms:

• Get up around the same time every day. Your get-up time is like an anchor to your day and night. Keeping a consistent get-up time will help other parts of your day fall into a regular routine and help you sleep better the next night.
• Get bright light into your eyes within a few minutes of getting up and seek light during the day . Our brain’s body clock (or circadian pacemaker) is tuned by daily light. Morning bright light, when received by our brain at around the same time every day, is a powerful time signal of our body clock. Bright light has the added benefit of promoting alertness, which is particularly important if you find it difficult to get going in the morning. Try opening curtains and let in direct sunlight; if you don’t have access to natural light, turn on bright indoor lights.
• Make your first social interaction of the day at the same time each morning. When you are in isolation, interacting with others can be difficult. Try to have a phone or video call with friends or family at about the same time each morning. Even a quick “hello” and check-in is useful. The other person will probably appreciate the human contact too!
• Eat meals around the same time each day, especially breakfast. Eating serves as a time-keeper and helps tune our body clock. Eating meals at the same time of the day supports a healthy biological clock, which is important for sleep.
• Exercise around the same time each day and avoid being sedentary for long stretches of time. Exercise indoors can be challenging. Many video streaming sites have nice at-home workouts you can follow. Here is an example of a 7-minute workout .
• Keep daytime and night-time different and separate. Our body clock benefits from keeping day and night clearly distinguished. During daytime, keep living space full of light, and keep active. For instance, organizing, cooking, cleaning, and indoor exercises. In the evening, keep lights dim, and do quieter activities such as watching TV, reading.
• Keep lights dim and block blue light on electronic devices 1 to 2 hours before bedtime. A dark environment can help your body naturally produce melatonin and prepare your body for sleep. To block out blue light from electronic devices, turn brightness of the screen to the lowest setting, and turn on apps such as f.lux (multi-platform) and Night Shift on iOS and Macs .

Part 2: Prevent and tackle signs of insomnia
Having some nights when you don’t sleep well during a stressful period is expected. The recommendations below can help prevent turning one night’s poor sleep into many nights of insomnia.

• What to do after a poor night’s sleep?
  • Get up at the same time as you usually do. It sounds counter intuitive. However, staying in bed longer to catch up on lost sleep could negatively affect your body clock (see above) so it does not optimally support your sleep. Also, waking up later than usual could make it even harder to sleep well the following night. It might comfort you to know that our body makes up for sleep loss by sleeping deeper , which is as important as sleeping longer.
  • Go to bed the following night around or after your usual bedtime. This means not going to bed too early. If we go to bed much earlier, it could make getting to sleep even harder. Even if you fall asleep fast, you are likely to have more wakefulness in the middle of the night or wake up too early.
  • Remain active and avoid/minimize napping during the day. If you are so tired that you unintentionally doze off, take a brief catnap (10-20 minutes). Otherwise, skip naps during the day, unless you are in a situation where sleep deprivation is a safety issue.
  • Worrying about sleep makes it harder to sleep . After a poor night sleep, it’s understandable to think “how am I going to sleep well tonight?”, “how can I cope with not sleeping well?”. These thoughts actually make us feel more anxious around sleep and bedtime and make sleep harder. Try telling yourself: “I can’t force myself to sleep. Let me focus on relaxing each part of my body, and rest. Sleep will come at its own time.”
  • Trust your body’s sleep system. When you lose that trust and become overly concerned about sleep, you are making it harder for your sleep system to do its job.
• What to do when you cannot get to sleep?
  • The best thing to do is to take a break from trying to sleep . Most of us have been through nights when we toss and turn, our mind racing, and we are feeling frustrated that sleep just does not come. Your experience probably tells you that trying harder does not make sleep come any faster. Paradoxically, it is better to take a break from trying and come back to it later, when you feel that your level of alertness went down. During this “reset” break, you can do something quiet, such as reading or listening to audio content that is not too activating.
  • Focus on getting yourself into a relaxed state of mind and focus on resting. When you worry about sleep, you are not resting. When you try hard to sleep, you are also not resting. Taking a break from trying to sleep will allow you to shift your attention away from making this effort. When you let go of efforts to sleep and focus on resting, your sleep system can take better care of your sleep need.
• Healthy sleeping habits to minimize the impact of isolation on sleep
  • The best time to go to bed is when it’s around your usual bedtime (not too early, not too late), and that you are feeling that “wave” of sleepiness is arriving. For some people this may feel like alertness is lower, eyelids are heavy, thoughts are slowing down. Learn to “surf the waves” of sleepiness, and “catch” it as your bedtime helps fall asleep quickly.
  • Unwind at least an hour before bed. This helps prepare your body and mind for rest and sleep.
  • Do not attempt to sleep when you are alert, fully awake, or distressed. If it is your bedtime and you are feeling this way, take more time to unwind your body and mind before trying to sleep.
  • Bed is for sleep and sex, not wake activities . It’s tempting to move laptop, phone, TV, and even meals into the bedroom and onto the bed. But doing this, could trick our brain into thinking that bed is a place for waking activities, and not sleep. Over time, our brain learns to be more awake, and not sleepy in bed. Keeping bed and bedroom for sleep and sex is a super-helpful thing to do when you spend extended period of time indoors. If you have limited space, and have to use bed or bedroom, you could allocate one side of the bed or bedroom for sleep only, and go to other parts when you are awake. Only do this if you truly have no other options for daytime activities.
  • Be wise with use of substances. Avoid caffeine at least 6 hours before bedtime; cigarettes are alerting, so avoid it in the evening; reduce alcohol – you may feel drowsy after drinking it, but it disturbs your sleep second half of the night, not at all helpful for sleep.
• When to get professional help? If your sleep problems persist for a while, happening on more days than not, severely interfere with what you do during the day, or you are very concerned or distressed about them, it’s a good idea to check with your physician. Most sleep problems respond well to treatments. For example, cognitive behavioral therapy for insomnia is a highly effective non-drug treatment for insomnia, the most common sleep disorder. For more information about sleep, check out National Sleep Foundation and fact sheets from Sleep Health Foundation.

This article is written by Drs Bei Bei, Shantha Rajaratnam, and Sean Drummond from Monash University Healthy Sleep Clinic, Turner Institute for Brain and Mental Health , Monash University, Australia, and Dr Rachel Manber from Sleep Health and Insomnia Program, Stanford University, USA. You may share this information freely with acknowledgement of the source. Contribution to this via Github is welcome. For questions and comments, please contact bei.bei@monash.edu