Can COVID-19 Cause Insomnia?

The latest evidence paints a stark picture that almost 20% of those who have had COVID-19 experience symptoms following the disease resolution, i.e., long covid. Although most common symptoms attributed to long covid have been cardiovascular and neurological in nature, sleep-related disorders are also seen at almost 1.5 times the risk in those with long covid.

Studies looking at survivors of even mild cases of COVID-19 have demonstrated that up to 30% have complaints of insomnia and associated disturbed sleep. Although the exact mechanisms underpinning long covid are yet to be elucidated, it has been shown that SARS-CoV-2 leads to neural inflammation, with even mild cases linked to shrinkage of brain tissue, as well as possible issues with the blood-brain barrier. All possible explanatory mechanisms, explaining the association of sleep disorders following a COVID-19 diagnosis.

Evidence suggests that COVID-19 diagnosis is closely linked to several sleep disorders, including insomnia. In a recent study,¹ around 40% of people recovering from the illness reported a decreased sleep quality. COVID-19-induced insomnia, also known as coronasomnia, is often attributed to mental health conditions such as stress, depression, and anxiety. 

This is no surprise. With many patients succumbing to death, and the ongoing restrictions with seemingly no end in sight, anyone struggling with the virus would experience mental disturbances. This post explores coronasomnia, including its impacts on your overall health and tips to fight back.

But let us begin by looking at the popular myths surrounding the COVID-19 vaccines.

Common myths about COVID-19 vaccines explained

There have been some myths circulating about the COVID-19 vaccines. These can be misleading and make some people scared of getting vaccinated. Let us look at a few of these myths versus the facts to clarify the confusion:

• COVID-19 vaccine affects fertility in women: No approved vaccination against SARS-CoV-2 in the US contains a virus that can replicate and thus cause disease. Vaccines will not affect your fertility. It encourages the body to develop spike protein copies present on the surface of the coronavirus. As a result, the immune system can fight any virus with the spike protein on it. Large studies, including a meta-analysis (a study looking at all available studies), have shown no evidence of direct or indirect harmful effects on fertility, embryo-fetal development, parturition, pregnancy outcome, or short-term postnatal development of offspring. If anything, vaccination was protective against the risk of stillbirth (about 15% lower in the vaccinated cohort), as COVID-19 during pregnancy is associated with bad maternal and fetal outcomes.

• You don't need a vaccine if you already had COVID-19: The latest evidence demonstrates that a recent COVID-19 infection provides some protection against subsequent infections. However, such protection is of short duration and is variant specific. As of September 26, there are three main variants of concern in the US — none of which provide sufficient cross-protection against each other. If you get infected with one, you’re still susceptible to the other variants. Vaccination appears to boost antibody levels and cell-mediated responses in those with past infections and has been shown to improve durability and breadth. Furthermore, vaccination of individuals that have had COVID-19 before is associated with better protection against hospitalization in subsequent COVID-19 infections and a lower risk of breakthrough infections.

The vaccine continues to be the best protection against the virus, whether you have had it or not. Studies² show that those who have had COVID-19 before and are not vaccinated have twice the risk of getting reinfected than those who have been infected and are vaccinated. While it’s believed that there is some immunity from catching the virus, it is unknown how long you will be safe from getting COVID-19 again, given the ever-changing variants of concern. Besides, the immunity level of vaccines is higher and offers greater protection against the virus.

• The COVID-19 vaccine development was rushed, so its safety and effectiveness cannot be trusted: The SARS-CoV-2 vaccine development was indeed accelerated, owing to the nature of the pandemic in the face of 21st-century technology and $18 billion provided for vaccine development by Operation Warp Speed. Such acceleration did not come at the cost of safety. All safety criteria remained stringent, and all vaccines went through standard preclinical and clinical stages of development. It is also true that the mRNA vaccine platform was used for the first time to fight SARS-CoV-2. However, this technology has been under development for about a decade and has been tested against various infectious agents. The vaccines have also been exceedingly safe, with a very rare risk of myocarditis with the mRNA vaccines (about 50 cases per million doses, i.e., one in two million doses, i.e., one person in Chicago if the whole city was vaccinated). You’re more likely to catch COVID-19 and develop myocarditis.

• The truth is that the vaccines have undergone sufficient research and have proven to be effective. For those still weary about the mRNA vaccine, there’s now also a “classical” vaccine option, Novavax. This vaccine is based on an adjuvanted recombinant protein, not unlike a hepatitis B vaccine, which was developed on the classical vaccine platform that has been commonly used over several decades.

• Getting a COVID-19 vaccination means you can stop wearing your mask and take safety precautions: CDC recommends continuously wearing masks and observing social distancing even for those who are fully vaccinated. Vaccination does not prevent you from contracting the disease. It offers a better disease-fighting mechanism. Although initially thought to protect against breakthrough infections, it’s been shown that the vaccine’s effectiveness wanes over time. And with the advent of much more infectious variants such as Delta and Omicron, vaccines do not fully protect against infection. The role of vaccines at this stage in the pandemic has evolved to be protective of severe disease and hospitalization as well as possible minor protection against long covid. Finally, data demonstrate that breakthrough infections in the vaccinated are shorter, milder, and more likely to be asymptomatic.

People also ask: What are COVID-19 vaccine side effects, and how long do they last? People respond differently to the vaccine. Some have reported several side effects, which are normal and indicate that the body is developing protection. These side effects are typically limited to the first two days after the vaccination. The most common ones include: 

• Swelling

• Redness

• Pain

• Headache

• Tiredness

• Fever

• Nausea

• Chills

Over-the-counter medicines like acetaminophen, ibuprofen, and aspirin can help to relieve the effects. You should consult your doctor before taking any of them.

Why does coronasomnia happen?

Coronasomnia is characterized by increased sleep problems during times of COVID. COVID-19 patients are likely to develop sleep disruptions because symptoms during the acute phase of the disease make it difficult to rest. Among them are continuous coughing, shortness of breath, body aches, and fever.

However, in the longer term, COVID-19 is associated with neurological damage, including brain shrinkage, even in mild cases, as well as vascular damage. Studies³ have shown that sleep-related disorders and insomnia are common in COVID-19 survivors and can possibly be explained by the damage to the blood-brain barrier or general vascular and neurological inflammation caused by the SARS-CoV-2 virus.

Similarly, healthcare workers, specifically those who work directly with COVID-19 patients, have higher rates of anxiety, depression, poor sleep quality, and insomnia. These individuals have the highest exposure to the disease and have elevated pressure over the infection.

Additionally, experiencing supply shortages and witnessing hundreds of patients die in their care can lead to depression. Many physicians and nurses report sleep disturbances.⁴

The general public or non-patients are also likely to experience coronasomnia due to fear of contracting the disease and stress from losing their loved ones. Stressful life events like terrorist attacks and natural disasters affect psychological well-being and cause sleep problems.

The COVID-19 pandemic qualifies as one such event, causing everyday emotional stress that reduces the time people spend in restorative slow-wave sleep. 

Broken routines fuel coronasomnia

Besides anxiety, stress, and depression, the change in our regular routines has also led to an increased rate of coronasomnia. Although many public places like schools, restaurants, movie theaters, and bars have reopened, many events still occur virtually. Many people still work from home, disrupting their everyday routines. 

Chronic insomnia is typically an issue with physiological activation, especially in the absence of a comorbid psychiatric condition. Thus, increased activation (anxiety) is the core of the problem rather than a primary sleep issue. Countries also have varying mask and vaccine regulations, making people lack stimulation and activity variety.

Getting involved in many activities often stimulates sleep. So, staying indoors with little to do may contribute to poor sleep. 

Coronasomnia and increased media consumption

People across the globe have significantly increased their media consumption to keep up with the latest COVID-19 information. They rely on many news sources, leading to higher mental distress levels. The behaviors of checking the news frequently and spending more time consuming the news media have both been associated with higher anxiety levels.

Even worse, elevated media consumption often happens at night, close to bedtime, with the light of the bright screens of tech devices leading to issues with our circadian rhythms, causing phase disorders.

More time on screens means higher blue light exposure, which increases your cortisol levels while suppressing melatonin. It makes you feel more stressed and alert instead of relaxed and ready for sleep. 

How coronasomnia impacts your health

The cumulative sleep disorders and sleep loss effects have been associated⁵ with various harmful health concerns, including increased risk of diabetes, hypertension, obesity, stroke, and heart attack.

According to the National Library of Medicine,⁶ prolonged insomnia also increases the risk of mental health problems like anxiety, depression, confusion, and frustration. People with coronasomnia are likely to experience these health issues. 

Tips to help you sleep during the COVID-19 pandemic

If you are experiencing coronasomnia, you need not worry. There are many practices to help you fight it and get better sleep. Improve your sleep hygiene, establish a day and night routine, and manage your stress. Here is how!

Improve your sleep hygiene

Hygiene is a term for the habits you have surrounding your personal care. Just like dental hygiene focuses on brushing and flossing your teeth, sleep hygiene requires healthy habits that enhance restful sleep. The following strategies will help you improve your sleep hygiene:

• Get a regular sleep schedule: 7–9 hours of sleep is considered sufficient for adults. Set bedtimes and wake times that fall between this range and follow them daily, including on weekends.

• Avoid prolonged naps: A 20–30 minute nap can energize and refresh you. However, sleeping longer during the day can make it difficult to find sleep at night, particularly if the nap is longer than an hour and late in the day.

• Get a sunlight dose daily: Light plays the strongest role in regulating our circadian rhythms.⁷ You can spend time near the window or outside to reset your circadian rhythms, especially in the morning.

• Limit your caffeine intake: Excessive caffeine consumption can disrupt sleep. If you have to, take in moderation at least six hours before bed, meaning no caffeine after lunch to allow for sufficient clearance of caffeine from the body.

• Limit alcohol: Alcohol, while initially sedating, negatively affects sleep architecture and thus should be avoided, especially near bedtime.

• Avoid nicotine: Nicotine is a stimulant and thus should be avoided after sunset. 

• Make your bedroom quiet, dark, and cool: Declutter your bedroom by clearing anything that reminds you of stress, such as your computer or work papers. Make it darker to create an enticing sleeping environment and avoid exposure to technology such as a TV.

• Have your dinner early: Eating late can cause stomach upset and lead to restless sleep. You should eat at least one hour before bedtime and switch to sleep-promoting foods like milk and nuts. 

Develop daily routines

Routines create cues in our brains of when to work, eat, and feel alert and tired. Following a daily routine gives you a sense of normalcy that reduces stress. Set clear times to begin and end work, take your meals, and, if possible, schedule regular breaks outside. 

For instance, morning walks re-energize you and can reinforce your natural sleep cycles. At night, practice a bedtime routine and repeat that every day. They will signal to your brain that it's time to sleep. You can listen to calming, gentle music or read a book. 

Relieve your stress

With or without the pandemic, stress makes it difficult to sleep. Journaling or regular exercise may help to reduce stress and promote sleep. Practice clearing your mind of the stressful information about the pandemic.

You can try writing down all that is stressing you. Putting pen to paper helps flush out such thoughts while reframing negative feelings with positivity. Getting vaccinated against COVID-19 can also help reduce stress because it gives you a sense of safety.

Take a break from the news

Try to avoid digesting new stressful information, especially in the evening hours. Do not scroll through your social media or watch the news when you are about to go to bed.

Worrisome and sensational news stories can activate your sympathetic nervous system and cause anxiety when you need to be calm. Understand that things are currently tough, but they will get better. 

The lowdown

Coronasomnia can be frustrating and potentially affect your quality of life. In most cases, people do not consider it a condition that requires medical attention, despite how miserable it makes them feel. If you experience weeks of sleepless nights, treatment may benefit you. Discuss it with your healthcare provider, and let them guide you on the best treatment options.