COVID-19 lockdown anxieties take toll on sleep cycles of people: Medical experts

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New Delhi: Binge-watching till dawn, playing endless online games, video chats until the sun rises or simply staring into darkness while everyone around is in deep slumber? wakeful nights are no longer about once in a while but too often for comfort.

As India navigates the ninth week of the nationwide lockdown that pushed millions of people into the confines of their homes, distress and anxiety are on the rise, manifesting primarily in the form of sleep disorders.

Medical experts said the number of consultation calls over erratic sleep cycles have shot up since the country went into lockdown on March 25 to stem the spread of COVID-19. 

"People are living with many uncertainties and insecurities. Worrying about health, job and financial security and managing household chores alongside office deadlines, all the while working from home are among the factors influencing our sleep quality," said Gulshan Kumar, a neurophysiologist at the National Institute of Mental Health and Neurosciences (NIMHANS).

The Bangalore-based medical institution has also seen an increase in the number of queries related to sleep issues like insomnia since the lockdown started, he said.

Quantifying the stress over jobs, working from home, a pandemic that shows no signs of ebbing and an uncertain future, a pan-India survey by wakefit.Co revealed that 44 per cent of 1,500 respondents were getting less than six hours of sleep during the lockdown.

The number of people facing a sleep crisis before March 25 was significantly lower at 26 per cent, the survey by the Bangalore-based sleep solutions company added, while many complain of insomnia and sleep deprivation, there are some who are seeking treatment for oversleeping or hypersomnia.

And there are those like Gaganjot Kaur who have both insomnia and hypersomnia. The 33-year-old said she cannot remember even one night of restful sleep in the last two months.

Most nights she can get barely get three hours of sleep, but there have also been days when she's slept for 10 hours at a stretch and still wakes up feeling unrested.

"It's not like I am consciously trying to stay awake. I find myself up at three in the morning for no reason. It's almost like there is a disconnect between my body and its need for sleep,? the Delhi University philosophy professor said."

She said she had been diagnosed with General Anxiety Disorder (GAD) a few years ago and was seeing a therapist. But her condition aggravated in the last two months. 

Gaganjot, who enrolled in a Phd course recently, said she was initially thankful for the lockdown, assuming it would give her a lot of time to focus on her research work. But as it kept getting extended, she found her mind inundated with panic-inducing thoughts.

"I think about hundreds of things when I lie awake in bed, but I immediately start spiralling when I think of my career. I constantly feel I am not being productive enough. Another thing I cannot stop worrying about is my parents, who are extremely vulnerable to the coronavirus infection," Ganganjot, who lives with husband and sister-in-law, said.

The "new anxieties" combined with the lack of enough sleep have started affecting not just her professional productivity, but also her relationships. "Work wise I am not able to achieve even half of what I aim for. Besides, I find myself snapping?and feeling irritated at my family members," she said.

Priyanka Dass, who once had a "nearly perfect" 11 pm to 5 am sleep cycle, found herself struggling to stay awake as soon as the clock struck 7 in the evening, particularly the first few weeks of the lockdown.

"I would fall asleep in the evening, for not more than a couple of hours around 7-9 pm, and then would barely sleep through the night," the Delhi-based publicist said. During most of these sleepless nights, the 25-year-old ended up "overthinking everything", and once also had a panic attack.

She then started watching Netflix and reading books to keep her mind occupied. "Sometimes, I simply hop out of bed to whip up something in the kitchen," she said.

According to mental health expert Prakriti Poddar, carefully cultivated routines over the years have gone for a toss and the stress is natural.

"In times like these when everybody is at home, and routines have changed, people might feel low, and even depressed, creating a sleep crisis." "Stress and worry have an intense impact on the sleep cycle," she said.

Both Kumar and Poddar advise against ignoring irregular sleeping patterns, which can affect cognitive abilities, including learning and memory retention, over a long period.

"Research confirms that there is a strong link between learning, memory and sleep. During sleep, nerve cell?connections in the brain are strengthened and this enhances the brain's abilities to stabilise and retain memories."

"With a disrupted sleep cycle or not enough sleep, it is very difficult for the brain to stabilise neural connections and consolidate memory effectively," Kumar explained. Sound sleep of seven-nine hours is an important aspect of recovery, added Poddar.

Doctors recommend physical activity, yoga and maybe some music to calm the mind and body. The list of don'ts includes using electronic devices like mobile phones and laptops before sleeping and caffeinated drinks such as colas, alcohol, coffee, and tea, particularly in the evening.

"The bedtime and wake time should be" consistent from day to day, including on weekends. Regular vigorous exercise for 20-30 minutes during the day promotes a good night's sleep.

"If despite all this, an individual is not able to sleep within 20 minutes, they should move out of the bed and perform some light, non-stimulating- activity like reading a book and wait until the feeling of drowsiness sets in," said Vivek Nangia, director, pulmonology, Medical Critical Care & Sleep Disorders, Fortis Hospital, New Delhi.