A Rutgers expert discusses how to maintain healthy sleep habits during the public health crisis

The constant barrage of news about the global coronavirus pandemic is causing fear, stress and anxiety for many during waking hours and preventing them from getting a good night’s sleep. 

Xue Ming, a professor of neurology at Rutgers New Jersey Medical School, and a specialist in sleep disorders, talks about how COVID-19 is bringing new challenges to sleep cycles, how sleep helps the immune system fight inflammation, infection and disease while producing proteins that are needed to recover from illness, and what can be done to get on the right track to a healthy sleep routine.

How have the pandemic and social isolation brought new challenges to sleep?
The COVID-19 pandemic has increased anxiety, often fueled by reading news on screens, which is extending bedtimes, exposing people to blue light and keeping the adrenaline system up. Also, our daily routines have changed — work and school hours are less structured and people are sleeping in later than usual. Without strong discipline, a person could sleep later, following their biologic circadian rhythm, which is more than 24 hours.

What are some tips for avoiding sleep disruption?
Schedule an “anxiety and worry” time. For example, in the morning make a list of anxiety-provoking thoughts, such as job insecurity, health and  education. Then, put this list away and out of your bedroom. Keep the same lights-out time, whether you have to get up at certain time or not. Nightshift workers should expose themselves to bright light to keep awake while working and then wear sunglasses when returning home in the morning and take melatonin if falling asleep is an issue.

How can sleep affect your mood?
The earliest sign of depression is sleep disruption. Depression makes sleep fragmented even though some depressed persons sleep longer. Anti-depressants can further suppress the quality REM sleep. Sleep deprivation also can lead to irritability, hyper-reactivity and mood swings.

Are there supplements people with insomnia can take?
Amino acids, such as glutamate, are involved in the production of GABA, a major sleep neurotransmitter. A balanced diet rich in proteins ensures GABA synthesis. Vitamins and essential minerals are important to bodily functions that maintain sleep health. For example, vitamin B and D play important roles in biochemical pathways in the cells.

When insomnia persists, you can try herbal supplements, such as tryptophan (an amino acid), melatonin (1–3 mg) or valerian root. These sleep aids should not be used frequently or long-term, however. Always seek the advice of your physician before using these sleep aids. For example, valerian root has been reported to cause liver damage in some people.

If you get sick, how should you change your sleep routine?
When you are sick, your body needs more sleep to increase immunity. Our natural defense mechanism adapts inflammation-induced sleep, which helps us fight infection. If your sleep is disrupted by a chronic cough, use cough medicine at bedtime under a physician’s guidance.

Remind us what good sleep hygiene means.
Keeping a bedtime routine and regular sleep time can condition your body to fall — and stay — asleep. Start about two hours before bedtime: dim the lights; practice meditation, yoga and deep breathing; listen to light music; wear a visor or sunglasses if you have to be in a lighted environment; and wear earplugs if necessary.

Do not drink caffeinated or hot beverages or take a shower as that can rev up your adrenaline system. Stop using any blue light–emitting device, which can affect your body’s production of melatonin, a sleep hormone. Avoid anything that prompts anxiety, such as an argument, watching horror movies, vigorous exercise, hot beverages or shower/bath, which are all counter-productive for falling and staying asleep. Also avoid alcohol at bedtime. While alcohol can induce sleep, when the alcohol level drops a few hours later, your sleep becomes fragmented. Likewise, eating close to bedtime can lead to gastric reflux due to a full stomach, which can disrupt sleep.

Are there optimal times for people to fall asleep?
A person’s circadian rhythm dictates the optimal times for falling asleep effortlessly. This can vary by age. The best time for adults is to go to sleep is from 9 to 11 p.m. — earlier if elderly — and they should get seven to nine hours of sleep. For older teens and young adults, the optimal time to go to sleep is between 10 p.m. to midnight and have eight to 10 hours of sleep. For young children and those who are school age, a bedtime between 7 and 8 p.m. is optimal, with nine to 11 hours of sleep.