Dealing with sleep problems during home confinement due to the COVID-19 outbreak: Practical recommendations from a task force of the European CBT-I Academy

Ellemarije Altena, Chiara Baglioni, Colin A Espie, Jason Ellis, Dimitri Gavriloff, Brigitte Holzinger, Angelika Schlarb, Lukas Frase, Susanna Jernelöv, Dieter Riemann, Ellemarije Altena, Chiara Baglioni, Colin A Espie, Jason Ellis, Dimitri Gavriloff, Brigitte Holzinger, Angelika Schlarb, Lukas Frase, Susanna Jernelöv, Dieter Riemann

Abstract

In the current global home confinement situation due to the COVID-19 outbreak, most individuals are exposed to an unprecedented stressful situation of unknown duration. This may not only increase daytime stress, anxiety and depression levels, but also disrupt sleep. Importantly, because of the fundamental role that sleep plays in emotion regulation, sleep disturbance can have direct consequences upon next day emotional functioning. In this paper, we summarize what is known about the stress-sleep link and confinement as well as effective insomnia treatment. We discuss those effects of the current home confinement situation that can disrupt sleep but also those that could benefit sleep quality. We suggest adaptions of cognitive behavioural therapy elements that are feasible to implement for those facing changed work schedules and requirements, those with health anxiety and those handling childcare and home-schooling, whilst also recognizing the general limitations imposed on physical exercise and social interaction. Managing sleep problems as best as possible during home confinement can limit stress and possibly prevent disruptions of social relationships.

Keywords: COVID-19; home confinement; sleep problems; stress.

© 2020 European Sleep Research Society.

References

REFERENCES

    1. Akerstedt, T., Kecklund, G., & Axelsson, J. (2007). Impaired sleep after bedtime stress and worries. Biological Psychology, 76, 170-173.
    1. Akerstedt, T., Knutsson, A., Westerholm, P., Theorell, T., Alfredsson, L., & Kecklund, G. (2002). Sleep disturbances, work stress and work hours: A cross-sectional study. Journal of Psychosomatic Research, 53, 741-748.
    1. Altena, E., Micoulaud-Franchi, J. A., Geoffroy, P. A., Sanz-Arigita, E., Bioulac, S., & Philip, P. (2016). The bidirectional relation between emotional reactivity and sleep: From disruption to recovery. Behavioral Neuroscience, 130, 336-350.
    1. Baglioni, C., Altena, E., Bjorvatn, B., Blom, K., Bothelius, K., Devoto, A., … Riemann, D. (2020). The European Academy for Cognitive Behavioural Therapy for Insomnia: An initiative of the European Insomnia Network to promote implementation and dissemination of treatment. Journal of Sleep Research, 29, e12967.
    1. Basner, M., Fomberstein, K. M., Razavi, F. M., Banks, S., William, J. H., Rosa, R. R., & Dinges, D. F. (2007). American time use survey: Sleep time and its relationship to waking activities. Sleep, 30, 1085-1095.
    1. Bastien, C. H., Morin, C. M., Ouellet, M. C., Blais, F. C., & Bouchard, S. (2004). Cognitive-behavioral therapy for insomnia: Comparison of individual therapy, group therapy, and telephone consultations. Journal of Consulting & Clinical Psychology, 72, 653-659.
    1. Bittman, M., & Wajcman, J. (2000). The rush hour: The character of leisure time and gender equity. Social Forces, 79, 165-189.
    1. Boullin, P., Ellwood, C., & Ellis, J. G. (2016). Group vs. individual treatment for acute insomnia: A pilot study evaluating a "One-Shot" treatment strategy. Brain Sciences, 7, E1.
    1. Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet, 395, 912-920.
    1. Cortesi, F., Giannotti, F., Sebastiani, T., Vagnoni, C., & Marioni, P. (2008). Cosleeping versus solitary sleeping in children with bedtime problems: Child emotional problems and parental distress. Behavioral Sleep Medicine, 6, 89-105.
    1. Craig, L. (2006). Does father care mean fathers share? A comparsion of how mothers and fathers in intact families spend time with children. Gender & Society, 20, 259-281.
    1. Devries, A. C., Glasper, E. R., & Detillion, C. E. (2003). Social modulation of stress responses. Physiology & Behavior, 79, 399-407.
    1. Drake, C., Richardson, G., Roehrs, T., Scofield, H., & Roth, T. (2004). Vulnerability to stress-related sleep disturbance and hyperarousal. Sleep, 27, 285-291.
    1. Ellis, J. G., Gehrman, P., Espie, C. A., Riemann, D., & Perlis, M. L. (2012). Acute insomnia: Current conceptualizations and future directions. Sleep Medicine Reviews, 16, 5-14.
    1. Espie, C. A., & Kyle, S. D. (2011). Cognitive and behavioral psychological therapies for chronic insomnia. In: T. J. Barkoukis, J. K. Matheson, R. Ferber, & K. Dohramji (Eds.), Therapy in Sleep Medicine (pp. 161-171). Amsterdam: Elsevier Health Sciences.
    1. Frase, L., Nissen, C., Riemann, D., & Spiegelhalder, K. (2018). Making sleep easier: Pharmacological interventions for insomnia. Expert Opinion on Pharmacotherapy, 19, 1465-1473.
    1. Fuller, P. M., Gooley, J. J., & Saper, C. B. (2006). Neurobiology of the sleep-wake cycle: Sleep architecture, circadian regulation, and regulatory feedback. Journal of Biological Rhythms, 21, 482-493.
    1. Gehrman, P., Seelig, A. D., Jacobson, I. G., Boyko, E. J., Hooper, T. I., Gackstetter, G. D., … Smith, T. C. (2013). Predeployment sleep duration and insomnia symptoms as risk factors for new-onset mental health disorders following military deployment. Sleep, 36, 1009-1018.
    1. Gouin, J. P., Wenzel, K., Boucetta, S., O'byrne, J., Salimi, A., & Dang-Vu, T. T. (2015). High-frequency heart rate variability during worry predicts stress-related increases in sleep disturbances. Sleep Medicine, 16, 659-664.
    1. Huang, Y., & Zhao, N. (2020). Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 epidemic in China: A web-based cross-sectional survey. medRxiv.
    1. Hysing, M., Sivertsen, B., Garthus-Niegel, S., & Eberhard-Gran, M. (2016). Pediatric sleep problems and social-emotional problems. A population-based study. Infant Behavior and Development, 42, 111-118.
    1. Jeong, H., Yim, H. W., Song, Y. J., Ki, M., Min, J. A., Cho, J., & Chae, J. H. (2016). Mental health status of people isolated due to Middle East Respiratory Syndrome. Epidemiology and Health, 38, e2016048.
    1. Kent De Grey, R. G., Uchino, B. N., Trettevik, R., Cronan, S., & Hogan, J. N. (2018). Social support and sleep: A meta-analysis. Health Psychology, 37, 787-798.
    1. Liu, N., Zhang, F., Wei, C., Jia, Y., Shang, Z., Sun, L., … Liu, W. (2020). Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter. Psychiatry Research, 287, 112,921.
    1. Mchugh, J. E., & Lawlor, B. A. (2013). Perceived stress mediates the relationship between emotional loneliness and sleep quality over time in older adults. The British Journal of Health Psychology, 18, 546-555.
    1. Miller, K. E., Brownlow, J. A., Woodward, S., & Gehrman, P. R. (2017). Sleep and dreaming in posttraumatic stress disorder. Current Psychiatry Reports, 19, 71.
    1. Mindell, J. A., & Jacobson, B. J. (2000). Sleep disturbances during pregnancy. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 29, 590-597.
    1. Mindell, J. A., Leichman, E. S., Dumond, C., & Sadeh, A. (2017). Sleep and social-emotional development in infants and toddlers. Journal of Clinical Child & Adolescent Psychology, 46, 236-246.
    1. Morin, C. M. (2016). Improving access to cognitive behavioral therapy for insomnia (CBT-I). Encephale, 42(5):441-442.
    1. Morin, C. M., Bootzin, R. R., Buysse, D. J., Edinger, J. D., Espie, C. A., & Lichstein, K. L. (2006). Psychological and behavioral treatment of insomnia: Update of the recent evidence (1998-2004). Sleep, 29, 1398-1414.
    1. Morin, C. M., Vallieres, A., Guay, B., Ivers, H., Savard, J., Mérette, C., … Baillargeon, L. (2009). Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: A randomized controlled trial. JAMA, 301, 2005-2015.
    1. Offer, S., & Schneider, B. (2011). Revisiting the gender gap in time-use patterns: Multitasking and well-being among mothers and fathers in dual-earner families. American Sociological Review, 76, 809-833.
    1. Palagini, L., Gemignani, A., Banti, S., Manconi, M., Mauri, M., & Riemann, D. (2014). Chronic sleep loss during pregnancy as a determinant of stress: Impact on pregnancy outcome. Sleep Medicine, 15, 853-859.
    1. Potter, G. D., Skene, D. J., Arendt, J., Cade, J. E., Grant, P. J., & Hardie, L. J. (2016). Circadian rhythm and sleep disruption: causes, metabolic consequences, and countermeasures. Endocrine Reviews, 37, 584-608.
    1. Randall, C., Nowakowski, S., & Ellis, J. G. (2019). Managing acute insomnia in prison: evaluation of a "one-shot" cognitive behavioral therapy for insomnia (CBT-I) intervention. Behavioral Sleep Medicine, 17, 827-836.
    1. Razzoli, M., Pearson, C., Crow, S., & Bartolomucci, A. (2017). Stress, overeating, and obesity: Insights from human studies and preclinical models. Neuroscience and Biobehavioral Reviews, 76, 154-162.
    1. Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J. G., … Spiegelhalder, K. (2017). European guideline for the diagnosis and treatment of insomnia. Journal of Sleep Research, 26, 675-700.
    1. Rosenbaum, S., Vancampfort, D., Steel, Z., Newby, J., Ward, P. B., & Stubbs, B. (2015). Physical activity in the treatment of Post-traumatic stress disorder: A systematic review and meta-analysis. Psychiatry Research, 230, 130-136.
    1. Simon, E. B., Oren, N., Sharon, H., Kirschner, A., Goldway, N., Okon-Singer, H., … Hendler, T. (2015). Losing neutrality: The neural basis of impaired emotional control without sleep. Journal of Neuroscience, 35, 13194-13205.
    1. Sivertsen, B., Hysing, M., Dorheim, S. K., & Eberhard-Gran, M. (2015). Trajectories of maternal sleep problems before and after childbirth: A longitudinal population-based study. BMC Pregnancy Childbirth, 15, 129.
    1. Taylor, M. R., Agho, K. E., Stevens, G. J., & Raphael, B. (2008). Factors influencing psychological distress during a disease epidemic: Data from Australia's first outbreak of equine influenza. BMC Public Health, 8, 347.
    1. Teti, D. M., Shimizu, M., Crosby, B., & Kim, B. R. (2016). Sleep arrangements, parent-infant sleep during the first year, and family functioning. Developmental Psychology, 52, 1169-1181.
    1. Tikotzky, L., Sadeh, A., & Volkovich, E. (2015). VII. Infant sleep development from 3 to 6 months postpartum: Links with maternal sleep and paternal involvement. Monographs of the Society for Research in Child Development , 80, 107-124. .
    1. Van Rhenen, W., Blonk, R. W., Van Der Klink, J. J., Van Dijk, F. J., & Schaufeli, W. B. (2005). The effect of a cognitive and a physical stress-reducing programme on psychological complaints. International Archives of Occupational and Environmental Health, 78, 139-148.
    1. Wakefield, J. R. H., Bowe, M., Kellezi, B., Butcher, A., & Groeger, J. A. (2020). Longitudinal association between family identification, loneliness, depression and sleep quality. British Journal of Health Psychology, 25, 1-16.
    1. Walker, M. P., & Van Der Helm, E. (2009). Overnight therapy? The role of sleep in emotional brain processing. Psychological Bulletin, 135, 731-748.
    1. Wheaton, A. G., Chapman, D. P., & Croft, J. B. (2016). School start times, sleep, behavioral, health, and academic outcomes: A review of the literature. Journal of School Health, 86, 363-381.
    1. Xiao, H., Zhang, Y., Kong, D., Li, S., & Yang, N. (2020a). The effects of social support on sleep quality of medical staff treating patients with coronavirus disease 2019 (COVID-19) in January and February 2020 in China. Medical Science Monitor, 26, e923549.
    1. Xiao, H., Zhang, Y., Kong, D., Li, S., & Yang, N. (2020b). Social capital and sleep quality in individuals who self-isolated for 14 days during the coronavirus disease 2019 (COVID-19) outbreak in January 2020 in China. Medical Science Monitor, 26, e923921.
    1. Zhang, B., & Wing, Y. K. (2006). Sex differences in insomnia: A meta-analysis. Sleep, 29, 85-93.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere