If you’ve ever had trouble sleeping, Amanda Chue once stood in your slippers.
Just as she began studying z’s as a psychology graduate student at AU, Chue, CAS/MA ’17, CAS/PhD ’19, was having trouble catching them. She struggled for months with insomnia, a disorder defined by acute or chronic difficulty falling or staying asleep. Now a psychologist at the Arlington/DC Behavioral Therapy Institute and a mood dysregulation researcher at the National Institutes of Health, she engaged in some of the same tired habits as her clients: cuddling up in bed with her iPhone and trying to force an early bedtime.
In retrospect, all that tossing and turning was helpful. Now a squeaky-clean practitioner of proper sleep hygiene, Chue (8 hours) can both “relate to some of those negative cognitions” surrounding sleep and counter them. “If I didn’t sleep that well, I learned to keep trying. I didn’t give too much power to the insomnia,” she says. She is also more conscious of inadequate sleep as an easy-to-overlook—yet potentially life-altering—troublemaker.
Whether the product of voluntary sleep deprivation (20 percent of college students pull an all-nighter at least once a month) or disorder (22 million Americans suffer from sleep apnea), a lack of rest can have nightmarish consequences. It’s linked to 7 of the 15 leading causes of death in the United States, including accidents and hypertension; diseases like diabetes and obesity; and declines in memory and cognitive function. And proper snoozes are growing scarcer.
In his bestselling 2017 book, Why We Sleep: Unlocking the Power of Sleep and Dreams, UC Berkeley neuroscience and psychology professor Matthew Walker writes that 30 percent of American adults sleep less than 6 hours a night, up from just 2 percent a century ago. And more than 65 percent of adults fall short of the recommended 7 to 9 hours at some point during the week, according to the National Sleep Foundation.
Until dogs discover DirecTV, humans are the only mammals who intentionally limit their sleep. So many of us regularly make a conscious choice that runs counter to our biological need, but it’s a decision that can be complicated or nullified by work, worry, or, lately, the world having turned upside down.
Sweet dreams are not made of this.
If over the last eight months you have awoken, confused and heart pounding, from a REM-cycle encounter with bugs, a prison cell, or an invisible foe in hot pursuit, you’re not alone. In the early stages of COVID-19 lockdown, a study from France’s Lyon Neuroscience Research Center noted a 35 percent increase in dream recall. The shift could be a sign of more fragmented sleep, and a waking nightmare that has us all on edge.
Heightened, vivid stress dreams “could be reflective of situations that we’re still trying to make sense of emotionally,” says Aria Ruggiero, CAS/MA ’16, a clinical psychology doctoral student studying sleep at the University of North Carolina at Charlotte. “This pandemic is essentially a collective trauma that our society is going through.”
Trauma can mean trouble for our sleep cycle. When we’re worried or anxious, the sympathetic nervous system flicks on, increasing heart rate and blood flow and releasing cortisol, our primary stress hormone. It is fight or flight mode, Ruggiero (8.25 hours) says, and the body’s instinctual response to evading bears is not conducive to counting sheep.
A Current Biology study of 435 people in Austria, Switzerland, and Germany this spring reported an uptick in sleep time, but a decrease in sleep quality and mental wellbeing. Humans crave routine. That means many of us have struggled through a year that has been anything but.
Hitting snooze on a crack-of-dawn commute is a silver lining of the pandemic, albeit one that comes at a cost. By sleeping in until it’s time to clock in, we open ourselves up to later and more inconsistent bedtimes and can miss social prompts and light cues that help balance our body’s circadian, or sleep-wake, rhythm.
“Most of us have a circadian rhythm that’s a little bit longer than 24 hours,” says Ed Huntley, CAS/MA ’05, CAS/PhD ’12, so it requires external cues to keep it in check. Whether our office is downtown or down the hall, Vitamin D should be priority A in the morning, says Huntley (8 hours), a research investigator at the University of Michigan’s Survey Research Center. And without daily rituals like catching the morning train or walking to the breakroom for coffee, successfully winding down at night starts with finding replacement habits to “allow you to wind yourself up to launch into your day.”
Except “launching” implies we’ve moved at all.
Whether we’re in search of comfort or just strapped for space, the bedroom has also become a dining room and an office—further blurring the line between work and home and allowing the stress of 9 to 5 to bleed into our “off” hours.
Even though Huntley has studied sleep for close to 15 years, he’s guilty of occasionally sacrificing slumber to meet work deadlines. But the pandemic has underscored for him the importance of boundaries. As a dad trying to strike the right work-parenting balance from home, Huntley recognizes that when he gets good sleep, he’s better able to take care of himself and his children.
“Part of the reason why sleep gets taken for granted is most of us have a fairly robust sleep-circadian system in place because our social lives create a routine,” Huntley says. “But in the absence of that, it’s up to us to impose some structure.”
Consistency is an admirable sleep goal—but it’s far from a universal luxury.
Take Mitchell Kannry, SPA/BA ’05, who eats dinner with colleagues every fourth night at 6, then begins winding down at 10 for a night he knows will be restless. That’s because he sleeps at his office: Engine Company No. 4.
A battalion chief in the DC Fire Department’s special operations division, Kannry doesn’t take as many calls as he did in his line officer days. But the veteran firefighter, who joined DC Fire in 2004 as a junior at AU, shares a workplace on Sherman Avenue in Northwest DC with a fire engine, an ambulance, and an air unit. That means his 24-hour shift, which starts and ends just after dawn, often culminates with a flurry of early-morning lights and sirens.
“Even if you’re not on a call, it’s never really a peaceful night,” he says.
Kannry (5.5 hours the night before work, 4 during a shift, and 7 on nonwork nights) is one of 15 million US shift workers for whom a regular sleep schedule is just a dream, according to the National Sleep Foundation. They work round-the-clock to extinguish fires, suture wounds, and stock shelves. Irregular schedules require ingenuity to keep workers awake and alert when the stakes are highest.
Economic risk, as measured by casualties and damage, quadruples for the most fatigued rail workers, according to a 2011 Federal Railroad Administration study. In Why We Sleep, Walker notes that medical residents working a 30-hour shift are 36 percent more likely to make a serious error than those on the clock for 16 hours or fewer.
It’s Lindsay Schwartz’s job to rein in the risk, transforming transportation and other shiftwork professionals into model sleepers. Schwartz, CAS/PhD ’18, a behavioral scientist for the Baltimore-based Institutes for Behavior Resources, works closely with the nonprofit’s SAFTE-FAST biomathematical model, which analyzes several work and sleep factors to predict cognitive performance and mitigate the risk of fatigue.
The tool counts among its users all major US airlines, the Federal Aviation Administration, and the Washington Metropolitan Area Transit Authority. This summer it helped Azul, one of Brazil’s largest airlines, determine ideal departure times and in-flight rest periods for special trips to China to retrieve medical supplies.
Working with clients to protect workforce rest has taught Schwartz (7.4 hours) that fatigue risk amounts to more than punch cards and pillow time. It is a complex mosaic composed of sleep history, shift transitions, time zones, and even nap opportunities. Sleep is like work—we might not complete a task on the first try, but it’s important that we keep at it to avoid falling behind.
“Sometimes employees need to sleep 5 hours at night and 3 hours later,” Schwartz says. “That might not be as good as getting 8 hours, but in our work, we don’t worry so much about what’s perfect. We worry about what gets the job done in the safest way possible.”
Breaking up sleep depends on the profession—a pilot with a set schedule might feel more comfortable napping than a resident on call for emergency surgeries—as well as the person.
Kannry’s advice to young firefighters: settle on a routine that’s least disruptive to you. Some in the fire service prefer to nap until noon after completing a 24-hour shift. Kannry discovered early in his career that the first two sleeps following a shift are his most precious, and that a lengthy nap risks sacrificing one. So he snags a short 4-hour power nap during his firehouse night and pushes through the next day, allowing his schedule to “balance itself out” within 24 hours.
“You get there through trial and error, and whatever the plan is, it’s never going to work all the time,” Kannry says. “The nights that you’re not at work, it’s trying to develop those good habits so that when you do get some downtime, you’re able to sleep.”
His routine is consistently inconsistent, but after 16 years as a firefighter, he can rest easy knowing that it works for him.
Even with a sleep plan, some nights will be a rude awakening. When people toss and turn, they can become fixated on the z’s they’re not catching, allowing the fear of fatigue to bankrupt their beauty sleep.
Ruggiero and Chue both encounter clients whose anxiety builds as the bedside clock ticks away on a full night’s rest. Ruggiero calls this phenomenon “rumination.”
“It’s pervasive worry that keeps people up at night, thinking about how tired they’re going to be the next day,” she says. “What I’ve come to realize through research and clinical practice is that sometimes it’s easier to accept that you’re just going to have a bad night of sleep, not make yourself sick with worry.”
Self-induced torment over tiredness is one of many triggers amid a troubling 2020 that can stimulate our stress response system. But it’s important to remember that, for most, good sleep is just on the other side of the pillow.
A 2018 University of Pennsylvania study found that close to 25 percent of Americans wrestle with acute insomnia each year, but that nearly 75 percent return to good sleep within 12 months. Less than 7 percent slide into chronic insomnia—at least three nights a week for three or more months.
For those who are struggling, help is just an acronym away.
If our thoughts begin to spiral as we doomscroll news on Twitter, Trisha Nakano Bhagen, SOE/MAT ’04, reminds us to STOPP and take time for mindful pauses. The nutrition educator and health and wellness coach with the US Department of Veterans Affairs tells her clients to stop, take a few deep breaths, observe what’s going on around and within, figure out the purpose of what they’re doing, and proceed.
“We can’t control the spread of the pandemic. We can’t control whether schools are open or not,” Bhagen (7.25 hours) says. “But when everything else is unknown and you’re trying to grasp at straws to establish normalcy, then you can structure it into your life: ‘I can control what time I get up, what time I eat breakfast, and what time I turn off my device and signal my body that I’m ready to go to bed.’ You just have to be a little nurturing with yourself.”
Cognitive behavioral therapy for insomnia (CBT-I) is also an option for the bleary and weary. The treatment focuses on sleep hygiene, sometimes moving to sleep restriction—a paradoxical practice through which a patient intentionally reduces time in bed to cut back on hours spent staring at the ceiling. Through small, incremental increases, 5 hours will eventually become a healthier 7 or 8. More importantly, the fear of missing out on sleep is put to bed.
“People think, ‘I only got 5 hours last night, today’s gonna be shot,’ and then they’ll lower their activity level that day accordingly,” Chue says. “That thought isn’t helpful, so we practice challenging it. Usually their ability to function is better than they believe. It’s about regaining confidence in your ability to sleep.”
Not every rest will be what dreams are made of, but even in the face of unprecedented stress, subpar shut-eye is not worth losing sleep over.
Still yawning after your fourth cup of coffee, fighting heavy eyelids after lunch, or staring at the ceiling at 1 a.m. after eight episodes of Schitt’s Creek on Netflix? You’re not alone.
Just as our sleep postures vary—74 percent of adults snooze on their side—there’s no one-pajama-size-fits-all solution for a good night’s rest. Still, there are things we can all do to scrub bad habits and practice proper sleep hygiene. Turn out the lights and get comforter-able with these best bedtime behaviors:
- Wake up at the same time every day.
- Take a few minutes to acclimate before grabbing your phone.
- Go outside and get some natural sunlight.
- Get your blood pumping by walking around the block.
- Start the workday somewhere other than bed if possible.
- Set up a workspace with ample light.
- Avoid napping after 3 p.m., and for most adults, naps of longer than 20 minutes.
- Eat a healthy lunch.
- Stop drinking caffeine at least 6 hours before bed.
- Exercise, but not too late.
- Eat an earlier dinner to avoid late-night indigestion.
- Stay hydrated, but remember too much liquid too late is problematic.
- Step away from work to set boundaries.
- Call a friend or loved one to stay connected.
- Skip booze before bed—it increases cortisol and reduces REM sleep.
- Limit your sugar intake, but a light snack is fine.
- Take a hot bath to lower your core body temperature.
- Turn off electronics right before bed; blue light blocks melatonin.
- Try a white noise machine.
- Set the thermostat to a cooler temperature.
- Try to avoid over-the-counter sleep aids.
- Prop up a partner who snores—or talk to a doctor if it’s not a quick fix.
- Reserve at least 30 minutes to wind down before bed.
- Avoid forcing an early bedtime if you’re not sleepy.
- Make sure your bedroom is dark and quiet.
- Go to bed at a consistent time.
- Be patient—change doesn’t happen all at once.
- Get out of bed if you wake up for more than 20 minutes and do something relaxing until you get sleepy.