Winter is Coming! Now is the time to roll back the clocks!

Winter is Coming! Now is the time to roll back the clocks!

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Since the invention of the clock, time has been synchronized with solar time, that is, noon is when the sun is highest in the sky; thus, there are as many hours of sunshine before noon as after. The practice of changing the hour, introduced 100 years ago, in particular in North America, consists of moving our clocks forward one hour in spring (early March) in order to move the period of sunshine one hour later at the end of the day. This is called “daylight saving time”. This does not affect the total duration of the daily light period, but the sun then rises an hour later according to our clock and sets an hour later. This practice allows activities (work and recreation) based on daylight, to be extended into the evening. In the fall, the total duration of daily light gradually decreases until around December 21 and requires a return to normal time, otherwise, the daylight would start too late in the morning so that we would arrive, for example, at school or at work in the dark.

But why are we changing the time?

In the beginning, the objective was economic: more sunshine at the end of the day during working hours reduced the consumption of coal, candles and, above all, electricity. After the First World War, Canada, the United States and several other countries in the northern hemisphere decided to nationally legislate the change of time but left the final decision to the provinces. Thus, Saskatchewan remains at normal year-round standard time.

And the science in all of this?

Researchers’ interest in daylight saving time has increased as our understanding of its effects on the brain and sleep has grown.

Several countries, including most European ones, and parts of Canada are reassessing the advantages and disadvantages of this practice. Most polls confirm that the general public wants the time change to be abolished. However, there is disagreement on which time to adopt permanently: standard time or daylight saving time. More and more studies are highlighting the pros and cons of each and the Canadian Sleep Society is currently conducting a detailed analysis of scientific publications on the subject in order to formulate recommendations on what would be preferable for the sleep of Canadians.

Time change and the brain: the importance of being in sync!

To understand how a change of just one hour is likely to be disruptive, it is important to realize that our brains regulate bodily behaviours and functions every minute.

Did you know that parts of our brain act as our biological clocks?

Our internal clocks allow our brain to maintain synchronization between our bodily functions and our behaviours, to put them in sync with the day-night cycle which ensures that we function well during the day and sleep well at night. This clock is naturally punctuated and resets according to our exposure to sunlight. In other words, the body clock is an intelligent mechanism with its own rhythm, which is also able to react to external stimuli such as natural light. All of this has repercussions on what time we fall asleep!

There is another mechanism in the brain called sleep pressure.

Sleep pressure strongly influences our behaviour because it determines the balance between sleep and wakefulness. This restorative mechanism balances the phases of sleep and wakefulness by warning our brain when it needs to rest: the more we stay awake, the more the pressure to sleep increases.

Being in sync is essential!

Being in sync with our body clock and the day-night cycle is essential for staying active and healthy. Being in sync means listening to our innate rhythms from our biological clocks and from our sleep pressure while keeping these innate mechanisms reliable and in tune with signals from the environment, primarily sunlight and darkness.

Get to know your innate rhythms.

Knowing the innate rhythms of our brain allows us to understand why changing the local time and thus altering our exposure to daylight can cause our brain to be out of sync. The negative impacts of the time change would most likely be explained by a disturbance of internal mechanisms such as biological clocks and sleep pressure. We observe during the summer, a tendency to go to bed later because it is lighter later in the evening. We also observe a change in social activities with daylight saving time: social contacts are prolonged in the evening and thus cause a lag in relation to the natural rhythm of our biological clock.

Stay in sync: know who you are and act on it!

The tips below are especially for you if:

You have insomnia or another sleep disorder.

 Ideally, the consensus of sleep specialists is that adults should get about 7-9 hours of sleep per night to function well during the day, both physiologically and psychologically. In children, the recommended sleep time varies with age but should not be less than 9 hours, and in adolescents, not less than 8 hours. For more information on this subject see the section “Age-specific dos and don’ts”.

You have a habit of not getting enough sleep

For example if you have to use an alarm clock to get to school or work on time and / or you feel the need to catch up on your sleep during the weekend because of a lack of sleep during the week.

You have mental health problems

Mental health problems such as anxiety or depression, are often associated with sleep and body clock disturbances.

You are more of the very early morning or very late-night type.

If you are an early riser or a night owl, you may be more affected by the time change.

Here are some tips for the return to standard time in the fall:

As we set our watches back one hour, we potentially gain an additional hour of sleep.

This is an interesting opportunity.

The fall time change presents an interesting opportunity for people with insomnia or for those who are sleep deprived. Usually this type of sleeper is in dire need of an alarm clock to get to work or school on time and tries to recoup some sleep time on the weekends. They are advised, on the evening of the time change, to go to bed at the usual time (rather than staying awake for an hour longer) and to set back the time of their clocks only at this time.  They will therefore get an extra hour of sleep in the morning. The following evenings, they could go to bed an hour earlier according to standard time in the hope of permanently keeping that extra hour of sleep.

Morning light.

The one-hour time change in the fall is quite positive as it will gradually bring the alignment of light exposure back into harmony with our body clock. In a few days, a natural synchronization will be established thanks to the presence of light closer to when we wake up in the morning.  

Only one negative effect.

The return to standard time has only one well-documented negative effect: the onset of darkness an hour earlier in the late afternoon can sometimes lead to feeling gloomy, especially for those susceptible to seasonal depression. To reduce this risk, it is recommended to get as much exposure as possible to daylight in the morning a few days before the time change to compensate for the loss of afternoon light, and to continue to do so after the time change. You can also exercise outside during sunny hours, for example taking the time to walk outside at noon.

Wishing you a beautiful, bright autumn!

Stay connected, we will give you more tips and information for daylight saving time in the spring.

Sleep and circadian rhythm in response to the COVID-19 pandemic

Sleep and circadian rhythm in response to the COVID-19 pandemic

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The COVID-19 pandemic has produced significant stress, anxiety, and worries about health, employment, and financial hardship. This unprecedented crisis has also affected sleep, both in healthcare workers and in the general population, at a time when healthy sleep is critical to build resilience to cope with the casualties of this pandemic. This commentary aims to highlight the critical role of sleep as a public health issue, particularly during a stressful life period such as COVID-19, and provide evidence-based practical guidelines to manage sleep disturbances during this crisis.

How prevalent are sleep problems during this pandemic?

Surveys of healthcare workers since the rise of COVID-19 have shown very high rates of insomnia (34–36%), as well as anxiety (45%) and depressive symptoms (50%), and those symptoms are especially prominent among frontline workers directly involved with patients diagnosed or at risk for COVID-19. Data from the general population also indicate that insomnia, sleep loss, and poor sleep quality are widespread complaints, with rates similar to those associated with other major crises involving, for example, natural disasters such as earthquakes, floods, or wildfires. Not surprisingly, individuals with more severe anxiety and depressive symptoms also report more sleep disturbances during COVID-19. Conversely, those with a stronger social support network and a sense of belonging report less psychological symptoms and better sleep quality.

Why is sleep more disrupted during COVID-19?

Any stressful life event, whether related to one’s personal life or caused by natural disasters that threaten one’s psychological or physical well-being, is likely to precipitate sleep disturbances, and more so among individuals with higher vulnerability. Of course, healthcare workers on the front lines are likely to experience significant stress due to the pressure to organize or provide care to patients, the fear of being infected, and facing death repeatedly, all of which can also disturb sleep when they return home. With the COVID-19 pandemic, at least two factors beyond stress are also involved: the effects of confinement and atypical work schedules. Sleep-wake schedules are regulated by homeostatic pressure (i.e. the need for sleep that accumulates with time spent awake) and the circadian timing system (our biological clock that keeps us awake during the day and makes us sleep at night), the latter being controlled by daylight exposure and several social and environmental timekeepers. Those timekeepers include daily routines such as arising at a specific time with an alarm clock, showing up at work at a fixed time, eating, exercising, and engaging in social and leisure activities at relatively fixed times throughout the day and evening. Under confinement conditions, several of those time cues are altered since there are fewer constraints to perform these activities at fixed times. Furthermore, as daylight exposure is the primary factor regulating the circadian timing system, it is crucial to get some daylight exposure in order to maintain a good signal from the circadian timing system, since time spent outdoors is reduced while in confinement. Research investigating sleep and circadian rhythms under temporal isolation in which participants are isolated from the outside world for several consecutive days (they can sleep and eat at their leisure and use artificial light as needed, but no contact with the outside world) has shown that participants’ sleep schedules quickly become desynchronized with the outside world. The atypical work schedules of many health workers and security agents doing shifts at different times of day are an important risk factor for sleep disturbances and sleep loss, and such problems can be further exacerbated when those workers return home with childcare and family responsibilities.

Why should we pay attention to sleep during this pandemic?

Healthy sleep—that is, adequate sleep duration, quality, and timing—is one of the three pillars of sustainable health, the other two being diet and exercise. Sleep plays a fundamental role for both mental and physical health. For instance, sleep is very much involved in emotion regulation and in immune functions. A single night of sleep deprivation can produce significant mood disturbances and lower immune defenses. Chronic insomnia and prolonged sleep loss increase risks of long-term adverse consequences for mental (depression, substance use), physical (hypertension, diabetes), and occupational health (disability). We also know that insomnia and nightmares triggered by stressful life events can outlast the crisis over a long period. Given these well-established associations, one can safely propose that those individuals who develop significant sleep disturbances during COVID-19 may be at greater risk for long-term negative health outcomes. Thus, protecting sleep during this pandemic is particularly important to build resilience and cope more effectively with the social confinement, distress, and uncertainty produced by this pandemic.

How to manage sleep disturbances during COVID-19?

Several generic strategies can help prevent or minimize sleep problems during this pandemic (see below). Public sleep health education should be the first priority to provide broad-based information about sleep health (e.g., the importance of maintaining regular sleep schedules, staying away from electronics in the bedroom, obtaining a daily dose of day-light exposure) even during a prolonged period of confinement. For those with persistent insomnia, professional help may be required. Evidence-based treatment options for the clinical management of include hypnotic medications (sleeping pills) and cognitive behavioural therapy. Whereas medications may provide rapid relief of insomnia symptoms and may be indicated for acute insomnia (short episodes of situational insomnia), evidence-based systematic reviews, as well as clinical practice guidelines, have all come to the same conclusion that cognitive behavioural therapy should be the first-line treatment for chronic insomnia (that persists over time). Most of these behavioural methods can be adapted to the needs of different individuals during this pandemic. They can also be made more widely accessible through web-based and telehealth platforms.

Strategies to manage sleep disturbances during the COVID-19 pandemic

  • Make sleep a priority.

    Reserve at least 7–8 h per night for sleep.

  • Keep a regular schedule

    for sleep, meals, work, and social contacts. These activities are important time cues that help maintain entrainment of one’s biological clock.

  • Get as much daylight exposure as possible

    (turn on the lights, open the curtains, go outside if possible) to regulate sleep-wake and circadian rhythms.

  • Avoid

    using electronics (cellular, tablets) in the bed or bedroom or near bedtime.

  • Relax.

    Allow at least 1 h to unwind before bedtime.

  • If sleep does not come within 15–20 min,

    go to another room and engage in quiet activities (reading), and return to bed only when sleep is imminent.

  • Reserve the bed and bedroom for sleep and sex only.

    This is not the place to worry, problem-solve, or plan the next day.

  • Get up at the same time every morning,

    regardless of the amount of sleep. While it may be tempting to sleep in, particularly when there is no obligation to be at work, itis best to arise at the same time to keep a regular sleep-wake schedule.

  • Napping or not?

    Although it is better to avoid napping for someone with insomnia , napping is beneficial for sleep-deprived people. Older adults, without sleep problems, may also benefit from a short catnap (15–20 min) around mid-day.

  • Short bouts of insomnia is a normal reaction.

    Keep in mind that short bouts of insomnia is a normal reaction to stressful life events, but when sleep difficulties occur several nights per week, take action and seek

Conclusion

Healthy sleep plays a critical role for coping physically and psychologically with major life events such as this COVID-19 pandemic. Public health education is essential to keep the general population well informed about the importance of sleep and healthy sleep practices to prevent or minimize long-term adverse outcomes. Evidence-based short-term and long-term interventions are also available, as well as online support strategies.

For more information on Sleep and COVID-19, visit: “Sleep: your ally during the COVID-19 crisis”


Summary

This commentary highlights the critical role of sleep as a public health issue, particularly during a stressful life period such as the COVID-19 pandemic, and provides evidence-based practical guidelines to manage sleep disturbances during this crisis. The COVID-19 pandemic and the imposed social confinement have produced significant stress, anxiety, and worries about health and the fear of being infected, jobs and financial problems, and uncertainty about the future. The incidence of sleep disturbances has also increased dramatically during this period. Aside from stress and anxiety, two other factors are likely to contribute to increased sleep disturbances during this crisis. First, alterations of our daily routines such as arising at a specific time, showing up at work, eating, exercising, and engaging in social and leisure activities at relatively fixed times are all important timekeepers for our sleep-wake cycles to remain synchronized with the day (light) and night (dark) cycles. Alterations of these timekeepers, combined with reduced daylight exposure, also essential to keep our biological clock synchronized, are likely to disrupt sleep and circadian rhythms. Sleep plays a fundamental role for mental and physical health, and adequate sleep duration and quality are essential for coping with major life events such as the COVID-19 pandemic. Public health education is warranted to keep the population well informed about the importance of sleep and healthy sleep practices in order to cope with the pandemic and prevent or minimize long-term adverse outcomes.

Adapted from: Morin, C.M., Carrier, J., Bastien, C. et al. Sleep and circadian rhythm in response to the COVID-19 pandemic. Can J Public Health 111, 654–657 (2020). https://doi.org/10.17269/s41997-020-00382-7 . To access a view-only, full-text version of the original article: https://rdcu.be/b8crX

The Art and Science of Napping

The Art and Science of Napping

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Call it a snooze, a doze, some shuteye, a few winks: the nap has its fans. Some like the idea but can’t seem to pull it off, while others avoid it. It comes in different forms, in different positions, and with varying durations. It can also be used for different purposes; to compensate for a lack of sleep, in preparation for a short night’s sleep, or just for fun. It constitutes a physiological need at different times of our development, such as in toddlers and in old age, but can be beneficial at any age. To reap all the benefits – and to avoid the disadvantages – a nap should be done correctly and tailored to your needs. Here is a short guide to better understand what naps are, their benefits, who they are for, and how to optimize them.

WHY TAKE A NAP?

Getting enough high quality sleep is essential for maintaining good mental, physical, and cognitive health. Despite its importance, it can be difficult to get enough sleep every day. Making a nap part of your routine, or under special circumstances when you lack sleep, can be of great benefit in the short and long term.

To decrease sleep pressure.

 Several factors determine our need for sleep. Sleep pressure (called homeostatic sleep pressure) gradually builds up throughout the day as we stay awake, just like an hourglass. Conversely, this sleep pressure gradually dissipates when we sleep, whether it is a daytime (nap) or nighttime sleep. A nap is a temporary ‘knockdown of the hourglass’ to decrease sleep pressure and to leave us more alert and rested for the rest of the day. A daytime nap will not replace a good night’s sleep, but it may still compensate for a poor or short nighttime sleep. It helps improve our alertness and concentration during the day and decrease our drowsiness, thus reducing errors and accidents.

For our mental and physical health.

Sleep has direct effects on our mental health and a long-term deficiency is a major contributor to psychological distress and mood disturbances. A nap can help reduce stress, regulate our emotions, and improve our mood. For physical health, it is also effective in relieving headaches, strengthening your immune system and reducing the risk of diabetes and cardiovascular disease.

For cognition and inspiration.

Sleep plays an essential role for memory and a nap, even a short one, can reinforce the things you’ve learned during the day. For example, in students, a nap taken immediately after completing new learning can lead to better long-term retention of the material than an equivalent period of intensive study. Napping can increase your cognitive and motor performance and improve your ability to learn new things. A nap can also give you a creative boost, help you solve problems, and allows you to explore our dreams.

ADVICE FOR MANAGING THE ART OF THE NAP!

When?

In the early afternoon. Our body clock regulates the periods of sleepiness and wakefulness throughout the day. Synchronized with light, this clock naturally oscillates over approximately 24 hours and imposes a more alert state during the day and a sleep signal in the evening. However, a little feeling of fatigue and a drop in alertness normally set in at the beginning of the afternoon (around 1-3 PM). Together with sleep pressure which has had time to build up since the morning, this is the perfect time to take a short nap!

Avoid naps late in the afternoon or evening: Decreasing sleep pressure late in the day could make it harder to fall asleep in the evening and could affect the quality of your sleep at night. If you work at night, also check “Night shift workers” special report ( available soon) to identify the best time for your nap.

Duration?

Choosing the right duration of your nap is essential to get all the positive effects of sleep while avoiding a state of drowsiness when you wake up. The optimal duration of a nap may vary according to your needs and is based on what is called the architecture of sleep. From the first signs of falling asleep, sleep unfolds in a predictable and cyclical manner: a sleep cycle lasts about 90 minutes and generally consists of falling asleep (stage 1, transition to sleep), light sleep (stage 2, making up most of the night), deep sleep (stage 3, also known as restorative sleep), a return to light sleep and ends in REM sleep (when our brain is almost as active as when it is awake and our dreams are the most vivid). The duration of the nap thus depends on the stage of sleep from which you want to wake up:

  • The 10-20-minute power nap is optimal for a quick energy boost – it should help you stay alert without affecting your night’s sleep. By limiting yourself to a short nap, you stick to the stages of light sleep and it’s easier to wake up on the right foot.
  • A 30-60-minute nap is generally to be avoided as it is the length required to achieve deep sleep – it makes waking up more difficult and can leave us in a drowsy state. This is called sleep inertia, which can cause a feeling of discomfort, disorientation and “sleep drunkenness” that persists after waking up and can alter our mood or cognitive performance. This sleep inertia can last for a few minutes or a few hours after waking up.
  • A nap of about 90 minutes gives time to complete an entire sleep cycle (light sleep, deep sleep, REM sleep). This is an ideal duration to have all the cognitive benefits of a nap while avoiding strong sleep inertia. A long nap is especially useful when you want to compensate for a short night’s sleep.

How?

  • If possible, use an alarm clock (for example 15 minutes + estimated time to fall asleep), find a comfortable sitting or lying position, and relax! If you are in a loud or bright place, using earplugs or an eye mask can make it easier to fall asleep.
  • If you don’t fall asleep, consider taking this time as rest while being awake – it will still help you achieve a more alert and rested state for the rest of the day.

For whom?

A nap can be beneficial for most people, especially when nighttime sleep is insufficient to maintain alertness and quality wakefulness during the day. A well-planned nap can also alleviate the fatigue that can occur in night workers, in travelers changing time zones, in drivers on long journeys (car, trucks, boat, trains, planes) or in parents with young children.

Finally, the ideal time and the optimal duration of a nap vary and depend on the sleeping habits as well as the cultural, physiological and genetic profile of each individual. It is recommended that you experiment with different nap times and lengths and to note how you feel when you wake up in order to find the perfect nap duration for you. You can even keep a sleep diary for a while to help you fully understand your sleep habits and needs, to help you find the ideal time of day for your rest period, and to track your energy level during days with or without a nap.

  • Naps in Children: Naps are a critical need for young preschoolers who split their total sleep time during the day and night. (For more information, see “Age-specific dos and don’ts“)
  • Nap in the elderly: The evolution of sleep as we get older causes nighttime sleep to become lighter, shorter and more fragmented. However, the recommended duration of sleep remains 7 to 8 hours. Daytime sleep can thus compensate for a poorer quality nighttime sleep as we age. If you are in good general health, you should enjoy, without fear or remorse, the invigorating benefits of a short nap (about 10-20 minutes) when the need arises and, why not, adopt this habit on a regular basis.
Do you want to keep track of your nap? Download our Nap Diary

VARIATIONS OF THE NAP

The Coffee-nap (or "nappucino")

The Coffee-nap consists of having a quick coffee just before settling down for a short nap and can provide a double boost of energy in a situation of great fatigue. While this practice seems counterintuitive, it can help counteract sleep inertia when waking up from a nap. This is because caffeine takes about 20 to 30 minutes to reach its maximum level in the bloodstream and does not fully exert its stimulating effects until you wake up from a short nap. This combination can help give you a quick energy boost during jet lag or night shifts, for example, and works best during severe fatigue or for those who fall asleep quickly. With or without a nap, however, it is best to avoid caffeine in the afternoon, especially for those who have difficulty falling asleep at night.

The creative micro-nap

The creative micro-nap makes use of our sleeping brain’s special ability to create spontaneous associations that are more flexible and less controlled than when we are awake. When falling asleep, our thoughts start to wander into a state called hypnagogia (a state of semi-consciousness during the transition to sleep), where we can witness ‘micro-dreams’ which often manifest themselves as forms of thoughts or abstract visual forms, bodily sensations, sounds or movements. Often falling into sleep amnesia, this particular imagery can otherwise be captured and used as a source of inspiration or contemplation. For example, scientist Thomas Edison, who was one of the contributors to the invention of the incandescent bulb and the phonograph, was known for getting little sleep at night, but he was a great expert on power naps. It is said that one of his techniques was to doze off in a seated position while holding a steel ball in each hand: while falling asleep, his muscles relaxed and the balls fell on metal saucers placed on the ground – a crash that woke him up. These short naps are said to have been the source of ideas or creative solutions to his problems. Using the same strategy, but this time with a heavy turnkey, the surrealist painter Salvador Dali also used his short naps in order to capture on the fly his hypnagogic imagery which largely inspired some of his artworks. Without the need for steel balls or keys, if you are looking for inspiration, this self-observation technique works well using an alarm, or simply by falling asleep while sitting in a chair and paying attention to hypnagogic reveries as soon as you nod off.

THE CULTURE OF NAPPING

Did you know that the word siesta comes from the Latin ‘sexta’, which indicates the sixth hour of the day (starting at dawn, so around noon), when the sun is at its zenith and it was common to stop for a siesta?

Taking a daytime nap is not only a result of physiological factors like sleep pressure or circadian rhythm (body clock), but is also a result of socio-cultural factors. Taking an afternoon nap or rest period is common in many cultures around the world. This practice is historically common across Southeast Asia, mainland China, Africa, the Middle East, Southern Europe, and Latin America, and is believed to have originated in cultures where the climate is warm in order to give farmers time to rest and to avoid the scorching afternoon hours. Among the best known, we note the riposo or the pisolino in Italy, or the siesta in Spain and in some Latin American countries, where businesses traditionally close their doors for a few hours during the afternoon to give citizens the chance to recharge their batteries. However, this practice is said to be gradually declining in large cities where economic pressure, tourism, certain regulations about working hours and even the use of air conditioning threaten this moment of sacred rest. In Nordic European countries, on the contrary, it is customary to have young children, well wrapped up, nap in the open air, in temperatures below zero degrees Celsius. Obviously, certain safety instructions are required, but these chilly naps are seen as a key element for maintaining good health in children and would, as a bonus, facilitate their daytime sleep. In Japan, taking a micro-nap in workplaces or in public places can be seen frequently among white-collar workers. Known as inemuri or ‘sleep when present’, these moments of rest are culturally accepted as a sign of diligence and hard work, but may reflect widespread sleep deprivation among these employees.

In Canada and the United States, the nap is still broadly stigmatized and can sometimes be seen as a sign of laziness or non-productivity. Although we are still a long way from celebrating the culture of the siesta, a growing awareness of the benefits of sleep is leading more and more public bodies and employers to accept and even encourage napping. For example, nap room initiatives on university campuses are starting to appear in order to allow students to snooze between classes. Well-being and rest areas, or even the provision of “sleep capsules” or reclining chairs are increasingly in vogue for employees of large companies. Lucrative “nap stations” at airports or in some major cities also allow weary travelers and workers to pay by the hour to rest their heads on a pillow.

The practice and prevalence of the nap is strongly dependent on the culture in which it is used.

 

Reminder

  • A nap is generally not recommended for those who tend to have chronic insomnia: it decreases sleep pressure that builds up during the day and can make it more difficult to fall asleep in the evening.
  • Excessive sleepiness during the day causing you to take daily naps, may indicate an underlying health problem, even as you get older, and may warrant seeing a doctor.

 

 

Do you want to keep track of your nap? Download our Nap Diary

 So, whether it’s to benefit memory and mood, for a quick boost of energy, for a breath of inspiration, or simply to make up for a short night’s sleep, the nap is at your disposal to complement your night’s sleep, which, let’s remember, remains the priority!

 

Sleep and Post Traumatic Stress Disorder

Sleep and Post Traumatic Stress Disorder

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What is a Post Traumatic Stress Disorder (PTSD)?

PTSD is a condition that can develop after someone has experienced a traumatic event, either by being involved directly or witnessing another person being involved. It is also possible to develop PTSD after hearing about something traumatic.

What is meant by “traumatic”?

An experience is traumatic when it is very frightening, overwhelming, causes a lot of distress and the person feels there is a threat of death or serious injury to oneself or someone else. A trauma could even be in the form of receiving news about the unexpected or violent death of a family member or close friend, or learning that one’s child has a life-threatening illness. A trauma could include being the victim of a crime (e.g. being mugged), being in a natural disaster, such as an earthquake, being in an accident, being caught in a situation of war or conflict. Trauma is usually unexpected. People often say that they felt powerless to stop or change what was happening.

Who gets PTSD and how common is it?

PTSD can occur at any age, including childhood, but it is more common in adulthood. Most people do not develop PTSD, even after an overwhelming trauma.

Someone is more likely to develop PTSD if the traumatic event was caused by another person, as for example, rape or torture, than if it occurred as a result of an accident or natural disaster. It is thought that people who have recently come from countries where there is conflict or war are more at risk for PTSD.

Women appear to be at higher risk than men after certain types of trauma such as accidents and assault.

It is difficult to say exactly how many people suffer from PTSD. Research has shown that in Canada almost 1 in 10 people will suffer from PTSD during their lifetime. Higher rates of PTSD occur in veterans and those whose work involves exposure to life-threatening events, e.g. police, firefighters.

What are the symptoms of PTSD?

In PTSD, the response to the traumatic event is usually intense fear, helplessness or horror. In children their behaviour may become disorganized or agitated. Certain symptoms tend to occur when someone is suffering from PTSD. These last at least a month (but could continue for years) and cause marked distress or impairment in the person’s ability to function.

There are four groups of PTSD symptoms

1. Re-experiencing the traumatic event, for example with recurrent and intrusive distressing memories of the event, recurrent distressing dreams, flashbacks or having a marked physical reaction when exposed to cues (which could be
internal or external) that resemble or symbolize the event.

2. Avoiding stimuli associated with the trauma and a sense of decreased responsiveness, for example, avoiding thoughts, feelings or conversations associated with the trauma or avoiding people and places that may trigger memories of the event.

3. Symptoms such as difficulty falling or staying asleep, being on edge and experiencing outbursts of anger or irritability.

4. Changes in cognition (e.g. memory) and mood (this could include fear, shame, guilt, sadness) starting or worsening after the traumatic event.

As well as the listed symptoms, a person with PTSD may feel guilty about having survived the trauma when others did not survive. There may be feelings of ineffectiveness, fear or intense shame. Social withdrawal, problems in a marriage or relationship and loss of employment can occur.

A person suffering from PTSD may start to have thoughts such as people can no longer be trusted or the world is no longer a safe place. They may experience a change in their religious / spiritual beliefs.

Sometimes, there may be self-destructive and impulsive behaviour. Someone suffering from PTSD may resort to alcohol or other drugs as a means of coping with the effects of the trauma.

How does PTSD affect sleep?

Someone who is suffering from PTSD may have recurrent distressing dreams about the traumatic event. He/she may have difficulty falling or staying asleep. Sleep may be disrupted by more awakenings during the night.

Nightmares are more common in women. They tend to occur more frequently soon after the trauma. Women may also have hot flashes no matter what age they are.

When sleep recordings are made at a time further away from the trauma, there is a decrease in the amount of rapid eye movement (REM) sleep and in the ability to remember dreams. The change in dreaming may be a way dealing with the effects of the trauma.

How is PTSD treated?

The sooner the symptoms of PTSD are treated, the more effective treatment is likely to be. This includes dealing with poor sleep quality since this can affect recovery.

The most important part of treatment is providing support and a sense of safety for the person with PTSD. The person should be encouraged to talk about what has happened and helped to develop ways to cope with stress.

Meeting with a therapist has been shown to be helpful. Short-term therapy seems to work best. During therapy, the person’s thoughts about, and reactions to, the trauma are discussed. Sometimes, a type of therapy called “Exposure Therapy” is used.
This involves getting the person to imagine the traumatic event and instructing them about how to deal with their reactions (e.g. feeling frightened, having a flashback).

Group therapy can be helpful. It allows the person to share what has happened with people who have also been through a trauma, decreasing the feelings of isolation and increasing the sense of
being supported.

Medical help may be required also. A person with PTSD may benefit from antidepressant treatment to help with the depression and/or anxiety that is often part of PTSD. Some antidepressants are helpful for getting to and staying asleep.

Other antidepressants can make sleep worse by causing movements or brief awakenings. If an antidepressant is not necessary, sleep problems may be treated with a sleeping medication but it is recommended that these be used for a few
weeks only. If nightmares are a major problem, a medication  may be prescribed to reduce how often they occur.

People seem to get most improvement in their sleep after doing a form of therapy known as Cognitive Behavioral Therapy for Insomnia, along with Imaginary Rehearsal Therapy. After this
treatment, people reported an improvement in the quality of their sleep, their PTSD symptoms were reduced and they had less depression than others with PTSD who were on a waiting list and had not received the therapy.

SUMMARY

For most people, the effect of a traumatic event will be time-limited. However, there are those for whom the reaction will be of greater intensity and longer duration and the symptoms that they
experience can have a significant impact on their ability to function at work or at home.

It is important that in such cases people do not continue to suffer alone since treatment is available. They should speak with their health care provider so treatment can be started.

Seniors, for you also sleep is your ally during the COVID-19 crisis

Seniors, for you also sleep is your ally during the COVID-19 crisis!



Sleep is your ally!

Since the beginning of the COVID-19 crisis, you, seniors, have experienced a lot of upheaval notably due to your social and family isolation imposed suddenly to protect you from a possible COVID-19 infection.  For some of you, this isolation is new and uncomfortable.  You may also feel stressed about contracting the virus and becoming seriously ill.

It is therefore normal that this crisis can generate stress, worries, fear and even depression. This is why it’s possible that your sleep may be disturbed, which is completely normal in times of great stress, especially since we know that sleep becomes more fragile with age. This means that it is more disturbed by outside elements or unusual situations. Even if you don’t have specific sleep disorders, medical or psychological problems, your sleep changes as you get older. In general, the sleeping needs of an aging person remain about the same as before in terms of sleep duration. On the other hand, normal changes occur in your quality of sleep and your sleep schedule. In fact, older people sleep less deeply and wake up more often at night than younger adults. In addition, they tend to go to bed earlier and get up earlier. These changes can affect your daily life and may explain why stress like the one that we are experiencing with COVID-19 is more likely to cause sleep disturbance in older adults than in younger people.

Experts in the field therefore advise paying close attention to your sleep habits during this period of uncertainty. Why? Because an adequate quality of sleep will have benefits for managing your stress and emotions as well as your physical health.

Indeed, in this period of upheaval, sleep is your ally and a protective element within your reach.  So, take advantage, use it!

 

 

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Eight ways for seniors to maintain a restorative sleep in a period of crisis

1. Make your sleep your best ally!

The recommended duration for sleep in seniors is 7 to 8 hours on average which includes daytime (naps) and nighttime sleep. Be careful, this is only an average and it’s possible that you need a little more than 8 hours or less than 7 hours of sleep, provided that you feel fit during the day with your chosen duration of sleep.

Prioritizing your sleep does not mean excessively increasing your time in bed. It is important to limit the time spent in bed to the number of hours of sleep you need in order to be fit the next day. If you are unable to fall asleep or go back to sleep in about 30 minutes, it means that your brain is not in a suitable state for falling sleep. It is therefore important to get up, get out of your room and do some relaxing activities (reading, listening to soft music, etc.) until your eyelids feel heavy, a sign that it’s time for you to go back to bed again.

2. Cultivate social ties with the outside world.

With today’s technology, it’s possible to speak to friends, children, grandchildren by phone or video-conferencing.  Social connections, kind words help reassure your mind and reduce anxiety. Frequent contact with those close to you also helps to strengthen ties, support each other, helps to discover yourself or rediscover yourself. In addition, the resulting well-being helps you to sleep better.

3. Brighten up your days!

We tend to forget, but light has important effects on our brain. Among other things, it increases our alertness and our mood. So if you feel a little depressed or sleepy *, go on the balcony, open the curtains and turn on the lights in the house.  Artificial light has the same beneficial effects as natural light on the brain. A bright environment also allows your biological clock to be properly adjusted to give you a good quality sleep at night.

4. Avoid caffeine and alcohol late in the day and in the evening.

Although alcohol can calm you and help you to fall asleep, it considerably reduces the quality of your sleep (for more information on this subject, consult the article: “Alcohol and sleep during a pandemic”. Caffeine (coffee, tea, energy drinks, chocolate) not only increases the time it takes for you to fall asleep, but also it decreases the amount of deep, slow sleep (which is already reduced as you age).

5. Get moving!

Physical activity increases the quality of our sleep, especially among seniors. Stretch, do yoga, go for walks.  Any activity can be beneficial for your sleep.

6. To take a nap or not to take a nap, that’s the question!

If you are generally in good health, you should enjoy the invigorating benefits of a short nap (20-30 minutes) without fear or remorse, when you feel the need and why not adopt this habit on a regular basis.  Please note, this only implies if you have no significant difficulty falling asleep or staying asleep at night. If you have trouble sleeping at night, it’s preferable that you avoid napping because it may further decrease your ability to fall asleep. In all cases, if you nap, it’s important to limit it to 20 to 30 minutes, and not later than 3 pm, using an alarm clock if necessary.

7. Create an ideal environment for sleep.

In order to sleep well, your bedroom should be a quiet room, very dark and with an optimal room temperature (around 19ºC).  This place should be devoted only for sleep and intimacy.  Don’t hesitate to sleep in another bed in your house in order to protect your sleep or your life partner’s if one of you has a sleep problem (insomnia, snoring, periodic leg movements during the night, etc.).

8. Be careful of too much news especially at bedtime!

Avoid using different media outlets in your bedroom or at bedtime. You want to stay informed and that’s normal. It is, however, advised that you reduce the number of media outlets you consult, choose reliable sources of information about COVID-19 and reduce the number of times per day that you search for information. Exposure to a variety of news and articles about COVID-19 can quickly cause anxiety. It is also strongly advised to consume news during the day in order to prevent your sleep from becoming disturbed by too much information and that to ensure that your bedroom remains free from the stress generated by bad news.

At least an hour before bedtime, turn off all electronic devices and sound notifications and don’t check them during the night.

You can also try to reduce stress and worries as much as possible before bedtime by making a list of things to do during the day. Your mind will be more peaceful at bedtime!

 

* SLEEPINESS VERSUS FEELING FATIGUE

Sleepiness is the urge or need, difficult to repress, to sleep during the day. Not to be confused with fatigue, which is a feeling of exhaustion that requires one to rest, but that does not translate into involuntary sleep or an excessive need for it. Tired people can fight sleep without difficulty during the day. Sleepy people, on the other hand, are consumed by sleep. They can fall asleep easily at work or while driving, for example. Sleepiness is not a normal state because it is related to either an acute (sleep deprivation) or chronic sleep loss or poor sleep quality. Severe sleepiness is often a critical symptom of sleep disorders, but also of certain medical or psychological problems.

Don’t sleep on it!

For more information on the evolution of sleep as we age: “What normal sleep changes can be expected as you age?”

CPAP recommendations for Sleep Apnea patients during the pandemic

CPAP recommendations for Sleep Apnea patients during the pandemic



Do you have any concern?

It is normal that the COVID-19 crisis can cause stress, anxiety, and fear. It is also possible that your sleep will be disrupted during this time, particularly if you are questioning yourself about the safety of using your Continuous Positive Airway Pressure (CPAP) or if you changed your device’s compliance.

 

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The American Academy of Sleep Medicine (AASM) answered eight frequent questions that you might have!

1. Do I have a higher risk of getting coronavirus because I have sleep apnea ?

There is no evidence linking sleep apnea with coronavirus risk. People who have a higher risk for severe illness from the coronavirus include:

  • Those who are 65 years of age or older
  • Those who have serious underlying medical conditions. These conditions include:
      • Chronic lung disease
      • Moderate to severe asthma
      • Serious heart conditions
      • Severe obesity with a body mass index (BMI) of 40 or higher
      • Diabetes
      • Chronic kidney disease
      • Liver disease
  • Those who have a medical disorder, or take a medication, that weakens the immune system.
  • Those who have had close contact with another person who has the coronavirus.

2. If I have symptoms of the coronavirus, should I continue using my CPAP?

If you have symptoms of the coronavirus, you should isolate yourself in a separate bedroom and use a separate bathroom, if available. In this “recovery room,” you should continue to use CPAP while you sleep alone. CPAP treatment could protect you from developing more severe complications from the COVID-19. Be sure to follow these steps for routine CPAP care:
  • Wash your hands thoroughly with soap and water before and after handling the CPAP device, mask, tubing and filters.
  • Clean your CPAP equipment according to manufacturer’s instructions.
  • Change filters and accessories as directed in your CPAP user guide.
  • Avoid letting anyone smoke in your home, especially around the CPAP machine.
  • Keep pets away from your CPAP machine.
  • Use distilled water in your humidifier to keep the tub clean.
**Get medical attention immediately if you develop emergency warning signs for COVID-19. Emergency warning signs include trouble breathing and persistent pain or pressure in the chest. After you are free from the coronavirus, replace your CPAP filters and disposable accessories.

3. If I have symptoms of the coronavirus, will using CPAP spread the virus to others?

Current evidence suggests that the virus that causes COVID-19 spreads between people who are in close contact with one another (within about 6 feet/ 2-meter distance). It is transmitted through respiratory droplets produced when an infected person coughs or sneezes. However, there is some concern that using CPAP could spread the virus through the exhalation port, which allows carbon dioxide to escape from your mask. This port also may release smaller virus-containing particles as an “aerosol,” which can remain suspended in the air for a few hours. It’s possible that your bedpartner could inhale these virus particles. Therefore, it is important to sleep alone by isolating yourself in a separate bedroom. You can continue to use CPAP while sleeping in this recovery room.

The virus also can remain on surfaces for a long time. Others could get the virus by touching an infected surface and then touching their own mouth, nose or eyes. Be sure that you routinely clean “high-touch” surfaces in your recovery room and bathroom. This includes include phones, remote controls, counters, tabletops, doorknobs, bathroom fixtures, toilets, keyboards, tablets, and bedside tables.

4. Should I use CPAP if I have symptoms of the coronavirus but can’t self-isolate?

If you have symptoms of the coronavirus but are unable to isolate yourself in a separate bedroom, then you should contact your medical provider. Ask your medical provider if there are short-term interventions or alternative treatments for sleep apnea that could help you while you recover from the coronavirus.

5. If I have the coronavirus, will my CPAP be helpful for my breathing? Or could CPAP cause the coronavirus to get worse?

If you have the coronavirus, you should continue using CPAP while sleeping alone in a separate bedroom. There is no evidence that using CPAP will cause the coronavirus to get worse.

6. If I have the coronavirus, how should I clean and disinfect my CPAP mask and hose?

It is recommended that you clean and disinfect your medical equipment according to the manufacturer’s instructions. The directions for CPAP masks and hoses normally include regular cleaning with soap and water.

Health Canada recommends that you clean and disinfect frequently touched surfaces in your household. This includes door knobs, light switches and handles. Learn more from Health Canada about how to clean and disinfect your household.

7. Is it safe to use CPAP if I don’t have symptoms of the coronavirus?

Even if you don’t have symptoms of the coronavirus, you may want to sleep and use CPAP in a separate bedroom during this public health emergency. Otherwise, you may be able to spread the coronavirus to others before you have symptoms if you do contract it at one point.

8. Distilled water is unavailable in my area. What should I use in my CPAP humidifier?

 “Optimal humidifier performance requires distilled water. That’s because most or all of its minerals have been removed, preventing mineral buildup in the humidifier tub. That said, tap or bottled water may also be used. It will not harm the device or pose a risk to patients. It will, however, require more rigorous humidifier cleaning to prevent excess mineral buildup in the tub.”

 Adapted from AASM (https://aasm.org/coronavirus-covid-19-faqs-cpap-sleep-apnea-patients/ ; April 3, 2020)

Dreams during the pandemic

Dreams during the pandemic

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Why do we have the impression that we have the most bizarre and negative dreams during the pandemic?

 



Because… it’s normal! Did you know that…?

Our dreams are influenced by our waking life that proceeds sleep. Elements of our day often appear in our dreams. However, these elements which are always transformed, tend to be negative and can take a turn that go beyond reality. The representation of our preoccupations and emotions play an important role in our dreams. During the pandemic, we are naturally more anxious and worried for a variety of reasons and it is normal that our dreams reflect this unease. We should not be surprised if our dreams contain more elements relating to the crisis and the coronavirus (i.e. virus, news, themes of death, even politicians, etc.)

Most of our active, living dreams come from paradoxical sleep (the period where we dream) when our brain functions differently that during wakefulness. The centres of our brain that control memory, emotions, notably fear and anxiety, are most active at this time while those that control rational thought are in repose. This leads to a negative acceleration of the dream experience.

Our sleep during the pandemic can also be fragmented, and this can lead to waking up with more recollections of our dreams than usual. With frequent awakenings, we are therefore better able to remember our dreams. In addition, paradoxical sleep mainly occurs at the end of the night. And, if our sleep extends into the morning, more dreams can occur.

Lastly, having more distressing dreams with more anxiety-provoking content, can also have repercussions for our waking life. Some people will find it difficult to detach themselves from the emotions and/or content of their dreams when waking up and this could impact the way they approach their day. Similarly, scary dreams, even if normal during this period of crisis , could cause you to wake up during the night and you could have difficulty falling asleep again. They are called nightmares. You may have more nightmares or night terrors due to stress and a lack of sleep.

What should we do if our dreams become too unpleasant?

1. Reassure yourself.

This situation is normal given the current circumstances.

2. Clear your mind early in the evening.

Dreams are heavily influenced by our thoughts proceeding sleep. It’s important to clear your mind of any topics that cause you to worry early in the evening. Try writing your thoughts down for example.

3. Visualize pleasant things.

When going to bed, imagine pleasant experiences that are special to you and that you would like to dream about (sports, the beach, etc). This practise complements the recommendation of preparing yourself for sleep by relaxing. There are also dream control techniques such as lucid dreaming, which can be learned by consulting specialist publications.

4. For children with nightmares.

Consult our article on kids’ sleep during this time of crisis.

BONUS

This pandemic can be an opportunity to help us understand how our dreams can lead to understanding ourselves better and for learning to use them as a tool for self-awareness.  Certain dreams can sometimes be a source of creativity as many artists have tapped into them for inspiration. Several discoveries have also been made thanks to creative images that have appeared in the dreams of scientists. Some people also find in dreams, solutions to their problems.

Alcohol and Sleep during the pandemic

Alcohol and Sleep during the pandemic

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Taking a small glass of alcohol (wine, beer or spirits) might seem harmless and even comforting during this crisis period.  Perhaps you use alcohol to help you fall asleep because it gives you a feeling of well-being and alleviates your anxieties during this difficult period.

 



Do you know what the effects of alcohol are on your sleep?

It’s true that alcohol helps you fall asleep. In general, it takes less time to fall asleep after you take a class or two. However, contrary to what you might think, alcohol does not lead to a healthy or good quality sleep. In fact, after the early part of the night when your sleep is deep, alcohol causes fragmented sleep. It therefore causes you to walk up more frequently and sometimes leads to longer periods of wakefulness (making it impossible to fall asleep again) or causes you to wake up too early in the morning. Lastly, alcohol significantly shortens the duration of your paradoxical sleep (the period of sleep during which you are dreaming), a stage of sleep that is very important for balancing your mood and for several cognitive functions.

To ensure a better night’s sleep, it’s better to drink during happy hour rather than having a drink just before going to sleep.

Don’t forget that moderation  always tastes better.

Here are some strategies for alleviating your anxiety in favour of a good night’s sleep while reducing your consumption of alcohol.

1. Limit the amount of time you consume news about COVID-19 (especially during the evening).

2. Share your concerns with members of your family or with your friends

during your phone calls, videoconferencing or video chats (the fact that you express your concerns out loud often reduces the impact our worries have on our daily lives).

3. Take the time to feel things when it’s the right moment for you.

To alleviate your anxiety and chase away any worries, find an hour for yourself (or even 30 minutes) during the day to think about everything that bothers you (as if you’re saying to yourself, okay, now is the time I’m setting aside for myself to worry) and then, continue with your other activities. The time you set aside for writing down your daily concerns will lift the weight off your shoulders before you go to sleep. If these worries come to you just before bedtime, say to yourself, “I will think about this tomorrow when I will have my reserved time for worrying.”

4. Avoid consuming coffee, energy drinks, sugary drinks, nicotine.

5. Practice daily physical activities.

Thirty minutes of daily physical exercise is tied to a good quality sleep (and less anxiety). However, limit physical activities that are too strenuous just before bedtime. There’s good news! On line you’ll find a number of apps and free videos specializing in indoor physical activities as well as a number of free dance courses. Be creative!

6. Read a paper book (not on line) during the evening.

Eye movement from left to right during reading mimics the same type of movement that the eyes make during one of the sleep stages that lead to falling asleep.

7. Relax and establish a calm routine for going to sleep that doesn't involve using a screen.

Meditation and gentle, relaxing stretching, help to calm your body and spirit and therefore help you to fall asleep.

How to encourage good sleep habits for your children during the COVID-19 crisis.

How to encourage good sleep habits for your children during the COVID-19 crisis



Sleep and a sleep routine are your allies!

The Covid-19 crisis can cause stress, worries, fear and even anxiety. Children aren’t sheltered from these problems and therefore changes in their routines can disturb their sleep.

We advise you to pay particular attention to your children’s sleep during this time of uncertainty because a good sleep is beneficial for their mood, their ability to manage their emotions and their physical health. When their sleep is good, everything is good.

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*Adolescent sleep  during a time of crisis (video capsule at the bottom of the page)

Here are ten pieces of advice to follow for better sleep for our children during this period of upheaval.

1. Reassure your child.

If you haven’t already done so, now is the time to explain to your children, in a straightforward way, the current situation. For example, there is a new virus, it’s like the flu but they haven’t yet found a vaccine. On the other hand, we can protect ourselves by playing hide-and-seek with this virus. This is why everyone is staying home and it’s important to wash your hands very well.  We advise you to listen to your children, respond to their questions, but above all, reassure them.  A reassured child will sleep better.

2. Re-establish a good sleep routine.

Why? Because it helps your child feel secure in his/her own environment. A good sleep routine, consistent and predictable is desirable. Not easy when the parents’ sleep routine is disturbed!

Because your children’s lives have been disrupted, it would be comforting for them if you re-establish a daily routine of activities that worked well before the crisis (a quiet hour before meals for example) as well as a routine for bedtime and waking up.

Although one or two pyjama days can be fun and beneficial for everyone, preparing for the day and getting dressed as if they were going to daycare or school will allow your child to distinguish the difference between daytime activities and sleep.

3. Physical activity and daylight = a good quality sleep!

Your child likely has ants in his/her pants and still has the need to move. Did you know that having regular physical activity is beneficial for sleep and can help to reduce anxiety as much as for children as for adults? Now is the time to organize family time by playing, dancing, laughing, and in this way improving the family’s well-being. Good news! There are a lot of applications and free videos that specialize in indoor physical activities as well as many free dance courses. Take advantage of them!

Make your child move but be careful of physical activities that are too intense during the evening, before bedtime. It’s easy! Begin the day with very stimulating activities then during the course of the day, reduce their intensity and your children’s level of stimulation in order to prepare them to fall asleep better at night.

During daytime, we advise you to ensure that your children get as much light as possible. This will help them keep their biological clocks running on time. Leave curtains open during the day and when possible, go out with your kids on your balcony or in your garden while at the same time respecting social distancing. In the evening, soft light enhances the production of melatonin and increases the chances of falling asleep.

4. Avoid talking about serious subjects early in the evening!

It is recommended not to wait until the evening to talk about controversial issues (punishments) or expectations (“Tomorrow I am going to show you something that you have wanted for a long time”). In preparing for sleep, it is important to free our children’s minds of any subjects that could excite them or upset them.

 

5. An hour before sleep, plan good old-fashioned activities that don’t involve screens!

Technology is a precious ally during this moment of crisis. It permits many of us to continue to work and to keep up our important social contacts and helps us maintain our psychological well-being. It’s possible that your children are currently in the habit of using cellphones/tablets/computers for speaking to their friends, their grandparents and other important people in their lives. It is important however to remain vigilant and not to use any screens one hour before bedtime. If your child’s sleep is poor, exposing them to light from screens and difficult content could significantly impact the time it takes them to fall asleep and could cause more awakenings and bad dreams.

Children learn by example. Get started on a family challenge! Everyone in the family closes their screens an hour before sleep!  Why not try making a small box or a case so that the tablet or telephone can stay there during the night. Involve your children. They will enjoy this family activity!

6. Add a moment of « relaxation » to your routine of preparing for sleep or make your current one even longer.

The sooner bedtime is, the calmer the pre-sleep routine should be. We want to encourage even-keeled moods, optimizing relaxation before sleep.

This may be a good moment to play some calming games, to give some hugs, to speak (in a calm manner) about positive and upbeat things, to tell stories. At the very end, before putting on pyjamas and going to bed, give your children a bath, (or take one) do we have to say it, in the calm : lights softened, lowered voices. Once in the bedroom, tense children could benefit from a massage in bed or from meditation or relaxation exercises. There are a lot of good examples on the internet. Who knows? Maybe they will help parents as well! Calm activities during the evening are beneficial for falling asleep for both little ones and big ones.

It is possible that your children may have nightmares, sleepwalking issues or night terrors because of stress and a lack of sleep.

7. Respect your children’s real need for sleep.

Children’s need for sleep varies according to their age. For more information: “Age-specific dos and don’ts”

8. Encourage a cozy nest

Your child’s bedroom should be their special nest. This contributes to a good quality sleep. Find an optimal ambient temperature (their bedroom should be relatively fresh), good bedding (comfort!) and the room should be exposed to ideal lighting (a very dark environment is recommended). Be careful of night lights that emit blue light and directly reach eyelids because they impede sleep. Depositing a few drops of sweet-smelling drops that your child likes, on a sheet or a comforter, can also help them fall asleep.

9. Things to be cautious about or to avoid:

Exposure to anxiety-causing content: You might be in the mood to watch the news about the current crisis with your children but that can cause anxiety and can affect their sleep. On the other hand, if your child asks you questions about this subject, respond by being reassuring. For example, say that together, you make a great team against this microbe.

Heavy or fatty or spicy meals before going to sleep:  You can eat these meals occasionally but they can sometimes cause a slower rate of digestion, stomach burning or gastric reflux and can consequently lead to a poor sleep quality.

Planning activities for tomorrow:  Take a moment for this just after dinner and not before bedtime in order to not become overstimulated physically or mentally before getting into bed.

10. Add to your schedule:

Ties with the outside world:  Confinement doesn’t mean stopping your social life. It may be emotionally difficult for children to be separated from their grandparents and their friends. To compensate, it’s possible for example to organize virtual interactions with friends and the rest of the family by telephone and videoconferencing. Social ties and kind words uplift our spirits and diminish anxiety. Cultivating contact with loved ones also allows us to grow closer. A feeling of well-being helps us to sleep better. Be creative and involve your children in choosing activities!

REMINDER

Generally speaking, it’s advised to establish reasonable screen time, to choose educational content that’s fun and comforting and to find past times (cook as a family, involve the children in household chores, board games, learn a new language, do home repair jobs, visit a museum on line, travel on line, colour, paint, make dough, etc.) There are many tutorials on line to inspire you. It’s important to focus on the most stimulating activities during the day, including time for reading and studying for school-aged children, and then to choose calmer activities for the evening as the hour for sleeping approaches.

 

To all parents who have been trying to come up with solutions these past several weeks, our team takes its hat off to you and is happy to accompany you in making sleep a priority for your child!

Dear parents, you might also be interested in this article: “Sleep is your ally: How to finetune your sleep habits during this COVID-19 crisis.” and in this video about adolescent sleep.

Sleep is your ally: How to finetune your sleep habits during this COVID-19 crisis

Sleep is your ally:
How to finetune your sleep habits during this COVID-19 crisis



It is normal to not sleep well in a period of stress!

It is normal that the COVID-19 crisis can cause stress, anxiety, fear and even depression. It is also possible that your sleep will be disrupted during this time, no matter what your age.

Sleep experts are advising that you pay particular attention to your sleep habits and needs during this period of uncertainty. Why? Because a good sleep in both quality and quantity will be beneficial for managing your stress and your emotions as well as your physical health.

During this period of upheaval, sleep is our ally and a protective force at our fingertips. Let’s use it.

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Here are nine steps for adults to protect your sleep during this period of crisis.

1. Make your sleep a big priority by ensuring you obtain the sleep you need by getting at least seven to eight hours per night.

You have probably neglected your sleep for a long time because of many reasons (work, family, obligations, etc.) For most of us who now have to stay at home, this time can (at last!) be used to make sleep your priority. It’s time to allow yourself to sleep more hours if you feel the need.

Depending on your age, your need for sleep can change. For more information: “Sleep, a personal and evolving natural need” and “Age-specific dos and don’ts”

2. Keep normal bedtime and wake times.

These days, it is difficult for many people to keep a regular bedtime and to maintain normal daily activities. Because of our biological clock, our body and our brain respond well to routine.  Respecting a regular sleep-wake schedule can be beneficial not only for the quality of your sleep but also for regulating your daytime activities. Perhaps this is a good opportunity for you to experience the benefits of a regular sleep schedule. To try it, we recommend you go to bed and wake up at the same time (plus or minus 30 minutes) every day of the week, even during the weekend.

3. Establish a routine before bedtime.

In setting aside at least an hour to relax before going to bed and by establishing a relaxation ritual, you will be in the right frame of mind to fall asleep. You can use this time to take a bath, read, listen to some calm music, or even practice a method of relaxation or meditation. No matter which activity you choose, you should do it outside your bedroom. These calming activities are beneficial and allow you to reduce any anxiety and also, they will enable you to fall asleep.

4. Stay away from using any kind of electronic devices in your bedroom or at bedtime.

Your desire to stay informed is normal. However, it’s advised to reduce the number of different sources of information on COVID-19, to instead choose reliable news outlets and to reduce the number of times per day you listen to the news. It is also strongly advised to listen to the news during the day in order to avoid listening in your bedroom before going to sleep.  It is also suggested that you don’t read articles about COVID-19 on your tablet in bed.

Why? Because exposing yourself to a variety of news sources and articles on COVID-19 quickly leads to anxiety. By avoiding the news in your bedroom, this special place becomes less associated with stress resulting from your reading. In addition, even elsewhere in your home, we advise you not to read about the crisis in the evening nor just before going to sleep!

Turn off all your electric devices and sound notifications and don’t look at them during the night.

5. Expose yourself to light.

During the day, think about seeking out exterior light to help your biological clock stay on time. Leave the curtains open during the day and when possible, go out on your balcony or in your garden but remember to follow the social distancing recommendations. During the evening, dim light stimulates melatonin production and therefore enhances your ability to fall asleep.

6. Your healthy lifestyle is also your ally for a good quality sleep!

A healthy lifestyle complements a good quality sleep and includes drinking enough water during the day and eating a balanced diet at regular hours as well as keeping up your physical activities while respecting the new rules of social distancing. Remember that sleep is one of the three pillars of long-term health.

7. Prepare your bedroom for a healthy sleep in a secure and comfortable environment.

Were you dreaming about cleaning your bedroom or rearranging it? Take this time to make your bedroom even more comfortable. This special place can even become a peaceful and serene oasis. Now is the time to reorganise your bedroom. Why not repaint the room if you have access to paint? By adding 2-3 drops of sweet-smelling scents to your linen or comforter, you will experience a feeling of well-being which may help you fall asleep faster. Find the optimal room temperature (your bedroom should be relatively fresh), the right bedding (comfortable!) and the ideal exposure to light (a very dark environment is recommended). Your bedroom should be a safe and secure place, only used for sleep and intimacy.

8. Things to be cautious about or to avoid:

The consumption of stimulants (coffee, tea, energy drinks and nicotine) particularly at night, can have a stimulating effect on the nervous system. They can impede your ability to fall asleep, can cause you to wake up during the night and can reduce the depth of your sleep.

The consumption of alcohol:   We often think that consuming alcohol helps us to relax and therefore to sleep better. Even though alcohol can help you to fall asleep, if you live with anxiety, alcohol during the evening lightens sleep and can wake you up often or too early in the morning.

Exposure to anxiety-inducing content:   Limit watching any content or news that induces anxiousness and anxiety. During the day, establish a reasonable time to watch television and to use tablets and try to select more enjoyable and comforting content. We also suggest to get busy with activities (housecleaning, organizing, home repair jobs, cooking, reading, on-line courses, virtual museum tours etc.). Watching stimulating content in the evening, even if it’s enjoyable, negatively affects sleep. Moreover, it is recommended to turn off all screens at least one hour before sleeping to limit your exposure to their blue light which has a stimulating effect. Blue light can delay the secretion of melatonin, your ally for falling asleep.

Heavy or fatty or spicy meals before going to sleep:  These meals that fill us up sometimes cause a slower rate of indigestion or gastric reflux and consequently can lead to poor sleep.

Planning activities for tomorrow just before going to sleep: Take a moment for this just after dinner in order to reduce the chance of becoming overstimulated, or enhancing anxiety at bedtime.

9. Add to your schedule:

Regular physical activities: Thirty minutes of physical activity every day is linked to good quality sleep (and reduced anxiety!) However, you should avoid rigorous physical activity just before bedtime. That’s good news! You can find a number of free online videos and apps which offer suggestions for physical activities as well as a number of free dance courses. Be creative!

Take the time to feel things when it’s the right time. To reduce anxiety and chase away your worries, take an hour (or even 30 minutes) during the day to think about what is bothering you (It’s as if you say to yourself, okay, it’s my time to reflect and to think about what is upsetting me) and after you have done this, set aside the time to write down your concerns and then continue with your other activities. The time you set aside to think about and to write about your worries, will help to alleviate them before going to bed. If you find yourself thinking about your concerns at bedtime, tell yourself, “I will think about this tomorrow when I will set aside some time”.

Social ties with the outside world: With today’s technology, it is possible to speak to friends and family by telephone or by video conferencing.  There are even groups on social media that are designed to help combat isolation. Social ties and kind words lift our spirits and reduce anxiety. By reaching out to our loved ones, it allows us make connections, to discover ourselves and to rediscover them. This sense of well-being helps us to sleep better.

 

Remember that it is normal to have difficulties in the situation that we are all experiencing right now. By applying these recommendations, you can minimize your risk of developing chronic insomnia.

All these proposed practises are beneficial in the long-term.