The New Sleeplessness in town- Meet ‘Coronasomnia’

By: Syahira Khan, MindWell Intern, Dr. Cassandra Aasmundsen-Fry, Psy.D, Psychologist

Coronasomnia, is a term created by experts to explain new and worsened sleep difficulties faced in the COVID-19 pandemic. Reported sleep issues and the use of sleep medication have risen significantly since 2019.

It’s no secret that the pandemic has definitely stayed for the long-haul, and the enormous impacts it has had on individuals' social, economic, public and psychological domains. It's no lie that as a global community we face challenges that have caused insurmountable stress, anxiety, overwhelmness, fear, amongst other salad of strong emotions that have taken center stage in our lives.

In addition, the inception of the pandemic has led to the creation of a new reality for us- a reality that many of us are DONE with. This new reality we have been living in for the past two years has created distance from close circles due to the government-imposed restrictions for our own safety which has made access to our close ones difficult- for valid reasons though. This new reality has also created ongoing uncertainty in our global ecosystem in social, economic, public and psychological areas.

The implications of the COVID-19 pandemic stated above can be summed up into an easy to remember acronym “DONE” coined by the Mindwell Team;

Distance from your close circle

Ongoing uncertainty

New disrupted routines

Emotional and financial stress

Coronavirus Pandemic and Psychological Distress

The above implications pose dire consequences to individuals mental health and cause psychological distress. Why?

• Distance from close circle such as social support networks

Psychological distress that this causes; This exposes individuals to feelings of loneliness due to separation from support groups, and social isolation due to government policies. This can lead to individuals developing depressive symptoms due to long-term social isolation, which can cause low moods, feelings of hopelessness and loneliness, and difficulty sleeping.

• Ongoing uncertainty has instilled fear and hopelessness in individuals that range from being afraid of infection and loved ones dying to uncertainty of the duration of the pandemic, and the ongoing changes it continues to bring to societies on a global scale.

Psychological distress that this causes; This poses a risk for individuals to develop increased anxiety and worry.

• New disrupted routines as many are faced with changes in work culture to one that priorities working from home. This creates difficulty in work/life balance and longer working hours.

Psychological distress that this causes; anxiety symptoms such as worry and difficulty focusing,and depressive symptoms such as hopelessness and low moods.

• Emotional and financial stress as millions of people are facing economic turmoil, having lost or being at risk of losing their incomes and livelihoods which greatly impact individuals mental health.

Psychological distress that this causes; increase levels of stress due to the uncertainty brought by the pandemic.

In Malaysia, the pandemic has caused a surge in rates of mental health issues but the country has struggled to recognize the seriousness of mental health disorders due to the ongoing stigma on mental health. A recent study by Wong et al., (2021) conducted between August-September 2020, postulated that since the first nationwide MCO, there have been an increase in depressive (59.2%), anxiety (55.1%) and stress (30.6%) symptoms. In addition, populations at risk included young adults, low income households, health care workers, and elderly adults (Wong et al.,2021; Grossman et al., 2021).

Sleeplessness and Coronavirus Pandemic

Who hasn’t suffered some sleepless nights during the pandemic? A major stressful life event, the 2019 novel coronavirus (COVID-19) pandemic, is likely to have impaired sleep and circadian rhythms- hence the term coronasomnia. Coronasomnia can be defined as impaired sleep, or even increase in sleep problems, caused by the stressors highlighted above brought about by the Covid-19. Recent statistics reported in a systematic review of sleep problems during COVID-19 showcased that the rate of sleep problems among all populations was 35.7%.

So how can we help manage sleeplessness? Some psychological interventions for sleeplessness are;

• Relaxation Techniques

• Locus of Control

However, it is important to note that interventions are not a magic pill, to see effects- consistent practice is key.

Relaxation Techniques

There are a myriad of relaxation techniques that can work for you and here are two relaxation exercises;

• Deep Belly Breathing

1. Sit comfortably, and relax your head and neck.

2. Now, place one hand on your chest and the other on your stomach. This will allow you to feel your diaphragm move as you breathe in and out.

3. Then, slowly breathe in through your nose, your stomach will inflate like a balloon. The hand on your chest should remain as still as possible.

4. After, slowly breathe out through your mouth- your stomach will deflate like a balloon. The hand on your chest should remain as still as possible.

5. When you breathe in and out, make sure you breathe in 8 counts, and breathe out 8 counts.

• 4-7-8 Breathing

1. Find a comfortable place to sit.

2. Close your lips and inhale through your nose for a count of four.

3. Hold your breath for a count of seven.

4. Exhale completely through your mouth making a whoosh sound for a count of eight.

5. This completes one cycle. Repeat for three more cycles.

Relaxation technique is very important in dealing with sleeplessness because it helps to slow down our heart rate and breathing through reducing stress hormones like cortisol and adrenaline in our bodies.

However it should be noted that relaxation can induce anxiety and “People who are more vulnerable to relaxation-induced anxiety are often the ones with anxiety disorders who may need relaxation more than others.” If you think you are vulnerable to relaxation-induced anxiety, try grounding techniques, the five senses intervention. The difference between relaxation and grounding is that the goal of relaxation is to calm us, while the goal of grounding is to bring you back into the present moment.

Locus of Control

Another intervention that you can use in tandem with the relaxation activity is the locus of control. The Locus of control refers to how strongly individuals believe they have control over the situations and experiences they have in their lives. The goal of the locus of control is to identify areas that are within and outside of our control and to manage our expectations based on it. It's about focusing on what we can control, and letting go of what we can’t control- more often than not, our anxiety and sleeplessness can be caused by our focus being on what we can’t control.

How much control you have over the situation depends on whether you are a person with a strong internal locus of control, or a dominant external locus of control.

• Internal locus of control; Individuals with a dominant internal locus of control believe that they are responsible for their own success and have a I make things happen, I control my destiny. Their behaviours are driven by personal decisions and efforts.

• External locus of control; Individuals with a strong external locus of control believe that external forces, like luck, determine their outcomes and have a “Things happen to me”. Such as “why is this happening to me?”Why should I bother? “There is nothing I can do”. Their behaviours are driven by fate, and other external circumstances.

Reference site; https://playvolutionhq.com/handout-rotters-locus-of-control/

Individuals fall somewhere between these two orientations, they either have a stronger internal locus of control, or a dominant external locus of control. Where do you fall?

Here is an activity that can help you find out!

Activity:

●Write all the stressors you are experiencing.

●Add these stressors into the respective circles.

Questions to think reflect on;

●What are the key takeaways you realise?

●Which circle do you focus on more?

●What would you like to do next?

●What can you do to make yourself feel calmer, and in control of your circumstances?

How have you coped with your sleeplessness in this pandemic? Did you find the above tips useful?

References

Wong LP, Alias H, Md Fuzi AA, Omar IS, Mohamad Nor A, Tan MP, et al. (2021) Escalating progression of mental health disorders during the COVID-19 pandemic: Evidence from a nationwide survey. PLoS ONE 16(3): e0248916. https://doi.org/10.1371/journal.pone.0248916

Grossman, E. S., Hoffman, Y., Palgi, Y., & Shrira, A. (2021). COVID-19 related loneliness and sleep problems in older adults: Worries and resilience as potential moderators. Personality and individual differences, 168, 110371. https://doi.org/10.1016/j.paid.2020.110371

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