COVID-19 has exposed us to a wide variety of different stressors. In the short term, our stress response is useful as it helps us respond quickly and effectively. But when the stress lasts longer, we have to identify and acknowledge the “downside” risks.

We should not stress about stress but protect ourselves against it.

Intense, prolonged stress has a negative impact on our immune system. Stress increases the risk of developing infections, prolongs illness, and can make the infection more severe. Each of these issues is problematic as we try to maximize our body’s defense against a highly contagious respiratory virus like the novel coronavirus.

Long-term stress increases the risk of mental health problems such as anxiety and depression, substance use, pain, and bodily complaints such as muscle tension. Stress impairs brain areas critical for learning, memory, and emotional functioning, causes learning and memory problems, and increases emotional reactivity.

Stress can also affect our sleep. High levels of stress and poor sleep influence each other over time: an individual’s stress levels underlie the extent to which daily experiences interfere with sleep and the extent to which poor sleep increases the stress experienced during the day.

We need to not only “flatten the curve” of the virus spread, but also to lower stress levels. This helps us maximize the strength of our immune system and our overall resiliency as we continue the long-term battle against COVID-19.

So how do we do this?

One of the ways to protect against stress is by giving ourselves the opportunity to obtain healthy sleep.  During sleep, the immune system produces and releases proteins called cytokines. These are needed at higher levels when we have an infection or inflammation or when we are under stress. When we don’t get enough sleep, the production of these protective cytokines is reduced.

Emotional regulation and the experience of positive affect (mood) are critical for our ability to cope with stress. Nighttime sleep affects daytime mood, emotional reactivity, and the capacity to regulate positive and negative emotions.

Sleep benefits our ability to regulate emotions and increase positive emotions. In contrast, when we do not get healthy sleep, we react negatively and intensely because it is difficult for us to regulate our emotions when we are tired. Impaired emotional regulation leads to increased stress and it is difficult to break this negative cycle.

So, how can we improve our sleep so it protects us against stress?

Create a routine that will be the best for your body. Then stick to it so that you follow a consistent bedtime and wake up time. This helps your brain stay on a good sleep-wake rhythm.

Because many of us do not get out to work now, we can forget to be outside and get light exposure during the day. We need bright light to help our brain keep our daily rhythm. Make sure to spend some time in a sunny room, or if possible, outdoors while maintaining social distancing.

In the evening, you can help your brain clock set itself to night mode by dimming the lights and filtering out blue light during the final hours before going to sleep.

It is also important to make sure you are not spending the day in bed. When you do that – watch movies, eat, read, talk and do everything in the bed — it confuses your brain and makes it difficult to get sleepy and fall asleep at night.  When you do this, your brain starts associating your bed with having fun and stimulating activities, rather than falling and staying asleep.

If you can integrate some movement and physical activity into your day – not too late in the day – it will make it even easier for you to fall asleep quickly at night.

If you are a worrier, try to set time during the day in which you think about all that you have to worry about, then try to develop a plan to address your concerns. Then, at night, you will be less likely to repeat this pattern as you try to fall asleep.

Finally, if you do all of these things and you cannot fall asleep, get out of bed and only go back to bed when you are drowsy.  Avoid watching screens during this time, and consider reading a boring or under-stimulating book.

If these tips do not help, reach out for help. There are experts who can help you remotely using telemedicine. Make sure to find a certified Cognitive Behavioral Therapist who has experience treating insomnia.

Remember: Winning over COVID-19 means that we are not only avoiding the virus itself, but we are staying strong, resilient, and not allowing stress to take over our lives or our sleep.

Reut Gruber is a behavioral psychologist.

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