As I see more and more clients with Long Covid I am noticing how many are saying they have terrible insomnia and are being made even more miserable because they cannot sleep properly. As far as I know, the experts have not yet found evidence that Long Covid is a direct physical cause of insomnia and disrupted sleep patterns, but it is early days and other facts may emerge over the next few months. But I do know that for many people who have symptoms of Long Covid and report that they are not sleeping well it is seriously adding to their problems. I hope I can do something about this. A good starting point is to look at what is happening on the ground.
A worldwide problem with sleep
The general anxiety around the pandemic is one cause of the sleep problems we are experiencing. On top of that, the worries which Long Covid can cause play a big role. The pandemic has caused a worldwide problem with sleep. For example, in the United States prescriptions for medication to help with sleep have gone up by a quarter since the beginning of the pandemic.
What is causing sleep problems?
There are many reasons why our sleep has been disrupted in the pandemic. This has affected everyone whether or not they have had Covid. One big factor has been the disruption of our routines. I know as someone who works a lot to try to improve the sleep patterns of people with chronic pain, that a good routine is very important. When this routine is broken, the patterns can get disrupted.
As we emerge from lockdowns, it is a good time to set up a good sleep routine again. At the end of this blog, I give you some tips to help you do this.
Long Covid and sleep
Before that, I want to talk about Long Covid in particular. We know that anxiety and depression are common in Long Covid sufferers and these can badly affect sleep. Muscle pain is also common and any pain makes sleeping difficult. Another culprit is fatigue. You may think that if you have fatigue then at least you should be able to sleep. Unfortunately, this is not true. If you are fatigued you may find you cannot do all the things you usually do to tire yourself out during the day. You may not have been moving about very much, you may find yourself falling asleep during the day. Then it comes to bedtime and you are fatigued but not tired. And you cannot sleep.
Another symptom of Long Covid is brain fog, the inability to concentrate, and the feeling that you cannot properly order your thoughts. As fatigue stops your body from exercising and getting tired and ready for sleep, so brain fog stops your mind from working and getting tired and ready for sleep.
You probably know that we have natural biological rhythms, circadian rhythms, which regulate our sleeping and our daytime activity. On its most basic level, we get up in the morning, we are active for the daylight hours, we relax in the evening, we sleep, and then the cycle begins again. In real life, the pattern is richer and more complex than this. In normal times our days are filled with natural markers of our progress through time. Travelling to work, going out for some fresh air at lunchtime, relaxing in a bar with friends after work, watching some television when we got home, all these activities were markers in our day which set our own rhythms. If these routines are disrupted or even disappear altogether then our bodies do not know where they are in the day or night. This is not good for sleep.
It is even more of a problem if you have Long Covid. For one thing, disrupted circadian rhythms affect our immune systems, and we know that malfunctions in our immune system lie behind at least some of the symptoms of Long Covid.
Cortisol and melatonin
These are the two hormones that matter to our sleep. Cortisol rises when we wake and gets us ready for the day. Melatonin begins to increase in the evening to prepare us for sleep. When this is working normally all is fine. But there can be a problem. Cortisol levels can rise if we are under stress. If our cortisol levels are high and remain high into the evening, we are likely to have problems sleeping. On top of this, our lifestyles in the pandemic have disrupted our production of melatonin. Melatonin production is largely dependent on the amount of natural light we are exposed to. If you have been in lockdown you almost certainly have reduced your exposure to natural light. If you have Long Covid you may find that you are too fatigued to get out into natural light as much as you should and that may affect your levels of melatonin and therefore disrupt your sleep.
Some tips to help
Go to bed and get up at the same time every day
Avoid long sleeps in the day
Get some natural light, go for a walk if you can but if you are just too fatigued the at least sit outside in natural light for at least half an hour a day, preferably in the morning.
Avoid stimulants before bedtime, especially alcohol and caffeine.
Do not eat late, allow a few hours between your last meal and bedtime.
Prepare for bed. Take some time before your bedtime and do whatever suits you to relax. Try some self-hypnosis, meditation or progressive muscle relaxation. Go to for detailed guidance on how to do these.
Keep your bedroom cool
Keep your bedroom and technology free zone. The blue light from your mobile will disrupt your natural sleeping patterns.
If you cannot sleep, get up. The sit quietly, in a low light for about twenty minutes. Then go back to bed. Repeat this pattern until you get to sleep. You are training your mind to learn that bed is the place for sleep, not for wakefulness.
I hope this is helpful. If you want more support, give me a ring and we can set up some personalised help.
You might find my book Sleeping with Pain useful. You can get it, in print and as an e book.
Finally, pop over to my Facebook page where I will be giving some more advice on sleeping with Long Covid.