1. Because of quarantine, sleep quality may be affected by major changes in routines (less physical activity, less exposure to daylight, homeworking and homeschooling), living with uncertainty (for example, about duration of the situation) and with insecurity (for example, about health and financial situation), social isolation and lack of rewarding activity.
2. Insomnia is a major risk factor for post-traumatic stress disorder, which in itself is associated with an increase of sleep disruption.
3. Recommendations from the European Academy for Cognitive-Behavioral Treatment of Insomnia for:
- Home confinement
- Keep a regular sleep schedule: try to always wake up at the same time
- Avoid the use of any electronic devices before bedtime and prioritize relaxing activities such as yoga and reading.
- Social media should be used to express feelings of stress and anxiety and spread positivity. Reduce the amount of time exposed to news about the pandemic.
- Exercise should be done in daylight and avoid snacking at least two hours before bedtime
- Women and children in family contexts
- It has been proven that women suffer more than men from poor sleep and insomnia, specially mothers during pregnancy and the first years of life of their children.
- Regular sleep times should be followed and a 30 minute routine before bedtime with calming activities without electronic devices is recommended.
- Bring some structure to the day, in particular for children. It is also important to promote physical activity and to go out in the morning as much as possible, e.g. having breakfast outside in bright light.
- Healthcare staff
- Express any feelings or concerns about workplace conditions during the day with people you trust
- A short nap can be helpful if you ever deal with symptoms related to lack of sleep, irritability or strong emotional reactions.
- Sleep medication
- It is preferable to avoid using prescription sleeping medications as cognitive behavioral therapy (CBT-I) should be the first choice of treatment for insomnia.
- Short-term use of benzodiazepines or hypnotic benzodiazepine receptor agnostics can be successful if CBT-I is ineffective.
- Short-term sedating antidepressants for insomnia in patients with comorbid mental disorder can be used.
This review, conducted by a task force of the European Academy for Cognitive Behavioural Therapy for Insomnia, gives recommendations on the management of sleep disturbance during the confinement of the new COVID-19 pandemic.
Ellemarije Altena., Chiara Baglioni., Colin A. Espie., Jason Ellis., Dimitri Gavriloff ., Brigitte Holzinger ., Angelika Schlarb., Lukas Frase., Susanna Jernelöv., Dieter Riemann. (April 4, 2020) Dealing with sleep problems during home confinement due to the COVID‐19 outbreak: practical recommendations from a task force of the European CBT‐I Academy. Journal of Sleep Research. doi: 10.1111/jsr.13052