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Cedars-Sinai Blog

Good Sleep in Times of Stress

A man on the edge of his bed who can't sleep fighting insomnia because of anxiety.

Uneasy times can fuel anxiety and make getting a good night's sleep feel impossible. And with a global pandemic, isolation, economic instability, wildfires, protests over racial inequality and an election, there's no shortage of stressful situations to keep our minds racing at all hours. 

About 41-56% of people have experienced sleep disturbances during the COVID-19 outbreak, according to recent studies in the International Journal of Environmental Research and Public Health. That's up from pre-pandemic rates of around 14-25%.


With a global pandemic, isolation, economic instability, wildfires, protests over racial inequality and an election, there's no shortage of stressful situations to keep our minds racing.


While sleep can be tough during difficult periods, it's also important not to let it fall by the wayside, says Dr. Jeffrey Wertheimer, a clinical neuropsychologist at Cedars-Sinai. He talked to us about the role of sleep amid stress and how better sleep practices can help us get ahead of late nights.

Sleep and Health

Sleep is closely tied to overall health

"There's clear, unequivocal evidence that there's a strong relationship between psychological health and sleep," Dr. Wertheimer says. "They go hand in hand."

Anxiety and depression can interfere with the ability to fall asleep, as well as quality and duration. Conversely, lack of sleep can lead to higher levels of stress, frustration, depression and anxiety. 


Anxiety and depression can interfere with the ability to fall asleep, as well as quality and duration. Lack of sleep can lead to higher levels of stress, frustration, depression and anxiety.


Sleep deprivation can also lower thinking and problem-solving skills, attention span, memory, patience, ability to connect with friends and family, and even physical health, Dr. Wertheimer noted. 

In turn, these problems reduce sleep quality, creating a vicious cycle.



Look at sleep from a global health standpoint

We often take sleep for granted until we can't seem to get it, but we should be practicing healthy sleep habits long before we hit the pillow.

Because of how intertwined sleep is with other aspects of health, it's important to focus on wellness and lifestyle factors when trying to improve it, Dr. Wertheimer says.


A healthy diet and exercise encourages better sleep. And meditation, calming music, guided relaxation, self-reflection and deep breathing techniques can boost mental health.


For example, a healthy diet and exercise encourages better sleep. And mindfulness boosts mental health. That includes meditation, calming music, guided relaxation, self-reflection and deep breathing techniques. Even just breathing in and out in a slow, controlled fashion will help calm you down, he says. 

Smoking and drinking more alcohol might be tempting to help take the edge off, but they actually disturb sleep.



Consistent sleep

Consistent sleep hygiene can facilitate better, deeper sleep

The key to a good night's sleep is routine, Dr. Wertheimer says. 

He recommends going to bed and waking up at the same time each day, regardless of how much sleep you've managed to get the night before. Avoid napping during the day. 

And go outside regularly if possible: Sunlight helps strengthen the circadian rhythms that regulate your sleep-wake cycle.


The key to a good night's sleep is routine.


Overstimulation before bed

Be careful with overstimulation before bed

Screen time has dramatically increased with school and work moving online, while outdoor activities have been limited for many people. The added stimulation before bed can interfere with sleep. 

Dr. Wertheimer suggests getting off phones and devices 30 minutes before bedtime, focusing on other entertainment such as reading or listening to music. Likewise, exercise spikes the nervous system, so he suggests doing it earlier in the day and no later than two to three hours before bedtime.  

Also, avoid eating and drinking things that will interfere with sleep before bed—such as heavy or spicy foods, caffeine or even water. Drinking too much close to bedtime can result in interrupted sleep.


If you can't sleep, get up and engage in a relaxing activity—just make sure it's not in bed.


Get out of bed if you can't sleep

Pressuring yourself to fall asleep is counterproductive, Dr. Wertheimer says. 

Instead, if you can't sleep, get up and engage in a relaxing activity—just make sure it's not in bed. 

"It's a conditioning paradigm where you're training your brain and body that the bed is a facilitator to fall asleep," he explains.


If you're struggling with sleep or still feeling tired after a full night's sleep, know you're not alone.


Treating Sleep Challenges

Sleeping challenges are normal and treatable.

If you're struggling with sleep during stressful times or still feeling tired after a full night's sleep, know you're not alone. 

Dr. Wertheimer notes there are many options if you realize you need extra support. 

Sleep specialists can determine the cause and can recommend behavioral techniques and medications. Mental health professionals including psychologists, clinical licensed social workers and chaplains can also help address underlying anxiety or mood disturbances that may be impacting sleep. 

Specifically, providers can offer cognitive behavioral therapy for insomnia, an evidence-based therapy designed to strengthen sleep quality.

Talking more openly about your challenges with a support system can lighten the load.