Covid-19 Changes Our Sleep
theatlantic.com
theatlantic.com
What we know is that since COVID and lockdowns, the number of people reporting sleep issues and seeking treatment for insomnia is increased. This is obviously entirely unsurprising.
I think the more important point, somewhat ironically made on HN, is the critical effects of sleeplessness and promoting healthy sleep as a national public health priority. It seems to me this is just another pernicious example of how lockdowns and disrupting a population’s routines directly and indirectly damages public health.
Didn't you learn anything at all in the last 11 months? I recall you categorically dismissing it and claiming that it was going to all be over in a couple of months. Here we are, almost a year later, the worst is yet to come - in spite of a vaccine, the roll-out is obviously not going to be instantaneous - and still you're harping away in every COVID-19 related thread minimizing whatever is written. It really is astounding.
What I've learned over the past 11 months, from watching the numbers wax and wane with the seasons totally unrelated to the severity of lockdowns, the ages of those most affected (and for that matter asymptomatic estimates and the corrected IFR estimates), and the knock-on effects of the lockdowns? While it was good to be cautious initially, turns out for this particular virus we've blown it way out of proportion and ought to be letting up a lot more than we have been.
The pandemic is disrupting people's routines, not the lockdowns. The idea that society would be functioning as normal without lockdowns is silly.
Given the large number of people disobeying restrictions, even in California, it seems that society would be quite a bit more "normal" if people were allowed to behave as they wished. See also how people flocked back to bars and restaurants when they reopened, how people have been crowding shops and malls, etc.
I'm sure some people flocked, but for example in my friends circle, nobody did - of course, that's an anecdote which is why the numbers would be needed.
A reasonable discussion has to start by accepting that every course of action is shitty here! The task is to weigh up the amount of shit and the different qualities of the shit down each pathway; it'll help nobody to claim that one pathway is shining and clean.
Fine, then mention both. The comment I was replying to blamed it all on the lockdowns even though the problem would exist without lockdowns.
> I think the more important point, somewhat ironically made on HN, is the critical effects of sleeplessness and promoting healthy sleep as a national public health priority. It seems to me this is just another pernicious example of how lockdowns and disrupting a population’s routines directly and indirectly damages public health.
Does this really blame it all on lockdowns? All I see is "lockdowns are damaging", which is certainly true whatever your political beliefs.
There is not even a hint in the comment that there is another cause to this disruptions besides lockdowns.
https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6932a1-H.pdf
Here’s a longitudinal study, showing that lockdowns were directly associated with increased depression in children:
https://pubmed.ncbi.nlm.nih.gov/33298552/
Rates of depression in Wuhan decreased after the lockdown ended:
https://www.healio.com/news/psychiatry/20201112/anxiety-depr...
A study showing that rates of depression tripled during lockdown in the UK:
https://www.newswise.com/coronavirus/depression-and-anxiety-...
At some point, facts have to matter.
> It seems to me this is just another pernicious example of how lockdowns and disrupting a population’s routines directly and indirectly damages public health
And people literally dying from a virus isn't a public health priority?
Yes...mentioning things like this sure gets in the way of all the virtue-signalling that's going on these days.
[0] https://www.wfp.org/news/wfp-chief-warns-grave-dangers-econo...
(This is going to seem combative, but it's not meant to be...)
https://www.england.nhs.uk/statistics/wp-content/uploads/sit...
Look at the deaths by age and pre-existing-condition ("Tab 3 Deaths by condition")
If you are under 60 and healthy, you are appear to be at almost no risk from C19.
There are going to be a lot of long haul knock-ons to the health system, like cardiovascular issues, from what I'm reading.
Citation?
The effects of lockdowns are presumably also going to cause a significant effect on health in the medium and longer term?
The economic effects are certainly going to be felt for decades.
I wrote a long response to your claim. However, for my mental health and your time, I will simply state that your assessment that the mental health impact of lockdown means it is not worth lockdown is superficial, misaligned to understanding the nation-cratering impact of a health system collapse, and should be reconsidered.
There are remarkably fewer people diagnosed with early stages of cancer, for example. The question is then, if suddently the incidence went down or will people die unnecessarily from worse screening programs and non emergency care?
Things like kids missing out on school is a clear factor in lower life expectancy, one of the few things which hold true independent of country and age group studied.
The primary thing this pandemic has taught me is that people (myself included) weren't aware of what the flu could do to a person.
[0] https://www.health.com/condition/cold-flu-sinus/flu-long-ter...
According to a recent paper[0]
"in-hospital mortality for COVID-19 was nearly three-times higher than for seasonal influenza"
[0] https://www.thelancet.com/journals/lanres/article/PIIS2213-2...
> In recent months, however, Salas has watched a more curious pattern emerge. Many people’s sleep continues to be disrupted by predictable pandemic anxieties. But more perplexing symptoms have been arising specifically among people who have recovered from COVID-19. “We’re seeing referrals from doctors because the disease itself affects the nervous system,” she says. After recovering, people report changes in attention, debilitating headaches, brain fog, muscular weakness, and, perhaps most commonly, insomnia.
There is a contingent of HN posters who are primed to blame a lot of bad effects on "the lockdown." Frankly, I was one of them 8 months ago when there was actually a lockdown, but at least in most places in the USA there really hasn't been anything I could reasonably describe as a "lockdown" since early Summer. Mask mandates, and limits on how specific businesses can operate, sure, but nothing like the draconian shelter-in-place orders we saw in the spring.
I can say from firsthand experience that my families mental health is severely compromised at this point, but unfortunately none of it could be solved by less restrictive laws. It's all related to the pandemic and the choices we've had to make to reduce our chances of getting infected and passing that virus on to other people who have higher risks of dying.
My daughter (5) talks almost daily about the stuff she wants to do "when C19 is over".
I'm not worried about getting infected, I'm not worried about her or her elder siblings getting infected (they're at higher risk of getting hit by lightning). I'm not even worried about us infecting older relatives. I am worried about elder relatives not seeing their grandchildren for over a year (and so are the elder relatives, just for that extra data point)
She's talking about the stuff she's not allowed to do "because" of C19.
I don't really understand the logic behind not being worried about your daughter being infected, because the odds of that are not in fact all that low. Do you mean the odds of her ending up with serious symptoms? Part of the point of articles like this is that we don't really yet know the prevalence of serious symptoms that don't involve acute respiratory failure.\
In a similar vein: I sort of understand the logic behind letting grandparents see their grandkids, because time is limited for them either way. But it's probably not a win if your kid visits your mom and she dies as a result, even if it was the last opportunity your mom would ever have to see your kid; it would be a scarring, debilitating thing to live with for your kid.
Do I really need to itemize all the things that kindergarten kids could do a year ago and can't do now? (Anyone with a 5 year-old, or indeed any child, can no doubt rattle off a list of this stuff pretty effortlessly...)
> it's probably not a win
Sorry, but who are you to judge that?
I offered to take my daughter to see one set of grandparents a few weeks ago, involving international travel and - how can I put this? - a somewhat liberal interpretation of the rules. The grandparents bit my arm off. Their choice. Yes, they had a fantastic time with their granddaughter for about 24h.
People die all the time, for all kinds of awful reasons. Looking at the raw stats, this year just isn't that outstanding. Sorry.
Why don't you go ahead and rattle some of the things you're referring to off for us, so we're all talking about the same things.
> I don't really understand the logic behind not being worried about your daughter being infected, because the odds of that are not in fact all that low.
1) Citation needed? 2) Definition of 'all that low' needed?
EDIT: the boss at my daughter's kindergarten had C19 earlier this year, the mandatory quarantine was more of a big deal for her than the C19 itself. She's not talking about "Long Covid", she's not complaining about how bad it was, instead she's back at work looking after our kids.
As a parent of three kids, I've made multiple trips to a local hospital to a) watch the kids be born, and b) get out-of-hours urgent treatment when no local doctor's practice was open.
With multiple kids, it's not a surprise that we're on good terms with the staff at our local doctor's practice. [Un]surprisingly they're [also] pretty skeptical about the whole C19 story. They're even more skeptical about getting tested for C19, something our local government seems to be pushing.
The data[0] appears to show that if you are under 60 and otherwise healthy, the risk from C19 is somewhere between "very low" and "zero".
The younger you are, the lower the risk. If you're a child, the risk from the virus itself is so small as to be basically meaningless; the impact from society's response to C19 is likely to be severe[1]
[0] https://www.england.nhs.uk/statistics/wp-content/uploads/sit...
A visualization showing differences between countries illustrates the median changes in when people wake up is related to the country's response to covid: https://jeffhuang.com/covid_sleep/wakeups-countries-20200829...
And all in all, about half of people have changed their sleep behavior; about 2/3 of those sleep more hours, and 1/3 of them sleep fewer hours. The usual caveat of a self-selecting population sample applies here.
For me the disruption was that I finally slept enough. You save so much time commuting, there's nothing to do at night, so you get a much more stable circadian rhythm, and more hours of sleep on average.
While there are plenty of confounding variables caused by changes to the population's lifestyle, that doesn't mean that covid can't also affect these things. It is possible for there to be overlap.
Don't think like one of those doctors in the 60's that told patients their Epstein-Barr was all in their head or gave them anti-depressants.
To this day I have issues sleeping and I'm not solely sure if it's anxiety due to pandemic or because of my presumptive case of covid.
It's gotten slightly better in recent weeks but for months now I'd wake up about 30 minutes after falling asleep with a pounding heart and and feeling of extreme anxiety. Not as bad as a panic attack but still not pleasant.
I used to wake with near panic attack just like that.... turns out I wasn’t breathing well. And you don’t have to be overweight to have sleep apnea. Since treating it, I sleep like a baby.
Maybe covid induces some type of central sleep apnea?
(Snoring is normalized/funny in our society but should be viewed as cause for potential concern)
https://www.mayoclinic.org/diseases-conditions/snoring/sympt...
I tell people it’s more like needing glasses. Most people just are born with the issue that develops over time. We don’t have hang ups with treating vision problems (at least not anymore)... sleep apnea should be the same.
I recall another submission on HN yesterday, talking about how the brain puts on "brakes" to cognitive capacity in response to some viruses/injuries (the article itself was about reversing that cognitive decline) [0]. I wonder if some of the neurological effects of COVID-19 are related to that or something different entirely.
[0] https://www.ucsf.edu/news/2020/12/419201/drug-reverses-age-r...
The amount that we do know about the potential long term effects of various other illnesses, including some that most of us have already had in our lifetimes, is also terrifying.
Let's not forget that many illnesses can, in some percentage of cases, cause serious and ongoing problems. COVID-19 doesn't appear to be bizarrely unique in this respect, it's just new and receiving a uniquely massive amount of attention (obviously for good reason).
I don't agree. How many highly contagious, long-incubation, temporarily debilitating, and permanently damaging (cardiovascular, neurological, etc) diseases do we deal with regularly that we aren't already vaccinated against/haven't mostly eradicated? I haven't been alive long enough to remember tuberculosis, so this is quite bizarrely unique to me.
You're alive right now, aren't you?
From wikipedia (https://en.wikipedia.org/wiki/Tuberculosis):
> In 2018, there were more than 10 million cases of active TB which resulted in 1.5 million deaths.[7] This makes it the number one cause of death from an infectious disease.[13] [..] About 80% of people in many Asian and African countries test positive while 5–10% of people in the United States population test positive by the tuberculin test.[14]
Mentions of tuberculosis stick out for me because there was a scare in my middle school that resulted in lots of us getting tested for it (in 2003, in the US). Luckily it was only a scare, as far as I'm aware none of the tests came out positive (and I know mine didn't).
Maybe a dumb question, or maybe I did not understand (the part before the "and"), but how can one be terrified of what one does not know about?
I agree with the part after the "and".
Not everyone likes Mark, but if you’re curious, he explains the psychological situation better, at least, than I can.
Even after a brief look at his site, I can see why :) Didn't put me off, though. A guy who can read @dhh and @gnat can read Mark. Plus, I can see it is for effect.
A terrifying prospect. Misuse of lead (pipes, paint, gas) was a national tragedy with demonstrable ill effect on society and, IMO, still badly affecting the mental health of the older folk who grew up in that era. We can’t afford to take on another generation of mentally diminished, emotionally fragile citizens.
I was sleeping an average of 4-5 hours maximum a night. Once in a while I slept 7 hours, that was the maximum I could and I felt really great about it. Then I accidentally started intermittent fasting about 6 months back to see if helps with lowering cholesterol. But surprisingly I started sleeping more. Now, I eat my meals between 6am and 1pm. After that I fast. I sleep well and I can feel my body producing enough melatonin. For some reason, melatonin supplements never helped me when I tried before. My urge to drink alcohol has also lowered since even though I am an occasional drinker and I sleep for at least 8 hours a day. I can feel my body healing from at least 10 years of insomnia.
At least, that's how my body adjusts when I go between phases of eating breakfast and not easting breakfast.
Could you describe what feeling you’re referring to here?
Acceptance of this statement requires trusting the output of the CCP, which is inherently dishonest with these sort of metrics for political purposes.
> We identified that melatonin usage (odds ratio [OR] = 0.72, 95% CI 0.56–0.91) is significantly associated with a 28% reduced likelihood of a positive laboratory test result for SARS-CoV-2 confirmed by reverse transcription–polymerase chain reaction assay. Using a PS matching user active comparator design, we determined that melatonin usage was associated with a reduced likelihood of SARS-CoV-2 positive test result compared to use of angiotensin II receptor blockers (OR = 0.70, 95% CI 0.54–0.92) or angiotensin-converting enzyme inhibitors (OR = 0.69, 95% CI 0.52–0.90). Importantly, melatonin usage (OR = 0.48, 95% CI 0.31–0.75) is associated with a 52% reduced likelihood of a positive laboratory test result for SARS-CoV-2 in African Americans after adjusting for age, sex, race, smoking history, and various disease comorbidities using PS matching. In summary, this study presents an integrative network medicine platform for predicting disease manifestations associated with COVID-19 and identifying melatonin for potential prevention and treatment of COVID-19.
I'm not sure what to make of this. In my mind, melatonin usage is associated with sleep disorders just like ACE inhibitors are associated with cardiovascular disease (CVD), a known comorbidity. There are better ways to determine the impact of sleep on COVID-19 and vice versa.
[1] https://journals.plos.org/plosbiology/article?id=10.1371/jou...
https://www.evms.edu/covid-19/covid_care_for_clinicians/#d.e...
> Melatonin (slow release): Begin with 0.3 mg and increase as tolerated to 2 mg at night. [1,7,69-75]. Melatonin has anti-inflammatory, antioxidant, immunomodulating and metabolic effects that are likely important in the mitigation of COVID-19 disease. It is intriguing to recognize that bats, the natural reservoir of coronavirus, have exceptionally high levels of melatonin, which may protect these animals from developing symptomatic disease. [76]
For the more serious stages:
> Melatonin 10 mg at night (the optimal dose is unknown) [75]
From my quick scan of the papers in the related footnotes, melatonin is a good antioxidant and may be anti-inflammatory, in addition to the well known association with sleep regulation.
https://www.uclahealth.org/brain-fog-following-covid-19-reco...
This is not a normal year by any measure of it. It's much more likely that the stress and change of habits caused by the pandemic response is causing the sleep patterns than the virus itself.
> IgA antibodies were five times more effective than IgG antibodies at neutralizing SARS-CoV-2, the coronavirus that causes COVID-19.
https://chrismasterjohnphd.com/covid-19/iga-antibodies-vitam...
> Conclusion Greater proportion of vitamin D-deficient individuals with SARS-CoV-2 infection turned SARS-CoV-2 RNA negative with a significant decrease in fibrinogen on high-dose cholecalciferol supplementation.
https://pmj.bmj.com/content/early/2020/11/12/postgradmedj-20...