Task Force Offers Sleep Management Recommendations During the Pandemic

The Society of Behavioral Sleep Medicine (SBSM) has convened a group of experts to create recommendations related to the management of 2019 coronavirus disease (COVID-19)-related sleep disturbances.

The SBSM COVID-19 Task Force noted that their patients had experienced disrupted sleep-wake patterns during the pandemic and ensuing lockdown. To help address these issues, they produced a series of case vignettes with corresponding advice for healthcare providers, as well as handouts for patients containing sleep hygiene recommendations.

First, the task force recommended that behavioral and environmental controls may help address acute bouts of insomnia. Specifically, tracking sleep with a diary, avoiding non-sleep related activity in the bedroom, and practicing cognitive control and imagery distraction techniques should be considered first line treatments. The task force recommended these treatment options are prioritized over prescription sleep aids, which carry the risk for dependence and adverse effects.

The SBSM task force also warned against maladaptive coping strategies, such as alcohol consumption before sleep, and advised that patients address recurrent daytime stressors, which may be especially concerning for essential or healthcare workers. Additionally, for patients experiencing nightmares, identifying potential causes and triggers can be important, alongside deep breathing after waking from an episode.

Maintaining a consistent sleep-wake schedule, including exposure to bright light in the morning and avoidance of it at night, may be the most reliable way to reduce pandemic-induced sleep problems. Healthy social, exercise, and eating routines are also encouraged.

Parents with children or adolescents may experience challenges related to disrupted routines, school closures, and lack of daytime activities. The experts recommended encouraging “activities that build sleep need” and prevent sleep disruption, such as napping or late night screen time. In addition, for older adults, physical activity and light exposure early in the day, avoiding napping, as well as consistent communication with family and friends may help prevent sleep trouble relating to inactivity and increased social isolation.

Lastly, the task force recommended cognitive behavioral therapy for insomnia delivered over the phone or by video, which may help patients experiencing sleep problems at this time.

Reference

Crew EC, Baron KG, Grandner MA, et al. The society of behavioral sleep medicine (SBSM) COVID-19 task force: objectives and summary recommendations for managing sleep during a pandemic [published online June 13, 2020]. Behav Sleep Med. 18(4):570-572.