This is a terrible time to be an insomniac. Headlines are designed to provoke anxiety or fear. Contentious political clashes and war make the nighttime news distressing. When the days get shorter and there is not as much sunlight in the late afternoon, many people get moody. If it is cloudy, rainy or cold outside, it is hard to exercise. Those who don’t normally toss and turn are finding it very difficult to sleep during anxious times such as these. Shift workers often have a hard time getting adequate sleep.
A Scary Consequence of Inadequate Sleep:
Insomnia has many undesirable health consequences…from morning grogginess to an increased risk for diabetes. A new analysis of data from the Nurses Health Study 2 shows that women who have trouble getting a good night’s sleep are more likely to develop high blood pressure (Hypertension, Sept. 18, 2023).
Researchers collected data from 66,000 volunteers between 24 and 42 years old. The study ran from 2001 to 2017. During this time, more than 25,000 women were diagnosed with hypertension.
Those who slept less than 7 or 8 hours a night were much more likely to get such a diagnosis. That was also a problem for those who had trouble falling asleep or staying asleep. This association held up even after the researchers adjusted for shift-work schedules.
Tips on Getting to Sleep During Anxious Times:
Q. I have been having a terrible time falling asleep. The nonstop grim news stories about the virus have me on edge. I am tempted to go back on Ambien even though I had a hard time getting off it last year. Do you have any other suggestions?
A. We completely understand why you and millions of other people are feeling anxious. News of COVID-19 and the terrible toll it is taking here and around the world is indeed terrifying. We offer a few tips that may help.
Turn Off Your Phone or Tablet:
First, try turning off your devices at least an hour before bedtime. The blue light emitted by tablets, smart phones and computer screens can suppress your production of melatonin.
Experiments have found that reading from the phone interferes with sleep patterns early in the night. Blue light also reduces the normal nighttime rise of melatonin (Clocks & Sleep, Oct. 28, 2021). Reading from a book instead does not disrupt sleep.
Block Blue Light With Special Glasses:
If you really cannot give up your tablet before bedtime, consider wearing blue-blocking glasses. Norwegian scientists conducted a randomized controlled trial and found that blue-blocking glasses allowed an earlier rise of melatonin levels, making it easier for the pregnant volunteers to fall asleep (Neurobiology of Sleep and Circadian Rhythms, May 2022). While you can purchase such glasses online, your optometrist might be able to guide you to a reputable brand.
Make Time to Relax:
Finding some quiet time to relax before bed is more important now than ever before. That means no news or video at least an hour before bed. Devoting that time to a hot bath instead can help your body prepare for sleep. If you have ever tried meditation, this would be a good time to brush up on those skills. Taking time to breathe slowly could help you sleep during anxious times. If you can safely get out for a walk in the middle of the day (maintaining physical distance), this too will often help you unwind when evening comes.
Try Melatonin Supplements for Sleep During Anxious Times:
Melatonin supplements are another option for people who have a hard time falling asleep. Unlike sleeping pills, though, they are not sedatives. Instead, they help reset our biological clock. If you take melatonin an hour or two before bedtime, it helps prepare the body for sleep. Although there are not lots of studies, one systematic review and meta-analysis concluded that this natural hormone can be helpful for people with sleep disorders (Frontiers in Neuroendocrinology, Jan. 2019).
Melatonin has another unexpected benefit. It can reduce stomach acid secretion.
Even more importantly, it tightens the lower esophageal sphincter (World Journal of Gastrointestinal Pharmacology and Therapeutics, Oct. 6, 2010). That’s the connecting valve between the swallowing tube (esophagus) and the stomach that keeps stomach acid where it belongs. As a result, melatonin reduces nighttime reflux and that improves sleep.
Going Back to Ambien?
If you can avoid it, we urge you not to start taking zolpidem (Ambien, Edluar, Zolpimist) again. As you have experienced, some people have great difficulty with rebound insomnia when they try to stop taking this drug. Occasionally, people who have taken zolpidem engage in dangerous sleep behaviors, such as driving. In addition, readers have reported increased heartburn while taking this medication.
An Unusual Side Effect of Melatonin–Insomnia:
Q. I read with some interest that melatonin could be helpful for reflux at night. When I took 3 mg of melatonin, it kept me awake. Is this a common complaint?
A. Most people take melatonin to ease insomnia. The idea that melatonin might keep someone awake was news to us. There is not much in the medical literature about this potential problem.
We did find a recommendation to take melatonin at least three hours before bedtime to maximize efficacy (Journal of Pineal Research, Aug. 2024). Some people have posted online that they too have been awakened in the middle of the night when they take melatonin.
Nondrug Approaches for Getting to Sleep:
Instead, you may wish to consider nondrug approaches to getting to sleep during anxious times.
Turn Off the Light:
Do you like to sleep with a nightlight in your bedroom? Many people fall asleep with the TV or a reading light on. Others may have outside lighting that comes in through the windows. Not only could a darkened bedroom help you get to sleep, it is also better for your health.
That is the conclusion from a new study published in the Proceedings of the National Academy of Sciences. Twenty young, healthy volunteers participated in the study (PNAS, March 14, 2022). They were randomized to spend a night with either dim light or relatively bright room light. Exposure to just one night of room light increased insulin resistance the following day. Those who slept in a lit room also had a higher heart rate while they slept. The scientists hypothesize that light activates the sympathetic nervous system leading these cardiometabolic changes. That may also explain why listening to podcasts in bed can interfere with good sleep.
Try Magnesium:
Magnesium may help you get to sleep (Journal of Research in Medical Sciences, Dec. 2012). Many people do not have adequate levels of magnesium, especially if they are taking powerful acid-suppressing drugs (PPIs). This essential mineral may help people with sleeping difficulties.
Herbs Might Help:
Herbal remedies such as valerian, passionflower, lemon balm or hops may also be useful. In fact, a double-blind placebo-controlled trial demonstrated that lemon balm (Melissa officinalis) helps alleviate anxiety and reduce sleep disturbance (Clinical Nutrition ESPEN, Aug. 2018).
Some insomniacs have a hard time turning off their internal dialog. The Indian herb ashwagandha (Withania somnifera) can help with that problem (PLoS One, Sept. 24, 2021).
Cognitive-Behavioral Therapy for Insomnia:
Cognitive behavioral therapy for insomnia (CBT-I) has an excellent track record. This would be a very good approach to being able to sleep during anxious times. However, you might have trouble finding a knowledgeable therapist during the pandemic. Some people find online resources can fill that gap.
Learn More:
You will find details on these and many other suggestions in our eGuide to Getting a Good Night’s Sleep. You may also want to listen to Show 1268: Learning How to Sleep. To learn more about other strategies to control heartburn, you may wish to consult our eGuide to Overcoming Digestive Disorders.
