Are Covid concerns causing a sleep crisis?

I didn’t know I had a problem until I had a problem. Or, more specifically, I didn’t know I had a problem until I was face down on the cold, wooden floor of my living room, with tears running down my cheeks. 

It’s 4am and I have just fallen over. Minutes ago I was asleep, in a fashion anyway. Just another of my nightly excursions; out of bed, around the flat, sometimes even out of the front door. I woke up tonight as I was falling, my face inches from the floor. As I sit there, bruised, crumpled, I try to remember the last night that hasn’t been curtailed by an accident, or being woken up by my wife because I am singing at the top of my lungs (bizarrely, and much to my wife’s annoyance, the songbook of The Phantom of the Opera is an unconscious favourite) or where I’ve woken up to find myself doing something extremely strange (taking apart electrical equipment is my go-to sleepwalking activity).

I cannot remember the last time I slept properly. And so I go to hospital.

A nurse looks at me with sad eyes and says, “Why are you like this?”

I am in a mess. Somebody in my housing complex has complained to the property manager that I’m up at night, sat on the patio singing. My father-in-law has commented that a recent Instagram photo I’ve uploaded makes me look a million years old. As for work, it’s often taking me a full day to write just a sentence or two; sentences I’ve rewritten so many times I’ve lost count. I’m a freelance journalist. As the job demands, I work quick and I work efficiently. These days I just push words around a blank Word document. My wife walked into my office the other day and found me passed out on my laptop, my crushed nose pressing down the ‘R’ key, the cursor dancing across the page.

The hospital are alarmed. My blood pressure is through the roof. An infection on my leg that’s being treated as a separate issue is refusing to heal. I’m put on a ward where I will stay for 10 days. The first night in I continue my regular nocturnal clown show; the nurses find me in the toilet, asleep (in a fashion anyway) headbutting the soap dispenser. I can’t remember any of it the following morning, only being reminded of the incident when I trace the faint cut the dispenser left on my scalp. A nurse looks at me with sad eyes and says, “Why are you like this?”

I’d do anything to have an answer to that question. I’ve never slept brilliantly. Too much on my mind. Too much I want to do. But since Covid things have been different. Whereas before I’d wake up a lot, I’d normally go back to bed after having a wee. Now I can’t resist putting the television on. I must know what’s going on. I must know what’s happening. Unluckily this period of time syncs perfectly with endless rolling news analysis: Donald Trump, George Floyd killed in Minneapolis. How can you sleep when you’re this angry and afraid when the world burns?

I’m not the only one awake at night. Sleep charity The Sleep Council believes the country finds itself in the middle of a sleep crisis. A recent survey reveals some unnerving statistics; close to half of respondents (43 per cent) say they now find it significantly more difficult to sleep. More than three quarters (77 per cent) say a lack of sleep is interfering with the ability to function in the daytime. Unsurprisingly, more than one in 10 (12 per cent) say they’re experiencing severe symptoms of depression. They fear an incoming epidemic, with stretched NHS mental health services already underfunded and ill equipped to deal with demand. I’m told this by almost every medical health professional I talk to in hospital. They’re scared.

I awoke to my wife crying. “I’ve got you back,” she said

I was seen by a psychiatrist in hospital. My notes told them I’ve battled obsessive compulsive disorder for the last 20 years, and yet after a series of tests it was deduced my sleep issues actually lay with undiagnosed sleep apnoea, meaning I stop breathing in my sleep. The inability to sleep and the anxiety of such unprecedented times had created a perfect storm. I was offered a CPAP machine, a device you strap to your face before sleeping that keeps a constant flow of air flowing into you and holds your airway open at night. It’s a strange sensation, and I’ve watched far too many sci-fi movies not to associate the device with an alien creature clinging to my face. Eventually I got used to it. The first time I tried it I slept six hours straight. I can’t remember the last time that happened. I woke to blissful, restful relief.

It took another five days before I was able to take the machine home. Five days sat watching the world drag by. Watching professional, kind, but harassed and overworked medical staff patch people up and direct them towards the door. They wanted to trial the machine further but needed a side room on a ward to try it out – you can’t be using a machine that circulates air during a pandemic unless quarantined from the rest of the ward.

Then I went home. The first night I used the machine and slept through the night I awoke to my wife crying. “I’ve got you back,” she said. The guilt of the stress I put her through, unconsciously rampaging through the flat each night, remains.

James McMahon is a freelance journalist

01. The NHS recommends finding a daily routine. Easier said than done when our lives look so little like they did six months ago. If you can, wake up, wind down, then go to bed around the same time each day. Try to avoid napping through the day.

02. This is a worrying time. It’s natural to worry. But you’ll find it easier to rest if you set aside time before bed to make a to-do list for the next day. You need to expel your worries, not have them churn around your mind.

03. You need to prepare yourself for sleep. Caffeine, alcohol, nicotine or a big meal can prevent your ability to fall asleep, let alone enter the crucial phase of deep sleep. Exercise is useful, just don’t overdo it or the endorphins will keep you wired and awake.

04. What does the area where you sleep look and feel like? Prepare your sleeping area to resemble a calm, restful environment. Maybe you need earplugs? Maybe you need to make the room cooler or better ventilated? And put your phone away!

05. Sleep rarely comes to those actively trying to get it. If you’re finding it hard, don’t force it. Get up. Read a book. Listen to music. Rest. Then sleep will mostly likely take over.