Quarantine dreams

By: Christina Pierpaoli Parker

A behavioral sleep medicine researcher and psychologist offers advice on how to get our circadian rhythm in sync and sleep soundly in a time of chaos.

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From weird dreams and nightmares to increased insomnia symptoms, the coronavirus pandemic has stimulated some unusual sleep issues for many people, including Christina Pierpaoli-Parker, PhD, and a postdoctoral clinical research fellow of behavioral sleep medicine at UAB. Like many of her patients, she’s had her fair share of restless nights and wacky dreams during quarantine. In one, she boards a cruise ship, dressed head to toe in bubble wrap, and is carrying nothing but a roll of toilet paper. In another, she sleeps through her telemedicine clinic and misses all her patients.

Luckily, she’s been able to get those unwanted dreams under control and return to sleeping soundly by practicing what she preaches.

“In this time of heightened distress and uncertainty, the limbic system—our brain’s primary emotion and memory center—has more demands to process,” explains Pierpaoli-Parker. “And because our brain likes order, it attempts to digest, organize and integrate all of this stimulation—our thoughts, stressors and experiences—into narratives. Our colorful, strange dreams, combined with changes in our daily routines and sleep patterns, may reflect the strong negative emotions COVID-19 has invited. Some patients have shared having dreams of escape, avoidance and vulnerability, getting either enormous or tiny, gaining some superpower like running really fast or flying, or showing up to things naked. These make sense given the emotional climate of things.”

Keeping things light

Because light is a primary synchronizer of our roughly 24-hour internal clock, called the circadian rhythm, it plays a key role in how we sleep. But not all light is the same. On one end of the spectrum, there’s blue light—bright, white and energizing. On the other end there’s red, which is warmer, softer and more relaxing (like a cozy fire).

To get a restful night’s sleep, a person needs exposure to bright light during the day to cue the body into wakefulness and expending energy. And the more the better. Daytime light entrains our circadian rhythm, giving the body cues to remain awake. Conversely, dim, soft light at the red end of the spectrum helps signal it’s time to wind down and relax in the evening. Too much blue light before bed can prolong sleep onset, shortchange deep sleep and cause fatigue upon waking.

That’s why Pierpaoli-Parker recommends disconnecting from blue light-emitting devices including cellphones and computers a couple of hours before bedtime, and transitioning to warm light and finally darkness, which facilitates the production of melatonin, a hormone involved in regulating sleep. She also suggests a warm shower or bath before bed to decrease the body’s core temperature, which can hasten sleep onset.

Researchers at the National Center for Biotechnology Information have long understood the correlation between sleep and cognitive functioning. During deep sleep, growth hormones get released to repair damage throughout the body. It’s also when cerebrospinal fluid gets released into the brain, which may help to clear out things like beta amyloid plaque and tau protein implicated in Alzheimer’s disease.

Rewriting the script

“The more our behavioral patterns align with our endogenous (or physiological) circadian rhythm, the better,” Pierpaoli-Parker explains. “Your chronotype determines whether you identify as a lark, night owl or somewhere in between. Whatever your chronotype, the body rewards regularity. A consistent sleep-wake schedule has strong associations with improved cognitive, emotional, social and cardiometabolic health.”

Some good ways to regulate the circadian rhythm include the following:

  • Establish a daily routine, including an anchored wake-up time every day, even on weekends because the body doesn't know the difference between days.

  • Get plenty of daytime light exposure and exercise to build “sleep pressure.”

  • Well before bedtime, dim interior lights to induce relaxation—something that pairing Google Home with smart lights can help achieve consistently.

For those experiencing persistent nightmares that disrupt waking life, however, Pierpaoli-Parker recommends consulting with a psychologist or behavioral sleep medicine specialist who can help teach relaxation skills and re-script the nightmare to change or reduce the intensity of its outcome.

“Culturally, we do a fairly good job of recognizing the importance of eating well and exercising,” she adds. “But we do less well at recognizing the necessity of sleep, which we typically associate with laziness. But sleep undergirds every aspect of mental and physical health, which we need to support now more than ever.”

Following the sun

With millions of people working, learning and staying safe at home, more time is being spent indoors than ever before, which means less exposure to the natural sunlight we need to keep our circadian rhythm regulated.

To help the body adapt to the current changes and thrive, watch Techxpert and wellness pro Rachel Nicks in the video below as she shows you how to use smart lights and a Google Nest Mini to sync your indoor lighting to match the sun's natural light cycle. By mimicking the spectrum from dawn until dusk, your automated lights can help with developing and maintaining a healthy sleep schedule—and a positive outlook.

About the author:

Christina Pierpaoli Parker, PhD and a postdoctoral clinical research fellow at the University of Alabama, specializes in adult and geriatric behavioral medicine. Her research and clinical interests explore the intersection of older adults’ physical and psychological health, focusing on the adjustment to, as well as the prevention and management of chronic health conditions. Christina translates her academic and clinical work for Eng(aging), her blog on Psychology Today.

Disclaimer: The views and opinions of Christina Pierpaoli Parker are her own and do not reflect those of her employers including the University of Alabama, University of Alabama at Birmingham, or the Birmingham VA Medical Center.

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