Since the pandemic from Covid-19, at least one in two Italians suffer from insomnia. Fear of getting sick, uncertainty of tomorrow, revolutionized rhythms of life: there is enough to mull over all night. It is no coincidence that experts speak of a new type of insomnia: the Covidsomnia.

«Which is not just a consequence of the disease, why it also affects those who have not contracted the virus and it derives from the side effects of Covid on our life and our psyche », explains the professor Giuseppe Plazzi, full professor of child neuropsychiatry, University of Modena and Reggio-Emilia and president of Aims, which brings together the leading Italian experts in sleep disorders.

«It is a global problem now, and it is the subject of an international study in which we participate. Depending on your research, you go 27 to 50% of the cases studied presenting, during and after lockdowns, an insomnia characterized by delayed sleep, frequent awakenings and an increase in nightmares. In people who have recovered from the infection, on the other hand, insomnia, after anxiety, is the most common side effect ».

Your sleep pattern is altered because you go to bed too late

With the first and the beginning of the second wave of Covid-19 experts have seen a significant number of people with an alteration of the rhythm of the sleep: so many have begun to to delay time to go to bed. «By breaking that process that guarantees true restful sleep, which is made of precise phases»Explains Plazzi.

“Sleep first light of falling asleep, then that deep in the first part of the night (and this is what guarantees us the “real” rest). Finally, towards dawn, the return to the light phase. This new habit of postpone rest led to multiply the nightmares and to give cognitive and behavioral disorders during the day”.

With stress, sleep becomes lighter

Therefore, after the first lockdown, half of the Italians fall asleep later. «Not only that: he sleeps more light, which is one of the characteristics of the syndrome from post-traumatic stress, like the one we are experiencing ”, explains Plazzi.

“It is true that the awakening is a bit delayed, many are not yet going to work, but the European population has lost an average of half an hour of sleep, a problem that in big cities also touches an hour and a half ».

Insomnia can make you depressed, overweight and put your heart health at risk

The sleep debt from Covid accumulates, with repercussions even during the day involving memory, mood, up to affect the character of a person: irritability increases, restlessness and we become intolerant, aggressive even against ourselves.

Up to Depression: Research says that sleep disturbances, particularly delayed sleep, predispose to depression. “But also the cardiovascular system it can be damaged (the risk increases by at least 15% after age 55), starting with a increase in blood pressure and the appearance of hypertension.

Metabolism also slows down, which is why those who sleep less tend to gain more weight. Our metabolism needs the continuous sleep (slow wave sleep) to be efficient, ”Plazzi points out.

Let’s clarify the sleeping pills

Then there is a lot of confusion on the word sleeping pill. “Sure, these are sleep drugs, but there is no type that guarantees the famous 8 hours of sleep. On the other hand, there are hypno-inducing molecules with a short half-life, which have a sleep-boosting effect and act on average in the first three hours, such as certain benzodiazepines and the Z-drugs, similar psychoactive drugs, ”explains Plazzi.

“Then there is melatonin pharmacological, but also over-the-counter, and various products that actually fight anxiety more than insomnia, such as hypericum (a natural antidepressant), valerian and chamomile, and which can be associated the sleep hormone “.

One of the side effects of Covid insomnia was the abuse of so-called “sleeping pills” (some products sold up to 45% more). “In this period, the benzodiazepines he hypno-inducing over-the-counter were often used in much higher doses with respect to the indications, thus causing disturbances ”, emphasizes the professor.

“In Italy, then, we use some benzodiazepines with a long half-life to sleep inappropriately, with the consequence that the their “sleeping pill” action is prolonged during the morning. Also there melatonin, excellent molecule, has often been taken in excessive doses. But any substance, pharmacological or over the counter, should be taken at approximately lower doses, because levels that are too high interfere with sleep chemistry. It’s not just about “Too much” equals “toxic“: If you take too much St. John’s wort, for example, first of all it will occupy the chemical receptors that are responsible for receiving other strategic substances for rest”.

Covid then saw the use of remedies at inappropriate doses, but also in wrong times. “The classic case is that of those who take the basic dose, do not wait the physiological time required to enjoy the effect (also because perhaps they take it too early or too late) and so take another pill, or rather two” which is better “. But these products must be taken strictly following the instructions: and if they don’t work within a few days we must not insist»Says Plazzi.

Yes to the nap, but for no more than 20 minutes

Many of us have tried to combat insomnia from Covid recover lost sleep at night with the afternoon nap. «The problem is that to be restorative and not add disturbances to disturbances it must be 20 minutes, no more»Explains Plazzi.

“We must wake up before we go into deep sleep, otherwise a mechanism called “sleep inertia” is triggered which leaves us asleep even for hours, which is not good if you already go to bed late and then you are sleepless. The alarm should be set, even earlier than 18 minutes, if we realize that at the twentieth we are already completely asleep and the alarm brings us back to the state of consciousness of a start. We must therefore remain in the phase of preparatory sleep, also to avoid mood problems and restart in the afternoon.

Not by chance airplane pilots are prohibited the nap before landing: it can lead to mistakes ». Has been Thomas Edison, the inventor of the light bulb, who was the first to theorize the beneficial power of the 20-minute nap (he used it as a propellant to invent new things), which he called “power nap”, and to which he dedicated a book, The power of sleep .

Fewer computers for the under 18s

The population deserves a separate discussion younger. “IS very affected by insomnia and related daytime side effects, ”explains Professor Luigi Ferini Strambi, director of the Sleep Center of the San Raffaele Hospital in Milan.

“We did research on students during Covid and found that theanxiety has significantly affected even the youngest. Second fact, more related to rest: the boys, who are already usually owls, then they tend to sleep and wake up late because they have a delayed release of melatonin, today they are even more so. Third: lockdowns led to one desynchronization of their sleep-wake rhythms. Fourth fact: being more indoors, they expose themselves less to light, and this aggravates the desynchronization of biological rhythms.

Result: the under 18s in the pandemic era they go to sleep an hour and a half later and wake up almost 2 hours later on average. And, also for them, the bad dreams“. What to do? “Try to keep the same hours for eating and sleeping or studying, avoiding anarchy,” advises Ferini Strambi. «Get moving, even if it’s a bike ride. Do not overdo the personal activity on the PC, especially from 11pm onwards. Often this is enough to put the rest back in place ».

How to avoid nightmares

One of the peculiar characteristics ofpandemic insomnia is the multiplication of nightmares. But they can be avoided
Don’t stay up late
Because it concentrates the dream phase, the Rem one, and therefore facilitates the appearance of dreams, in this worst and most frequent period of the pre-Covid era.
No alcohol
One glass too many at dinner apparently induces sleep but affects its quality. If we then add the spirits we inhibit the REM phase, moving it towards the morning and giving rise to nightmares.
Stop the cell phone
It is precisely the particular light of mobile phones that suppresses the production of melatonin. «It doesn’t matter what we read: even a relaxing book with the light of the ‘wake up phone’», explains Professor Plazzi.

How to use melatonin correctly

Melatonin is the main driver of sleep, but it must be used appropriately. Here are the advice of Professor Plazzi

Quantity: the right dose as a supplement is 1 mg. The drug prescribed by the doctor is 1 mg for children and 2 mg for adults.
Formulation: In theory, retard is better, but to be sure there is a slow-release pharmacological melatonin that mimics its natural production during sleep.
When to take it: about 20 minutes before bedtime. And no later than 11pm, no later than midnight.
Other substances: Valerian and chamomile are good relaxants, and can accompany melatonin. Eye to hypericum, which acts on serotonin: in excessive doses it disturbs the mood, especially in the elderly.

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Article published on n. 6 of on newsstands and in the app from 18 May 2021