COVID Insomnia: Causes, Treatments, and What We Know So Far

Can’t sleep at night and have COVID or recovered from it? You might have what’s known as COVID-somnia or coronasomnia. It’s the name given to any sleep problem related to the coronavirus. 

But COVID-somnia doesn’t just affect people who are currently battling the infection or have recently recovered. You might have trouble sleeping due to issues related to the pandemic in general — thanks to things like heightened anxiety, loss of routine, and lockdown and social isolation.  

If this is you, you’re not alone. COVID-related sleep disorders are thought to affect 30% to 40% of us — and for those who are currently infected, it’s a whopping 75%.

Below, we’ll dive into what COVID insomnia is, what causes it, and — most importantly — what you can do to get a good night’s sleep if it’s affecting you. 

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COVID insomnia is the catch-all name for the sleep problems that SARS-CoV-2, or COVID-19, can cause. It can also cover sleep dysfunction caused by simply living through the COVID-19 pandemic.

Common symptoms include: 

• Insomnia
• Trouble sleeping through the night 
• Changes in your circadian rhythm, or body clock 
• Excessive daytime sleepiness
• Nightmares
• Restless leg syndrome 
• Non-restorative sleep
• Decreased sleep quality 

It’s thought that rates of insomnia symptoms and insomnia disorder were about twice as high during the first wave of the pandemic than in pre-pandemic times. 

It’s hard to know for sure which sleep problems COVID and the pandemic cause, and how many people it's affecting, though. 

Studies comparing sleep during the pandemic to sleep pre-pandemic use different sampling methods, definitions, and survey methodologies, so it’s tricky to see whether insomnia rates have truly risen or not. 

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Sleep problems related to COVID may be common, but can they be classified as full-blown insomnia? 

According to the third edition of the International Classification of Sleep Disorders (ICSD-3), insomnia is confirmed when all four of the following criteria are met: 

• Difficulty falling asleep, maintaining sleep, or waking up too early 
• Having difficulty sleeping despite having the opportunity to sleep 
• Daytime impairment or distress attributable to sleeping difficulties
• The sleep-wake difficulty is not better explained by another sleep disorder, mental disorder, or medical condition 

ICSD-3 differentiates insomnia to be either less than three months (acute) or three-plus months (chronic). 

Therefore, COVID insomnia when you have COVID may not be classified as full-blown insomnia. But it could creep closer to fitting the traditional definition once you’ve recovered or if your sleep issues are from the pandemic, not the illness.

Of course, even if your sleep problems aren’t classed as true insomnia, this doesn’t make them any easier or any less damaging to your health. 

In fact, we argue that any sleep problems — be they insomnia or not — are worth finding a fix for as they can seriously impact your energy, mood, and mental and physical health. 

While every study on the topic defines it differently, one study surveyed more than 22,000 people during the first wave of the pandemic and found clinical insomnia symptoms were reported by 36.7% of them, while 17.4% met the criteria for probable insomnia disorder. So, while many had sleep problems, a smaller proportion of them had insomnia. 

There are a few problems with studies on COVID insomnia, though. These include: 

• When the studies were done — during lockdown vs. post lockdown 
• How sleep was measured in each study, and it’s hard to compare this to pre-pandemic times as the measurements may be different  
• Lockdown severity and deaths rates varied by country
• The pandemic is arguably still ongoing
• There’s still more to learn about COVID and long COVID
• Definitions for acute insomnia vary, even before the pandemic kicked off  
• It’s hard to tell whether it’s COVID or the pandemic (without getting infected) causing insomnia 
• Many studies use self-reported sleep data, which is notoriously inaccurate (it’s hard to tell exactly how long you slept for at the best of times, let alone when you’re sick)
• As COVID is still a relatively recent development, we don’t have any studies spanning longer than two or so years 

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Many factors can cause insomnia. And things get even more complicated when you throw COVID into the mix. Here’s what could be keeping you up at night. 

COVID 

Sleep issues are common if you’ve got the COVID-19 infection itself. One paper states 75% of those with COVID reported poor quality sleep, and a meta-analysis and systematic review found sleep problems were found in more than 52% of COVID-19 patients. 

The symptoms of COVID — like a cough, fever, and breathing difficulties — can easily keep you up at night. 

The effects of COVID-19 can also impact areas of your brain that control your sleep and respiratory regulation, which cause an increased risk of sleep-disordered breathing such as snoring or sleep apnea — not a recipe for a restful night. 

COVID may also affect blood flow to the brain, which can contribute to sleep disturbances like an inversed sleep-wake cycle.

If you’re in hospital, you’ll have the additional difficulties of trying to sleep in a busy ward or while being interrupted throughout the night. Even if you’re at home, side effects from the medication you’re taking to treat COVID may contribute to sleep problems. 

You may also be out of sync with your circadian rhythm (your roughly 24-hour biological clock) as you’ve been sleeping and eating whenever you can or feel like it. But now your body can’t fall asleep at your usual bedtime. 

Sleep issues while battling COVID are particularly frustrating. It’s a cruel fact of life that it’s often when you’re ill that sleep is the hardest to come by, but it’s also when your body needs it the most. 

Not getting enough sleep weakens your immune system, can make you suffer from an infection for longer, and it also makes you feel pain more intensely. Even if you’re not sick, you need sleep for everything from general health and wellness, to energy and productivity. 

Long COVID

You may experience sleep problems long after the initial COVID infection has cleared up. This is called long COVID, and it may last weeks, months, or even years. 

The most common symptoms of long COVID include: 

• Poor sleep 
• Fatigue 
• Anxiety
• Brain fog
• Memory problems
• Aches and pains  

Research is still being done to find out what exactly causes some patients to develop long COVID, how long it lasts, and how best to treat it. 

A 2022 study found about 41% of those with long COVID reported at least moderate sleep disturbance, and about 7% reported severe sleep disturbances. 

Another 2022 study found those who had recovered from COVID showed changes in many areas of their brain, including the area associated with regulating your circadian rhythm. This research was done within six months of recovery, and the researchers are conducting more studies to see whether these brain changes persist. 

Yet another study found more than 26% of people had insomnia two weeks after being discharged from hospital. There’s even research to show 12% reported insomnia as long as two years after recovery. 

Anxiety

You might be feeling anxious about catching COVID, worried about how long it’ll take you to recover if you’ve got it currently, or feeling stressed about the health of loved ones. Beyond the illness itself, the pandemic may be spiking your anxiety levels due to loss of income and financial worries, or feeling confined and isolated.

Whatever’s causing it, anxiety and sleep don’t play nice together. Insomnia symptoms often present themselves after acute stress or life changes — and catching COVID and simply living through the pandemic are both stressful events.

Research shows nearly a quarter of patients suffer from anxiety, depression, and post-traumatic stress disorder during infection and until six months after — and all three are associated with disturbed sleep, especially insomnia.

Plus, if you had pre-existing insomnia symptoms before the pandemic, you’re more likely to be susceptible to stress, anxiety, and depression during the pandemic, putting you at a higher risk of more sleep problems from the increased anxiety. 

Psychiatric illnesses, unemployment, and frequent exposure to social media or news regarding COVID were found to be risk factors for insomnia. 

You can learn more about the bidirectional link between anxiety and sleep here. 

Pandemic-Related Changes in Routine 

Even if illness or anxiety isn’t at play, the pandemic could still be behind your COVID-somnia in other ways. Research suggests the prevalence of insomnia increased significantly during the pandemic.

The pandemic may have changed your lifestyle in some way, such as: 

• You might now be working remotely, meaning you don’t leave the house to get morning sunlight. 
• You might be exercising less, either because you’re in isolation, can’t get to the gym, or fell out of the habit during lockdown.  
• You might be drinking more alcohol now that lockdown is over or perhaps because you now use it to help you fall asleep
• You might have lost your job or gotten more flexibility with your work times, meaning you now have no routine or set sleep-wake times, making it easy to get out of sync with your body clock and have irregular sleep patterns. 
• You might no longer just be using your bed just for sleeping (and sex), but not for working, if you now work from home. 

One study found the risk of insomnia was higher in those who reported greater financial burden, were in confinement for a period of four to five weeks, and were living alone or with more than five people in the same household. 

Research also found loneliness and intolerance to uncertainty during the pandemic also predicted insomnia. 

Children and adolescents experienced sleep problems during the pandemic, too, potentially due to school closures, loss of recreational activities and social life, and fear of illness. 

Insomnia is also common among healthcare workers: almost four in ten experienced sleep difficulties or insomnia. 

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Whether you’ve got full-blown insomnia or persistent sleep problems with or without a COVID infection itself, here’s what you can do to get more sleep. 

Heads up, though: More research needs to be done into COVID insomnia and the possible treatments. As there are so many potential causes of the sleep disorder, what works for some people, may not work for others.  

1. Improve your Sleep Hygiene 

Sleep hygiene is the name for the daily habits you can do to help you fall and stay asleep at night. They’re important for everyone, pandemic or not, but they’re especially important if you’re suffering from COVID insomnia as you may find many healthy sleep habits have been sabotaged during the pandemic. 

Here’s what to do: 

• Get bright light first thing and avoid it close to bedtime: Light in the morning resets your circadian rhythm for the day, helping you feel sleepy at the right time come bedtime. But bright light can keep you up in the evening. Aim for at least 10 minutes of light as soon as possible after waking up, and 15 to 20 minutes if it's overcast or you’re getting light through a window. About 90 minutes before bed, dim the lights and put on blue-light blocking glasses. 
• Avoid caffeine, large meals, intense exercise, and alcohol too late in the day: All four can disrupt your sleep, keeping or waking you up during the night. 
• Keep your bedroom dark, cool, and quiet: Aim for 65 to 68 degrees Fahrenheit, use blackout curtains, and wear earplugs and an eye mask to create the ideal sleep environment.  
• Wake up and go to bed at the same time each day: Keeping a consistent sleep schedule, even if you no longer have a set routine for work, will help keep your circadian rhythm in check. 
• Avoid sleep aids: As tempting as it is to reach for over-the-counter sleep aids when you’re suffering from sleeplessness night after night, they come with risks and dangerous side effects and they’re not a long-term solution. 

To help you stay on top of it all, the RISE app can guide you through 20+ sleep hygiene habits each day and tell you the ideal time to do each one to make them more effective.

RISE can also predict your circadian rhythm each day, showing you when your body naturally wants to wake up and go to sleep. You can then see whether your pandemic lifestyle has caused you to get out of sync, and work to get back in sync. 

RISE users on iOS 1.202 and above can click here to set up their 20+ in-app habit notifications.

RISE users on iOS 1.202 and above can click here to see their circadian rhythm on the Energy screen.

2. Lower your Anxiety 

COVID isn’t going anywhere anytime soon, so we need to learn techniques to manage our COVID-related anxiety to stop it from keeping us up. 

Here are some science-backed tips you can try: 

• Do a calming bedtime routine: Before bed, take time to do some relaxing activities like reading, listening to music, or yoga. This will also help you disconnect from work if you often find yourself working late and struggling to know when to power down for the day. 
• Do a brain dump: If racing thoughts are keeping you up, try a brain dump. Write down the things you’re worrying about or try writing tomorrow’s to-do list (research shows this is especially helpful for falling asleep faster). Use RISE’s brain dump feature to get a reminder of everything you write down the next day.  
• Try relaxation techniques: RISE’s audio guides can walk you through relaxation techniques for sleep like progressive muscle relaxation and diaphragmatic breathing. 
• Ask for help: If anxiety, depression, or other mental health issues or health conditions are sabotaging your sleep regularly, seek help. Speak to friends and family about your worries or reach out to a therapist or a doctor. 
• Reduce your exposure to bad news and social media: If you find yourself scrolling new sites and reading about the pandemic, try reducing this or cutting yourself off completely. Opt for less stress-inducing activities, especially in the run-up to bedtime. 
• Use cannabis and CBD cautiously: While CBD and cannabis can help lower anxiety, they may not be as good for your sleep as you think. CBD is often advertised as a sleep aid, but more research needs to be done. You can learn more about whether cannabis helps with sleep here and whether CBD helps with sleep here.

You can learn more about how to sleep with anxiety here. 

RISE users on iOS 1.202 and above can click here to go right to their relaxation audio guide homepage and get started.

RISE users on iOS 1.202 and above can click here to set up their Brain Dump Habit notification

3. Reverse Pandemic Changes That Have Impacted Your Sleep 

The pandemic changed many aspects of our daily lives, and some of these changes may have contributed to your insomnia. If you can identify which ones are keeping you up, work on reversing them and reverting back to your pre-pandemic lifestyle. 

Many of these changes come under good sleep hygiene including: 

• Avoiding alcohol before bed
• Getting outside daily, especially in the morning to get sunlight 
• Getting exercise, which can help you fall asleep and reduce anxiety, but avoiding it close to bedtime 
• Giving yourself a set bedtime, wake time, and time to finish work, even if you don’t have a set routine anymore

4. Try Cognitive Behavioral Therapy 

Cognitive behavioral therapy for insomnia (CBT-I) is often the first-line treatment for insomnia. It involves changing your thoughts and behaviors around sleep and can include exercises like: 

• Sleep hygiene education 
• Sleep restriction
• Relaxation training 
• Cognitive interventions, or changing your unhelpful thought processes about sleep 

There’s not much research into CBT-I for COVID insomnia specifically, but it has been shown to be an effective treatment for those with insomnia during menopause, pregnancy, and in general. A 2023 study found even a one-week course of CBT-I delivered virtually helped reduce rates of chronic insomnia.

From the research that has been done, CBT-I has been shown to improve insomnia symptoms, sleep duration, sleep latency (the time it takes to fall asleep), and sleep efficiency (the time you spend actually sleeping in bed) in those with COVID.

5. Speak to a Doctor 

Reach out to a medical professional or sleep specialist to get help with your COVID-somnia, especially if it’s long-lasting or seriously affecting your day-to-day life. 

They may be able to suggest medication to help or treatment options for your specific case such as: 

• Avoiding naps 
• Melatonin supplements (although more research needs to be done into whether these are suitable for those with full-blown insomnia)
• Light therapy 
• Taking sleep aids as a short-term solution
• Addressing health problems contributing to sleep problems, like anxiety and depression 

Is your COVID insomnia leading to daytime fatigue? We’ve covered how you can get energy back after COVID here.

Sleep Easy With or Without COVID

You could be struggling to sleep while suffering from COVID or long COVID, or simply due to changes in routine during the pandemic. But whatever’s causing it, it’s a problem. 

Sleep is not only vital for our health, well-being, and quality of life, it’s needed for daytime energy, productivity, and mental performance. Plus, sleep loss impacts our immune response, increasing our risk of catching and then suffering more from COVID. 

To help tackle your COVID-somnia, try improving your sleep hygiene, reducing your anxiety, reversing any pandemic changes in your lifestyle that could be impacting your sleep, and seeking cognitive behavioral therapy. 

The RISE app can help by guiding you through 20+ sleep hygiene habits each day and telling you the ideal time to do each one to boost their effectiveness. Plus, RISE can predict your circadian rhythm each day, so you can easily sync up your life to it, helping you drift off easier each night and enjoy more energy each day.