Practicing Self-Care Helped People Sleep Better Early on in the Pandemic

Early on in the pandemic, many struggled with sleep and found themselves tossing and turning into the early morning. But what helped those who were able to get some rest? Researchers say practicing self-care may have something to do with it.

A study from Germany suggests that self-care and remaining positive helped people sleep better amid the COVID-19 pandemic's many stressors early on.

Just under 1,000 participants in Germany answered a questionnaire about their sleep habits during the first lockdown period, which began in March 2020, and afterward. The study was published in the Applied Psychology: Health and Well-Being journal in early June.

High Levels of Stress Led to Poor Sleep Quality

The participants answered questions about the following subjects to gage their relationship between stress and sleep:

• Overall sleep quality
• Changes in sleep variables
• Positive affect and self-care
• Stress levels due to the COVID-19 pandemic

Self-care behaviors were measured using the Hamburg Self-Care Questionnaire, which asks participants about their specific mindful behaviors. Some questions ask participants to measure if they have allowed themselves times of rest and relaxation or if they've arranged their day in a way that makes them feel good.

People reported experiencing higher levels of stress during COVID-19 due to restrictions, fear that other people will contract COVID-19, reports from the media, uncertain economic development, and more.

The researchers found that "higher COVID-19-related stress was associated with lower self-care, positive affect, and poorer overall sleep quality."

Women experienced higher levels of stress, lower overall sleep quality, and higher positive affect. People in relationships had a better sleep quality, as did those with higher levels of education.

"I think the findings of this study make a lot of sense," Nicole Avena, PhD, assistant professor of neuroscience at Mount Sinai Medical School, tells Verywell. Avena was not involved with the study. "I think that a positive mindset and behaviors that promote self-care would help with stress and therefore, help with sleep."

How Stress Affects Women's Sleep

Previous research demonstrates that chronic stress can interfere with women's sleep, especially for middle-aged women.

A 2015 study published in the Sleep journal found that life stressors over a 9-year period resulted in a range of sleep disturbances for middle-aged women, affecting their sleep quality.

"Women characterized by high chronic stress profiles had lower subjective sleep quality, were more likely to report insomnia," the researchers wrote. Higher levels of stress had a greater impact on sleep than moderate levels of chronic stress.

Avena says that the way women process and express emotions could also impact their stress levels, and in relation to that, their sleep.

"It is theorized that women may possibly experience and express more emotions than men due to the different social roles that women take on," Avena says. "Women may have been more likely to admit that they were having sleep issues or were stressed about the pandemic."

How to Improve Your Sleep

Self-care can help people manage many different parts of their health, even beyond sleep. For example, a 2020 study found that spiritual self-care practices helped improve quality of life for stroke survivors.

While more research needs to be done to further demonstrate the cause and effect between self-care during times of increased stress and better sleep, engaging in self-care practices could be helpful.

"As I tell my patients, sometimes we are not sure of the causality, but certainly implementing positive behaviors, including self-care, would always be of benefit to the patient," Alex Dimitriu, MD, double board-certified in psychiatry and sleep medicine and founder of Menlo Park Psychiatry & Sleep Medicine, tells Verywell.

Self-Care Measures You Can Take

Self-care to improve sleep, just like other forms of self-care, is not one size fits all. Avena recommends that people tune into their emotions to help manage their stress levels.

"Keeping a journal and writing down how you may be feeling on a specific day, or what you may be thinking could help you become more aware of your emotional and mental state," Avena says. "It is important to understand that self-care does not have a cookie-cutter definition."

The Centers for Disease Control and Prevention (CDC) also recommends that people keep a sleep diary if they want to develop better sleep habits. They recommend documenting your sleep schedule, as well as substances you may consume like medication or alcohol.

"Exercise, time with friends and family, as much as possible with COVID restrictions, meditation, eating healthy, and having downtime away from work are all beneficial habits," Dimitriu says.

When You Should See a Doctor

Brushing off not sleeping well because of added stress can be easy. However, if sleep interferes with someone's life, seeing a doctor is a good step.

"Whenever sleep issues begin to impact daily functioning, it's time to get help," Dimitriu says. "The same is true for stress. Many patients often ask me about stress and anxiety, 'When is it a problem?' The answer is, when it gets in the way of life, work, love, or sleep."

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.