Blog: NNUH Head of Sleep Medicine discusses Covinsomnia

Dr Philippe Grunstein, Head of Sleep Medicine at NNUH, discusses Covid nightmares and insomnia.

The coronavirus pandemic has brought a collective trauma that has not spared our sleep. 50 per cent of the population has experienced unrefreshing sleep since the start of the pandemic, up to 60 per cent of the adults in the UK suffer from insomnia and a quarter from vivid and recurrent nightmares. The impact of the pandemic has been massive and the root cause of nightmares and insomnia has been collective and personal fears.

Studies have found an almost threefold increase in the occurrence of nightmares, which affect more women, younger people and singles.

Additional risk factors are alcohol, sleeping less than five hours per night, sleeping pills, and previous psychiatric disturbances.

Insomnia has soared to staggering levels during the pandemic and a new word has been coined for this new condition – Covinsomnia.

A good night sleep is at the core of metabolic and immune balance among other functions like memory consolidation, clear thinking and sociability.

Any chronic insomnia impairs our immunity and makes us more vulnerable to viral infections by at least four times compared to seven to eight hours of unbroken restorative sleep.

In case of Covid infection, most of the patients can hardly sleep during the active phase of the disease. We could attribute this acute insomnia to anxiety, difficult breathing, fast heartbeat or cough, but Covid-19 enters the brain as well. A quarter of the survivors develop chronic insomnia.

The pandemic has brought a massive collective sleep disruption leading to a surge of sleep onset and sleep maintenance insomnia, sleep deprivation and vivid nightmares, a surge of chronic fatigue and PTSD.

Everything that disrupts or breaks our usual time landmarks and routines we had before the pandemic can generate insomnia.

No more office or jobs on fixed times, no more regular outdoors sports activities, increased screen times for work, news, social media or binge TV, decreased natural light exposure, isolation, lockdown of big families are risk factors.

Everything that brings a lot of anxiety opens the door to insomnia: financial worries, loss of physical connections with family members and close friends, tensions at home, alarming news, cancelled or delayed appointments for health conditions, age group above 70, pregnancy, jobs with inevitable contact with the public.

How to avoid Covinsomnia?


  • Try to wake up at the same time during the week and same at weekends during lockdown
  • Even if you work from home, get showered and dressed as going to work as usual
  • Take the morning light at least 15-20 minutes, open blinds/curtains and windows and bring fresh air
  • Set up fixed time for work, exercise and meals
  • Exercise at least 30 minutes in the afternoon between 3pm – 4pm
  • Walk your dog and play with your cat, enjoy the garden, watch the birds, trees and skies
  • Read more, watch television less
  • Remain connected to the people out of your household, write to them, do not forget birthdays, show kindness
  • Do not nap more than 20 minutes
  • Stop all computer activity by 5.30pm and start cooking

Late afternoon, evening & bedtime

  • Dinner by 7pm maximum, limit alcohol intake
  • Stop television at least 40 minutes before going to bed
  • No News at Ten
  • Bed must be inviting, change bed linen once per week, fluff up your pillows, bring candles, no TV, no computer and no mobile phone if possible
  • For those who are anxious and at higher risk of insomnia, before going to bed, write down on a notebook what to do the next day. It works better than a sleeping pill
  • Do not take sleeping pills, they give less deep restorative sleep, the one you need the most to consolidate memory and maintain good intellectual activity

If, despite these recommendations you suffer from insomnia and/or vivid nightmares, alert your GP who can refer you to our sleep service at the NNUH.

Sleep onset insomnia means that it takes at least 30 minutes at least three times a week, to fall asleep.

Sleep maintenance insomnia means that you wake up for at least 30 minutes at least three times a week, after having fallen asleep.

Chronic insomnia means that insomnia has been present for at least three months, of which the treatment requires specialised interventions and cognitive behavioural therapy (CBT).

At the NNUH we are involved in post-Covid issues of which insomnia and recurrent nightmares are complications to prevent or to treat.