Pandemic insomnia could be 'gateway complaint' that leads to substance abuse


Insomnia during the pandemic could be the “gateway complaint” that leads people to increased substance use like drugs and alcohol.

Disruption in our daily lives can often impact how we sleep at night. Recently, there’s arguably been no greater disruption than the pandemic. Kaiser Permanente Mid-Atlantic psychiatrist Dr. Leonardo Cubillos says he’s seeing more fatigue in his patients than ever before in his 20-year career.

“Many of my patients come, for example, for sleep problems or come to see me for depression. And then as we talk, it becomes evident that they are drinking too much, or smoking too much or using a particular substance,” he told ABC7 News reporter Victoria Sanchez.

If sleep issues and substance use sounds familiar, Dr. Cubillos said it’s time to pick from a new list of coping strategies. He uses the analogy of a dinner menu.

“When you go to a restaurant and you have five main courses, clearly you’re not going to eat five of them. If you’re super hungry, you might. But you may just have one, the one you prefer,” he said.

Just like a new food item, try something new. Swap out an unhealthy habit for a better choice.

“We are looking for ways to cope with the stressors that arise from the pandemic. Can we find healthy coping mechanisms? Can we find things that can help us grow as an individual or as a family?” he said

The first on Dr. Cubillos’ menu is exercise. Forty-five minutes a day, four days a week.

“I ask that their heartrate is increased to 150, 120 beats per minute,” he said. “It doesn’t have to be sprinting or running a marathon, it can be fast-paced walking, it can even be slow-paced walking depending on the fitness of the patient.”

The second option is one you’ve tried before – restarting hobbies.

“Even if at the beginning you don’t enjoy them, try to cultivate the practice of doing those hobbies again. And eventually, and this is scientifically tested, it’s called ‘behavioral activation therapy’. Eventually, your brain will begin to feel pleasure again.”

Behavioral activation therapy is a treatment for depression. The theory is that engaging in activities the patient did before becoming depressed, can improve mood.

“The third thing is socializing and clearly one thing we have lost with COVID is the ability to socialize in person. Yet, we have multiple other ways to do it,” said Dr. Cubillos.

Try mingling COVID style with Zoom, text, or phone calls. The connection can help from feeling isolated.

“Maybe to vent, ‘This pandemic is just awful. I am tired.’ ‘Oh! So am I!”

Fourth on the list is spirituality but that doesn’t necessarily mean religion. Try meditation, praying, or mindfulness.

“What we’re doing is helping the patient to increase pleasure through different activities or practices,” explained Dr. Cubillos.

Last is intimacy or human touch. A hug or kiss can boost endorphins, though that goes against social distance rules unless it’s with someone in your household or pandemic pod.

Review your options and see which one or two work best for you. Exercise, hobbies, socializing, spirituality, and intimacy could just be the starting point.


Originally published on WJLA. 

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