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Sleep, interrupted

August 12, 2021

New research from ASU shows how the COVID-19 pandemic affected people's sleep around the world

Sleep has become elusive for many as a result of the coronavirus pandemic, according to new research from Arizona State University’s Edson College of Nursing and Health Innovation.

From increased insomnia symptoms to poorer sleep quality and a shift in the time people go to bed and wake up, the struggle for a good night’s rest is real for people across the globe.

“Overall, sleep disturbances were heightened, with 56.5% of our sample reporting clinical levels of insomnia symptoms during the pandemic,” said Megan Petrov, Edson College associate professor.

While the data are not totally surprising, Petrov, who specializes in sleep research and led this project, says there is still cause for concern.

The findings were recently published in Sleep Health Journal. The study was conducted online with responses coming in from people living in 79 countries. 

Researchers were interested in the specifics of how various challenges presented by the pandemic, including lifestyles and livelihoods being upended, impacted people’s sleep.

 I found it unsettling to see how many people prior to the pandemic had incredibly restricted sleep opportunities."
— Associate Professor Megan Petrov

The changes reported by respondents tended to cluster around four major sleep pattern profiles:

  • Delayed sleep.

  • Sleep lost and fragmented.

  • Sleep opportunists.

  • Dysregulated and distressed.

Image icon Infographic: How the pandemic has changed sleep patterns

In this Q&A for ASU News, Petrov explains the four sleep patterns observed and the percentage of people experiencing each one. She also shares some of what surprised her and worries her about the findings as well as what steps we can all take to increase the quality of sleep as we transition back to pre-pandemic routines.

“Valuing your sleep is not just a personal matter. By valuing your sleep, you are contributing to the communities you are a part of. Good sleep health increases your likelihood of being a safe, more productive member of society, and a more engaged family member, friend and co-worker,” she said.

Question: What does your recent research show about how the pandemic has affected individuals’ sleep around the world? And what are some next steps you’re suggesting as a result of this research? 

Answer: Almost two-thirds of our sample experienced a “delayed sleep” pattern, which was associated with little change in sleep duration or time spent in bed but rather a later bedtime, and increased nightmares and naps. 

The second most common sleep pattern change experienced by 20% of our sample was the “sleep lost and fragmented” pattern. Individuals that experienced this pattern went to bed later and had a shorter time in bed attempting to sleep. In essence, their sleep was restricted, lower in quality and they were less likely to compensate for it with naps. Women were more likely to experience this pattern than men. 

About one out of 10 individuals tended to be “sleep opportunists.” These were individuals that had significantly restricted sleep opportunities prior to the pandemic who then during the pandemic spent a lot more time in bed and had the longest sleep duration compared to any of the other profiles. Unfortunately, despite the better sleep these individuals also reported the greatest change in their daily routines, which was associated with a lower likelihood of being employed and greater family stress and discord.

Lastly, the least common sleep pattern profile was the “dysregulated and distressed” pattern experienced by 5% of our sample. These individuals had the worst sleep deterioration with accompanying heightened nightmares and naps and had the greatest insomnia symptom severity. 

These four profiles tell us that acute responses to a pandemic depend heavily on prior sleep history, gender and other household factors, which can inform clinicians and public health professionals to better identify at-risk groups and potentially personalize behavioral sleep health interventions.

Q: As a sleep scientist, what, if anything, has been the most surprising thing about how people’s sleeping habits have changed during the course of the pandemic? And on that same note, what’s been the most troubling?

A: We originally hypothesized that there would be large shifts in sleep patterns for the majority of the population characterized mostly by delayed bedtimes and increases in naps. Indeed that appeared to occur for many individuals. However, there were two changes that I found surprising. 

First, the large presence of “sleep opportunists.” I found it unsettling to see how many people prior to the pandemic had incredibly restricted sleep opportunities — increasing their personal risk for accidents as well as those around them — and only after experiencing quarantine, huge shifts in daily routine and possibly unemployment were they afforded better sleep opportunities. The experience of these persons reflects a serious public health and economic problem in our global society that we must address as we tackle our current and post-pandemic world. These individuals are likely vulnerable, disadvantaged and at risk for poor health and economic outcomes. 

Second, the substantial sleep deterioration experienced by one of four individuals in our sample — “sleep lost and fragmented” and “dysregulated and distressed.” Sleep disturbances can take on a life of their own independent of the acute event that may have instigated it. Thus, these persons may be at a greater risk for poor sleep health over the long term.

Q: Why is the quality of sleep so important?

A: Sleep is an essential part of living, just like air, water and food. Your health and functioning are compromised when the quality of the air you breathe, the water you drink and the food you eat are poor. This is also the case if your sleep is poor quality and insufficient in quantity.

Q: Now that things are really starting to open up again and people are expected to be back in the office, at school, social functions, etc., what are some things they can do to readjust their sleeping habits or perhaps create new, better ones?

A: The pandemic, thankfully, has not changed the essential ingredients of good sleep health. Essential ingredients include a consistent sleep/wake schedule, a safe and comfortable sleep environment free of distractions such as electronics, food, etc., sufficient sleep opportunity for your personal sleep duration need — the majority of adults need seven to eight hours of sleep for optimal functioning — daily exercise and good nutrition, and bright light during the day and dim light to darkness at night.

As we shift into new routines once again, this is a good time to reflect on what aspects of your sleep health have not been serving you well either pre-pandemic or since then. Ask yourself what could you do differently this time around to not settle into old habits, but instead to align your daily routine with the essential ingredients of good sleep health.

Q: What’s one piece of advice you’d give to people struggling to find a good sleep routine during this time of transition?

A: Monitor your sleep. You can do this with a daily sleep diary or app. Oftentimes, when you pay attention to your sleep over time, you can discover some low-hanging fruit for changes that can be made.

Q: Where can people find resources/support if they find themselves dealing with something beyond just an out-of-whack sleep routine?

A: Perhaps you are experiencing extreme daytime sleepiness and fatigue, trouble sleeping despite adequate opportunity and circumstances to get sleep, and/or experiencing other odd behaviors during the night. In these situations, it is best to seek professional support whether through a sleep medicine specialist or behavioral sleep medicine specialist.

Top photo: A new study found poor sleep and depressive symptoms were widespread and increased during the pandemic and that women were more affected than men. Photo from Canva.

Amanda Goodman

Senior communications specialist , Edson College of Nursing and Health Innovation

602-496-0983

 
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August 12, 2021

ASU's Pat Tillman Veterans Center will commemorate its 'tin' anniversary with simultaneous celebrations, reflections at all four campuses

As Pat Tillman’s life recedes further into the past, the legend of his courage and sacrifice has grown, elevating him to an almost mythical figure in Arizona State University history.

The story of the football player who gave up a lucrative NFL contract to join the Army Rangers and fight for his country has achieved Homeric stature. Related to that, it’s been 10 years since Tillman’s selfless service prompted the stand-up of a namesake center at his alma mater to help veterans and their families succeed.     

“For us, Pat’s name is synonymous with honor and a commitment to service above self. We strive to live up to his legacy and project what that means to us through the center’s activities and support functions,” said Jeff Guimarin, executive director of the Pat Tillman Veterans Center. “The honor shield emblem that is often in the form of a sticker stuck on a window, bumper or door entrance, as well as hanging on the wall in our new Sun Devil Stadium office is what symbolizes everything that Pat believed in and what we do our best to emulate. There’s a lot behind that shield and it has great significance for the center’s staff, our numerous partners and the students we support.”

A successful transition to college life and academic success for student veterans are the preeminent goals of the center. It provides more than 10,400 military-affiliated students services to promote a smooth transition to campus. Support ranges from processing veteran and military benefits to providing a hub for veterans to gather for studying and making social connections — and everything in between.

In honor of the center’s "tin" anniversary, ASU will host simultaneous cake-cutting celebrations at all four ASU campuses at noon on Aug. 16. The Tempe campus celebration will recognize the Tillman Center’s pioneers organized by support staff at their location inside the Memorial Union. Events are open to all student veterans.

Guimarin said his remarks on Aug. 16 will focus on honoring the pioneers of the Pat Tillman Veterans Center, as well as the vision for the next decade.

Flying in first class

Like most centers at ASU, the Tillman Center started small with a staff of just seven people. However, their mission was holistic and big — maintain and develop ASU’s reputation as a national leader in veterans services.

While in the military, service members nearly have their entire careers scripted for them. The transition from a strict hierarchy with little flexibility and limited choices to a college campus with little direction and endless choices can often be overwhelming to new student veterans. Additionally, many schools are extremely focused on serving the traditional 18- to 22-year-old student, not the 30-something veteran. The Tillman Center defied that model by doing things differently.

But in the beginning, there were more questions than answers, said Steve Borden, the center’s first director.

“What did veterans really need to help them succeed? Were there differences between what veterans said they wanted/needed versus what they really needed? How could we tell? Why were veterans choosing ASU? What were they studying? Why?” Borden said. “It was a lot like trying to build a plane while in flight.”

But over the years, the center’s altitude continually climbed. That’s because they held true to one overriding principle: helping veterans navigate the foreign culture of college and connect with academic and student support services to promote a smooth transition from the military. Additionally, the center provided assistance for veterans benefits, deployments and referrals, as well as a place where veterans can connect with each other. The center has also built innovative and first-class programs for veterans.

The Veterans Scholar Program fosters professional development by preparing student veterans for life after college as leaders and community members. It does so by mapping out the steps members can take to achieve professional and academic success through the completion of workshops and events. These activities include resume building, learning interview skills for internships or jobs, networking, dressing to impress, financial responsibilities, goal setting, leadership seminars and discussing controversial topics with other cohort members.

For those just looking to talk, the Veterans Support Circle is a supportive and safe environment for student veterans at ASU that allows for judgment-free communication. It also helps build camaraderie through shared experiences of service. The meetings are currently held through Zoom and are open to online and immersion students.

Similar in nature, the Virginia G. Piper Center for Creative Writing partnered with the Office for Veteran Military Academic Engagement to offer the Veterans Writing Circle. This program gives students veterans and other local veterans a space to write together, workshop creative pieces and share stories. This circle is veteran-led and veteran-focused.

Last year, the Tillman Center and the Office for Veteran Military Academic Engagement offered a pilot program called the Arizona Warriors’ Wilderness Journey based on the Huts for Vets model. Now called Treks for Vets, the wilderness therapy program allows veterans to commune with nature in the Payson area and experience a perspective shift to more fully integrate with civilian life.

“Because the Pat Tillman Veterans Center staff is made up of veterans, we understand the needs that student veterans have,” said Shawn Banzhaf, assistant director of student success. “Knowing the culture they are coming from, and having navigated this one before them, gives us a keen eye for development of these programs. We see student veterans on a human level and offer these programs to provide a transformational experience and this happens time after time.”   

A numbers game with meaning

Before the center opened, the university already had gained a reputation as a military-friendly school, with an enrollment of 1,978 student veterans in fall 2011. Today that number is more than five times that: 10,405-military affiliated students.

The numbers are even more impressive when you do a deep dive.

According to Tillman Center statistics, ASU has conferred 10,755 degrees to veterans over the past decade. And in their academic pursuits, they have represented multiple disciplines, such as liberal arts and sciences, engineering, public service, health, criminal justice, nursing, teaching, and business and finance. That’s quite a feat given that the average age of a military and veteran student is 31 and many contend with other pressing life matters such challenging financial situations, balancing families, working full time and adjusting to college life.

“Through our outreach and engagement efforts, we continually communicate with our student veterans of their success mindset that they learned while in service,” said Michelle Loposky, director of student success and partnerships for the Pat Tillman Veterans Center. “Reminding them how they were successful in one world-class organization and now can be successful at ASU and beyond. Also, how they persevered in the military is a transferrable characteristic they can apply to their academic career.” 

Degrees also translates into dollars for veterans. A recent survey completed by ASU’s Career and Professional Development Center shows that 88% of all undergraduates and 90% of graduate students receive a job offer within 90 days of graduation. Well-paying jobs, too. Most undergraduates have a median full-time starting salary of $68,000 a year while grad students earn $80,000 a year. About 48% of these undergraduate students stay in Arizona while 32% of graduate students also remain in the state.

Guimarin said the center’s success is not a solo story. It is enabled by support from a variety of people and organizations across the ASU enterprises as well as from partners outside the academic environment. He said the aim for the next decade is to drive up retention rates from first-year students and transfers, and continue to build on what they already do well.

“Our aim is to build up the success culture scaffolding needed to ensure persistence and progression for these learners,” Guimarin said. “To do that we will seek new partnerships and cultivate the existing ones to build up a larger portfolio of programs structured to enable those desired outcomes. We’re really excited to take things to the next level and look forward to enhancing the services the center has to offer.”

Top photo: Pat Tillman Veterans Center Director Jeff Guimarin poses for a portrait next to the Pat Tillman statue at Sun Devil Stadium in Tempe on Aug. 9, 2021. Photo by Deanna Dent/ASU News