Impact of Sleep Deprivation on Emotional Regulation and the Immune System of Healthcare Workers as a Risk Factor for COVID 19: Practical Recommendations From a Task Force of the Latin American Association of Sleep Psychology

Abstract

Healthcare workers who are on the front line of coronavirus disease 2019 (COVID-19) and are also undergoing shift schedules face long work hours with few pauses, experience desynchronization of their circadian rhythm, and an imbalance between work hours effort and reward in saving lives, resulting in an impact on work capacity, aggravated by the lack of personal protective equipment (PPE), few resources and precarious infrastructure, and fear of contracting the virus and contaminating family members. Some consequences are sleep deprivation, chronic insomnia, stress-related sleep disorders, and post-traumatic stress disorder. These sleep alterations critically affect mental health, precipitating or perpetuating anxiety, stress, and depression, resulting in the inability to regulate positive and negative emotions. Pre-existing sleep disorders are an important risk factor for the development and maintenance of PSTD when individuals are exposed to an important stressor such as a COVID-19 pandemic. At the same time, how an individual regulates the emotion associated with worries during daytime functioning impacts nighttime sleep, precipitating and perpetuating difficulties in sleeping. All of these changes in sleep and emotional regulation also alter the immune system. Sleep deprivation is commonly associated with chronic inflammatory diseases, due to the desynchronizations in circadian rhythms, causing possible psychophysiological disorders and impaired neuroimmune-endocrine homeostasis. From this perspective, we clarify in this article how sleep disorders affect the immune system and emotional regulation, explaining their phenomenological and neurobiological mechanisms, and discussing elements of cognitive and behavioral coping for health professionals to adopt and manage a healthier sleep pattern in the COVID-19 outbreak.

Sleep During the COVID-19 Pandemic

“…As mentioned above, sleep plays an essential role in physical and mental health. Sleep is an important regulating factor of immune system [ 20 ], while, by influencing the hypothalamic–pituitary–adrenal (HPA) axis and the sympathetic nervous system, mediates in the circadian expression of cells, including cells of the innate and adaptive immune system [ 21 – 23 ]. Therefore, sleep deprivation could modify this function, inducing immunosuppression [ 24 ].…”

Effect of a Recliner Chair with Rocking Motions on Sleep Efficiency

“…Thus, this result proved that the deep latency caused by the rocking motion was significantly decreased during the three hours of the short nap on the recliner. Several previous studies reported that increasing the length of deep sleep stages, which is one of the key indicators of the improvement of sleep quality denoted by TN3, is effective in regenerating the body [101][102][103] and strengthening immunity [104][105][106]. In addition, the investigation of the sleep parameters is considered as an additional quantitative sleep quality analysis corresponding to the three different recliner conditions shown in Table 2.…”

Factors associated with Insomnia among Frontline nurses during COVID-19: A Cross-Sectional Survey

“…According to neurobiological and psychological views, individual [23], behavioural [24], cognitive [25], and emotional [26] variables have been implicated in the onset to maintenance of Insomnia. In addition to the theoretical frameworks conceptualized to address the insomnia pathophysiology (e.g., neurobiological, behavioral), the Insomnia etiology is signi cantly taught from a diathesis-stress perspective.…”