COVID update: Vaccine recommendations, COVID-somnia

COVID-somnia is taking its toll

A new survey commissioned by the American Academy of Sleep Medicine (AASM) has found that more than half of Americans (56%) say they have experienced “COVID-somnia,” an increase in sleep disturbances, since the beginning of the pandemic. Of the reported sleep disturbances, most common was trouble falling or staying asleep (57%). Additional disturbances included sleeping less (46%), experiencing worse quality sleep (45%) and having more disturbing dreams (36%).

“COVID-somnia can be brought on by multiple stressors: fears about the pandemic, concern for loved ones, financial worries, and limited socialization,” said clinical psychologist Jennifer Martin, who is president-elect of the AASM board of directors. “The best way to get healthy sleep during these unprecedented times is to be intentional about your sleep habits and routines.”

Men (59%) were more likely than women to report COVID-somnia sleep disturbances. Those age 35 to 44 had the highest rate of COVID-somnia at 70%. Ages 55 and older were most likely to report trouble falling or staying asleep.

Dr. Fariha Abbasi-Feinberg, Fort Myers, Florida, and an AASM spokesperson and board member, said if someone is having problems sleeping, they should talk to their doctor. These problems can often be addressed with changes in behavior.

“Older adults tend to spend more time in bed, which can affect their sleep quality. I often recommend sleep restriction therapy to match the actual sleep time with the time in bed,” said Dr. Abbasi-Feinberg.

For a good night’s sleep, she said it is important to maintain a consistent sleep schedule, have a relaxing bedtime routine, and keep your room cool and dark. Avoid heavy meals and alcohol too close to bedtime. Brief naps are OK, but if you’re having trouble falling or staying asleep at night, you might not need a nap.

“Practice those good sleep hygiene tips and remember that sleep is as important as nutrition and exercise to be our best. Poor sleep is linked to heart disease, diabetes, car accidents and many other health issues, so it’s important to get sufficient, healthy sleep on a nightly basis,” said Dr. Abbasi-Feinberg.

CDC updates recommendations on vaccinations

The CDC is endorsing updated recommendations made by the Advisory Committee on Immunization Practices (ACIP) for the prevention of COVID-19, expressing a clinical preference for individuals to receive an mRNA COVID-19 vaccine over Johnson & Johnson’s COVID-19 vaccine. ACIP’s unanimous recommendation followed a robust discussion of the latest evidence on vaccine effectiveness, vaccine safety and rare adverse events, and consideration of the U.S. vaccine supply.

The U.S. supply of mRNA vaccines is abundant, with nearly 100 million doses in the field for immediate use. This updated CDC recommendation follows similar recommendations from other countries, including Canada and the United Kingdom. Given the current state of the pandemic both in the U.S. and around the world, the ACIP reaffirmed that receiving any vaccine is better than being unvaccinated. Individuals who are unable or unwilling to receive an mRNA vaccine will continue to have access to Johnson & Johnson’s COVID-19 vaccine.

“We have made important strides in the year since the COVID-19 vaccination program started. More than 200 million Americans have completed their primary vaccine series, providing protection against COVID-19, preventing millions of cases and hospitalizations, and saving over a million lives,” said CDC Director Dr. Rochelle Walensky.

Apple Watch measures resilience in health care workers

Health care workers with high resilience or strong emotional support were protected against the effects of stress related to the COVID-19 pandemic compared to those who had low emotional support or resilience, according to a study published in the Journal of Medical Internet Research. Researchers also found that the number of individuals with COVID-19 in the community was a significant factor associated with stress in health care workers over time.

Several hundred study participants wore an Apple Watch that measured their heart rate variability and downloaded a customized app to complete weekly surveys measuring perceived stress, resilience, emotional support, quality of life, and optimism. The researchers found that health care workers with high resilience or high emotional support had different autonomic nervous system stress patterns compared with those who had medium or low emotional support or resilience. The autonomic nervous system is a primary component of the stress response and can be found by measuring heart rate variability. The participants’ physiological results aligned with their self-reported answers.

The team found that high emotional support or high resilience (the ability to overcome difficulty and a reduced vulnerability to environmental stressors) resulted in a unique nervous system profile, demonstrating that these features impact both how health care workers perceive stress and how their bodies are physically affected by stress.

“Our study highlights the importance of emotional support and resilience in moderating the effects of stress on health care workers during the ongoing pandemic,” said study author Dr. Robert P. Hirten, who is an Assistant Professor of Medicine at the Icahn School of Medicine at Mount Sinai Medical Center, New York, New York. “Assessing the resilience and emotional support of health care workers may be able to help identify those at risk from ongoing stressors and may help guide health care institutions in allocating mental health resources for these at-risk employees.”

The study’s co-author Zahi Fayad, PhD, who is Director of the BioMedical Engineering and Imaging Institute at Mount Sinai, said these findings are important for families of health care workers. “Our study is one of the first to document not only the toll the pandemic has taken on our health care workers, but also the importance of resilience and social support as specific paths toward efficiently and effectively directing support,” said Fayad.

The latest findings from the Warrior Watch Study build on previous research that used wearable devices to identify COVID-19 cases earlier than traditional diagnostic methods. Researchers monitored the participant’s physical activity and tracked subtle changes in their heart rate variability measured by an Apple Watch, which signaled the onset of COVID-19 up to seven days before the individual was diagnosed with the infection via nasal swab.

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