By Bryan Lufkin

作者: 布莱恩.勒夫金

Disrupted routines and ongoing uncertainty are contributing to a surge in insomnia. What can we do about it?

日常生活的中断和持续的不确定性导致了失眠的激增。我们能做些什么呢?

A new year comes with resolutions. One of the most perennially popular goals is, unsurprisingly, getting more sleep. But there’s a problem: the ongoing coronavirus crisis has made getting a good night’s rest significantly harder. Some experts even have a term for it: ‘coronasomnia’ or ‘Covid-somnia’.

新的一年人们往往会下新的决心。毫无疑问，人们长期以来最普遍的目标之一就是睡个安稳觉。但有一个问题: 持续的冠状病毒危机让人们很难睡个好觉。一些专家甚至给它起了一个术语:“冠状动脉失眠症”或“冠状病毒失眠症”。

This is the phenomenon that’s hit people all over the world as they experience insomnia lixed to the stress of life during Covid-19. In the UK, an August 2020 study from the University of Southampton showed that the number of people experiencing insomnia rose from one in six to one in four, with more sleep problems in communities including mothers, essential workers and BAME groups. In China, insomnia rates rose from 14.6% to 20% during peak lockdown. An “alarming prence” of clinical insomnia was observed in Italy, and in Greece, nearly 40% of respondents in a May study were shown to have insomnia. The word “insomnia” was Googled more in 2020 than it ever had been before.

这是一种困扰世界各地的人的现象，因为世界各地的人们在新冠病毒期间都经历了与生活压力有关的失眠。在英国，南安普顿大学2020年8月的一项研究表明，患上失眠的人数从六分之一上升到了四分之一，失眠症患者包括母亲、一线工作者和非白人族裔群体，这类人群更容易出现睡眠问题。在中国，封锁期间失眠率从14.6%上升到了20%。意大利和希腊的临床失眠症“普遍程度令人震惊”，在5月的一项研究中，近40%的受访者被证明患有失眠症。2020年，“失眠”一词在谷歌上的搜索次数超过了以往任何时候。

Simple, more of us are now insomniacs. With the pandemic into its second year, months of social distancing have rocked our daily routines, erased work-life boundaries and brought ongoing uncertainty into our lives – with disastrous consequences for sleep. Our health and productivity could face serious problems because of it. Yet the scale of the problem could potentially bring change, introducing new elements into how we treat sleep disorders – and get our lives back on track.

很简单，现在越来越多的人患上了失眠症。随着疫情进入第二个年头，几个月的保持社交距离动摇了我们的日常生活，消除了人们工作与生活的界限，也给我们的生活带来了持续的不确定性，最终给睡眠带来了灾难性的后果。我们的健康和工作效率可能因此面临严重的问题。然而，这个问题的规模可能会带来潜在的改变，为我们治疗睡眠障碍的方式引入新的元素并让我们的生活重回正轨。

Disrupted lives

被打扰的生活

Insomnia, whether in a pandemic or not, is difficult to live with. Consistently having trouble falling asleep, or experiencing poor quality sleep, can lead to long-term health impacts including obesity, anxiety, depression, cardiovascular disease and diabetes. Sleep insufficiency – which many health authorities classify as less than seven hours a night – also affects your work; many studies have shown that it makes you more likely to make mistakes, wrecks your concentration, increases reaction times and affects your moods.

不管是在疫情期间或其它时候，失眠都很难忍受。持续失眠或睡眠质量差会长期影响健康，可能会导致肥胖、焦虑、抑郁、心血管疾病和糖尿病等。许多健康权威机构将每晚少于7小时的睡眠时间认定为睡眠不足，这种睡眠不足也会影响你的工作;许多研究表明，睡眠不足会通过破坏你的注意力，让你的反应变慢，影响你的情绪等方式让你更容易犯错。


A lack of a strong work routine can contribute to insomnia, and may explain why you're tossing and turning.

缺乏强烈的工作习惯会导致失眠，这也可以解释为什么你会辗转反侧。

That so many of us are currently experiencing sleeplessness comes down to the current configuration of challenging, “almost Biblical” circumstances, says Dr Steven Altchuler, a psychiatrist and neurologist who specialises in sleep medicine at the Mayo Clinic, one of the US’s largest medical research organisations. “If you’re having insomnia, you’re in good company – much of the world is, too. It’s a consequence of all the changes we’re experiencing in Covid,” he says.

梅奥诊所是美国最大的医学研究机构之一，它专门研究睡眠医学的精神病学家、神经学家史蒂文·阿尔图勒博士表示，我们许多人目前都经历着失眠，原因在于当前面临的挑战，“这几乎是圣经式的”环境。他表示: “如果你患有失眠症，你其实有很多同伴，因为世界上很多地方也是如此。这是我们在新冠病毒中经历的所有变化的结果”。

Multiple factors are at play. First, our daily routines and environments have been disrupted, making it hard to keep our circadian rhythm intact. Normally, our days run to a schedule of alarm clocks, commutes, breaks and bedtimes – but Covid-19 has shaken all that up. “We lost many of the external cues that are present in the office meetings, the scheduled lunch breaks,” says Altchuler. “What you’re doing [during remote working] is disrupting your body’s clock.”

有多种因素导致了失眠。首先，我们的日常生活和环境已经被打乱，这使我们很难保持完整的昼夜节律。通常，我们每天都有闹钟、通勤、休息和就寝时间，但新冠病毒打乱了这一切。阿尔图勒说:“我们失去了很多存在于办公室会议和午餐休息时间的外部诱因。你(在远程工作时)所做的事情正在扰乱你的生物钟。”

“Your brain is conditioned: you’re always at your workplace and working, and then at your home and you’re relaxing. There’s a differentiation there. Now, we’re all just home all the time,” says Angela Drake, a clinical health professor at the University of California, Davis who treats patients with sleep disorders and who’s written about coronasomnia. She also flags up the fact that when we work from home, we may be getting less exercise and potentially less exposure to natural light – both of which contribute to better sleep.

“你的大脑是有惯性的:你总是在你的工作场所工作，然后在你的家里放松。两个地方是有区别的。而现在，我们得在家里做所有事。”加州大学戴维斯分校的临床健康教授安吉拉·德雷克这样说。她治疗过睡眠障碍患者，也写过关于冠状动脉失眠症的文章。她还指出，当我们在家工作时，我们可能会少锻炼，也可能少接触自然光线，而锻炼和自然光都有助于改善睡眠。

That so many of us are currently experiencing sleeplessness comes down to the current configuration of challenging.

我们很多人现在都在经历失眠，这可以归因为当前的挑战.

There’s also the issue of work performance. Unemployment in many countries is the highest it’s been in years, so it’s no surprise those who are employed want to work hard to keep their jobs. The problem is that working from home can blur lines that used to be fixed, with many people reporting working longer or irregular hours. “We tend to have much less clear boundaries between home and work,” says Altchuler. “People tend to be staying up later.” For many of us, leaving “work at work” is now completely impossible, and disconnecting from the to-do lists and daily stresses of the workday is harder than ever.

还有工作表现的问题。许多国家的失业率都达到了多年来的最高水平，所以那些有工作的人都有希望努力工作以保住工作的念头，所以对于他们来说失眠也就不足为奇了。问题是，在家工作模糊了原本可以弥合的界限，许多人称他们在家工作时工作时间更长了或变得不规律。“我们在家庭和工作之间的界限往往不那么清晰，”阿尔图勒说。“人们往往熬更久夜”。对我们中的许多人来说，离开“工作岗位”现在是完全不可能的，而且远离工作清单和工作日的日常压力比以往任何时候都更加困难。

Added to this is the fact that we miss our hobbies and friends – vital outlets for relaxation and destressing. Many of us are experiencing mental health problems, which can feed into sleep problems, or vice versa. Our general sense of uncertainty and lack of control can also feed into sleep issues, while the pandemic’s longevity is also a factor; what started out as a “hunkering down” period to play video games and stockpile toilet paper has become a landscape for life that feels semi-permanent. “Initially, people tended to feel motivated to get through the stress [of the pandemic]. But as it continues over time, most people become less able to cope, resulting in greater problems, including insomnia,” says Drake.

此外，我们还会想念自己的爱好和朋友，他们是我们曾经放松和释放压力的重要途径。我们很多人都经历着心理健康问题，这可能会导致睡眠问题，反之亦然。我们普遍的不确定感和失控感也会导致睡眠问题，而疫情的持久性也是一个因素; 疫情初期人们是“盘坐下来”玩电子游戏和囤积厕纸的时期，现在这已经变成了一种半永久的生活景观。德雷克说：“最初，人们倾向于感到有动力来克服(流行病的)压力。但随着时间的推移，大多数人会变得无力应对，从而导致失眠等更大的问题。”

Some sleep problems will have become “chronic and long-lasting”, she adds, because the pandemic has created delays to getting treatment in some cases; people have only sought medical attention in emergencies, while some healthcare facilities have become short-staffed or overwhelmed with Covid-19 patients.

她补充说，一些睡眠问题将发展为“慢性和长期的”疾病，因为在某些情况下，疫情导致了治疗的延误;因为疫情期间一些医疗机构人手短缺或因新冠肺炎患者过多而不堪重负，所以人们只在紧急情况下才寻求医疗救助。


You may have a compulsion to consume news before bed, but experts say to put down the phone if you want to sleep better.

你可能会在睡前忍不住看新闻，但专家说，如果你想睡得更好，就放下手机吧。

In fact, healthcare workers have been hit particularly hard by insomnia over the last 12 months. In December, the University of Ottawa analysed 55 global studies of more than 190,000 participants to measure the prominence of insomnia, depression, anxiety and post-traumatic stress disorder (PTSD) since the beginning of the pandemic. All disorders rose at least 15% among healthcare workers, with insomnia seeing the biggest spike at nearly 24%.

事实上，在过去的12个月里，医护人员受到失眠的困扰尤其严重。去年12月，渥太华大学分析了55项全球研究，这些研究涉及19万多名参与者，其研究目的是衡量疫情开始以来失眠、抑郁、焦虑和创伤后应激障碍(PTSD)的显著性。在医疗工作者中，所有疾病都增加了至少15%，其中失眠的上升幅度最大，达到近24%。

Altchuler points out that insomnia is “commonly associated with PTSD” and, whether you’re a frontline worker or not, it’s common for insomnia to spike after big, negative world events. In general, whenever someone experiences trauma – whether it’s a widespread health emergency like Covid-19, a public disaster like 9/11 or something more individual like a car accident – they can experience persistent sleep problems that go along with PTSD.

阿尔图勒指出，失眠“通常与创伤后应激障碍有关”，而且，不管你是不是一线工作者，在发生重大的、负面的世界事件后，失眠发作是很常见的。总的来说，无论是像新冠病毒这样的大范围卫生紧急事件，还是像9/11这样的公共灾难，亦或是像车祸这样的个人事件，无论一个人经历了什么创伤，他们都可能经历伴随创伤后应激障碍而来的持续性睡眠问题。
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How to fight back

如何反击

Experts say it’s important to seek help when sleeping problems persist – especially these days.

专家说，当睡眠问题持续存在时，寻求帮助是很重要的，尤其是在现在的情况下。

“As the pandemic has continued for a significant time period, not just a couple of months, there’s a high possibility that rates of insomnia won’t dip,” says Lisa Artis, deputy CEO at the Sleep Charity in the UK. “That’s because if people don’t seek help when they start to suffer with their sleep, the chances are their sleep issues become a sleep disorder, i.e., insomnia, and unfortunately there isn’t a quick fix… It’s difficult to break habits that have formed.”

英国睡眠慈善机构的副首席执行官丽莎·阿蒂斯说:“由于疫情已经持续了很长一段时间而不仅仅是几个月，失眠症的发病率很有可能不会下降。这是因为，如果人们在开始受到睡眠困扰时不寻求帮助，他们的睡眠问题很可能会发展为睡眠障碍，也就是失眠，不幸的是，这个问题没有快速的解决办法……已经养成的习惯很难改掉。”

It’s common for insomnia to spike after big, negative world events

在世界上发生重大的、消极的事件后，失眠症状会激增，这是很常见的

But there is some good news. Twelve months into the pandemic, some experts think that it’s triggered advancements in treatment of sleep disorders. Altchuler points to the “rapid expansion of telehealth – virtual medicine and virtual visits” lixed to quarantining and our inability or reluctance to visit medical facilities in person. The most common treatment for sleep problems is cognitive behavioural therapy for insomnia (known as CBT-I), which improves your “sleep hygiene” (no smoking or drinking before bed, for example) and trains your brain to associate bed with sleep only by behavioural changes (no working in bed). A University of Michigan study from last year showed that patients who sought CBT-I via telemedicine received just as effective treatment as they would have had in person, potentially opening up better access to assistance.

但也有一些好消息。一些专家认为12个月的疫情触发了睡眠障碍治疗的进步。阿尔图勒指出，“虚拟医疗和虚拟访问等远程医疗的迅速扩展”与隔离政策以及我们无法或不愿亲自访问医疗设施有关。最常见的治疗睡眠问题的方法是治疗失眠的认知行为疗法(CBT-I)，它可以改善你的“睡眠卫生”(比如睡前不抽烟、不喝酒)，并通过行为改变(不在床上工作)训练你的大脑将床和睡眠联系起来。密歇根大学去年的一项研究表明，通过远程医疗寻求CBT-I治疗的患者得到的治疗效果与他们亲自得到的治疗效果一样好，这可能为他们提供更好的援助渠道。

There are also things individuals can do to try and address the problem. “One of my big rules is you can’t work on your laptop in bed,” Drake says. “I don’t care how comfortable it is.” Also limit your news consumption to avoid anxiety that keeps you up at night, don’t use your phone as an alarm clock (the “blue light” devices emit are bad for your sleep) and turn the clock on your nightstand around so you don’t get stressed as you try to fall asleep.

个人也可以尝试解决失眠问题。德雷克说:“我的一条重要规则是，你不能在床上用笔记本电脑工作。我不在乎穿着有多舒服。” 同时，限制你看新闻的时间，这可以避免让你夜不能寐的焦虑, 也不要使用你的手机当闹钟( “蓝光”设备不利于你的睡眠),把床头柜上的闹钟打开，这样当你尝试入睡的时候就不会太紧张了。

And remember, these circumstances are far from ordinary – so it’s not surprising we’re facing challenges. “The last time there was this kind of event was over 100 years ago,” says Drake. “This is not anything any of us have ever experienced before.”

记住，目前这些情况（疫情）并不寻常，所以我们面临挑战也并不奇怪。德雷克说:“上一次发生这种事件还是在100多年前。这是我们之前从未经历过的事情。”