Consider This from NPR - Q & A: Sleep Problems And Summer Childcare

Episode Date: May 16, 2020

Sleep experts answer listener questions about insomnia, and a nurse practitioner offers advice to parents about summer childcare.These excerpts come from NPR's nightly radio show about the coronavirus crisis, 'The National Conversation with All Things Considered.' In this episode:- Dr. Sonia Ancoli-Israel of the Center for Circadian Biology, and Dr. Christina McCrae of the Mizzou Sleep Research Lab offer advice to listeners who are having trouble falling asleep.- Pediatric nurse practitioner Suzannah Stivison answers parents' questions about childcare this summer.If you have a question, you can share it at npr.org/nationalconversation, or tweet with the hashtag, #NPRConversation.We'll return with a regular episode of Coronavirus Daily on Monday.This episode was recorded and published as part of this podcast's former 'Coronavirus Daily' format.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

This is Coronavirus Daily from NPR. I'm Kelly McEvers. Doctors say one way to help your immune system is to get a full night's sleep. But for many people, the stress and anxiety of this pandemic makes it harder to get that sleep. We will hear advice from two doctors on that. And a pediatric nurse will answer parents' questions about what to do with their kids this summer. These excerpts come from the radio show, The National Conversation with All Things Considered. Here's Michelle Martin. These are unprecedented times.

Millions of people have lost their jobs, their health insurance, their support systems. Tens of thousands of people have died and many more have lost a loved one to the coronavirus. The fear, the stress and anxiety that come with a global pandemic have taken a huge toll on many people's mental health and also our ability to sleep. Many of you have sent us questions about having a hard time falling asleep or staying asleep or having a restful sleep. So here to help us get some answers, we have Dr. Sonia Ancoli-Israel of the University of California, San Diego and of the Center for Circadian Biology. Dr. Ancoli-Israel, thanks so much for joining us. Thank you so much for having me. And also with us, Dr. Christina McRae of the University of Missouri. She's also the director

of the Mizzou Sleep Research Lab. Dr. McRae, welcome to you as well. Thank you for having me. And we have a lot of ground to cover. So let's just jump right in with Britt. What should you do if you can't fall asleep? I'm staying in bed listening to audiobooks, but I don't know if that actually helps or hurts my sleep. I just know that it keeps me from anxiety spiral. And Julie wants to know about staying asleep. She writes, what do you do when you can fall asleep, but you wake up in the middle of the night and you can't get back to sleep? She writes, in bed, whether from a real book, an e-book, or audio, may be making it harder for you to fall asleep. We want our brains to associate the bed with sleeping and not with reading, watching TV,

listening to a book or radio, playing computer games, etc. So the best advice is if you haven't fallen asleep in what seems like a reasonable amount of time, usually like 20 minutes, but we don't want you watching the clock, get out of bed, leave the bedroom, and do something relaxing like listening to your audio books until you feel sleepy. Only then do you go back to bed. And Julie, the advice for getting back to sleep in the middle of the night is the same. If you can't fall asleep in the middle of the night after you've woken up, leave your bedroom. Find something relaxing to do until you feel sleepy and only then go back to bed. This will help your brain learn that the bed is for sleeping. Dr. McCray, anything you want to add?

I would just add that I think it's really important to not actively try to fall asleep. That can be counterproductive. Instead, you want to follow the tips that Dr. Ancoly Israel was mentioning, so you can set the stage for good sleep to occur. Okay, we have a lot of questions about that. So let's keep going with Joe in New York. And he asks, I've never had sleep issues in my entire life. Why am I having them most every night now? So Dr. McRae, I'm going to start here with you. I bet you've been hearing this all day long when people find out what you do. What would you say to Joe? I would say you're definitely not alone. Many people are experiencing sleep issues now for the first time. And those who had sleep problems before COVID-19 may find their sleep problems have gotten even worse.

We're living in the midst of a global pandemic that may be contributing to sleep difficulties in multiple ways. So you might be experiencing heightened stress and anxiety, worrying about your health, others' health, safety, the future. You may have job-related concerns. If you're still working, your conditions may be more stressful. You might be working longer hours. If you're still working, your conditions may be more stressful. You might be working longer hours. If you're working from home, you might find it challenging to balance work, home. And if you have children at home, you might have difficulty with homeschooling on top of everything else.

And if you aren't working, you might have financial concerns. Most of us are experiencing disrupted routines. We have fewer social outlets now with social distancing. There's less structure to our days often. You might be starting later and ending later, a day later, and you might be getting overall less activities, spending more time on screens, maybe watching a lot of Netflix, those types of things can all contribute to poor sleep, even in people who didn't have poor sleep before. And if I could just add to that, the other thing is that many of us now that we're home are drinking more alcohol, whether in the evening or before bedtime. And while alcohol makes you sleepy initially,

several hours later, when it leaves your bloodstream, it wakes you right back up again. So if you are having trouble sleeping, try cutting out the alcohol and see if that helps. Okay, our next two questions are related, so I'm going to play those again back-to-back as well. First, we have Hannah in Covington, Kentucky. Are there any recommended alternatives for melatonin? I feel like sometimes it works and sometimes it doesn't. And this next one is from Zoe in Norfolk, Virginia. I find that no matter how tired I am during the day, I have trouble falling asleep until

sometimes as late as 2 or 3 a.m. I've taken melatonin, but I generally feel like it doesn't help me fall asleep. It just makes me feel drowsier when I wake up. I've heard that CBD can help with insomnia. Is that true? And if so, is it safe? So melatonin is a hormone that we produce in our brains, which is secreted in darkness, which is usually when we're asleep, but it can also be bought over the counter. And a lot of people are using melatonin as a sleeping aid. It does work for some people. It doesn't work for everybody. Part of the problem is getting the right dose and the right timing. Many people are using way too high a dose. If you

want to use it to help you fall asleep, the best approach is to try three to five milligrams, about 30 minutes before bedtime. And if that dose is not working, then it's not the right treatment for you. With melatonin, less is better. So you don't want to double or triple the amount that you're taking. So no chugging, or whatever you take it. No chugging the melatonin. Okay. And what about CBD? I think a lot of people are hearing about it as a sleep aid. What can you tell us about that, Dr. Ancoly Israel? So CBD is cannabidiol. It's an active ingredient in cannabis. And thank you, Zoe, for asking that question because it is asked a lot.

There are a lot of studies going on testing the effect of CBD on sleep, but at this point, we have no data. We don't know if it is effective or is not effective in treating insomnia. So we just have to wait for the science to help us with that answer. That's psychiatry professor Dr. Sonia Ancoli-Israel of the University of California, San Diego and of the Center for Circadian Biology, and psychology professor Dr. Christina McRae of the University of Missouri. She's also the director of the Mizzou Sleep Research Lab. This message comes from WISE, the app for doing things in other currencies.

Send, spend, or receive money internationally, and always get the real-time mid-market exchange rate with no hidden fees. Download the WISE app today or visit WISE.com. T's and C's apply. It's less than two weeks until Memorial Day, and we're beginning to face the fact that this is going to be a pandemic summer. It's something that's been on a lot of parents' minds as they juggle working from home with their kids. To answer questions on summer and families, I spoke with Susanna Stuyvesant. She is a pediatric nurse practitioner at the Capital Medical Group, which is in the Washington, D.C. area. Susanna, welcome. Thanks so much for joining us.

Hi, Michelle. Thanks so much for having me. So let's jump into some big questions that I know a lot of people have right now. And Susanna, I'm sure you're hearing this from your friends and neighbors as well. Let's start with Barbara in Indiana. I wanted to know when it might be safe to send children back to daycare now that state economies and local economies are slowly starting to open back up. So, Susannice, you know, states are sending people back to work. What should the parents do? Do you recommend that parents send their little people back to daycare? This is an excellent question, and my best answer for

parents is for them to ask questions of their daycare providers. What are you changing your ratios of adults to kids to? How will you decide when a child who's been ill can come back? And then almost more importantly, what are you going to do if a child or a parent tests positive? What is your plan to move forward? And one of the ways that we can work with this, and maybe if people are considering not going back to daycare, is, is a nanny share possible? We have a lot of people who aren't working right now, so you may have more availability for a nanny than you thought prior to this. This is from Adam in Salt Lake City. Here it is. I live in a house next to two other kids, and I have a five-year-old daughter who, before

the pandemic, played with those kids every day to the extent that we considered our neighbors our second family. We have nobody else coming to our house. Do you think it would be socially responsible to let our daughter play with our next-door neighbors only? What do you think? So I just found out that there is actually a term to refer to this, and that is the double bubble. And it's the idea of making your bubble bigger to including another family. And I've known a lot of families who've really successfully done this so that if a parent has a call or a Zoom meeting, they check in with the other parents and say, hey, can you watch the kids for this period? I've got this time of day. I have two families on my street who are doing it very, very well. Their kids actually

only play outside. They're not allowed to go in each other's houses. So it's important to ask questions again, set up your rules, make clear what your expectations are, and then you're going to have to go back to those questions as your community opens up. Talk to the parents. Are they essential workers? Are you going into your office and socially distancing? There's absolutely a way to incorporate another family into your isolation. Mary Ellen in Ann Arbor, Michigan is one of many people eager to see family and this is her question. We have three children and five grandchildren ages two to nine. All of us have isolated for nine weeks. Some of us think it is safer to see each other now before states open up and they return to their workplaces. Do you think it might be safer to visit now? What do

you think? So this is a great question. And I actually put this one to my colleagues as well. I had a few ideas, but wanted to see what other people thought. And one of the things that came back is that now is a good time to do it. At the end of these stay-at-home orders, now is a great time to do it. But then again, how are we going to do this? And how are we going to do it safely? And this is the time that I ask the question, who has the best deck or who has the best backyard? And I recommend that you go be with your family, don't share food, stay away six feet. Sorry, but it's no hugs and kisses. And when you have to go to the bathroom, it's time to go home. Now, if it's going to involve travel, of course, you're going to want to quarantine yourself for two weeks

prior to the visit. You're going to want to travel by car. And if you're going to see your grandparents, it might not be the best thing to stay with them. Stay somewhere else. And again, see them in the backyard, outside as much as possible, and have a designated bathroom that you clean before you leave. This is Alan, and she's in middle school in Tennessee. It's really strange because I haven't seen my friends in almost over two months now. I was looking forward to going to an overnight camp, which has a lot of fun activities, outside activities, and also a day camp that has the weeks are themed so there's like a messy week

and water week okay so this was her question now that almost school has ended and most summer camps have canceled there's not much to do do you have any interesting but fun activities to do that don't involve chores thank you Suzanne you got, you got that right. No chores. And I think that's a good reminder for parents. Don't put your kids to work. And if you do, make sure they get something for it. Give them some extra screen time. Look up token economy and how to use them on childmind.org. There's a way to do that. But Alan asks a really good question. And Alan's in a very particular time in that friends are becoming much, much more important to her life and her development. And so it's important

actually to find a way to have her have some socialization. Consider a double bubble, make a camp yourself, don't go broke, but hit the DIY sites and figure it out. That's Susanna Stuyvesant. She's a pediatric nurse practitioner at the Capital Medical Group in the Washington, D.C. metro area. NPR's Michelle Martin. That's it for today. You can join the National Conversation with all things considered weeknights on your NPR radio station. And if you have a question, go to NPR.org slash National Conversation or tweet with the hashtag NPR Conversation. We will be back on Monday. I'm Kelly McEvers and this is Coronavirus Daily from NPR.