March 14 is World Sleep Day, a symbolic reminder of how important quality rest is for health. But for Ukrainians, it is nothing more than a date on the calendar. In the conditions of a full-scale war, sleep has become a luxury that not everyone can afford. Continuous anxiety, explosions, life in the mode of constant stress – all this does not just take away rest, but turns it into another struggle. Chronic fatigue has become an integral part of everyday life for millions of people. Even when the night is quiet, the brain does not turn off: thoughts about safety, the future and losses do not allow you to fall into a deep sleep. The body works for wear and tear, and gradually it turns into a large-scale problem for the entire society. So let’s try to figure out how the war changed the biological clock of the country, why even in relative silence it is not possible to rest and what consequences it will have in the long run.
A sleepless nation
Ukraine has been living in a state of constant stress for three years. This psychological factor has become a biological restructuring that forces the entire organism to change. Fear, anxiety and instability activate the stress hormone cortisol. Under normal conditions, its level gradually decreases until night, allowing the body to rest. But when the brain does not receive a signal of safety, cortisol remains elevated, and the person cannot fall asleep or falls into short superficial sleep cycles that do not allow the body to fully recover.
For data of the fourth wave of the All-Ukrainian study on the mental health of Ukrainians during the war, we have very disappointing results:
- 58% of respondents noted that they most often had anxiety and tension;
- 50% of respondents experienced sleep deterioration;
- 49% feel exhausted;
- 49% suffer from a bad mood;
- 45% feel emotional instability.
Since the first years of the war in Ukraine, it has been significant worsened people’s mental health and sleep:
- 86% of respondents indicated that they suffer from nightmares;
- 49% – cannot fall asleep at all;
- 27% have symptoms of post-traumatic stress disorder (PTSD).
With the start of the full-scale invasion, 82% of Ukrainians immediately indicated on nervousness. Among the common symptoms of stress, Ukrainians noted:
- disturbed sleep (63%);
- insomnia (45%);
- severe mood swings (40%);
- increased heart rate (37%)
- stomach and intestinal problems (27%);
- increased pressure (29%);
- nightmares (23%).
Deterioration of sleep caused by the war is quite understandable, but the situation was not better during the coronavirus pandemic. Researchers from the Canadian University of Ottawa analyzed the data of about 190,000 people, among whom were both patients who fell ill with COVID-19, as well as members of their families, as well as medical workers. It turned out that 23.87% of them suffered from insomnia, and this problem was most common among doctors. Among them, 36.53% had difficulty sleeping. In addition, the study showed an increase in cases of depression, anxiety disorders and post-traumatic stress disorder.
If we compare the results of the surveys, we observe a consistently disappointing picture of how the psychological state of tension destroys the body’s ability to healthy and natural recovery through sleep. We lose the opportunity to sleep peacefully.
Warnings and recommendations of experts
Sleep is the foundation of physical and mental health, and when it’s disrupted, the consequences are felt by everyone from soldiers on the front lines to children in back-country cities. Ukrainians have learned to live in new realities, but their dream has not yet adapted to the harsh conditions of wartime.
Specialists explain, how serious can be the consequences of sleep deprivation (lack or complete absence of sleep – ed.) using the example of an experiment during which rats were deprived of sleep, which led to the death of the animals. After the autopsy, it turned out that almost all of them died from internal bleeding, while the brain remained intact. This means that the complete lack of sleep led to the fact that the brain began to send incorrect signals to the internal organs, which caused serious disturbances in their work. The brain was not physically damaged, but its activity ceased to be synchronized with the work of the organs. Lack of sleep can lead to mental disorders, and in case of prolonged deprivation, a person can even die.
Most people look for salvation in sleeping pills, and they start taking them without consulting doctors. But it is worth remembering that sleeping pills can very quickly cause addiction, slow down the reaction and reduce the speed of thinking. Their action can be life-threatening. Therefore, it is important to carefully familiarize yourself with the instructions for the medication, where side effects and warnings are indicated.
Problems with the quality of sleep at the age of 30-40 years can accelerate the aging of the brain. This fact was confirmed research, published in the journal Neurology. 589 people, whose average age at the beginning of the study was 40 years, answered questions about the quality of their sleep and filled out questionnaires at the beginning and after five years. Scientists divided them into three groups:
- those who had very minor sleep problems (0-1 symptom);
- average level of problems (2-3 symptoms);
- high level of violations (more than 3 symptoms).
Fifteen years later, the participants underwent brain scans. Analyzing the images, the scientists applied machine learning to determine the “brain age” of each participant, which made it possible to estimate the level of shrinkage of brain tissue. The results showed that people with high levels of sleep problems had a brain age 2.6 years older than those with less severe problems. Participants with average levels of sleep disturbances had 1.6 years more brain “aging” than their peers with better sleep.
The study confirmed the importance of sleep for the normal functioning of the glymphatic system, which is responsible for cleaning the brain from harmful substances. During deep sleep, this system works more actively, removing waste from brain tissue. Insufficient or disturbed sleep reduces the efficiency of this system, which can impair memory, cognitive abilities and even increase the risk of developing dementia in the future.
Doctors emphasize that if there is not enough sleep for a long time, it inevitably changes many aspects of our condition. Concentration and focus become unstable, it becomes increasingly difficult to focus on important tasks, and thoughts seem to scatter like sand through the fingers. Memory begins to fail – a person can forget simple things that usually do not cause difficulties. Reaction speed slows down, and even routine tasks begin to require more time and effort. Decreased motivation: what used to bring joy or interest now seems too difficult and unnecessary. Irritability appears, and even small things can make you angry, and physical weakness creates a feeling that the whole body is working at a minimum. Limb tremors may occur — the hands tremble, and it seems that even the simplest movements become difficult. And, of course, mistakes become more frequent in both physical and intellectual tasks. Every step and every choice seems less certain than usual. If a person sleeps for 10-12 hours, then this is also a reason for anxiety. After all, such a condition can signal inflammatory processes or the beginning of a depressive period.
In order to effectively overcome depression and anxiety disorder, it is important to restore sleep in the first place, but this becomes extremely difficult or even impossible due to the depression itself and high levels of anxiety. So we seem to have fallen into a closed circle. In such cases, it is necessary to consult a doctor – it can be your family doctor, a neurologist or a psychiatrist, in order to receive adequate medical treatment. In other situations, you can try to restore sleep on your own, paying special attention to sleep hygiene.
Experts advise, firstly, to accustom the body to fall asleep at the same time every day. It is also necessary to wake up in the morning at the same time, regardless of how the night went. This will help the body adjust to a stable mode of sleep and activity. The temperature in the bedroom should be comfortable, but slightly lower than in other rooms. It is desirable to sleep with access to fresh air, and if this is not possible, be sure to ventilate the bedroom. You should also think about a comfortable place to sleep: sleep in comfortable clothes, have a bottle of water nearby.
In addition, you should make it a habit to isolate yourself from watching the news or scrolling through social networks for an hour and a half before going to bed, and even better – for 3-4 hours. A warm shower or bath will help you relax. If this is not possible, you can use a soft towel soaked in hot water. Warm herbal tea before bed or a glass of milk will also promote relaxation. Creating a ritual from such simple actions will help the body get used to a stable regime, and the problem of insomnia will disappear over time, and falling asleep will become much easier.
A person has an internal biological clock, which determines which processes in the body take place during the day, and which – at night. This daily rhythm is called the circadian rhythm, and it is regulated by a specific nucleus of the hypothalamus in the brain. As doctors note, the main factor affecting sleep is the change in lighting during the day. The brain perceives light of different wavelengths and intensities thanks to special retinal cells that work even when the eyes are closed. For the normal functioning of daily rhythms, it is important to follow the following scheme:
- In the morning – bright cold light (as at noon on a clear day);
- In the evening – soft warm light (like at sunset);
- At night there is complete darkness.
That is why experts advise receiving these three types of light signals during the day. For example, in the evening, you can turn on the night mode on gadgets, and at night create darkness by covering your eyes with a cloth.
To minimize the impact of nighttime alarms and shelling on the quality of sleep, it is important to follow a few simple recommendations. At night, observe the dark regime. If you sleep in a bomb shelter, use a sleep mask or a cloth over your eyes. In active war zones or in emergency situations, if you have not been able to sleep at night, you can sleep in during the day to regain strength.
Sleepless trenches
People in the front-line zones and the rear suffer from insomnia and its consequences, but worse than all our defenders. Falling asleep at the front is a real test, even for the strongest. After hard days, when you have to be constantly on your feet, be under stress, experience danger, your eyes close only physically. The brain works at maximum speed, and even when you are in bed, listening to the silence of the night, you cannot let go of anxiety. The noise in my head does not allow me to calm down – the echo of explosions, footsteps in the dark, the constant feeling that something is about to happen. The body is tired, but the mind cannot switch.
Armed forces soldiers have to sleep in the trenches, in the best case, in sleeping bags or on a hard mattress on the cold ground, dressed in a uniform that does not allow them to relax. Added to this is the need to be on guard even at night. If you are not worth it, then it can have serious consequences. And being in the conditions of the front itself does not promote relaxation, because there is a constant feeling of tension, even when it seems that everything around has quieted down. Therefore, sleep for fighters is not just rest, but a battle with oneself, with a head that refuses to calm down.
Experts emphasize that it is important to get rid of the “culture of sleeplessness” as something normal in combat conditions and to abandon the stereotype that the need for sleep is a weakness. The brochure “Take care of yourself” advises to take regular and full rest during rotations or at any convenient opportunity. However, for the military, methods of “sleeping ahead” or using polyphasic sleep (distribution of 7-9 hours of sleep over several periods during the day) can be a temporary solution until an opportunity for full rest appears. According to “Take Care” experts, soldiers should sleep whenever possible, especially if operations are planned that will require prolonged alertness. At the same time, such methods should not be abused in peaceful conditions.
Chronic fatigue of Ukrainians is not just a consequence of personal habits or the modern rhythm of life, but a deeper problem caused by war, economic instability and constant stress. Loss of sense of security, financial uncertainty and emotional exhaustion are creating a society where quality sleep is becoming a luxury. However, it is necessary to believe that soon peace will come and we will all begin to sleep peacefully.
