Long COVID: Sleep Hygiene

Long COVID: Sleep Hygiene

Trouble sleeping and insomnia can occur among those with long COVID. Sleep hygiene refers to behaviors, practices, and habits that promote healthy sleep. It includes what you should and should not do to help you sleep better. 

Bedtime Routine And Sleep Environment

Your bedtime routine and sleep environment can improve your ability to sleep. Key measures include:

  • Routine. Try to go to sleep (and wake up) at about the same time every day. This includes weekends and vacations/holidays.

  • Amount of sleep. Most people need at least 7 to 8 hours of sleep every night, although you may require a different amount.

  • Don’t lie awake. If you are lying in bed and cannot fall asleep after 20 minutes, get up and do something else until you feel sleepy - then try again. 

  • Bedroom for sleep only. Use your bed only for sleep and sex.

  • Create a relaxing, comfortable sleep environment. Keep your bedroom cool, dark, and quiet.

Daily Habits

Your routines and behaviors can both promote and interfere with your sleep. For example: exercise and activity; napping; eating and drinking; stimulants (caffeine and nicotine), and medicines and medical conditions.

Exercise And Activity

Regular exercise improves the quality of sleep. If you are currently exercising, or when you’re able to do so, exercise close to bedtime doesn’t usually disrupt sleep

Vigorous exercise - i.e running or weight training,  might make it difficult to sleep. However, gentle stretching or slow-paced walking may help you sleep better - they can become part of your nighttime routine. 


Due to fatigue or post-exertional malaise (PEM), you may need to nap during the day. Although naps may be necessary, be aware that they may interfere with your nighttime sleep.

Eating And Drinking

Eating large amounts of food near bedtime can impact your sleep.  However, a healthy snack is okay - you don’t want to wake up during the night because you’re hungry. 

Avoid spicy foods, citrus fruits, tomato products, alcohol, etc. They may cause heartburn or reflux - which may increase when lying down. 

Make sure you’re not thirsty,  although drinking a lot may cause you to wake up with a full bladder. 



Caffeine is a stimulant. It increases arousal or alertness. Caffeine-containing drinks, foods, and medicines can make it difficult to sleep, even if you have them several hours before bedtime. Caffeine also increases the need to urinate, so your sleep may be further disrupted to empty your bladder. 

We recommend eliminating, limiting, or changing the timing of your caffeine intake. You should limit drinks (and foods) containing caffeine to the amount of caffeine in three 8-ounce cups a day (one 8-ounce cup of brewed coffee = 100 mg of caffeine).  It is best to avoid all caffeine after lunchtime.


Those who smoke may think that a cigarette before bedtime will help them relax. In fact, the nicotine in cigarettes, like caffeine, is a stimulant. It increases your alertness, making it difficult to sleep. You may also wake up in the early morning hours craving a cigarette, as the nicotine in your system decreases during the night.

Coughing and other respiratory symptoms associated with smoking impact your sleep, as well as your COVID recovery. Regardless of your medical history and long COVID symptoms, please consider quitting. For support in the U.S., go to:  https://smokefree.gov/quit-smoking.


Drinking alcohol may help you fall asleep since it induces drowsiness. However, it affects the quality of your sleep and is associated with restless, non-refreshing sleep. Alcohol may also cause or contribute to heartburn which often adds to difficulty sleeping.

Because sleep quality is affected, we suggest that you avoid drinking alcohol close to bedtime. Even a small amount may affect your sleep. 


Some commonly used medicines may negatively impact sleep patterns:

  • Antidepressant medicines, for example, bupropion (Wellbutrin-U.S.)

  • Asthma medications

  • Beta-blockers, a category of medicine used to treat heart conditions

  • Cold and allergy medicines, including decongestants 

  • Steroid medicines

Talk with your doctor or pharmacist about the medicines you take. Do not stop or make changes to your medicines without their approval.

Medical And Mental Health Conditions

In addition to long COVID, many other health problems, both short- and long-term, can disrupt sleep

Trouble sleeping is also common in those with depression and anxiety. Despite your challenges with long COVID, it’s important to adhere to treatment for other conditions - to support sleep and your overall health. 

Contact your Goodpath coach for help with sleep problems and for support in coping with long COVID.