{"id":9231,"date":"2020-05-29T18:55:31","date_gmt":"2020-05-29T17:55:31","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=9231"},"modified":"2020-05-29T19:04:52","modified_gmt":"2020-05-29T18:04:52","slug":"anxiety-and-insomnia-in-athletes-during-the-era-of-covid-19-part-2-solutions-and-suggestions","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2020\/05\/29\/anxiety-and-insomnia-in-athletes-during-the-era-of-covid-19-part-2-solutions-and-suggestions\/","title":{"rendered":"Anxiety and Insomnia in Athletes during the era of COVID 19: Part 2\u2013 solutions and suggestions"},"content":{"rendered":"

By Dr. Meeta Singh, MD @athletesleepmd1<\/a> and Dr. Carla Edwards, MD @Edwards10Carla<\/a><\/em><\/strong><\/p>\n

The enforced societal restrictions over the past three months have left athletes feeling negative, unmotivated, emotionally detached from sport and feel as though they have lost direction\u2014all of which impacts their overall mental health.<\/p>\n

We both witnessed how athletes\u2019 psychological experiences evolved during this period. Athletes with preexisting <\/em>anxiety and insomnia need extra support now especially as these conditions serve as major risk factors for PTSD to develop. Disaster Psychology models predict common trajectories through significant life-changing events, and there is evidence that the psychological effects of quarantine can be detected months or years after the event has happened.2<\/sup><\/p>\n

A recent study published from Wuhan suggested that younger people, and those who spend excessive time focusing on the epidemic (\u2265 3 hours per day), were at higher risk for mental illness.3<\/sup> Many of our athletes fit that profile. Another study involving healthcare workers in Wuhan demonstrated that provision of social support was associated with better sleep quality and lower anxiety. Interventions such as these in this period are vital.4<\/sup><\/p>\n

As described in part 1 of this blog post<\/a>, both pharmacotherapy and cognitive-behavioral therapy (CBT) are effective for the treatment of anxiety and insomnia. It is important to remember that best outcomes are obtained if both anxiety and insomnia symptoms are targeted.<\/p>\n

Healthcare professionals generally agree that it is important to limit pharmacological interventions because of the chronic nature of both anxiety and insomnia and the limited data of the benefits of pharma. However, in severe cases of acute symptoms due to the conditions of this pandemic, short term use may be necessary. In such cases, agents that target both symptoms should be tried.<\/p>\n

CBT for Anxiety and Insomnia<\/strong><\/p>\n

For anxiety, CBT aims to alter maladaptive emotional responses by changing the patient’s thoughts and\/or behaviors using education, exposure, and cognitive techniques.\u00a05<\/sup><\/p>\n

For Insomnia, CBT aims to increase the drive to sleep whilst eliminating any conditioned arousal to the bedroom and bedtime routine. Reduction of sleep-related catastrophic worry and concerns, as well as identifying and challenging pre-existing sleep-related dysfunctional attitudes and beliefs, are additional goals.\u00a06<\/sup><\/p>\n

We recommend that athletes:<\/strong><\/p>\n