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From New Yorker

From Vox

Why we still can’t sleep, and what to do about it.

Remember sleeping?

For too many Americans, it’s a distant memory: a time when we were able to get in bed, close our eyes, and drift off unencumbered without worries about contracting Covid-19, or the hours of work that piled up after supervising a day of remote school, or whether we need to buy a different kind of mask (again).

Sleep deprivation has become one of the many side effects of the pandemic. It’s one that’s often invisible — a lot of people have no choice but to muddle through their day no matter how tired they are — but one that’s slowly wearing us down.

For some, lack of sleep is about lack of time. “I get up now hours before my kids to get a few hours of writing and work done,” Courtney Boen, a professor of sociology and demography at the University of Pennsylvania, told Vox. “I know I’m not alone.”

Seen some version of

“I’ll get to that around 10pm after kids go to bed.”

“I’ll send to you by 7am, before kids wake up.”

in countless emails/texts w colleagues w young kids (mostly women) over last 18 mo.

This is unsustainable but we’ve been sustaining it for over a year.

— Dr. Courtney Boen, PhD, MPH (@CourtneyBoen) August 30, 2021

But for others, scheduling isn’t necessarily to blame. When the pandemic hit, rates of insomnia spiked around the world, driven by everything from the stress of living during an international public health crisis to the changes in daily life wrought by lockdowns. “People had additional responsibilities, new challenges, much more uncertainty,” Lauren Hale, a professor of family, population, and preventive medicine at Stony Brook University, told Vox.

And as the delta variant continues to spread around the country, that uncertainty and its effects on sleep may not have abated. Some people have just gotten used to disrupted cycles and 3 am anxiety spirals; it’s how life is now. As Jennifer Martin, a clinical psychologist who serves on the board of directors for the American Academy of Sleep Medicine, told Vox, “There are some people who are still experiencing a lot of disruption.”

While there are steps people can take in their own lives to address insomnia, sleep deprivation isn’t just a personal problem; it’s also a social one. And as with so many other problems in the pandemic, real relief will require policy changes — like shorter work hours, better pay, and improved access to health care — to make American life more secure for everyone.

“The stress and sleep disruptions and uncertainty that so many Americans experience now during the pandemic is something that is preventable,” Boen said. “It’s something that can be mitigated through policy decisions.”

The pandemic is a major insomnia trigger

Sleep is a basic human need, just like food or oxygen, and most adults need about seven hours a night. If we miss out on it for a night or two, we may notice problems like difficulty with decisions, not feeling mentally sharp, and becoming less tolerant of social conflict. Lack of sleep “kind of makes it harder for us to function around other people,” Martin said.

Those short-term effects are reversible once we do get a good night’s sleep. But when people get less than seven hours of sleep on a regular basis, they face increased risk of metabolic problems like type 2 diabetes, as well as mental health issues like depression, Martin said. And when they go below six hours for a long period of time, they can experience cardiovascular problems and even an increased risk of mortality.

All of this is bad news for a population that, even before the pandemic, wasn’t getting enough sleep. Americans’ sleep hours have been declining since the 1980s, according to NPR, with long work hours and stress the likely culprits. In one 2018 study, 35.6 percent of participants reported inadequate sleep, up from 30.9 percent in 2010. “We’re a very engaged 24/7 society, and one of the first activities that gets curtailed is our sleep,” clinical psychologist Todd Arnedt told NPR in 2018.

The pandemic made matters worse. In one study conducted across 49 countries in March and April 2020, 40 percent of people said their sleep was worse than before the pandemic. Participants’ use of sleeping pills increased by 20 percent. Google searches for “insomnia” also spiked in the US in April and May, when many parts of the country were under stay-at-home orders. Meanwhile, Americans’ spending on the over-the-counter sleep supplement melatonin increased by 42.6 percent in 2020. “That consumer behavior is a sign that people are struggling,” Martin said.

Then there are the hundreds of thousands of people who have contracted Covid-19. While insomnia isn’t technically considered a symptom of the disease, the respiratory symptoms can make it difficult to sleep. And clinicians are seeing a lot of chronic sleep problems in people experiencing long Covid. “We’re still trying to learn about that, and whether it might play a role in making the recovery more difficult,” Martin said.

While there’s not yet much data on sleep trends this year, experts say the sleep disturbances of the early pandemic could persist over time. For one thing, plenty of people are still dealing with a lot of anxiety around the pandemic, from those who have lost their jobs to those dealing with the stress of sending kids to school amid the delta variant. As Hale put it, “everybody has their own reasons why they aren’t sleeping as well during an international crisis.”

For another, any stressful experience that disrupts sleep for a period of time risks triggering chronic insomnia. When patients are asked how their sleep problems started, they’ll typically mention some “stressful event or a big change in their life as a thing that sort of got them off track,” Martin said. “Short-term insomnia is how long-term insomnia starts.” That’s one reason some Americans may still be having trouble sleeping now, more than 18 months into the pandemic, even if they’re vaccinated and their personal fears around Covid-19 have (somewhat) abated.

And that’s just the insomnia piece of the puzzle. Add to that the countless Americans who might be able to get to sleep — if they ever had time to actually get in bed. That group includes a lot of working parents, who have been navigating school and day care closures for more than a year and a half. For some, that’s meant dropping out of the workforce. For others, it’s meant doing the equivalent of a full-time job on top of their job: In 2020, mothers of kids under 12 spent an average of eight hours every day on child care, the 19th reported.

Those hours have to come from somewhere, and often, they come out of parents’ sleep. One 2020 study found levels of sleep deprivation in moms that were twice as high as those seen before the pandemic. And in a July 2020 poll by the Kaiser Family Foundation, 53 percent of moms and 29 percent of dads reported sleep problems from stress related to the pandemic.

For a lot of people, it hasn’t necessarily gotten better since then. “I’m chronically tired,” said Boen, the sociologist, who has a 6-year-old and a 2-year-old and has been without regular child care since March 2020. “I think that’s a really common experience right now.”

Sleep deprivation could worsen the impact of the pandemic, too

Being chronically tired could be putting our health at risk — especially as Covid-19 continues to spread. Habitual lack of sleep can harm our immune function, which is “particularly important when there’s a pandemic going on,” Hale said. “In an effort to prevent disease, we want to be sleeping well.”

Sleep deprivation could also exacerbate social inequalities. In general, “it tends to be the most vulnerable, disadvantaged individuals in society who have the worst sleep patterns,” Hale said. Racial disparities in sleep, for example, existed before the pandemic began. “African Americans, in particular, are the most sleep-deprived population in the United States,” Bridget Goosby, a sociology professor at the University of Texas at Austin, told Vox.

Since Black, Indigenous, and other people of color have been disproportionately impacted by the pandemic and financial crisis, they’re likely dealing with more stressors that could affect sleep. And that, in turn, could worsen the impacts of the pandemic by making these groups even more vulnerable to getting sick, either with Covid-19 or with conditions like diabetes that are affected by sleep.

“Not only has the pandemic heightened levels of chronic stress in ways that have been highly unequal, it’s also disrupted sleep patterns in ways that prevent people’s bodies from being able to handle that level of physiological stress,” Boen said. “It’s this sort of double jeopardy that I think a lot of people and groups are facing.”

Without policies to address them, the effects of these disruptions are likely to persist beyond the immediate stressors of the pandemic, affecting people across their lives. “We’re going to see higher rates of morbidity, illness, chronic disease risks,” Goosby said. “This is a really alarming situation for populations that were already vulnerable.”

To help people sleep, we need to make their waking lives better

Even in a pandemic, however, widespread sleep deprivation isn’t inevitable. On an individual level, there are changes some people can make that could help them sleep better. First, to the extent possible, people can try to replicate the daily rituals that structured their lives before the pandemic started. “Our sleep loves routine,” Martin said. “When the days look the same, our sleep at night is more predictable.”

For a lot of Americans, life looks very different than it did before the pandemic — and everything from shifting work schedules to child care and school disruptions can make it hard to establish a daily routine. But every little bit helps. “For me, one of the things that helped a lot early in the pandemic was to have a start and end time for my work day,” Martin said. “I just would pretend that I was going to go to work, and I would get up and get dressed, and have breakfast and do all the things that I normally would, and start my day, and then have a time that I would just shut down my computer.”

Sometimes, however, the modifications people can make on their own aren’t enough. In that case, a form of cognitive behavioral therapy, which helps people identify thoughts or feelings related to insomnia, has been shown to be highly effective, Martin said. People should also consider visiting a sleep medicine physician, because many people with insomnia also have other sleep disorders, like sleep apnea, that may need specialized treatment. The website sleepeducation.org, from the American Academy of Sleep Medicine, also has resources to help people sleep better or find a sleep specialist if they need to.

But unfortunately, these solutions aren’t accessible to everyone. Not everyone has health insurance to pay for therapy, and not everyone has enough control over their schedule to make sure it’s predictable from one day to the next. That’s why experts say ensuring healthy sleep for all will require systemic changes, not just individual fixes, to reduce the fear and uncertainty inherent in American life.

Some of those are changes employers can make, like allowing flexible work hours or providing consistent scheduling so that people can plan ahead for work and child care. “Anything that enables employees to get the sleep they need, as long as they’re still doing their job, will improve morale and reduce stress, which can help with sleep as well,” Hale said.

Shorter work hours could also help. In one Swedish study, reducing the workweek from 39 hours to 30 hours led to a reduction in sleep problems as well as a reduction in heart and respiratory issues. And while flexibility for working parents in the pandemic is important, it’s not much help if they still have so much work that they need all night to complete it.

Then there are larger policy changes. “People tend to think of things like stress and sleep as these highly individualized behaviors or responses,” Boen said. “But they’re entirely shaped and determined by social and political conditions.”

Federal, state, and local officials may not be able to end the pandemic, but they can address the stresses that have been exacerbated by it — and that contribute to racial and economic disparities in sleep, Hale said. That means reforms like raising the minimum wage, along with increasing access to affordable health care, both for sleep issues and for general well-being. “If you’re in pain or distress or sick, your sleep is often affected,” Hale said.

It also means combating structural racism, from housing segregation to police violence to the school-to- prison pipeline. “One policy is not going to be the thing that fixes sleep,” Goosby said. “We have to have a really big- picture way of thinking about this all holistically.”

Ultimately, she added, “sleep is just a symptom.”

The Inspiration4 capsule took off a little after 8pm ET and was carried into space by SpaceX’s Falcon 9 rocket before entering Earth’s orbit around 80 miles beyond the International Space Station (ISS). After about three days of zero gravity and magnificent views — not to mention activities such as a ukulele performance and a video call to a St. Jude patient — the crew will return to Earth, and in late September, Netflix will release a feature-length finale of its five-part reality TV series about the mission. (The first four episodes of the show are already available to watch, and Netflix is livestreaming the launch on its YouTube page.)

The mission also involves a motley payload of gear and collectibles, including merchandise that will be put up for sale in a charity auction after the crew returns to Earth. Those items range from space-themed watches made by IWC to stuffed rocket-ship toys based on characters from the animated Netflix series Space Racers. There’s a $2,000 Martin Guitar ukulele that Sembroski will play on board. And the Inspiration4’s official beer maker, Sam Adams, also arranged for 66 pounds of hops to go to space and will brew beer with them once the mission lands (the beer will be available for purchase later in the fall). Perhaps the weirdest of the items is a slew of non-fungible tokens stored on iPhones, including an NFT recording of a Kings of Leon song that’s set to become the first music NFT ever played in space. Bidding for these items starts on Thursday, and the auctions will end in November.

 Courtesy of Inspiration4
The watchmaker IWC designed Inspiration4-themed watches that crew members will wear during their time in space.

While selling stuff that’s been to space isn’t new, it’s about to become a lot more common. NASA, a government agency subject to congressional oversight, has traditionally restricted the commercialization of space missions. But as the number of non-NASA space flights has grown, so have opportunities for space-bound merchandise and product placement. Now, because commercial space companies don’t necessarily operate under NASA’s strict restrictions, there’s a race to seize new marketing opportunities in the cosmos: namely, sending products to space before selling them back on Earth.

A brief history of space merchandise

NASA itself doesn’t typically sell stuff that’s been to space, but items from NASA missions have found their way to the market in the past. Meanwhile, astronauts are civil servants and are not legally allowed to personally profit from their positions until they retire from government work, limiting when they can sell any personal items they’re allowed to bring on their missions. Other valuable items that have been to space on NASA missions are typically offered to museums or, on rare occasions, sold off by the government.

Some of the most remarkable items that have made the trip to space and back before being sold to the public have come from astronauts from the Gemini, Apollo, and Mercury programs, some of whom happened to save equipment from their missions. Regulations surrounding what astronauts could keep from these initial missions amounted to verbal agreements at the time, which has led to some controversy over who had the right to the artifacts. But in 2012, President Barack Obama signed a bill into law confirming that these astronauts indeed had ownership rights over many of these mementos. Now, these items sell for hefty sums: One bag from the Apollo 11 mission that was used by Neil Armstrong to carry samples of moon dust sold at Sotheby’s in 2017 for $1.8 million.

NASA also has strict rules against advertising or endorsing products, and it makes very little off of merchandise with branding or iconography. While the space agency’s various logos have appeared on everything from Vans shoes to Forever 21 tops, the image is in the public domain, which means it’s free for anyone to use.

“People have seen what the historic flown items have sold for and understand that there’s a market for that material, and that those things are valuable and collectible,” said Cassandra Hatton, Sotheby’s global head of science and pop culture, who works with astronauts on memento auctions. “The reason why they were flown originally — there was no commercial purpose behind it. Their value really is historic.”

NASA has started to welcome some commercial deals in recent years. In 2019, the space agency formally announced that it would allow 90 hours of crew time annually for astronauts to pursue marketing activities commissioned by private companies. For instance, Estée Lauder last year paid astronauts to take pictures of a face serum in zero gravity on the ISS. The ISS National Lab has also partnered with Adidas to test its soccer ball on the station, though it’s unclear how useful it is to test a soccer ball in space.

All this means that product placement and promotional stunts in space have historically happened without the US space administration. They have, though, had help from Roscosmos, the Russian equivalent of NASA. Over the past several decades, Russia’s space agency has helped advertise milk, ramen, Pepsi, and even Pizza Hut personal pizzas. And if Stanley Kubrick’s 2001: A Space Odyssey is any indication of what’s to come — the movie featured a Hilton hotel on the moon — the trend of private companies using space as a marketing opportunity will only grow.

“This exploration of space is not just about exploring the scientific or technical frontiers,” explains Scott Pace, director of George Washington University’s Space Policy Institute. “It’s also exploring about, you know, where can the economy go? Where do we expand economic activities beyond the Earth?”

Commercial space travel means space gear will become more common

Three private space companies have already begun the process of launching very wealthy civilians into space: Jeff Bezos’s Blue Origin, Richard Branson’s Virgin Galactic, and now Elon Musk’s SpaceX. All three companies have not only sold their own merchandise but have also cleared the way for space- themed branding and marketing opportunities.

Virgin Galactic, for example, partnered with Under Armour to sell branded sportswear, including the “spacewear” that Virgin Galactic customers wear on their flights and take home afterward. The space tourism company also collaborated with Land Rover to create an Astronaut Edition Range Rover that’s only available to people who have purchased tickets on a Virgin Galactic flight. The SUV includes a space plane-shaped puddle light, as well as cup holders made out of a piece of the landing skid from one of Virgin Galactic’s first flights.

Blue Origin similarly used the launch of its first crewed mission, which included Bezos himself, to debut the first electric vehicle from Rivian (one of the automaker’s biggest investors is Amazon, where Bezos used to work).

A few of these kinds of marketing opportunities, however, happen more serendipitously. After Bezos threw Skittles across the space capsule on his Blue Origin flight in July, for instance, Skittles quickly announced it would release a limited- time candy pack called “Zero-G Skittles.” The candymaker told Recode the move was not coordinated ahead of time.

We are honored to have heard SKITTLES were aboard #BlueOrigin @JeffBezos is it true #SKITTLES taste better in space?https://t.co/PPdYf6BVCZ

— SKITTLES (@Skittles) July 20, 2021

Though the trend in space-based branding and marketing campaigns seems to showcase the worst qualities of American capitalism, some argue there’s a greater good in it all. Most people can’t afford a ticket to space, as prices for space tourism missions are still in the hundreds of thousands of dollars. But merchandise and collectibles from these commercial missions mean private space firms can still sell consumers the feeling that they’re at least part of this moment in space history for a lot less money.

“By flying our brands, we get to fly along with them,” Robert Pearlman, a space historian who runs the space collectibles website collectSpace, told Recode. “We get to see a little bit more of ourselves in how spaceflight unfolds and say, ‘Yeah, I may not be able to afford a flight to space, but I eat Skittles.’”

Sponsored content from celebrities in space might not be far away, either. Plenty of celebrities have already reserved tickets on Virgin Galactic, and Virgin Galactic already has plans to bring a TikTok science influencer on one of its upcoming flights. Meanwhile, the private spaceflight company Axiom Space, which has contracted several flights from SpaceX, is offering a space-themed “content innovation platform” to help companies do product demonstrations and create ads in space. More space-based reality TV is in the works, too, including competition shows that aim to send civilians into space. The Discovery Channel is developing one called Who Wants to Be an Astronaut, and earlier this year, NASA signed off on a show called Space Hero that will send a lucky contestant to the ISS.

While commercial space travel feels exciting right now, the novelty of billionaires and ordinary people traveling to space for fun might not last forever. But keenly aware of the historic nature of its flight, the Inspiration4 mission is trying to capitalize on the enthusiasm — for charity — that comes with such an event. We’ll see just how much people will be willing to pay for a piece of that history when the mission lands.

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