Before the COVID-19 pandemic, falling and staying asleep was never difficult for Shoshi Aronowitz, a 33-year-old nurse practitioner who lives in South Philadelphia.

“I need a lot of sleep,” she said. “I don’t really like the way I feel if I don’t sleep enough. My partner would always joke that as soon as my head hits the pillow, it’s done.”

But that changed over the last year, as Aronowitz, like so many others, dealt with increased stress from the pandemic. She began waking up in the middle of the night, fully alert. Falling back asleep became extremely difficult because her “brain was very much just chugging along, thinking about my family getting sick or my career,” Aronowitz said.

“If I ever had a bad night’s sleep before, I knew that I was going to be able to sleep well the night after,” she said. “Now, even if I don’t sleep and am tired, the next day this all happens again.”

For many people, the pandemic affected their sleep as they adjusted to significant changes in daily schedules and experienced increased stress. Some, like Aronowitz, struggled with “COVID-somnia,” while others were able to sleep more deeply or longer because they had more flexible work or school schedules. Sales for melatonin supplements, said to boost the hormones that tell the body when it’s time to sleep or wake up, increased 42.6% from 2019, according to Nielsen, a global marketing research firm.

In a September study published in the journal Sleep Medicine, 25% of respondents reported that their sleep quality was worse, due to stressors such as caregiving, job loss, and COVID-19 symptoms. Another study published in November in the European Journal of Public Health analyzed smartphone data and found that people in the U.S. and 16 European countries had delayed their bedtimes during the pandemic and slept longer than usual.

Jennifer Goldschmied, a clinical psychologist at the Hospital of the University of Pennsylvania, said the combination of uncertainty and isolation has contributed to an increase in stress for most people. Those feelings often increase physiological arousal, which makes sleeping more difficult. Many of her patients have reported waking up in the middle of the night and experiencing stress dreams, she said.

“Despite the fact that [the pandemic] has gone on for a long time, there’s still a lot of uncertainty,” Goldschmied said. “With vaccines rolling out, there’s a light at the end of the tunnel. But people don’t know how long that tunnel is.”

To make falling and staying asleep easier, Goldschmied recommends practicing a “wind-down time” of 30 minutes to an hour before bed. During this period, the focus should be on relaxing and people should avoid news and social media, she said.

“It can be helpful to dim the lights,” she said. “Light is a really strong cue for our bodies. So if you shut off a couple of lights, it will really help start that sleep process.”

It’s also important to consistently wake up at the same time, even on the weekends, Goldschmied said. And while the temptation to get some rest during the day after one bad night of sleep can be strong, napping can trigger a cycle of chronic insomnia, which can affect how the immune system functions, she said.

Goldschmied said to think of a nap in the same way you would a predinner snack, in that it makes you “less hungry for sleep later.”

“Even though you think you’re trying to make up for the night before, what you’re actually doing is interfering with the night after,” she said. “It all starts to contribute to worse sleep the next night.”

On the other hand, the pandemic has helped some people develop healthier sleep patterns. Kyle Cassidy, a 54-year-old photographer based in West Philadelphia, had struggled with insomnia for most of his life up until the pandemic.

“I traveled an awful lot before. I was on a plane, often twice a month, going somewhere to photograph something,” he said, which greatly affected his ability to form a sleep schedule. His doctor prescribed Lunesta to help.

But because he could control how he spent his time at home more, Cassidy was able to stop taking Lunesta two months ago. He noticed he began falling asleep faster than usual with the help of a white noise machine and audiobooks, and being more rested has boosted his productivity during the day.

“I’ve been tired at appropriate times,” he said. “The pandemic has given me a routine, which I didn’t have before.”

Jeff Roser, a 34-year-old delivery driver for UPS, has also slept better during the pandemic. Because of a big increase in deliveries in recent months, which has led to longer hours, Roser said he feels a lot more tired at the end of the day.

Before the lockdown, he often slept only five or six hours a night before “powering through the next day.” On weekends, he often socialized with friends, which meant staying out late.

But now, “since there’s not a lot to go out and do, I’m sleeping eight to nine hours now and can feel that my body is more well rested throughout the day,” he said. “I didn’t realize how good it feels until getting a full eight hours consistently. Once you feel rested, you wonder what you’ve been doing with your life up until that moment.”

For those who are struggling with sleep persistently, Goldschmied recommended seeking out a behavioral sleep specialist. She said that treatment for insomnia, although not easy to follow, can be addressed in as little as six to eight sessions. Supplements like melatonin, although helpful for short periods of time, can be a “get rich quick scheme,” she said, because the effects tend to decrease over long-term usage.

“Don’t suffer if you’re struggling with sleep,” Goldschmied said. “There are ways to sleep better that don’t need to be medication-based. Sleep is important and we need to invest in it.”