Prescription: Sleep

It’s hard to believe that doctors and scientists are discovering new things about the therapeutic benefits of sleep. After all, humans, like all mammals, have been sleeping since well before the dawn of recorded history, and undoubtedly back as far as the time the first human ancestor decided to venture out of Africa. How is it possible to learn anything new about something that is such a fundamental, inescapable part of the human condition?

The Japan Times recently ran an interesting article on how scientists are developing a new “understanding” of sleep. Basically, the new “understanding” is this: sleep is really, really good for you. You want to make sure not only that you get the right amount of sleep, but that you also get that sleep at the right time, when the circadian clock that is built into every human being is telling you that it is time to hit the sack. People who align their sleep patterns with their personal biological clocks, scientists have concluded, “are less fatigued, have better moods, maintain healthier weights, gain more benefit from their medications, think more clearly, and have improved long-term health outcomes,”

On the other hand, if you don’t get enough sleep and at the right time, the human body compensates by doing things like releasing hormones that increase stress, injecting more sugar into the blood stream, and increasing blood pressure. If you consistently fight your circadian clock and that need to sleep over the long term, these bodily responses to the lack of regular sleep will produce adverse health effects.

None of this should come as a surprise, to scientists or anyone else. It makes you wonder if scientists and researchers have lost sight of the forest for the trees, by focusing on minutiae rather than the basics. Here’s a good rule of thumb: if humans have been doing something forever and in fact are driven by basic biological impulses to do it, it’s probably in your best interests to yield to those impulses and give in to what your body is telling you. And the nice thing about sleep is that it is something you can actually exercise some control over. Taking steps to plan your days to allow for regulated sleep patterns will pay dividends.

An End To Nightmares

Could technology bring about an end to recurrent nightmares? Scientists think they may have found a way to redirect the sleeping brain away from those disturbing bad dreams that cause the frightened sleeper to awake with a start, with their heart hammering.

The development came during a study of people, estimated to be as many as four percent of all adults, who experience nightmares at the “clinically significant” level. Nightmare issues are deemed “clinically significant” when they occur more than once per week and cause other symptoms, like general anxiety and daytime fatigue.

The study divided 36 participants into two groups. One group received imagery rehearsal therapy (“IRT”), an existing form of treatment where they were instructed to recount their bad dreams, develop alternative, happier endings to the dreams, and then rehearse those happy endings during the hours when they were awake.

The other participants received IRT treatment, with a twist: as they envisioned more positive scenarios for their nightmares, a major piano chord was played every ten seconds, in an attempt to have the happier endings associated with the sound. The participants then went to bed wearing headbands that were capable of detecting when the sleeper had entered the rapid eye movement (“REM”) phase, when dreaming occurs, and playing the major chord associated with positive outcomes. The sound evidently helped to generate the positive outcomes, because while both groups saw a decrease in nightmares, the results were significantly better for the headband-wearing group, both immediately during the treatment and for months thereafter.

My dreams are mostly a confused rehash of things that happened during the day, as if my unconscious brain is trying to sort diverse experiences and inputs into a narrative–and since the experiences and sensations aren’t logically connected, the dream ends up making no sense. Fortunately, I don’t have recurrent nightmares, other than the “I’ve got an exam and I didn’t prepare” dream that I still get occasionally, decades after my schooling ended. I can imagine, however, that people who do experience nightmares at the clinically significant level will welcome a therapy that works. Wearing a headband and listening to piano chords would be a small price to pay to avoid waking up in terror. And the results also provide interesting insight into the power of music and its impact on the unconscious brain.

The Lost World Of Two Sleeps

We tend to think that the basic elements of human lives–things as fundamental as sleep patterns–have forever been as they are now. I’ve always assumed, without thinking much about it, that sleep means going to bed and sleeping straight through until waking up in the morning. The BBC recently published a fascinating article about research that squarely refutes that assumption–and shows instead that our current approach to sleep is inconsistent with the accepted practices that prevailed for many centuries.

According to the BBC article, humans used to have “two sleeps” as a matter of course. The “first sleep” would last for a few hours, until about 11 p.m., followed by about two hours of wakefulness–a period known in medieval England as “the watch”–after which people would return to bed and sleep until morning. This pattern was confirmed by sworn testimony in court records and multiple references in literature, and the research indicates that it was followed across different countries and cultures dating back to classical times, during the prolonged period when life was much more communal than it is now and it was typical for multiple humans to share beds or other sleeping quarters.

What did those who awakened from their “first sleep” do during “the watch”? The research indicates they did just about everything from the exalted (it was viewed by some as a good time for quiet religious observances and reflection) to the productive (peasants completed some of their many daily chores, stoked the fire, and tended to animals) to the mundane (the newly roused typically answered the call of nature). The BBC article also reports: “But most of all, the watch was useful for socialising – and for sex.” People would stay in their communal bed and chat with their bedmates, and husbands and wives, refreshed from the day’s exhausting labors by their “first sleep,” might find a place for some alone time before “the watch” ended and it was time to hit the crowded sack again.

At some point, the practice of “two sleeps” ended and our current approach of seeking one, uninterrupted “good night’s sleep” became the norm instead. But, as the BBC article points out, a sleep research experiment from the ’90s suggests that it wouldn’t take much for people to be nudged back into the world of “two sleeps.” A careful look at some remote cultures also indicates that the practice of “two sleeps” still prevails in some areas. And of course, in some cultures where an afternoon siesta is commonplace, a different form of “two sleeps” is practiced.

What would the world be like if humans still followed the practice of “two sleeps,” and what would they do during “the watch”? I would guess that they would do just about everything that their medieval ancestors did–although with modern technology I imagine that many people would take “the watch” literally, and use the break in sleep to catch up on the latest offerings on streaming services.

The Weirdness Of Sleep

After more than 60 years of direct, personal experience, I’ve decided that sleep is weird.

Some nights I’ll go to bed and sleep as deeply as the dog shown in the picture above. I’ll be out for hours without any periods of wakefulness, and so far as I can tell during that time I’ve had one long, continuous dream that is like an extended feature film. I wake up and feel refreshed, but the sleep state lingers and it takes me a while to sharpen up and get going.

Other nights I’ll start off with a good period of rest, but then hit the sleep wall at about 3 a.m. I’ll wake up and struggle a bit to get back to sleep, and from then on until I get up for good, sleep will come in hour-long snatches, with lots of tossing and turning in between and dreams like sitcom episodes. When I finally give up trying to sleep any longer, I don’t feel particularly well rested, but I’m immediately alert.

And then there are nights when I hit that same sleep wall, wake up long enough to realize that I’m awake and need to try to get back to sleep, and then shift immediately into vignette mode, where I have brief, strange dreams interrupted by a minute or two of awareness before plunging back to get the next dream snippet. It’s as if my brain is shuffling the deck to sift through the day’s events and needs to lurch back to consciousness briefly before moving to the next selected short on the dream roster. And when I have one of those nights I finally wake up abruptly and get up immediately, wondering just how much strange stuff is lodged up there in my hippocampus.

I’m sure there are a lot of things that affect sleep patterns — what you’ve had to eat and drink that day, things that are going on in your life that cause concern, stress, physical fatigue, and so forth — but I suspect that much of it depends on subconscious stuff that just needs to be expressed for some reason. Sleep is intrinsically weird, and there’s not much we can do about it. Every night when you go to bed you just need to get ready for the show.

Another Reason To Make Your Bed

When you were a kid, your Mom probably reminded you — like, maybe a billion times — to make your bed.  Of course, your Mom wasn’t looking for army barracks/being able to bounce a quarter off the bed precision.  Her desires were simple:  when she walked past your bedroom, she was just hoping for a room that looked reasonably tidy.  If your Mom was like our Mom, when she reminded you — again — of the need to make your bed, she might have added that your bedroom looked “like a tornado hit it.”

It turns out that in this, as in so many things, your Mom was right — again.

A recent survey found that people who make their beds are more likely to report getting a good night’s sleep, and also are having more sex than the non-bedmakers — apparently because an unmade bed is a turn-off to many people.  Let’s set aside, for a moment, the issues of exactly how scientific the survey was, and let’s forget that second result, because this is, after all, a family blog.  Let’s focus, instead, on the notion that people who make their beds are more likely to report getting a good night’s sleep.

The survey result that a well-made bed equates with better sleep seems intuitively right to me, for several reasons.  First, I think beds that are made tend to be cooler.  “If your bed is made, the sheets are in the shade” — and I think most people sleep better when their surroundings are cool.  It’s the same reason people often flip the pillow to enjoy the cool underside.

Second, I think if you get into an unmade bed you’re going to spend the first few minutes trying to get the bed into some reasonable semblance of order, anyway.  While the members of the Made Bed Brigade have slipped between the sheets, enjoyed the cool cotton feel, and are slipping blissfully off to dreamland, the non-bedmakers are wrestling with the hot sheets and covers, trying to get them unsnarled so they can lie down in peace and comfort.  In effect, they are trying to make the bed while they are already in it.  Fussing with the bed, and getting out to tuck in the sheets or smooth the comforter, is not exactly the best way to start the process of falling asleep.

And third, most people tend to subconsciously crave order, and a made bed speaks of order.  The inner voice of your Mom has been obeyed, and you can feel good about checking one of the boxes for the chores to be done during the day.  And when you come back to the bedroom that night, your bed will look attractive and welcoming, rather than like — well, like a tornado hit it.

So, make your bed, already!  You’ll sleep better.  And who knows?  There might be other benefits, too.

A Working Man’s Cure For Insomnia

From time to time I experience insomnia.  After a while, you get used to it.  You wake up at 1:30 a.m., fully alert, and after trying unsuccessfully to fall back asleep you yield to the inevitable, get up, and do something until you feel like you can fall back asleep again.  I think insomnia occurs when something important is happening, and my subconscious brain just won’t stop fretting about it even while my conscious brain is asleep.

But, for me, at least, there is a cure for insomnia:  physical labor, preferably outside.

The last few days I’ve been fighting the dandelion wars out in the yard.  This involves bending over and, frequently, getting down on hands and knees to find the roots of the dastardly dandelions, then using a gardening tool as a lever to try to pop them out.  Often that’s a struggle, as you dig around in the hard ground trying to find the root — because if you don’t find the root those dandelions are just going to crop up once more and you’ll have to do the whole exercise over again.  Fill a bucket with the dandelion roots, flowers, leaves and other remains, walk down to deposit them in our compost pile, and then start over again in another part of the yard.  Do that for a few hours on a bright, sunny day and you’ll discover muscles in your back and legs and hands that you’ve forgotten you had.  Do that for a few days and hands that haven’t known callouses for decades might actually begin to develop a few, and hamstrings will be crying out for relief.

And at night, when darkness falls, you’ll find that you’re so exhausted that sleep comes easily and the nocturnal bouts with insomnia simply don’t happen.  It’s as if the physical fatigue overwhelms any effort by the subconscious mind to force you awake, so you sleep well — other than a leg cramp or two.

It’s just one of the many benefits of physical work — and obviously weeding doesn’t even hold a candle to the degree of effort needed to work on a construction crew or a farm.  People who do that for a living must sleep like rocks.

Popular Nightmares

Dreams, and nightmares, are among the most private things we experience in life.  No matter how close your relationship might be with your spouse, your family members, or your friends, no one can actually share the dream with you.  And if you’ve ever tried to describe a disturbing nightmare to someone, you realize you can’t really capture the way you experience it — if you can even recall the rapidly vanishing fragments of the nightmare at all.  At best, you’re providing a pale reflection of an intense experience.

Still, wouldn’t you like to know whether other people have the same kind of nightmares that from time to time haunt your dreams?

One company did a survey of 2,000 respondents to find out about their nightmares and see which nightmare scenarios were the most common.  The survey found some interesting results — including that the commonness of certain nightmares varies between men and women.  Women, for example, are far more likely to have a nightmare about a loved one dying or their house burning down, whereas men are much more likely to have a dream about killing someone.  (Curiously, women are slightly more likely than men to have a nightmare about going bald.)  The survey also showed that the frequency of certain dreams may be tied to the respondents’ specific circumstances.  Married couples are much more likely to have nightmares about abandonment by a partner or a partner’s infidelity than single people.

The top 10 most frequent nightmare scenarios, as determined by the survey, are:

1. Falling
2. Being chased
3. Death
4. Feeling lost
5. Feeling trapped
6. Being attacked
7. Missing an important event
8. Waking up late
9. Sex
10. Loved one dying

Farther down the list are other common scenarios, like being unprepared for an exam or being naked in a public place, and some weirdly specific nightmares, like your teeth falling out, being covered by bugs, or having car trouble.

Reading the list may cause you to realize that many of us have the same kinds of dreams, but also that there are other bad dreams that you luckily don’t have.  I’ve never had a nightmare about killing someone, fortunately.  And a word of caution — if you’re like me, looking at the list might cause you to remember a nightmare that you had otherwise forgotten.

Now, I can only hope that seeing some of the common nightmare scenarios other people have won’t cause my subconscious brain to add those to the nightly dream mix.

What A Difference A Night Makes

Recently I’ve been having some irregular sleep patterns.  I’ll go to bed and fall asleep promptly, but then wake up only a few hours later, with heart pumping and mind racing. When that happens, it’s hard to fall back into the REM cycle quickly, and I’ll inevitably toss and turn for as much as an hour, fretting all the while that I’m losing out on sleep that I need and will never make up.

But last night I fell asleep as soon as my head hit the pillow, slept through the night without any nocturnal wakefulness, and arose feeling refreshed.  When I went down to make the morning coffee the birds were chirping, I unloaded the dishwasher with a happy feeling, and the coffee tasted richer and better than ever.

There’s no doubt that sleep is therapeutic on multiple fronts.  The National Institutes of Health reports that, physically, the changes in breathing, heart rate, and blood pressure that occur during a good night’s sleep help to promote cardiovascular health, and while you sleep hormones are released that repair cells and control your body’s use of energy.  And although the physical aspects of sleep are significant, the mental aspects are even more important.  Getting your 7 or 8 hours of sound sleep enhances mood, alertness, intellectual functioning, and reflexes, while chronic sleep deprivation can lead to depression and anxiety disorders.

Knowing all of this, why doesn’t the human brain always do what is necessary to allow everyone to get their share of shuteye?  Unfortunately, things don’t don’t work that way, stresses and concerns at work and at home can interfere with the sleep cycle, and then the lack of sleep and the irritability it produces can have a compounding effect on those stresses and concerns.

That’s one of the reasons why getting a solid night of slumber time after a few night’s of anxious restlessness feels so good.  You may not be making up for lost sleep, but it’s comforting to know that your mind and body are back to their normal cycles — at least, until the next round of stresses and concerns hit.

Scented Sleep

When I got to the hotel at the Denver airport late last night, I found a little container of lavender balm next to the bed. It promised to help me “sleep well,” which sounded good to me.

I’ve never used lavender balm before, so I read the instructions. They read: “Wind down naturally with our Sleep Well Aromatherapy Balm, infused with essential oils of lavender and chamomile to ease tension and soothe the senses. Roll onto temples or wrists before bedtime to foster sound sleep.” Because I was keenly interested in fostering sound sleep, I did both. My temples and wrists have never smelled so good!

And you know what? I did sleep pretty well, until I had to get up at 3:30 a.m. Mountain time to catch an early morning flight. Was my sound sleep the result of the balm, or just exhaustion at the end of a long day? Who knows? But because sound sleep in a hotel is a rarity for me, I’m taking no chances. The lavender balm is officially part of my travel kit from now on.

Caffeine Cut-Off

Over the past year or so I’ve noticed that my sleep patterns had become much more erratic.  Whereas I once slept soundly and peacefully from bedtime until morning, I began waking up during the night and — most disturbingly — finding myself unable to fall back asleep readily, even though I still felt physically tired and sleep-ready.  At the first instant of wakefulness, my mind seemed to immediately shift into overdrive and begin churning through pending issues rather than remaining in a sleep-receptive mode.

I attributed this to age, and a heavy workload, and lots of travel that was affecting my circadian rhythms, and other extraneous factors.  But then I started wondering whether there were things I was doing that might be influencing my sleep patterns, too, and whether I could in fact take steps to avoid the unsatisfying crappy sleep nights.  I’d known for some time that too much coffee consumption during the day left me feeling jittery, and that the price of having a rich cup of coffee after dinner was staying up much later than normal.  Extrapolating from that evidence, I decided to practice a little self-science, and experiment with my caffeine intake to see whether establishing an earlier coffee cut-off would help me to get a more restful night’s sleep.

It wasn’t easy, because I’ve long enjoyed a cup of coffee after lunch and another one around 3 p.m., to keep me sharp during the afternoon.  Old habits die hard — but sometimes you’ve got to drive a stake through them, anyway.  So I started to consciously stop drinking coffee at about 2 p.m., and start drinking water at that point instead.   I missed the mid-afternoon steaming cup of joe, but that simple change had an immediate, positive impact on the soundness of my sleep, and particularly on my ability to fall back asleep, which was the problem that was bothering me the most.  Now I’ve backed off the deadline even farther, to 1 p.m., just to be on the safe side.

I definitely like my coffee, and I can’t imagine doing without my morning intake, but if the choice is between coffee and good sleep, coffee’s going to lose 10 times out of 10.

Sleepless, But On Guard

Everyone knows that, as you get older, your sleep patterns change and, for the most part, get worse.  A lot worse.

The arc of sleep goes from the totally out like a light sleep of the very young to the 12-hour power-sleeping capabilities of college students, but it’s all downhill from there.  By the time you’re in your 40s, 50s, and 60s, the realities of shrinking bladder capacity and ever-present concerns about developments in your career and family life combine to make sleep a fitful exercise, with lots of tossing and turning mixed in.  There’s not much REM sleep to be had.

Scientists think there is an evolutionary reason for this unfortunate trend — one that goes back to caveman days.  They say older folks sleep less soundly because their role in the tribe was to be alert for potential predators, attacks from warring clans, and other lurking disasters.  In caveman days, the blue-haired set would go to bed earlier than the rest of the tribe.  Then, with their lighter sleep habits, they would be roused by the sounds that a nocturnal animal would make upon entering the cave and could give the alert, so that the more youthful members of the tribe could help to fight the predator.  And the sleepless oldsters would also be first up in the morning, to get that all-important fire going and be ready to deal with any unwanted intrusions by bears or wolves or sabertoothed tigers.

It’s nice to know that there’s an exciting explanation for experiencing poorer, less satisfying sleep as you get older, and that in the dawn of humanity a codger my age would be quickly roused to alertness in order to grapple with cave bears and save the tribe.  I’d still trade it for a solid seven hours of sound sleep.

On The Edge Of Slumber

I woke up at 3 a.m. to go to the bathroom.  (Hey, I’m a guy in his late 50s.  It happens.)  When I came back to bed I knew the next few moments would be the acid test — either I would promptly drift back into blissful sleep, or I’d start thinking about something and deal with an unwanted period of tossing and turning.

Unfortunately, it was the latter.  For me, the wakefulness always seems to start with a single concrete thought — whether it be about work, or a family issue, or something else — that acts to drive away the possibility of sleep.  Just as I feel as if I am on the edge of slumber, another point will arise, and suddenly I’m getting up because I remember something and need to leave myself a reminder for when I will get up for good.

The experts will tell you that sleep occurs when the conscious mind goes dormant and the unconscious mind takes over.  But how do you encourage that hard-working conscious mind that you needed to help you stumble to the bathroom in the dark to let go, already?

This morning, I really felt the battle between the two parts of the brain, with the conscious mind and its structured ideas trying to remain in control and the subconscious mind always lurking beneath, ready to pounce as soon as the conscious mind lets its guard down.  It’s an interesting, if frustrating, phenomenon, and when it happens I try to slow my breathing, gradually clear my mind of everything, and let those dreamlike notions that are cavorting out on the periphery to come on down to center stage.  Sometimes, if the conscious mind is really persistent, I’ll try to think of some obviously surreal situation that is like a dream.  If it works, as it did this time, the effect is instantaneous, and the next thing I know it’s 5:30 and time to begin the morning.

I’d prefer to sleep like a log every night, but I’m convinced that it’s just not possible for people with busy lives.  When those wakeful nights hit, you have to have a technique for dealing with it and letting you get back to the shuteye that we all need.

An Extra Hour

“Spring ahead, fall back.”  The shifting of hours and the changing of clocks in connection with Daylight Savings Time has been going on for as long as I can remember.

As I’ve gotten older, though, I’ve come to appreciate the “fall back” part of the process more and more.  What the heck!  It’s autumn, and it’s getting colder.  Why not stay snug in your warm bed for an extra hour?  And after staying out later than normal last night, getting home after midnight after enjoying the Buckeyes’ drubbing of Illinois at Ohio Stadium, the extra hour of shut-eye is even more welcome.  The fact that it’s a shivery 28 degrees outside just confirms the wisdom of this timekeeping sleight-of-hand.

So I’d like to thank the ever-creative Benjamin Franklin, who came up with the concept of Daylight Savings Time in 1784 as a method to save on candles.  I’d like to thank the New Zealanders, Brits, and Germans who helped to popularize the idea, and Franklin Delano Roosevelt, who implemented the idea in America as a war-time measure during World War II.  And I’d like to thank the United States Congress, which enacted the Uniform Time Act of 1966 to finally implement Daylight Savings Time as we now know it.

Ben Franklin was all of 78 years old when he came up with the idea for shifting clocks to save a candle or two.  You think the idea might have been motivated by the notion of getting an extra hour of sleep on a cold autumn morning?

Get Some Sleep!

It’s hard to imagine that we need scientific studies to encourage us to sleep, but the evidence is mounting that getting enough shut-eye at night has crucial, lasting benefits for human beings.

The latest study examines the role of sleep in improving memory and learning.  The study found that sleep promotes the creation of brain synapses — the connections between the brain’s neurons — that are essential to learning.  That study follows countless others that demonstrate the physical and mental benefits of sleep — a state that allows the brain to discard toxins formed by daily activity, helps us recharge and reduce the risk of many different diseases, and restores the body to the ancient circadian rhythms that human beings have followed since the dawn of the species.

I’ve always tried to make sure that I get enough sleep.  In law school, on the day before our final exams when some of my classmates would stay up until all hours cramming, I  put my books aside and went to bed early so I could be fresh and ready for the big test tomorrow.  I always felt like my rested state gave me an advantage in terms of energy and mental focus, and I’ve tried to carry through that practice in my career, too.

Many of us — in our zeal to be SuperMom, or our focus on our jobs, or our desire to cram every conceivable bit of activity into the waking hours — have cut significantly into our sleep time.  Obviously, it’s a mistake.  If you want to help your kids do better in school or on the job, make sure they get a good night’s sleep.  And instead of staying up to watch a late night talk show or another Seinfeld rerun, why not hit the sack yourself?

Falling Nightmares

Normally I don’t remember my dreams. Since I’ve started using crutches, however, I’ve started to have vivid nightmares about falling.

If you accept the standard explanation of dreams — that they are a kind of post-day brain dump, when the conscious brain is out of it and the subconscious brain riffles through the images of the day just ended — my falling dreams shouldn’t come as a surprise. I know that I can’t put weight on my left foot, because it would painfully bend the steel pins in my toes and make them harder to extract. So, even something routine, like a short trip to the bathroom, becomes a cause for careful attention and concern about a slip and fall.

But there’s more to it. I scrabble up the stairs on hands and knees, dragging the crutches up the stairs with me, then use a chair at the top of the stairs to rise, balance, and get the crutches under my arms so I can move along. The transfer from chair to crutches is inherently unsteady, and I’m doing it balanced on one foot at the top of the stairs, wondering if a loss of balance will send me tumbling down the steps. The same process occurs when I go down the stairs, of course. And then there’s the silly worry about somehow falling out of bed and landing on my bad foot. I’ve never had that happen before, but now the possibility nags at me.

I don’t ever remember having falling dreams before, but they aren’t very pleasant. They’re not limited to the bed or stair scenarios; just about any falling context will do. I awaken with a lurch, arms flailing and grasping for a hold, heart pounding, hoping that the startling experience doesn’t itself cause me to tumble to the floor.

I hate these dreams. For years after I finished any form of schooling, I still had the occasional “failure to study for an exam that’s happening today” dream, and they never failed to get my pulse pounding. Now I wonder: long after these pins are removed and I’m walking normally again, will I continue to have these scary falling nightmares?