Sleep Hygiene

Getting a continuous long duration night of sleep has been elusive, probably since my residency days when after being up all night on call, I would return home, assuming a supine position and dozing off as my due reward for my dedication to the rigors of medical training.  Such hazing is no longer permitted but those restful catchups have never been duplicated for me.

In more recent years, sleep has gotten far off schedule, even unscheduled sometimes.  I go to bed early, not always tired, and wake up for one reason or another while still in the wee hours on the clock with the red numbers.  I had a four pill sample of Ambien a long time ago, used them sparingly, but each time however they proved highly effective.  OTC diphenhydramine works as well, with a hangover the next day.  That hints of something chemically causing this which can be corrected in a pharmacological way, as unappealing as that is.  Since I no longer need to keep a work schedule, sleep deprivation, at least to the most restful stages, has not been a handicap and I am still pretty productive in my waking hours.  I wish I felt better and I wish I were less guilty about my naturally haphazard sleeping hours.  If I were incapacitated, I'd seek a sleep lab but since I'm not, the sage expert advice from cyberspace or the NEJM review should suffice.

I am familiar with clinical sleep hygiene advice, which I violate regularly.  I have set times for lights out and no computer screens, which I follow.  The bed is a refuge for reading.  At one time it was a refuge for television but since I got a super screen 55-inch model for My Space, I rarely watch the bedroom 24 incher from bed.  I bought a lounge chair which until recently has gone the way of all flat surfaces in my house.  Now cleared and used and off limits to piling random stuff atop the seat or footrest, I have an alternative to bed in my bedroom, and I'm starting to take advantage of it.  Coffee usually stops at noon or shortly thereafter.  Never drank much alcohol.  A Hot Toddy never served me well as a liquid hypnotic agent.

This summer I started working on keeping the bedroom cooler.  I had bought a room air conditioner as the central air conditioning never cooled the master bedroom as well as the lower rooms of our house.  It made a difference, not only for the ambient comfort but the background sounds seemed useful as white noise.  I have tried binaural sleep sounds, a sleep sound unit with waves or rain, blindfolds to create true darkness.  None are on the standard sleep hygiene suggestions, probably for lack of efficacy. 

And the bedding.  Mattress overdue for replacement.  A priority this fall.  Other bedding is fine but down comforter with duvet in the pattern of a black cat tends to be uneven, though warm.

Blue emitting light from screens is everywhere.  My smart phone with internet access is my connection to the world.  I have set a moratorium from 11PM to 5:30 AM which I have maintained with very rare minor lapses.  It may be better to shut the screens down earlier.  And the alarm clock, which I almost never use as either an alarm or as a radio though often as a clock, has those red numbers.  I have tried turning it around or covering the numbers with a washcloth with little discernible benefit.

And there's always Cognitive Behavioral Therapy.  I'm not that desperate.