Wrist Alarm

Been trying unsuccessfully to restore my previously stable sleep pattern.  Read the pro's popular summaries of sleep hygiene.  Did sleep tracking by a smartphone app for two weeks which really didn't tell me anything I hadn't already figured out.  Watched a show on sleep hygiene, where I learned that there are some Cognitive Behavioral Interventions online and where I also learned that a lot of people who go to a sleep lab find that they get their first full night's sleep there.  That's a similar impression that I've had from the few nights I've spent at a hotel, so the barrier may be schedule.  I do not think it is environment.  My bed is comfortable, pillow maybe could be replaced.  Could use some of the $65 accumulated five dollar bills on that, but definitely not for a My Pillow, even if it is a good product. Comforter is warm, though I've made an effort to keep the bedroom a little cooler than I have before.  I cannot see the red numbers on the alarm clock without a concerted effort, which I rarely make.  And sleep latency is well within population norms.

Habits are another matter that need attention.  I exercise regularly two mornings of three, almost never consume caffeine after noon, except for minor amounts of chocolate, will have some sherry just before supper or a beer with supper, never both and none after supper.  And for the past few days I've not returned to bed at all between arising time and pre-determined sleep time.  Putting aside my screens still needs some work but I can set an evening hour when they shut down.  What the experts say is most important is the anticipatory schedule, which I've now set. Into bed at a fixed time with a half hour off screens before lights out.  My prescriptions, now five tablets taken at supper, are one of those wild cards, with only one recent change that I can try moving to the morning if no progress over the coming week.  And they all say the single best introduction is a fixed awake time with prompt arising no matter how you feel.  My iTouch works well for that.  The past few days the wrist nudge prodded me gently, and I proceeded on immediately to morning dental care.

I think I need to be a better taskmaster on this than I have been.  In the few days that I've implemented this I still awake at the same middle of the night times.  I've followed the advice of getting up after a half hour once.  It destroyed the next day, so I just make do and try to stay beneath my warm comforter for now.  Having done that I'm less tired over the next day, have less struggle with exercise or even with snow shoveling, though my mental acuity needed for some of my semi-annual intended projects could be better.  Always start with the easy stuff. Wrist alarm seems a good introduction.  And there's a scheduled doctor's appointment next month.  Sometimes do-it-yourself is not the best option.

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.

Rationing Social Media

In retirement, I have minimal must do now impositions on each day.  In one respect, it is freedom, control over my time, in another work has been replaced by other things that control my time, mostly by allure.  There are days when I can never get enough Facebook, even though most of my Friends, who are really more contacts, have either become less present, gotten snoozed for annoying me, or haven't yet gotten snoozed because my fondness for them overrides the endless political postings.  And no doubt I've done the same to others, which may be in part why their participation has waned.  Is it an addiction?  A Psychology Today essay by an addiction specialists suggests not.

https://www.psychologytoday.com/us/blog/in-excess/201805/addicted-social-media

But the allure is such that I become a clock watcher in its absence.  No electronics on shabbos, but I have become more aware of Havdalah time and what I plan to do shortly thereafter.  No screens from 11PM to 5:30AM, more to promote sleep, but from about 4:30AM onward, the red digits on the behind bed clock may as well count down instead of up.  Dr. Griffiths, author of the article, recognizes the sense of deprivation, what might be happening to the world when I am not part of it?

Rationing as in shabbos and overnight has helped, but I gave myself a two day more comprehensive trial this week.  So far so good, but I still have the urge.  It may be like choosing Kosher.  People give up pork, then lobster, then cheeseburgers.  Eventually they look for hechshers and one day they no longer miss the clam chowder or even think about it.  I suppose FB can go that route, Sermo largely has, but access to cyberspace is a lot more beneficial than access to shrimp scampi so it may not be all that realistic to promote electronic celibacy.  Time constraints and participatory limitations may have to suffice.  I'll have a better sense of this tomorrow when I am looking forward to posting again after 48 hours avoidance.  Enrolling in Cognitive Behavioral Therapy seems premature.