Dubious Expert Advice

Middle of the Night Insomnia affects a lot of us.  Despite my best faith effort to standardize my sleep times with widely accepted Sleep Hygiene rules, my first awakening comes with the red numerals on the clock radio behind me displaying approximately 3AM, sometimes earlier, rarely much later.  To be sure, it's never anywhere close to my aspired wake up time.  The books, and the professor whose seminar I just took at a modest fee to support the sponsoring organization, advised arising if not back to sleep in twenty minutes or so.  I set my smartwatch timer for a half hour, extend it once or twice a little beyond that, affirm my intent to enjoy the warmth of my down comforter for that interval, and avoid thinking about the last day's events or next day's agenda.  Never back to sleep before the wrist buzz.  Eventually I do get back to sleep, and frequently find myself restored to some respectable stage of the sleep cycle, I don'ttts know which, when the buzz from the smartwatch awakes me with intent.  If not really asleep I get up.  If sleep cycle interrupted I wait a while longer for the morning radio to blare its 7:15AM Sousalarm March feature, then get up almost always without fail

But the professional advice is not to do that.  It is to get up and do something relatively mindless.  Laptop and cellphone screens off limits, big screen TV OK.  Reading OK.  Studying not OK.  My default is a documentary on the Big Screen in My Space while I lean back on the recliner.  Nature shows.  Geography or geology shows.  I've exhausted most of the history shows.  Podcasts sometimes, though they tend to keep my mind too engaged for what I am trying to achieve.  Eventually I get drowsy, probably a little sooner than I had if I had stayed in bed, but not that much sooner.

Having now done this for consecutive nights, my observation is that I feel less rested when the intended wake up time arrives.  I still arise from bed, head to the sink for morning dental hygiene irrespective of how I feel, go downstairs where I successfully brew coffee in the Keurig Express, which I then take upstairs to sip at my desk.  I have the function to do a few petty chores, whether watering the indoor plants or retrieving the newspaper for my wife, and doing a few dishes still sitting overnight in the tub in the kitchen sink.  But I mostly really need that coffee back at my desk.  It washes down the morning antihypertensives and PPI.  And by about half the coffee consumed, adenosine receptors adequately blocked, I am reasonably ready to do a few of the day's projects outlined the night before.

Do I feel better or worse in the mornings when I follow the expert advice?  My assessment is worse, at least to the completion of that coffee.  That may not be the goal, however.  The purpose may be a more sustained ability to function for the duration of nature's daylight hours with the morning ookies the price for being able to do that.  I'm not sure yet if that will play out.

Two Half-Nights

It doesn't take very long to adapt to Daylight Savings Time, now in its second day.  Much like traveling to a different time zone.  Sleep times are affected first, though not for many nights.

My Sleep Tracker has helped improve my rest, for all its inaccuracies.  Some things it just doesn't seem designed to do, particularly measuring my middle of the night insomnia, those wakeful times, and it doesn't always measure sleep latency, or time from entering bed to falling asleep in the best way either.

Trying to adapt to DST, I followed the clock, which had not yet become my biological reset, entering bed at the desired time, probably falling asleep in a reasonable time, though not the seven minutes on the tracker.  I awoke five hours later, fully awake, engaging in some timed maneuvers with my smartwatch to return to real sleep.  I must have about an hour later, then awakening spontaneously, though not entirely refreshed at a reasonably desirable clock time, which by then was probably also my biological time.  I thought I would stay in semi-sleep until the tracker which has an algorithm for sounding within a band of preset time, signaled me to get up.  WRTI radio set by my wife got there first.  My first inclination, wait another fifteen minutes for their Souzalarm, which is a rousing march of some type aired at 7:15, which is also the end point of my tracker algorithm, but I just told the tracker to end the night's recording, look at its overnight statistics, and go on to dental hygiene followed by weekly weigh-in and coffee.

While the tracker offered its measurements, my internal assessment is that I really had two half-nights of sleep, each pretty decent.  First portion, falling asleep to awakening five hours later, second portion resuming true sleep probably an hour or so later and waking spontaneously close to a customary wake time.  Each seemed adequate when combined, neither adequate by itself.  And I don't really have a good sense of what transpired in each session except for maybe a fragment of a dream in the second half.

The purpose of sleep is to enable the next day.  Off to an OK start.

Chirping

Not a good night.  Smoke alarm needs new battery, first noticed when I awoke in the wee hours.  Not sure from the chirp whether the upstairs or downstairs unit.  I replaced one not long ago.  Transistor batteries not always easy to find.

Eventually just got up, took cell phone for scrolling which I virtually never do between 11 PM and 5 AM,  then back to bed, though did not doze off until the time I had planned to arise.  Gave myself another 45 minutes.  Now some coffee.

Restoring Sleep Predictability

At 1:40AM I arose.  Not only awake, but not the least bit sleepy, maybe about 3–4 hours after lights out.  Trying to return to sleep based on the clock would be a lost cause.  I went downstairs to the kitchen, being a little thirsty as well, poured half a cup of raspberry-lime seltzer, then tackled some dishes.  Mostly mugs that had accumulated but also my tall tangerine Swarthmore Latte cup and the beer glass that I bought myself on a tour of the Yuengling Brewery in Pottsville quite a number of years ago.  I returned the dry mugs done that afternoon to the closet, repositioned the ones that needed to dry more completely, returned a couple of dinner plates to the closet, and washed another load to include the Latte cup and beer glass, though I no longer had room to wash the porcelain mug with the seltzer and find a drying spot for it in my milchig rack.

Maybe TV would be better.  Netflix had a documentary on cats, amusing maybe, entertaining or enlightening, didn't seem so.  And The World According to Briggs on YouTube.  Looked at live TV.   By now the show times were within a few minutes of transitioning to the 3AM listings.  Another try at sleep seemed possible, so I shut down TV.  On returning to bed, I checked email, for which there was none.  Something taboo for me between 11PM and 5:30AM.  A personal transgression.  Cell phone off.  And successful return to sleep.  Biological clock nudge at 7AM.  Upright at 7:30.

Despite the wee hours, while really not very long, I did not feel sleepy in any way.  Everyone is familiar with restorative naps.  I wonder if there also might be a parallel restorative wakefulness, a break from sleep and the subconscious mental reframing it entails.  Despite the discontinuous nature of last night, I do not feel sleep-deprived.  Yet, as a matter of health, longer duration sleep seems more desirable than last night's discontinuous segments, so I'll see what the sages of cyberspace offer as remedies.

Wakeful Night

For all my efforts with sleep hygiene, difficulty falling asleep once tucked in and lights out rarely challenges me.  Some form of internal clock awakens me with no prompting at 3-4AM in a predictable way with variable success in returning to sleep, but something that nearly always happens prior to the wrist buzz as 6:3z0.  

Last night differed.  My day began with my dissatisfaction with my synagogue experience articulated more graphically than optimal.  I went on my way, doing good things the remainder of my usual wake times.  I walked on the treadmill after helping with a yahrtzeit minyan, began writing my monthly paid column, returned to OLLI for some quiet lounging followed by my scheduled class.  Then home and more writing.  Then a quick reheated supper followed by a quick run through Shop-Rite for a few items needed imminently for shabbos and Rosh Hashanah.  Then more writing leading to actual submission of a pretty good Jewish article, though I suspect not quite what its destination most likes to publish.  Then editing another Jewish article, this one needing considerable word reduction, or consolidation of thoughts.  As I juggle themes of resentment, at the start of my day, I find it hard to detach myself as a storyteller, but I tried.

As my usual time to call it a day arrived, I found myself not the least bit tired.  More accurately, my mind seemed energized, engaged in thought, though not really Mental Flow.  Some TV to distract me, something mindless, in this case David Letterman interviewing Howard Stern on Netflix.  It engaged me enough to surf the web while I watched to get some biographical background on Howard Stern.  Then some more attention to my monthly medical column.  A try at sleep unsuccessful, so more TV and some artificial inducements with a timer to limit my time awake and at screens.  Finally, around 1:30AM, still wound up without entirely satisfactory explanation, it was lights out.  The internal clock woke me about three hours later.  Usually I will use the bathroom, grudgingly hobbling there and back, eager to try to resume sleep.  This time I walked there with full energy, not at all inclined to give the night's sleep its second act.  Horizontal until I no longer wanted to be horizontal, rising an hour before the daily morning wrist buzz.  Dental hygiene, coffee, both basically time shifted by an hour, feeling not the least bit draggy.  Back to the medical column, accessing the core article on which it is based, typing my commentary, shifting back and forth between published contents and my own thoughts about it.  Coffee not quite finished, still warm enough.  Morning medicines swallowed.  Still not at all sleepy despite drastic reduction in my usual sleep hours.  Accomplish what I can.  Expect to have my back-up internal clock reset me by midday.

Extra Snooze

Out of bed delayed a bit.  Sleep hygiene has several components, occasionally in conflict.  Go to bed at same time each day addressed with a clock and a light switch.   Up at same time each day responds well to an alarm, for me a wrist buzz with an iTouch Slim, along with a commitment to arise when the signal denotes that time.  More complex is dealing with Middle of the Night Insomnia.  Sleep hygiene guidance advises limiting the tossing and turning to a short time, though I usually do that longer.  Then go to another room to read, watch TV, or some other activity that requires minimal mental engagement.

This morning I not only awoke nearly three hours before the scheduled morning buzz, but I felt wide awake.  An hour of mind shifting did not make me less awake, so off to the recliner in My Space.  I set a Netflix show with a lot of pictures, silencing it while I leaned back and watched.  Drowsy within minutes, apparently asleep before the 25-minute episode concluded.  Slept through the iTouch Slim, awoke 45 minutes after the scheduled time, but with ample rest.  Few minutes back to bed, then move ahead with my day.  Probably better than if I had just stayed in bed, dragging myself out at the buzz.

Following Sleep Hygiene Protocol

When my wrist alarm buzzes, I arise from bed.  Almost no lapses.  For any sleep hygiene recommendations, a uniform time to depart bed serves as the core.  And it has helped.  Gentle wrist alarm from low end smartwatch was a good purchase.  Middle of the night insomnia has been more intractable.  After mostly unsuccessful riding it out in bed, one of those shouldn'ts, I've started getting up, walking across the upper hall to My Space, and turning on the big screen TV.  The browse option comes in well here, as I can usually select something that I know to be boring.  Within a half hour, I've dozed off in the lounge chair, just like the sleep hygiene guru's recommended.  Mostly I re-awaken before the iTouch buzzes me to start the day, returning to bed feeling a little better, though not always in store for one more sleep cycle.  For the most part, following this protocol has enhanced my perception of rest.  I'm more ready for the day ahead.

Crammed Week

Some middle of the night insomnia got the better of me.  I arose to My Space.  It had been my intent to plan out my week as I do nearly all Sundays unless pre-empted by yontiff or travel, but being awake anyway I took out my new multicolored gel pens, semi-annual initiative affirmations, and markers to get a head start.  There's a lot for me, much of it not discretionary.  Sukkot arrives this week.  With it, a sukkah to finish building, a dinner at somebody else's sukkah the first night, special guest with special menu at my sukkah for shabbos, a Torah reading done twice, and a haftarah reading done once.  I will need to get a better folding eating table for the sukkah, using the current one for serving.  We have a fly infestation, far less severe than our last one, but it needs some attention.

On Thursday evening I make a public medical presentation via Zoom.  My monthly Medscape submission needs writing with a few days out of action for yontiff.  This will be the first sent to my new interim editor.  Expenses get logged this week, and it being the end of the quarter, an Excel summary needs to be created for review.  My financial advisor thinks we should get together.  

Monthly donation day arrives right before yontiff.  OLLI has a full schedule this week.  Our congregational President tossed a verbal gauntlet that needs a response, a very mixed response.  The bank branch that houses our safe deposit box will be closing within a few weeks.  Need to make a transfer.  I think I know where I keep the key.  Have lost any recollection of what the box houses, but it's a good opportunity to reconsider what it should contain.

And then the ongoing exercise, tidying, reading, writing, medicines, and thinking.  The special initiatives eventually resolve.  These don't, as it is never really clear what determines their completion.

And before you know it, we're into next month, with its typical daily and weekly cadences. The Hebrew month which almost coincides this year, is called Mar Cheshvan, or Bitter Cheshvan, since it the only month without a special calendar event other than Rosh Chodesh.  Between Holy Days, travel, and preparation for arriving commitments, I'm ready for a month's activity reduction, or really replacement of this surge in committed days with something more discretionary.

 

Overnight TV

Sleep has become more restful now that I adhere to sleep and wake times with little variation.  My smart phone tracker, while not terribly accurate, has proven consistent on consecutive nights.  I will have one major awakening following about two sleep cycles, stay up a bit, then get two more then a fifth sleep cycle, feeling adequately rested when the wrist buzz of the smart watch signals it is time to arise, which I do.  If I violate the principles, it has been by staying in bed too long after each sleep interruption.  I set a limit on myself, which I exceeded last night for the first time in a while.  After an hour of watch watching, I got myself up, heading into My Space for some TV, impeded by misplacing the needed Roku remote from its usual resting place.  Finding it, I scrolled what was one, made and initial poor choice on Smithsonian Channel followed by a better choice on Science Channel.  I took my tracker to the lounge chair, but eventually just put it on my desk where it remained.  It took about 50 minutes to get drowsy again, but on return to bed, the remainder of the sleep cycles seemed OK.  Perhaps a little less total sleep than average but reasonably functional for what I have on my Daily List today.

Blank Mind

As I grapple with Middle of the Night Insomnia, the recommended Sleep Hygiene action that I neglected most has been to set a time limit on returning to sleep.  I have more often than not acquired one more sleep cycle but usually quite a bit later.  This additional 60-90 minutes makes or breaks the following day.  Last night I resolved to follow the advice, departing for My Space and the comfy recliner in still looking at the clock a just over a half hour later.  Not succeeding in slumber, I arose for that lounge chair in the other room.  Formal guidance recommends either reading or watching something not requiring much focus on TV so I turned on an episode of New Scandinavian Cooking which Andreas had devoted to chocolate.  I remained awake to the end.  Then transfer the screen from Infinity to Netflix.  I don't even remember what show I ordered the remote to display but that's my last recollection until awakening two and a half hours later, or one and a half hours before my wrist alarm would signal out of bed time has arrived.

Most likely I really fell asleep, probably two sleep cycles.  If I achieved REM's dream state, I don't remember.  In fact, I have no recollection of that time at all but when I awoke Netflix was still on the big screen TV with some modern equivalent of a test pattern.  I remember nothing after switching from one TV format to the other.  Sleep science affirms that the mind becomes more restorative than absent during these intervals, yet I have no sense of the many dangling elements of my waking mind that achieved resolution this morning.

I returned to bed, remaining horizontal but mentally aware until my usual out of bed time, which has almost never been my real wake time.  But I feel mostly OK, as if those two additional sleep cycles really took place.

Insomnia

It had been my intent to attend Grand Rounds at the Medical Center this morning.  My inner clock awoke me overnight, though.  I did a Review of Systems on myself, which tends to work more effectively  than counting sheep, but to no avail.  I just got up with some pretense of either watching television or being productive.  Sipped a small amount of zero calorie cherry-cola, then remembered that I hadn't yet paid my COBRA dental premium which was coming due soon.  I retrieved the statement, which I just have to remember with no assistance as one of the carrier's purposes is to drop participants as best they can,  Wrote a check.  Signed another check issued to me six weeks ago.  Scanned the remote to see if there is anything on Cable worthy of watching.  There wasn't.  I have a very successful self-imposed mandate not to use the computer or tablets from 11PM to 5:30AM so that diversion was off the table.  I do not eat from 8PM to 6AM as pretty good research has shown that restricting one's hours of feeding is the easiest passive way to achieve weight control.  That has been less successful.  Could have made brownies, as mixes are on sale each week making my supply excessive.  Risk of falling asleep with the oven on just seemed too high.  Our cat, a nocturnal predator, was also awake but didn't seem ready to play.

While the news cycle and time zones when people are normally awake and functioning has gone 24/7, I have not.  If no laudable TV and other screens forbidden, I may as well give sleep another go.  Next thing I knew it was usual wake time, or a half hour later.  I could still have rushed myself a little to Grand Rounds where they serve coffee when the doctors sign in but the motivation was gone.  Just start the other morning activities, get some catch-up sleep later, and allow today to go wherever it is headed.

Insomnia

 Awake at approximately 3AM every night this week.  My internal clock must have some type of silent alarm.  I awaken slightly tired, too tired to begin my day for sure yet less tired than I will be at the intended sleep time a few hours hence despite my best non-chemical effort to return to sleep, which I usually do, if only briefly until the second arousal at about 6AM.  I try to be productive in a way, having read a NY Times article on insomnia that suggested just going along with what nature dictates.  So I have soothing sleep sounds of various types on my Nexus 7 and iPod devices.  I can listen to a shiur on yutorah.org or watch a video on Smithsonian channel, using one of the sets of ear buds kept next to the bed.  From the iPod I can listen to a symphony at any hour.  Sometimes I go downstairs and watch what is on.

I've never been so productive as to engage in things that have no time limit such as blogging or writing.  Even for the soothing sleep sounds I set a timer.  Eventually I return to snooze land, sometimes slightly more learned than the night before but usually not quite ready to pursue the days activities until the latest possible time.