Heeding Circadian Rhythms

Count myself among the many who wish their sleep patterns were better.  Short of a formal sleep study, a form of excessive medical care for me, I've engaged in a lot of interventions.  I am aware of sleep hygiene principles, which I commit myself to periodically.  My bottle of melatonin from the shelf at Walmart gets judicious use.  My card of diphenhydramine gel caps, obtained from the Dollar Store, allows me to get drowsy but at an unacceptable cost the next morning.  Unlikely that I will finish the remaining aqua capsules.  I've used Ambien samples, four of them conserved over several months.  That stuff works, and offered to me by my doctor, but not the direction I should be taking in my senior retirement years.  Sleep Hygiene is the way to go.

The principles are very easy.  Lights out at a predictable time.  Avoid zonking out early.  Put away the blue lights from the smartphones and tablets a couple hours in advance. Big Screen TV causes fewer disturbances.  Arise on time.  Avoid snooze button.  I've also had sleep trackers.  I found the free apps on my cell phone intrusive.  The Apps themselves periodically failed.  My smartwatch has a basic program that works consistently, if not all that accurately.  Often I have two half-nights sleep when trying to adhere to fixed sleep and wake times.  The most difficult advice for me has been how to deal with the middle of the night wakening that creates those two half-nights.  Professional sleep organization advice recommends getting up if not back to sleep by a certain interval.  My smartwatch has a timer that allows me to create that interval.  I am rarely back asleep.  However, the sleep app of the watch shows the wake time to be not that much longer than the recommended allowable in-bed wake time.  If I feel groggy I stay in bed.  If I feel wired, I head to My Space where I turn on the big screen TV to Modern Marvels or How the Earth was Made to maybe learn something.  By the end of the show, if not dozed in my recliner, I usually find myself loopy enough to return to bed for a successful second half of the night.

Wake times occasionally challenge me.  My smartwatch has an alarm set to my wake time with a snooze feature for ten minutes.  I am rarely jolted awake by the buzz.  My internal timer has me either awake or dozing lightly when it signals my left wrist.  By then I have already read the red numerals on the should be obsolete clock radio behind my bed.  I rarely arise with the buzz but nearly always am able to head to the bathroom for dental hygiene before the reminder buzzes ten minutes later.  Then to the kitchen to begin the day.  Make k-cup coffee, retrieve the newspaper from the end of the driveway for my wife, then bring that brew back to the laptop in My Space.

Recent weeks have changed my internal pattern.  The middle of night awakening still occurs at a predictable time, but my smartwatch indicates that light sleep resumes within a few minutes.  And if I am awake within a half hour of the alarm set, I just get up early to begin my day.  My internal rhythms seem a reasonable guide.  My energy has improved, as has my ability to stay awake past the designated lights out time most nights.  I rarely doze off before that, something I used to do most nights.  Time to falling asleep does not seem unduly long.

So the sleep hygiene protocols seem on target.  While they can sometimes be disruptive to follow, consistency seems to pay off.  While these recommendations make people subservient to the clock with its timers, biological signals remain recognizable.  It pays to follow them if not predictably destructive.  So now my wake times have become longer, my activities within those daylight times more productive.  That was the intent.  Sleep study not needed yet.

OOB

OOB.  Medical jargon.  An abbreviation for Out of Bed, understood by every nurse that a patient needs to be mobilized daily.  Sometimes the doctor specifies frequency or duration but usually that gets determined by nursing protocols, individual judgment, or competing demands on things the nurse must do that shift.  The core message, however, is that person would be harmed by excessive bed time.

I've added that notation to my weekly agenda and daily tasks.  It has a tacit intention.  Bed needs to be restricted to pre-determined sleep hours, one of the core principles of standard sleep hygiene intended to enhance daytime energy.  So OOB starts on arising, which has a set hour, and concludes at a slightly flexible time at night.

My adherence has not been bad, though not entirely complete, as I often like to watch Curiosity Stream or read a book while lying in bed.  Nor is OOB quite the same as stay upright or do not drift off to sleep outside of specified times.  The recliner in My Space often finds me dozing off while watching something on my flat screen.

Still, better regulation of sleep has made some progress as I impose rules that are not so demanding as to invite rejection.  And I do feel better than I did last year.

Up on Time

Eventually, I prefer the late sunsets of Daylight Savings Time.  This third morning of the new clock settings I resolved to depart my bed at the specified time that I plan to keep permanent until either the next clock adjustment or time zone travel.  It was a struggle, but I am up, dental routine completed, newspaper moved from driveway to the front door, first k-cup of coffee brewed, and morning pills swallowed.  I need that coffee to serve its intended purpose, though that typically happens after the second cup.

I have two sleep trackers, one a smartphone app, the other a feature of my smartwatch.  They agree with cumulative sleep times, differing only by 8 minutes.  The phone breaks down the components.  About half it called REM or deep sleep, the other half light sleep or awake.  I know I was awake far in excess of the 49 minutes its highly fallible method calculated, as I could check the red numerals on the clock radio with some regularity for about 2 hours at about the mid-point of my nightly sleep session.

However, the first step of sleep regulation, with few exceptions, is a commitment to Up on Time.  For the first morning of DST, I did that.

Unexpected Snooze

My out of bed initiative for 7AM has gone mostly well, though with a few unexpected disclosures of my innate sleep cycles.  Middle of the Night Insomnia continues, though the wake time has lost some of its 3AM predictability.  Last night it came closer to 4:30AM, though without as sense of completing my nightly rest.  Ordinarily I would begin to time 10-30 minute intervals with my smart watch, assigning each session uninterrupted time in a fixed position, whether supine or lateral, fully under down comforter or arms exposes.  Alas, my watch's battery had run out.  So I looked at the red numerals on the clock periodically, typically 10-15 minute intervals, as I made the best of my blanket options.  The last time I remember was 5:59AM.  Up in an hour.  At the next update, the clock read 7:15AM.  I had an unexpected 75 minute return to the oblivion of sleep.  Actual OOB time, 7:22AM, feeling mostly good.  That final lap of sleep, stages completely without ability to reconstruct, added to the night's restorative benefit.  Morning routine slightly delayed, but now with newspaper retrieved, indoor herb plants checked, overnight messages reviewed, and some coffee being sipped, that seems to be a very useful 75 minutes.

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.

Perking Up

First cup of coffee not yet finished.  Morning pills swallowed and washed down with that coffee.  I had changed my sleep pattern last week, adding ten waking minutes to the beginning and end of each day.  It has gone well, particularly at the end when I know I must be engaged with something, even if only a worthwhile streamed TV show, until I am allowed into my bedroom.  The morning does not force awakening, as I am already awake for some time, as much as it does exiting bed to the next step of daily dental hygiene, also reset as a new habit about two years ago.  However, I do too much clock watching to assure I get all the bed time to which I am entitled, so I really need to reset the morning alarm on my smartwatch to buzz at the arising time.

I'm probably a little less tired on the new schedule, probably not yet significantly more accomplished in my activities.  I have been waking partially refreshed, though definitely ready for coffee, which I have not yet rationed.  Usually two cups before the treadmill, for which I also have a fixed schedule of days and a reasonably adhered to target time for doing this, though I welcome those scheduled rest days.  By treadmill's completion I am usually ready to engage in productive activities, not only fully awake but reasonably motivated.  I am not always optimally focused, though.  

While only less than two weeks into the revision, having a finite start and end of the day has contributed to what come in between.

Slow Getting Up

Need to resume monitoring with a Sleep Tracker.  Not a good start to the morning. Forced myself out of bed about an hour after the usual start of day time, and reluctant to do that.  Did not perceive myself sleeping badly.  A usual middle of the night wakening, but more than an hour until sleep resumed some two hours before my usual arising time.  Dragged myself eventually to dental hygiene, now coffee.  Treadmill will be delayed, though not cancelled.  Less sure about afternoon stretch, as I'm a bit sore.

Other daily tasks within my physical and mental capacity.

Resetting Sleep Pattern

Returning to Eastern Daylight Time did not go well.  But neither was my rhythm still on Pacific Daylight Time.  Got up a little late, thought I was OK.  Retired at a typical EDT hour but did not fall asleep.  Nothing helped.  Went to kitchen and noshed.  Probably wrong thing to do.  Turned on laptop.  No new emails or FB messages.  Finally fell asleep.  Woke spontaneously at 8AM, quick snooze to 9AM.  Had considered going out for breakfast.  Not good idea.  Just coffee.  Hawaiian Blend picked up on sale at Sprouts.  Then adhere to my task list and see if it resets me tonight. 

New Sleep Tracker

Sleep has not gone well, at least my perception of it.  Changed from fixed times to let your body tell you what to do.  Neither of them quite right, but generally I felt better with fixed times once performed faithfully over a few weeks.  Tried to revive my old sleep App still on the phone.  They wanted money.  Not worth money, so Uninstall.  Lots of apps to replace it.  First one wanted a promise of money after seven days.  Uninstalled quickly.  Next one let me see what their device calculates for free.  Put it next to my pillow.  Wife put it on shelf behind the bed, not realizing it was left on the bed intentionally.  Straightened that out.  Second night, recorded only one minute then shut off.  Finally, last night I got data.  The electronic assessment exceeded my internal assessment.  Sleep time was about where I hoped it would be.  Wake time underestimated.  I do not know how the App calculates the deep and light sleep levels, but I did better on the deep side than usual.  I assume they calculate REM by absence of movement.  They gave mine under 1% though I recall active dreaming, even a little of its content, not at all lurid but worthy of interpretation, near the completion of last night's sleep.  It was probably more than 1%, though with the phone closer to me but still a second person in bed, true lack of motion with the phone settled on the shared mattress may be hard to detect.

Too soon to make an assessment of the App and whether it will contribute to improved sleep.  I got up just a little past my arbitrary target time.  I felt poorly for sure, achy, a little stiff, a tad unsteady but not dangerously so.  With no vigor, I filled my obligation of dental hygiene, then started to perk up.

The purpose of sleep is to enable peak function the following day.  I've been functioning reasonably well, past my prime, not sure what optimal in my Medicare years really is.  Have been able to exercise with consistency on my morning schedule, do my eight-minute stretch program in the late afternoon, usually not grudgingly.  And most days my mind has remained adequately agile.  So sleep must be OK for its end purpose.  It's intermediate purpose of having me feel my best still has elements for a sleep tracker to identify, or perhaps a sleep lab.

Too Much Sleep

Accounting for inaccuracies, my Smart Watch totalled my sleep time at 9 hours 33 minutes for the past night.  That's a lot.  I know I have been in bed more, probably sleeping more, and also more tired.  I had been doing rather well for a long time with regimented times, up 6:30AM, Bed 9:30PM, which is still a lot, though not all of it was sleep.  I think I need to reset firm times and do it long enough to become habitual, usually a few weeks, or for now probably the rest of the month.  The wake time of 6:30 should be functional.  I think I will set the to bed time at 10:15PM and the lights out at 10:30PM.

Too much sleep, assuming it really is sleep, correlates with a number of poor medical outcomes, for which the sleep pattern may be more of a marker than a cause.  And bed time may not really be sleep time.

See where it goes for a few weeks, then perhaps some medical assessment if not correcte

d.

Slept Through Alarm

Sleep Hygiene has been a struggle.  Each day starts, or is supposed to, with a buzz to my left wrist from an iTouch Slim at 6:30AM, to which I respond but forcing myself upright for daily dental hygiene.  Those hours preceding the vibratory jolt vary, with few nights really continuous sleep from lights out the night before to the morning demarcation signal.

On occasion, I will intentionally await the morning buzz, acknowledge it, but for one reason or another, usually rationalized as legit at the time, opt to delay getting up.  Those times are few.  Not noticing the signal almost never happens, but it did today.  Ironically, I was awake about 40 minutes before, committed myself to the final less than an hour of snooze, before moving on to the only day this week when I can count on being around other people.  I also resolved not to check the time before the signal appeared.  It took an unusually long time.  While the ability to judge how much time has actually elapsed from perception is not very good, as any SAT taker will well remember, I felt surprised that I had not been aroused up yet.  I glanced not at my iTouch Slim, but at the red digital numbers of the alarm clock behind me.  The out of bed time was twenty minutes before.

I felt pretty good, probably better than I would have if interrupted from what must have been more than a superficial sleep stage by the alarm.  Sat up for a few seconds to get my bearings, then on with the rest of today.

Up All Night

Sleep Hygiene can get out of hand.  For some reason, I awoke at 2:30AM.  Not a full bladder or other physiological hint, just wide awak and abrupt.  Turned on bedroom AC without benefit.  Withing a short time, I paced over to the recliner in My Space.  I had recorded a fair number of shows, mostly travel and Jewish, so time to catch up.  I did.  No drifting off at all, and got to watch some pretty good programs.  Some YouTube perhaps.  No benefit.  After a few hours, still fully alert, I'd give bed a second chance.  Not drowsy, but not wired either.  I considered staying in bed until mid-morning, but I have anti-hypertensives to swallow and crock pot shabbos dinner to assemble, along with daily dental hygiene, so I just did these.  A book awaits for me at the library later, and it's a treadmill day, though I think better postponed until the afternoon.  Just see how long the unanticipated alertness lasts.

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.

Woozy Birthday

Threescore and ten was so Last Year.  Moving along, another year with achievements and restraints completed.  Overall, I've been feeling well relative to my age.  Some exercise tradeoffs with sore legs in exchange for better stamina.  My new memory has limitations notable primarily to me alone, not incapacitating.  I can be focused.  I can sometimes be funny.  Struggling to come up regularly cheerful, though.  And very much tempered in my quest for new experiences.

My birthday itself found me a little woozy.  Sleep deprived overnight after making admirable progress with Sleep Hygiene.  Difficulty giving my OLLI class my undivided attention.  Just forgot a major component of my Passover shopping task while at Shop-Rite.  Nice dinner.  Some greetings via FB.  Yet a lot of time in the recliner in My Space.  Now onto the next personal earth orbit, the last one in which I can leave my IRAs dormant.  And it begins with feeling better.

Right Amount of Coffee

K-cups have transformed my morning experience, well worth the expense though I'm less certain about its likely environmental downside.  With variety options sorted in a revolving rack, and with scooped coffee that can be brewed in a k-cup adapter, each morning cup can be a little different.  I've hardly been out for coffee since the pandemic.  Even WaWa which offers the most variety, has challenged its price elasticity, now limiting this to a justifiable indulgence or traveling convenience.  But K-cups are the way to go, suspended for Passover, though technically with some effort or expense, they don't have to be.

Coffee at my desk in My Space has become the norm.  While loyalty to the core principles of sleep hygiene has made me less tired when my wrist alarm makes me woke, I still seek the boost of my first cup of java from the Keurig facsimile.  And the second cup.  It's that third cup later in the morning that seems to be changing the ritual.  It goes well with my OLLI schedule, not as well with my shabbos schedule.  And unless traveling or left over from the morning, never past 1PM.  

I experience it as part taste, which is why the ease of variety has become so attractive, and partly medicinal which is why it needs some restraint from excess.  My current pattern seems sustainable, the way to go after much trial and surprisingly little error.

Too Much Wine

Needed a bottle of wine for Valentine's Dinner.  I had been shopping for a few final items the day before but the distance between Shop-Rite and Total Whine was more than I wanted to drive for a basic bottle.  My state restricts alcohol sales to licensed stores, of which there are an abundance.  My route home from the supermarket took me to three.  I stopped at the one with the emptiest parking lot, a small store as these go.  There are some studies that people who choose from a few options, like at this store, tend to be more satisfied with their choice than people who choose among hundreds, as at Total Whine.  I only needed one.  Based on price and availability, I judged the best option to be a 1500 ml corked bottle, not the lowest price, but of the next tier in quality from a mass winery of good reputation.  For $13.99 I left satisfied, figuring I could have what I wanted for our dinner and gradually sip the rest over the week or maybe use some for cooking.

It really was a best buy.  Just right for seared tuna.  Mostly right the next supper for reheated lasagna I had made the week before.  Not at all right for Fish Market Apple Pie with home whipped whipped cream which made the aftertaste of the wine bitter.  But at least I know now that wine is not generic.  It really pairs better with some things than others.  The sommoliers that tried to emphasize this over the years remain snobs.

Not having anyplace to go after supper and needing to finish some of this stuff before it becomes only useful for cooking, I treated myself to one glass more than I would have ordered at a restaurant.  Went well the first night.  Less well the second, when I had also intended to do a major project while sipping the second glass and the desk timer ticks down to make sure I do it.  Didn't happen.  In its place, an early crawl into bed with a full agenda the next day, some e-reading from the cell phone, and an early drift off to the world of some stage of sleep.  And not very prolonged sleep at that.  Sleep Hygiene experts warn that evening alcohol makes falling asleep more predictably, but the piper gets paid in the later stages.  That's what happened.  

I never did my project.  Today for sure, earlier in the day.

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.

Not Very Smart Watch

To maintain sleep hygiene, I pretty faithfully arise when my wrist alarm buzzes.  This being clock change, I expected it to adapt as my cell phone does.  However, it links to the cell phone, which I left downstairs on the kitchen table.  The watch buzzed when it said 6:30 just as programmed.  However, it was really 5:30 but I got up anyway and went to the kitchen to begin my day with coffee.  The cell phone had adjusted automatically and the watch then linked, only to go off again in another hour when it read 6:30 a second time.  I can count of the alarm.

Sort of Awake

My low end not entirely smartwatch's most important feature, beyond its accuracy in telling time, might be the alarm that I set to wake me at 6:30 each morning, seven days a week.  I heed the signal by arising, usually within the 30 seconds that it continues to buzz.  Rarely does it truly wake me, serving more as a prompt to actually arise from bed.  On occasion, like today, it interrupts slumber but I still arise, as fixed out of bedtime provide the basis of optimal sleep hygiene.  Today, though, while I arose and did my habitual dental care, instead of coffee I plopped onto my recliner in My Space to resume my morning snooze, which amounted to another hour and a half.  Then coffee.  Then treadmill at the customary time.

It's Not Quite Daylight

After months or more of sleep disturbance, middle of night awakening multiple times, it's been a very favorable summer.  My study and implementation has brought regular sleep times, an air-conditioned room, a new pillow, and periodic tracking of pattern.  My sources suggest I likely only have a variant of normal commonly encountered in seniors.  And I feel notably more energetic.  My wrist alarm buzzes each morning at 6:30, and I heed its signal.  What has changed this week is the light through the windows when I arise.  I depend on the distinction between day and night to get me going.  These past two days have encountered a very dark gray, not at all the light that resets my internal clock.  Perhaps overcast weather, perhaps shortened daytimes though we are still about a month away from the equinox.

It has not changed my commitment to my wrist alarm.  I still feel good in the morning, ready to go make coffee.  And I have plenty of artificial light to guide me.  But I wonder if the gains I made in sleep hygiene this spring and summer might encounter a setback as we get closer to seasonal clock adjustment.