Sleep Well This Summer!

Jun25

Shortly I’ll be on a plane to Wichita, Kansas, for my high school reunion. Every time I step foot on Kansas soil a flood of great memories returns: Friday night football games, Knolla’s Pizza, midnight movies, parties, Bionic Burger, the River Festival, Galaga, and, especially around this time of year, the all-important beginning of summer.

Where I grew up, summer was all about crowded public swimming pools, Dairy Queen Hot Fudge Brownie Delights, baseball, mowing a huge yard all day every Saturday, hay fever, washing dishes at a restaurant by day, dragging Douglas by night, and listening to the Police and Marillion in my little green 2002. It was also about hanging out with my friends, and to be perfectly honest I often didn’t sleep as much as I should have. What did I know? Sleep deprivation and sleeping in were pretty common during the sweltering, humid summer months of my teenage years.

Sleep often suffers in the summertime. So before I depart I will leave you with some quick, easy tips to make your sleep easier, better, and more enjoyable during these hot summer months.

1. Keep your bedroom dark, quiet, and cool. Insulate your room and windows from noise and light to the extent that you can. It’s a tough time for many of us financially, but if you are unable to sleep because the room is hot, use your air conditioning; sleeping well is worth the money spent on utilities. If you can’t fix your hot, light, loud bedroom, try sleeping in the basement.

2. Strive to keep your sleep schedules regular. School’s out; loved ones are visiting; the neighborhood BBQ is in full swing; you’re off on a family vacation. There is always the temptation to party late, sleep in, and not set your alarm clock during the summer. Your body clock doesn’t care about any of that, however. A common cause of insomnia and daytime sleepiness is dysregulation of sleep schedules. Continue to awaken around the same time every morning (if you don’t have to awaken at any one specific time, you would do well to choose a preferred awakening time and stick with it), including on weekends and non-work days.

3. Mind your late-night alcohol. Alcohol has sedative effects for the first couple hours after you ingest it. However, after several hours it tends to be a sleep disrupter.

4. If you’re a night shift worker, get thick black curtains for your bedroom windows and wear dark sunglasses on your way home from work in the early morning. Remember: it’s light out early in the morning and late in the evening when it’s summertime, so your brain can be tricked into making you feel more awake and alert if there is bright light exposure around the time that you should be sleeping.

5. Avoid late-night exercise. The release of stimulatory hormones when you exercise hard can last for several hours, causing insomnia. I recommend that you stop heavy aerobic activity 2-3 hours prior to your projected bedtime.

6. Take care of yourself. Don’t sacrifice your health for all that summertime fun. Obviously, anything that causes physical discomfort can be a detriment to your sleep. Avoid sunburns and dehydration. Use nasal sprays or see your doctor for those seasonal allergies. Minimize hangovers. Don’t overextend yourself. And, as I will probably see firsthand this weekend, it’s best to remember you’re not in your 20’s when you’re, uh, no longer in your 20’s, just ’cause it’s summer.

Utilize these simple suggestions and chances are you likely you’ll be able to avoid a . . .

Where Children Sleep Around the World

May14

Today I am sharing a post I recently discovered through my dear friend Reta Wright, a reknowned “sleep coach.”

There is a book by photographer James Mollison called Where Children Sleep. This book contains photos of where children sleep around the world. Many countries are represented, from Africa to North America. As a disclaimer, I have not yet myself seen or read Mollison’s book (though I intend to), but Linen recently posted a blog on Demilked about it. To see some of Mollison’s photos, please click on this link to Linen’s posted entry:

http://www.demilked.com/where-children-sleep-james-mollison/

I find this work completely fascinating. The children depicted here all have stories, stories told on their faces and by their sleeping environments. The universality of sleep comes through in these photos: the basic need for a bed or at least a bed equivalent; a place of relative quiet and privacy; a personal space in which one’s personality and circumstances may be expressed. However, as you can see from the photos, that’s where the similarities end. The obvious contrasts between sleeping quarters from different corners of the world are equally engaging. My understanding is that Mollison was born in Kenya and raised in England; perhaps he may have had personal experiences to mirror such contrasts, at least to some degree.

One could come up with all sorts of political and social commentary by viewing these photographs, I suppose, but for me I am drawn in particular to the themes of the ubiquitous need for sleep and the necessity of getting sleep where and how you can, no matter who you are, where you are, or where you’re from. I encourage you to take a look.

Something to consider today. Cheers, everyone!

A St. Patrick’s Day Anecdote

Mar17

Long ago during my training years, a man in his early sixties—I’ll call him Karl—was admitted to our hospital service one day in mid-March. Karl had metastatic cancer, and he was dying. We on the in-service team liked him very much, remarking quietly to each other how it so often seemed to be the good ones that die early of such tragedies. Despite his terrible prognosis and physical discomfort he was pleasant–jovial, even–during morning rounds, putting everyone at ease with his polite disposition.

One day we walked into his hospital room, and he was having a tough morning, though not for physical reasons. He was really down, uncharacteristically so. We asked him what was troubling him. A little embarrassed at first, he shared that it was St. Patrick’s Day, and true to his Irish roots he normally celebrated that day with a glass (or two) of green beer. Doing so was a custom of his and his family’s for decades. He told us how unfortunate it was that he wouldn’t be able to celebrate this way this time ‘round.

Upon examining him and talking with him further, we took our leave and somberly continued morning rounds. Afterwards I stood at the nurses’ counter with my chief resident. I was post-call and yearning for sleep, so I wasn’t paying much attention to what he was doing; I was hanging around until his exit off the floor, which was tacit permission for me to go home and go to bed. He made a couple brief phone calls and wrote something in a patient chart. He slammed the chart shut, startling me, and grinning widely he proclaimed, “That oughta do it!” And he walked off, swinging his stethoscope in his hand as he disappeared down the hall.

I looked down: it was Karl’s chart. I couldn’t help it, of course. I opened it, flipped to the “orders” section, and read the following in my chief resident’s barely legible scribble:

“Administer 1 glass beer p.o. x 1. Apply green food color prior to ingestion.”

I smiled as I left the hospital that morning.

After awakening from my post-call nap I called the floor and spoke with Karl’s nurse. He had enjoyed his green ale. Several days later he went to hospice a happier man.

That was a couple decades ago. I hear that beer is still available in some hospitals. But I wonder how difficult it would be for a dying person to get it these days. The process of health care is so burdened now with endless complexities—regulations, statutes, administrations, commissions, regulations, third party payers, boards, committees, and did I mention regulations?—it seems hard to believe that underneath all of that still exists the original idea that I went into medicine for in the first place: to actually care for people, to make what is miserable less miserable, to heal, to help make life a little better, maybe lengthen it too. All this sounds so quaint and clichéic now, things one might say in a medical school interview. But isn’t it still true, what we’re all still supposed to be doing in health care? If so, does the administration of health care now really have to be such a struggle, such a fight all the damn time?

To some of those non-clinicians who have their hands in the business of health care, I would ask what they would do if charged directly with the task of making a person’s life better. What rules that they themselves created would they try to bend to grant a dying man a green beer? Or would they? A green beer would be difficult to pre-authorize.

As my life continues on, I am increasingly grateful for what I have, who I have it with, and what I am allowed to do every day for work. I think of Karl every St. Patrick’s Day. To my readers, if you choose to celebrate a little tonight, I’d appreciate your lifting one up to Karl and cheering the greatness of life. We’re lucky to have each day we have.

Happy St. Patrick’s Day, and Happy Selection Sunday! Lá Fhéile Pádraig Sona Daoibh!

How to Sleep Well After the Super Bowl

Feb3

Howdy y’all! I’m still licking my wounds following the Kansas Jayhawks’ tough loss in basketball yesterday. The only thing that makes me feel better about that is that no college team is infallible right now, including Michigan, who also lost yesterday. The increased parity of teams this year should make for a great NCAA tournament come March. I’ll probably have a sleep-deprived night or two during the Big Dance, and hopefully for good reasons!

Today America turns its attention once more to football and bids farewell to the 2012-2013 NFL season with the Super Bowl game between the San Francisco 49ers and the Baltimore Ravens. Now personally, me, my teams are, in order, the Seahawks, the Packers, and the Patriots, so with no horses in the race I’m not feeling particularly invested in today’s game (though I am curious to see if Beyoncé actually sings during the halftime show). I’m rooting for the Ravens because I respect Ray Lewis’ longevity (he’s an ancient 37 years of age, and he’s still kickin’ it all the way to the end), I love O.J. Brigance’s heartbreaking but inspiring story (he has Lou Gehrig’s Disease, he’s 43, and he still works, serving as the Ravens’ director of player development), and I’m not a big fan of that Kaepernick arm-kissing thing. I know a lot of people who are very emotionally invested, however, and particularly for them, as well as millions of other football fans ’round the country, there will be a high potential for subsequent problems sleeping, win or lose. So here are a few quick tips to prevent a sleepless night tonight.

1. Mind your timing. The game starts at 6:30 p.m. east, 3:30 p.m. west. Keep this in mind as you plan your bedtime routine tonight, because for most people life and work will go on tomorrow, Monday morning, as per usual.

2. “Come down” after the game. Whether your team wins or loses, the Super Bowl is exciting, and all of that adrenalin and dopamine has a stimulatory effect. I would suggest not jumping into bed right after the game, particularly after a night of partying and cheering on your team. Give yourself an hour or two to decompress from the game. Relax, read a bit, take a hot bath or shower. Shoving yourself into bed all hyped up will make it difficult to fall asleep quickly.

3. Time your caffeine use. Many people don’t realize that caffeine can last in your system for up to 8-12 hours after you drink it. Drinking that Red Bull may enhance the excitement at your Superbowl party, but I would suggest drinking it early on, particularly if you live on the east coast.

4. Time your alcohol use, and drink responsibly. Alcohol can have both excitatory (owing to emotional disinhibition) and sedative effects for the first 2-4 hours after it’s consumed, but after that it tends to be a sleep disruptor. I suggest taking it easy on the booze, man, it’s Sunday night. I’m not in my twenties anymore, however, so understand where my words are coming from, a place of age and hard-earned wisdom.

5. Eat early if you can. All those buffalo wings, all that pizza . . . you’re not gonna enjoy that bubbling up your esophagus tonight. Indigestion, heartburn, and reflux tend to happen more if you go to bed shortly after a big old spicy meal. Give all that pub grub some time to travel from your stomach and into your intestines. If you have to eat late, you may want to prop yourself up with a couple pillows before you go to sleep.

6. Try to awaken at the time you usually do on Monday morning. It may be a late night for you tonight, particularly if you live in Maryland and the Ravens win. However, if you sleep in Monday morning, it might be difficult to fall asleep at your desired time Monday night. We’re generally built to tolerate a night of sleep deprivation if necessary. That’s usually preferable to a protracted bout of insomnia.

Enjoy the game, all! Hoping for great things for the Seahawks in the 2013-2014 season. 12th Man!