Monday 2 December 2019

Sleep Hygiene

I mentioned Matthew Walker's Why we Sleep in a Wexford Science Café report this March. It sounded like the kind of book I could read. Then a few weeks ago, one of my younger colleagues assaulted me with a wild-eyed rant about the book which he'd just finished. That was the end of winding down the day's work with a couple of tinnies at home before bed. If you don't get 8 hours of quality sleep each night, my friend asserted, you'll be dead before Christmas. He didn't specify which Christmas, but you get his drift.

To a hammer everything looks like a nail and. to a sleep researcher like Prof Walker, a lot of the ills of society and physiology can be laid at the door of insufficient shut-eye. I was delighted with the talking book A History of the World in 100 Objects I stole from my mother in September, even though I'd read it before. But listening to all 25 hours of it on my commute was like reading it all over again, with more attention. Accordingly I ordered Why we Sleep from the now-national library service as a set of 12 CDs and have been listening with my jaw pretty much permanently dropped.

It's interesting that the publishers haven't really taken advantage of the switch in medium from print to audio. It would have been so easy to add some sound-effects for brain-waves, but they failed to do so, but do insist on reading out all the footnotes which are mostly citations to the original scientific literature. In the introduction, Walker writes about how he'd be flattered if his readers fall asleep while reading his book - so much does he believe in the vital importance of slumber. The AC-tor (John Sackville) reads this out without in the least acknowledging the irony that many of the listeners will be driving a car at the time. Old joke: "When I die, I just want to fall asleep and not wake up, like my Uncle Jack; not screaming in terror like his passengers". Driving drowsy gets a whole chapter of research and analysis. Losing 2 hours of sleep will so impair your attention as to be the equivalent of driving legally drunk. Yet Road Safety Authorities persist in spending the bulk of their money combatting drink-driving leaving only 1% of the budget to schooling people about the dangers of sleep deficit. We don't get barracked to put seat-belts on anymore; I guess because that war is won - except apparently in Donegal, which persistently has the highest rate of road fatalities in the Republic.

I tell ya, the list of diseases and conditions which are directly and adversely affected by sleep deficit is surprisingly alphabetical: atherosclerosis, bipolar, blood-pressure, cancer, dementia, depression, diabetes . . . and oh oh obesity. Sleep is vital to cleaning things up and processing the accumulated crud-du-jour. Your immune system needs this reset and without enough sleep you are living in a permanent state of inflammation. Fire-fighting real and imagined ailments allows cancers to progress beyond the scope of the immune-system to cope.

It's all about the melatonin, folks, the stuff the jet-set take to shake off jet-lag. As a non-medicine, melatonin falls outside the remit of the FDA, so wildly optimistic, not to say mendacious, claims about the quantities in each pill will appear on the packaging. The effect it largely placebo anyway. So you'd be better off getting a Trusted Friend, preferably in a white coat, present you with a large red sugar-pill intoning "this will make you sleep zzzzz this will make you sleep ZZZZZZ".  Melatonin gets switched on as evening falls triggered both by a fall in ambient temperature and the fading of the light. Sunset is very low in blue light because that gets scattered in the atmosphere; and with the sun oblique the sky is thicker. Melatonin concentration is badly affected by even by small amounts of light, but energetic blue light is the real killer. This is the reason for putting away your (blue-rich) devices [and your children's!] a couple of hours before bedtime. Reading [a book!] is okay. Talking through your day with your pardner is probably better. So here's a non-exhaustive, hopefully tiring, list of aids to sleep Matthew Walker speaks.
  • No tea and coffee
    • Caffeine and theobromine are stimulants and diuretics; while there is some placebo effect from regularity in any habit that you associate with bedtime, tea & coffee in-and-of-themselves make you wired and wake you up in a while with a full bladder.
  • No booze!
    • Alcohol is a sedative and sedation is not the same as sleep, in particular alcohol assassinates REM (dreaming) sleep.
  • Actually unless you have a particularly young and elastic bladder, go easy on all fluids in the time before bed.
    • Maybe install a micro-light [not that microlight R, y'daft bugger; I mean a light with a 5W bulb] in the corridor between bed and potty, to stop a jolt of bright light annoying your melatonin
  • Go to bed at the same time every night, weekends included. Also wake up at the same time and not less than 8 hours later. You may need an alarm clock to help entrain yourself on the wake front.
    • No you cannot remediate your short sleep-poor week-nights by binge-sleeping through early mass on Sundays
  • Dim the lights a couple of hours earlier
  • Compact Fluorescent Lights CFLs and LED lights - the ones you can afford - are particularly rich in blue light. Edison's incandescent hot bulbs were much richer in the reds and oranges; but effectively unobtainable nowadays. Techie details in bloboprev
  • Switch off the laptop - you should be bloggin' in the morning anyway.
  • Cool your heels. You sleep better /only if you can lower your core body temperature a couple of degrees. 
    • Thermostat the bedroom down to 18°C. 
    • Shuck off some of the blankets
    • Choose a lower TOG duvet
    • Forget hot water bottles in the bed. You (well I) can still use them earlier in the evening to keep warm
    • Paradoxically warming the hands and feet before bed (or having a hot bath) can help shed core temperature by stimulating peripheral circulation. Hands and feet (and the head) are particularly vascularized and therefore capable of shedding excess heat.
    • No bed-socks or night-caps you 19thC people!
  • Control the tik-tiks, as my parents used to call the roiling, largely futile storm of anxious thoughts that prevent sleep falling or getting back to sleep. That's damned hard, of course, and therapy is damned expensive. Maybe chatting to your roomie before bed about the truly annoying fuckwit at work will offset the advent of a sleep-breaking cycle of murderous fantasies at 0300hrs.
Here's some exec summary advice from the BBC.

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