Saturday, August 08, 2015
Medical apps and insomnia, sometimes just technically wrong
The Web MD and Home Remedies apps both have a variation on the same official formula when it comes to insomnia. WebMD says if you don't fall asleep by 20 minutes get up and perform a quiet task (??) and Home Remedies advises if you don't fall asleep within 30 minutes go in another room and start reading but keep the tv off (maybe the book Stephen King's Insomnia?) Traditionally and down through the ages we've always defined "falling asleep" as that sharp and definitive moment when the curtain magically drops and you lose consciousness and awareness. For practical purposes that definition is fine and works most of the time but many times it doesn't work that way. The best starting point for managing your insomnia is to simply lie in bed the whole night with your eyes closed. It's a scientific fact which the apps somehow neglect to mention that if you do this you will have brief periods of sleep which you're unaware of hence the feeling of being awake all night. You'll make it through the next day adequately as opposed to following their advice and getting up every 20 minutes performing quiet tasks and going in the next room and picking up a copy of William Manchester's The Arms of Krupp. It helps if you have or cultivate good dream recall because during such torturous nights you can often remember brief dreams you've had and you can use this as a kind of yardstick. The other thing which I've never understood is the official medical line mandating that everyone needs 8 HOURS OF SLEEP A NIGHT otherwise bad medical things are gonna happen like maybe five years from now they'll have to remove a couple of diabetic toes. At this point you're working on your sleep and doing the best you can and you don't need this added pressure. Chuck it and while we're on the subject I've been wondering what else the medical apps which are so popular these days are wrong about. TIPS - Next time you have trouble sleeping count all the names of the Republican presidential contenders over and over again in your head. Charlie Rose also works for me or maybe you can DVR a late Sunday afternoon golf game:)
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You cover a widespread problem . Sleep
ReplyDeleteis a natural human activity and probably came better back in the late Pleistocene:
battling a cavebear for a reindeer wears ya down. 99% of the time I fall right to sleep
after a few pages (this week, Steven Pinker's 'How The Mind Works' a brandy or two.
Heck, when I was a teen, I had a good night's sleep in a sleeping back on a granite
outcropping over a falls. Early to bed, early to rise is my circadian condition, but sometimes, I wake up in the middle of the night and have a lot of trouble getting back
to sleep. Which is why I sometimes get up and going around 3:30AM. They way worries keep people awake: their brain just can't go into standby. I didn't sleep the night before giving a presentation to 250 CIA personnel as a young Lt. But after the spooks left HQ, I slept the next night for 13 hours. It is true, people need different amounts of sleep. The Mrs. is fine with 4-5, we have a friend, a woman athlete, who
absolutely requires 10 hours every night. Even our small town has a clinic that specializes in sleep problems. Never been there.
Probably most people who can't sleep GET UP at some point. It's a thing and I used to do that as well but then I'd be a zombified piece of crap the next day. It's a lesser-of-two evils kind of deal but I'd rather stay in bed and get a poor quality sleep than no sleep at all.
DeleteI'm just surprised the medical websites counsel getting out of bed at some point thus setting off the panic mode. Serves absolutely no practical purpose imo and honestly folks only do it because a long night of awareness is so agonizingly boring.
DeleteIt is possible that insomnia, disregarding some physical problem, is an anxiety related condition related to fear of not enough sleep. 'too tiredaphobia' or something like that. The more the concern, the harder to get to sleep. Consider, you turn out the lights, lie down and try to force yourself to sleep, The harder you try, the more awake you become. Hence all the sleeping medicines. (I've heard that Nyquil will
ReplyDeleteknock one out pretty good until they become addicted). We wonder about those that sleep with pets...nothing like a Great Dane bouncing off the bed, or a kitten attacking
a human nose in the dark. Is that relaxing...or tiring?
I have to agree. Quite recently whenever I worried about insomnia I had insomnia that night. In fact anxiety about insomnia is its own subset within the topic of insomnia. It's called "insomnia phobia" and the whole thing feeds on itself. It's easy enough to counsel just don't worry about it, harder to practice it.
DeleteYears ago I tried OTC sleep aids like Unisom. At first they work then later on they don't. Dunno why but it seems most sleep/insomnia researchers have a bug up the bum about the spirits.
DeleteThe majority of my nights are still good although not as high as your 99%. I'm probably one of those few who decide to just lie there with eyes closed on those long sleepless nights. I'm pounding the point to death I know but the next day I'm adequately functional. The only sleep aid I'll use occasionally is melatonin. My advice: so maybe just that and lie there and count Republican presidential contenders.
ReplyDeleteRather than hard work and worry, sleep should be something to look forward to:
ReplyDeleterest & relaxation. LIke Army basic training: no exhausted kid soldier laid awake all night. We ponder the ability of the housecat to fall asleep anywhere, anytime.
Human sleep is truly a tough nut to crack, an enigma down through the ages. Then again cats don't get divorced, pay taxes, do shift work...
DeleteShift work: the enemy of sleep. Lot of rotating shift folks in my neighborhood. Zombies, mostly.
DeleteIf the brain is like a computer then depriving it of sensory input by lying down and closing your eyes should eventually shut the brain down so what's the problem?
ReplyDeleteHad a night a few months back I'd swear on my cat's grave I was awake most of the night. Had a long shift the next day and didn't really feel as tired as I thought I would. I'll let you hyperlink to this.
ReplyDeleteDr. Oz has recommended hypnotism for sleep disorders. Dr. Phil probably has a better idea. Me, I rather like 'white noise'. While on our long drive to Kansas, I slept
ReplyDeletenext to a running air conditioner. Worked for me__kept the Mrs. awake.
Michael Jackson and Heath Ledger both in effect killed themselves because they thought they couldn't sleep. Google paradoxical insomnia and it could explain alot of weird nights people have. It's said to be rare but I think it's underreported and mislabeled.
ReplyDeletePart of the key element of the definition of sleep is loss of consciousnesd and awareness and that's also the problem. I've often wondered why simple rest is not sufficient. The writer of that Time link makes it sound like you simply will yourself to sweetdreams.
ReplyDeleteThe reduction of consciousness relates to brainbiochemistry . Studies of electrical activity suggest the very
ReplyDeletecomplex human computer then goes about rearranging synapses and neurons,
erasing trivial and seldom used thoughts/concepts and strengthening the numerous
sub module arrays. So, many people are up to 30% more creative when they first
wake up. Like cancer, though, there is a lot of unknown factors and actions which
attract researchers. Its like finding out that A relates to w, k and m, they on other
factors, etc. It is certain that total lack of sleep results in death within 2-4 weeks,
which you seldom hear of...even in CIA dungeons. Probably best just to take the
process for granted; after all we've been doing it for the last few million years.
Kinda like the Cleanmaster app on my smartphone which gets rid of cache junk and residual junk files so the brain does the same thing at night. For most of my life I've averaged 6-8 hours of sleep per night. They say Maggie Thatcher only got four.
DeleteBottom line - I think we need to stop worrying, go to bed at night, just lie there and whatever happens happens. I am almost convinced that total insomnia is a myth or more accurately it's something we do to ourselves by getting up, going to the 'fridge and making a crisis out of it.
ReplyDeleteHave you thought of sleep banking ? Wells-Fargo could fix you up with an account.
ReplyDeleteDoesn't seem to work for me. For instance one night I slept extremely well, say 9 hours then the next night had insomnia and there was no positive holdover from the good night.
DeleteCuriously, sleep depravation has been found to involve a specific chemical, beta amyloid
ReplyDeletewhich ordinarily clears during normal sleep, but which studies have shown builds
in chronically sleep deprived lab animals and perhaps humans. Perhaps a cause of
Alzheimers. It may be that since the population requirement varies for sleep amount, that some folks brains are more efficient during sleep?
IMO sleep deprivation mainly occurs when you don't lie in bed as you should but when you have trouble sleeping you follow the advice of WebMD and Home Remedies and start performing quiet tasks and reading Robert Ludlum in the living room.
DeleteHaving had a fair amount of insomnia in my life I can offer up an informal study. I used to get up like everybody else and felt like crap the next day. Now I just brave it out and lie there and while seeming to stay awake most or all of the night most of the time I can recall short dreams and so feel not as horrible the next morning. Absolute insomnia is a myth.
ReplyDeleteTake Sominex tonight and sleep, deep and peaceful, sleep, sleep, sleep...
ReplyDeleteSomnapure an all natural sleep aid is the big one being touted on tv right now. Has the good stuff like valerian root but imo at only 3mg they're too bashful with the melatonin dose. It relaxes you but ya gotta have some spare melatonin on hand.
DeleteMy last major bout with sporadic insomnia was late last year going into the early part of this year (the winter time change didn't help). Sleep has greatly improved since then but I don't think we can banish insomnia once and for all. Trouble with doctors is they can't wait to get the prescription pad out whereas you just wanna know how the brain works. Having googled "sleep" extensively I think I know more about the subject than they do.
ReplyDeleteOne thing that seems non-controlled is the sleep type: non-REM vs REM, for example. The latter is prevalent in youngsters, and reduces as we age. Since my wife snores and has
ReplyDeleteapnea outbursts, I frequently get wakened anywhere between midnight at 4AM.
The best cure seems to be to trudge down to the basement bedroom and start
over. It seems that going back to sleep sometimes takes minutes (awakened from
non-REM,) or over an hour (awakened from REM). It would be simpler if the
neural networks and electrical/chemical cleansing would just be a waking subroutine during normal activity, rather than subjecting our noggins to an all night carwash.
At least we can either blame evolution or our intelligent designer.
Maybe Google can come up with something after they cure death.
DeleteDave brought up Sominex but to us drinkers some issues arise. Let's say you love your nightly goblet of brandy and 9 times out of 10 it knocks you out but on occasion it doesn't so you go to bed and got the dreaded sleeplessness but you also have some kind of sleep aid in your drawer. So unless you're a Marily Monroe type everyone knows you don't use sleeping pills with alcohol so now you're on the horns of a classic dilemma. You start doing rough calculations in your head like well the last sip of the spirits was 45 minutes ago, should be wearing off a little and the pills maybe take an hour to fully dissolve. Might be a slight overlap but I won't mention it to the doctor. It's a boggle.
ReplyDeleteThe data supports your hypothesis. Drug/alcohol death is an
Deleteepidemic
among the celebrity crowd
It's like at the end Michael Jackson was probably in such a state of mind that the powerful propofol was seen as a rational solution to insomnia. My doc says they use that for colonoscopies.
DeletePropofol has no antidote. "But it is a short-acting medication. If the blood pressure is too low, the anesthesiologist will give fluids and meds to support bp. If breathing slows or stops, we would ventilate by mask and/or insert a breathing tube to support breathing. As long as the problems are recognized promptly, they are easily managed by a trained professional." I was talking to a local periodontist who uses it. He said
Deletehe had to take considerable training. I've had it for a couple of colonoscopies and an endoscopy. Noticed that they had a nurse anesthetist each time. Women are more focused, ya know? Thing about propofol is that there is no after effect, you wake up with no hangover.
There's another one that Saty likes. Can't recall the name but she calls it the bomb.
DeleteEver have a dream you can't sleep?
ReplyDeleteMost of my dreams involve getting lost in either a large building or in some
Deletecanyonlands. Latest one, a kid from second grade told me where to find an
old lab coworker and he was lost too. Then an old college teacher came along and said we should fly his plane. Which we did, but when we were airborne, neither of us knew how to fly it. Dunno, they say dreams mean
something, but mine don't seem to.
One of my recurring dreams is I'm in a large unfamiliar building and I have to find a restroom and when I finally do it's poorly designed and lacks privacy. Downright Freudian, dunno.
DeletePossibley relates to real or imagined paruresis . Might
Deletecheck with John Tesh or Dr. Phil.
There's a kind of unwritten Men's Room law, if possible don't use the urinal right next to another man urinating but space one apart:)
DeleteThese are fastidious times. Back at the height of empire in Rome, we note, "In some ancient bathrooms there is space for one-hundred people at a time. The bathrooms are open to all genders and all ages, so imagine men, women, and children all standing or sitting, doing their business next to one another in an open space. People are discussing business or gossiping to one another while going to the bathroom. Since for most Romans privacy is a unheard of aspect of life, why would it be different in this situation? However, the public bathrooms are not only visited by the common citizen, the wealthy also frequent them. Every location in ancient Rome where large crowds gather is an opportunity for wealthy Romans to pander to their constituents. Most upper-class Romans were running for some sort of political office, so the public bathrooms were a great location for mingling with the Roman people. Therefore, if you wished to hear the local gossip, chat with a friend or stranger, or simply do your business, the public bathrooms are always a good choice. Roman bathroom habits were communal, lacking in privacy, and surprisingly efficient. Senator Craig would have been right at home.
DeleteFew nights back I had a weird night. The second half of the night I slept well but the first half of the night I really struggled. In fact my first dream that night I discovered new traffic cams in White Plains.
ReplyDeleteThe brain uses about 20% of our energy, more than the other organs. Much of that
ReplyDeleteis for firing and recharging neurons, some for brain cell repair. A considerable amount of sleeping energy involves cellular repair, not only in the brain, but in all
areas. It has been determined that the most lucid dreams are during REM sleep,
and some studies relate it to creativity (the parallel processors and linked sub routines sorting things out); which is why lack of sleep, particularly REM, leaves many folks feeling like zombies...going through the routine without much thought.
I was reading about visualization vs actual seeing: how we conjure up images as well as how those weird art things makes us see two things at once. The author
demonstrated perception with the old carpenter joke: Two builders are hammering away, and one notices that the other is throwing out half his nails. He asks why and
the other carpenter notes that half the time, the sharp end is pointed the wrong way.
The first carpenter is critical and offers that those with the sharp ending pointing the
wrong way are for the other side of the house. (two perceptions, both wrong). My
best dreams are when I come up with something clever, save the day and everyone
(including some good looking dames) gathers round to congratulate me. Probably like everything else, some Freudian potty training mishap.
I know it sounds conspiratorial but I can't help reaching the conclusion that the real reason the medical community keeps reminding us we NEED 8 hours of sleep/night has to do with Big Pharma.
ReplyDeleteRight on. I think the SOPs invented cholesterol too.
Delete