Sleep is on my mind, as usual, and this time it’s because I got bad news at the dentist.
I need a root canal due to this mysterious process called ‘resorption.’ Nobody knows precisely what causes it. Don’t you love it when you’re on the cutting edge of research? Two things that could have triggered it are grinding my teeth, and inflammation in general.
Both of these things are related to sleep. Bruxism is something I do at night, especially when I’m in pain or my stress level is high. Inflammation is reduced through sleep.
Note that there are no known medical connections between lack of sleep and root canals. This is just a possibility that, for my own purposes, I want to explore.
I’m short about 2-3 hours of sleep a day on average, and sometimes it’s 4-5. Sleeping more is going to benefit me no matter what else is going on. It’s free and it doesn’t have any side effects. It won’t negatively impact anyone else, not like my upstairs neighbor running a high-powered blender over my bed at 6:00 AM.
If I never need another root canal, and I never have resorption problems on another tooth for the rest of my life, I won’t be able to prove whether my behavior impacted that in some way. That’s because this is a complex issue, because I would be an anecdote, and because I don’t even know how to submit data in the world of dentistry.
Still, I add ‘root canals’ to the list of Reasons I Should Probably Sleep More.
File Under: SleepQuest
This approach is consistent with how I approach every problem, not just health issues but problems in general.
I refuse to live with a persistent problem. I won’t accept it. I’ll find a way to work around it somehow. I’ll research it. I’ll test it. I’ll experiment on it. I’ll reframe it. I’ll read up on it. I’ll measure it and document it on a spreadsheet. I’ll ask people from other disciplines what they would do differently.
My endodontist lectured me about not wearing my night guard. He showed me on the scan exactly how he could tell from looking at my teeth that I “clench and grind.” Then he told me that AT MY AGE I couldn’t afford to ignore this and that it would definitely start wearing away my teeth.
Mmm. Love it. I’ve finally reached the point when medical professionals start using the phrase “at your age.”
Night guard. The one in the brightly colored plastic case. In the drawer where I see it at least twice a day.
You can lie to yourself, but you can’t lie to your dentist. I had to admit that I was not, in fact, doing 100% of every possible thing to take care of my precious teeth.
I care about this significantly more now that I have a ballpark estimate of how much preserving a single tooth costs out of pocket. Without dental insurance, ugh. I wonder if this endodontist needs some back-office help?
As these thoughts swirl about my chronic sleep deprivation, my incipient cash deprivation, and my poor middle-aged teeth, I think about the concept of “trying everything.”
Everyone says this, all the time, about everything, but it’s a scam.
There is NO WAY that anyone has ever “tried everything” because not even an expert in a given field even KNOWS everything. There is nowhere that is capped on research, human knowledge, or potential technological development.
We also tend to have mental blinders about thinking that one single input is responsible for stuff. We think that making one change will fix a problem, and if it didn’t work, then the problem is unfixable.
There are so, so many problems with this approach!
One is that we may simply not have tried long enough.
Another is that we may not be doing the thing we’re trying in the right way.
Yet another is that the thing we’re doing may only work in certain situations, but not this one.
More likely, what we’re trying is just very far down the list of Things That Work. Most people will skip the first ten items on the list of Things That Work because we desperately want it not to be that. Please, not that one!
The way I look at it, there is a paradigm or a set of behaviors that goes with a certain issue. The group of people who have the issue tend to have a group of traits in common. Then the group of people who do not have that issue have an entirely different set of traits. There tends to be very little overlap.
For instance, my clients who hoard all tend to scatter coins, save expired food, stuff clutter into plastic bags, and have a plain rock somewhere in the home. Nobody else has rocks!
When I want the results of the “other” group, I observe them, ask them, research around what they’re doing, and then try it out. This is what I did when I started running, when I learned about minimalist travel, and when I finally decided to lose weight.
Obese Me had a lot of habits that Athletic Me finds comical, or sad, depending on the day. While I can sum up the habits of Athletic Me in a brief policy statement, it would take pages to try to describe just what the heck Obese Me was doing. Example: Getting a 64-ounce Pepsi with pumps of blackberry syrup. Please, for the love of your pancreas, do not try that at home.
While attempting to figure out what was different about athletic people, I spent a lot of time feeling frustrated and impatient. I’m working so hard, I thought. I did not think “I’ve tried everything” because I knew I spent most of my time lounging around reading and eating cereal.
I’m in a similar state right now with my sleep problems, which are dominating my attention. Certainly I’m as frustrated and impatient as I’ve ever been.
What I wonder is, when I look back on this period of time, what will stand out to me? What could I be doing differently that I already know about? Have I really tried everything?
Sleep is mysticism. It’s easy to believe that when you’re so tired that you start to think burrowing a trench in the sand would be a good way to get some rest. Any habit is a complex blend of many factors, not a single one of which will solve a persistent problem on its own. Quality sleep is so valuable that it’s worth focusing on marginal sleep gains.
The ‘aggregation of marginal gains’ is the term for the cumulative effect of small inputs.
Let’s take a pizza for example. I’m going to make you a pizza with a frozen crust, canned tomato paste, and a packet of herbs I got at the dollar store. My friend is going to make what he calls “bachelor pizza” with a slice of white bread, ketchup, and a slice of processed cheese. Hopefully he remembers to remove the wrapper.
Because you’re a smart person, you’re going to make an excuse to leave and get a pizza with a crust from scratch and fresh ingredients, baked in a proper pizza oven.
There is no single factor that differentiates these “pizzas” - they each combine features that make a whole. Even my friend’s bachelor pizza would be marginally improved by using pizza sauce instead of ketchup.
What does this have to do with sleep? A word of advice: don’t eat pizza late at night if you’re having sleep problems. Have it for lunch instead.
Where are the aggregate gains for sleep going to be found?
Some of this depends on the individual. Most of it, I suspect, is universal, and in a couple of decades we’ll have a better understanding deriving from tech, big data, and sleep research. The trouble is that we tend to associate sleep with one specific aspect, our ability to fall asleep in the first place.
As an example, I can think of three people off the top of my head who claim they are fine on no more than six hours of sleep. All fall asleep quickly (go figure) and all are great at their jobs. Unfortunately, all of them are also crabby, snarky individuals with short tempers. What they think of as their “personality” is what I’m like after a rough night. Because they share the common Puritan-work-ethic problem of scorning sleep, everyone will just think they’ve mellowed out during retirement rather than correcting a problem that was decades in the making.
When we’re looking for marginal sleep gains, we want to be clear about which areas are up for improvement. We also want to broaden our time scale, so that we’re talking about sleep by the week and month, not just individual nights.
For myself, I’m looking at sleep gains in:
Falling asleep more quickly
Sleeping through the night without waking
(Or at least waking fewer times)
(Or at least not lying awake for 90 minutes each time)
Sleeping eight or more hours per night
No night terrors
I’m also looking at “externalities” that not everyone would think are related to sleep.
Other people might be looking at:
No restless leg syndrome
No circles under the eyes
Or any other way that sleep loss lowers your quality of life.
What I’ve learned from years of quantifying my habits is that the approach that works for one thing may have nothing to do with something else. This is why tracking is so important. Marginal gains may take a month or a year to really notice.
For instance, when I finally quit my day job, I slept about 15 hours a day for three days, followed by 12 hours a day for a month. A few months later, I started taking melatonin supplements (careful here!) and hated them because I felt drowsy all day long. I told my husband I was going to quit, and he was shocked. He said I finally had color in my face again. I kept at it. By the end of the year, I had lost 15 pounds (from doing literally NOTHING but sleeping all day and mastering all the crops in FarmVille) and suddenly had the bright idea to take up running.
At the time, I found my constant sleep and lethargy to be embarrassing and unpleasant. That wasn’t the reason I quit my job! In retrospect, that year completely changed my life, helping to make me the athlete I am today.
For thyroid disease, I found my biggest change came from extremely strenuous activity. For migraine, it was keeping my body weight in a certain specific range. For night terrors, the secret was the timing of when I ate - nothing for three hours before I go to sleep. I suspect one of the major keys for sleep, at least in my case, is hydration - drinking enough water at the right time of day.
The secret for me was a change in attitude. I adopted the philosophy that I call Do the Obvious. I assume that there is no reason to deviate from mainstream health advice unless I have tested it on myself in multiple ways. As a scientist I fully commit to designing a proper experiment that can give quality results, and then I analyze my metrics like I really mean it. If I don’t like the answer, then I am choosing my own suffering.
The aggregation of marginal gains does not apply only to one area of life, such as sleep or headache management. It all combines into one big thing, which is your experience of daily life.
As a young, broke, exhausted person, I know I would have been deeply annoyed with the expectation that I make the kind of changes I made for the quality of life I have now. What, quit drinking soda? Go to bed earlier? Lose twenty pounds? Get out of here! Yet the fact is that that young version of me suffered from four-day migraines and often felt sad and hopeless. Today Me would never return to Young Me’s habits out of fear of Young Me’s cruddy life experience.
Today Me has great faith that Future Me will sleep on a peaceful peachy cloud of sweet dreams and aromatherapy. This is hard as Today Me has to listen to Today Upstairs Neighbor clomping up and down the stairs at 5:00 AM.
Here are some of the factors that have gone into the marginal sleep gains I have made so far:
An air filter/white noise generator (or you can try a phone app and/or a fan)
Cracking the window at night
A $25 pillow I discovered at a hotel
A $9 eye mask
Drinking all my water for the day before 8:00 PM
Not eating for at least three hours before sleepy time
Putting my phone in Do Not Disturb mode from 10 PM to 10 AM (and now that I think about it, I should change that to 8 PM)
My husband training our dog to quit whining at 5:30 AM
No naps after 3 PM under any circumstances
Wearing a sleep tracker at night (Fitbit Flex 2) and checking metrics daily
Worth noting: I never drink coffee or alcohol.
In the past week, I have:
Left my coat on a plane and had to run back for it twenty minutes later
Spilled half a bottle of water into my suitcase by carrying it upside down
Worn a one-inch hole in my reusable shopping bag because I didn’t notice I was dragging it
Left town and forgot to pack deodorant
Dropped my sleep tracker on the bedroom floor and convinced myself I somehow lost it in a public restroom, then found it the next day and forgot to charge it
Put an important appointment in my calendar an hour late
Dropped my sweater on the sidewalk and kept walking, causing a passing driver to honk at me
Forgotten to auto-schedule a day’s content on my blog
Forgotten to lock our dog in his crate, risking another barking-related citation
I also gained four pounds, which I believe consists almost entirely of cortisol and bitter unshed tears.
What’s my problem? One of three things:
The last time I was this tired, my upstairs neighbor was a crackhead who would smoke crack on the porch in the afternoon, play guitar above my bed in the early hours of the morning, and bust up furniture in the evening. My hair started to fall out in patches then, just as it’s doing now.
Nobody cares about one person who is tired. The reason I talk about this stuff is that a lot of people are voluntarily running around in a state similar to mine. It’s a lot like being drunk, or snoring. Drunk people don’t think they’re drunk, and people who snore refuse to believe that they snore, sometimes even if you play them a recording of their 70dB clamor.
If you’re chronically sleep-deprived, you’re screwing up. Somehow. You’re stumbling around and making preventable errors. If you’ve done it for a long enough time, you might even think it’s just part of your personality, like Bella from Twilight always talked about how clumsy she was.
(Why is that supposed to be an endearing quality in female characters? I sure don’t find it endearing in myself).
Making silly mistakes is fine. It’s not the end of the world if you have, like I have, pumped liquid soap onto your toothbrush, only put deodorant under one arm, or walked around with a pair of nylon underpants hanging out of your sweater through the pernicious powers of static cling. Stuff happens.
We just have to ask ourselves how often it happens when we’re well rested, rather than when we’re really tired.
Why am I so tired? Because my upstairs neighbors do a lot of loud stuff between 5 and 7 AM every day.
What are they doing? Some guesses:
Training a donkey to tap dance
Three-legged race promoting Dutch clogs
Why don’t I just go to bed earlier? I have, oh, I have. It’s annoying to have to shift your schedule by three hours to accommodate someone else, for one thing, but it’s also only somewhat possible. The same people who are up banging around at 5 AM are also up and around at 12:30 AM, not to mention our other neighbors and passersby on the sidewalk. The rest of the world isn’t all that interested in facilitating some cranky middle-aged woman’s need to go to sleep at 9 PM.
9:00 PM bedtime: the ultimate luxury!
It makes me crazy to think of other people indulging in sleep procrastination, choosing to stay up late when they don’t have to. Oh, you’re not using your nice quiet bed? Can I come over? You can stay up and binge-watch TV episodes that will still be there tomorrow, even though you have to get up and go to work. Meanwhile I will try to sleep enough that my eyelid will stop twitching.
Twenty years ago, I would stay up until 4 or 5 AM for the occasional party, just because that’s where the action was. I’ve never been a drinker. I just wanted to socialize and eat chips and hope something interesting would happen. It took years to realize that these are my same friends from daylight hours. They weren’t going to, say, transmogrify into a wolf or a bat or anything. Now the idea of being awake until 4 AM strikes fear into my heart.
Out of all the persistent problems in the world, a sleep issue is in the top ten. It’s not like a messy garage that you can cheerfully ignore for ten years. It’s not like having a pet that isn’t housebroken, where you might swear a lot and go through a gallon of carpet cleaner. It’s not even like debt, although debt and sleep loss do tend to go together. Being exhausted follows you all day, every day.
Yawning through movies. Blanking out on chunks of conversation. Leaving a trail of lost items behind you everywhere you go.
Generally not doing anything with full engagement.
Getting headaches, getting sick all the time.
Desire to kick in neighbor’s door and ask, “What are you even DOING???”
I was talking to a young friend who just got his dream job after eleven years of planning. I asked what he was going to do next, and he promptly shared his five- and ten-year goals. Later I thought about my own goals and realized that they now consist of: Sleep twelve hours every day for a week.
If you’re out there being all tired and clumsy and stuff, pause for a moment. Ask yourself whether you could possibly find a way to sleep more every day. If not, is there somewhere else you could go? If so, would you tell me where that is?
Diogenes used to walk around Ancient Greece with a lit lantern in the daytime. People would ask him, “Hey, Diogenes, what’s up with the lantern?” He’d say, “I’m looking for an honest man!” I dig this right now, except instead of an honest man I’m in search of a decent night’s sleep. This is SleepQuest 2019, one woman’s journey to stop being tired all the time.
The week of the New Year, I realized that my (current) sleep issues might have something to do with my ten-year dependency on melatonin. I quit taking it. That was a very hard week, but I did start sleeping better soon after. Three months in, I’m still not taking melatonin or any other sleep aid, and I’m finding that I can usually drop off to sleep in under twenty minutes.
IS THAT GREAT, OR WHAT?
I started wearing an older-model Fitbit at night as a sleep tracker. According to my metrics, I often fall asleep in 5-7 minutes. That honestly surprises me. It could be that I just quit shifting around in bed and lie still at that point. Maybe one day there will be a brain scanner that will give better data. Who knows?
I had been waking up in the middle of the night a lot, sometimes 3-4 times per night. I usually sleep through the night now.
These are the things that are going well. Unfortunately, I think one of the reasons I’m falling asleep more quickly and staying down through the night is that I am just so tired lately.
We have upstairs neighbors.
They are loud.
They keep late hours.
They also get up early.
First it’s the man getting ready for work. He has a HEAVY TREAD which is very noticeable above your head at 5:00 AM. Then, just as he’s leaving, his wife comes down. She stays at home. That’s why it’s such a mystery why she feels that she needs to do all her housework before 9:00 AM. She probably thinks that mopping at 7:00 is a quiet and respectful thing to do, not realizing that it sounds like squirrels are digging their way through our ceiling. Then there are the middle school daughter and the family dog, everyone waking up and tromping down the stairs in their own sweet time.
Essentially 90% of the noise in our apartment complex happens between 5:00 AM and 9:00 AM.
Another 5% is the period between 11:30 PM and 12:30 AM. Someone walks around and does things in the kitchen. I think it might be the kid.
Anyway, enough about that. The point is that I am preoccupied with the doings of these people because THEY KEEP WAKING ME UP and I don’t have a lot of options. They just aren’t quiet for an 8-hour stretch.
Whenever I confront a persistent problem, I go at it in multiple ways. The first is to strategize and try to reframe the problem. Next step is to ask for advice. After that I try to solve the problem with money.
First wave: Do we have recourse about the noise? We went to the property manager back when these neighbors were doing their laundry at 6:00 AM, and that got dealt with. We had a couple of challenges when they kept trying to push back to more like 7:30. The real issue is that the simple act of walking to the bathroom and taking a shower is louder in our apartment than it is in theirs. It’s not unreasonable for them to get ready in the morning. We could probably talk to a lawyer and get out of our lease early, but then we’d have to move. (Another way to reframe the problem).
Second wave: What are other people doing? Talk to the landlord, fix your nutrition, etc. I have the most screwed-up sleep of anyone I know, so for this topic I am reading up on sleep research.
Third wave: Solve the problem with money. Eye masks, a white noise generator, fan, air filter, ear plugs, new sheets, a new pillow, etc. In the past I’ve tried essential oils, lotions, teas, herbal supplements, meditation, progressive relaxation, yoga, hot baths, and basically everything else on the market. I’ve even tried prescription pharmaceuticals, which is replacing one problem for another.
At this point on the SleepQuest journey, I am ready to say that my main sleep problem is external. It’s disruptive noise.
That’s actually amazing. As an optimist, I have to remind myself that this is a good thing. As soon as I can move somewhere with our own roof, and no longer have heavy booted footsteps walking six feet over my head early each morning, I’ll have a chance of sleeping like a normal person.
Taking 90 minutes to fall asleep? Gone. Waking up with stomach cramps? Gone. Waking up 3-4 times a night? Gone. Restless leg? Gone.
On the other hand, since I started SleepQuest 2019 I have had a couple instances of night terrors. I’ve also had a couple of migraines. I’ve been down with a cold three times. While my sleep quality is nowhere near as bad as it was back in November and December, it’s certainly not as good as it could be.
Overall strategy is to put a small amount of focus in several things, rather than concentrate on only one thing. What I’ve found with complicated problems (like migraine, weight loss, and parasomnia) is that fixing one input is never enough. One percent improvement in ten things is ten percent improvement, right? I already know a bunch of things that work, so for the rest of the year I will methodically make sure that I am putting as much effort into those proven areas as I can. I’ll also continue to do more research.
What have I done that works?
Wear the eye mask
Find the right distance and noise setting for air filter and fan
Quit taking melatonin and suffer through a week of very poor sleep
Adjust my hydration and make sure I’m drinking my full quota before 8:00 PM
DO NOT EAT or drink any non-water fluids close to bedtime, preserving a three-hour gap between last food and sleep initiation
Try to go to bed earlier and wish neighbors would, too.
A friend of mine happened to mention that she was just diagnosed with fibromyalgia. This came as a huge surprise to me, because we talk for hours every week and she had never mentioned that she had been seeing all sorts of doctors. She always looks fresh and lovely. I had no idea.
I told her, “I was diagnosed when I was 23. We should talk.”
“Okay!” She seemed excited.
Then I gave it some thought. What would I tell her? She wasn’t doing any of the things that I was doing when I got sick.
I shared a bed with my first husband, a man who snored heinously all night long. (My symptoms dramatically decreased after our divorce). My friend is single.
I was obese. My friend is fit and works with a trainer.
I drank soda every day. My friend never does.
My diet was generally poor; I ate a lot of sugar and vending machine snacks, and I rarely ate vegetables. My friend eats clean.
My symptoms started after I took a bad fall. My friend’s symptoms seem to have popped up on their own.
I thought back to how cruddy I felt as a 23-year-old, and how much better I feel now. Twenty years have gone by and I feel like I’ve aged in reverse. I would be in so much pain sometimes that I’d need help sitting up in bed.
Now I train in martial arts, and we routinely do “sprawls” and “breakfalls” where we throw ourselves to the ground and pop back up over and over.
I remember the morning after I did a half-day counter-abduction workshop. I had been elbowed in the face a few times, among various other indignities. I was bashed and bruised on every limb. I used to feel that way all the time, for no reason, with no bruises to show for it.
That’s how I knew I would know what to say to help my friend. I understood how she felt. I could listen empathetically. I could give her advice on how to talk to her doctors without them treating her like a malingering mental case.
I’ve talked to other friends and acquaintances who have been diagnosed with fibromyalgia. It usually doesn’t go well. They will still say “You don’t know what it’s like” even though I demonstrably do! Like I would lie about having experienced chronic pain. Why? What would possibly be the motive of pretending you were ill and in pain?
[Getting away with things? Social loafing? Thinking that other people find it more interesting than any other topic of conversation? *shrug*]
The sad truth is that saying, “I used to feel the same way you do, and you don’t have to be in pain like that forever,” can come across as cruel. Why, I’m not sure. I only know it does.
My friend and I sat down to dinner. We talked about a bunch of other things. Then I brought the topic back to her. As a modest person, she found this uncomfortable. I told her I was worried for her and I wanted to help if I could.
I shared my experience from the mid-nineties, when a doctor told me that fibromyalgia was considered a “wastebasket diagnosis” and a psychosomatic illness. They only started to take it seriously when a medication was developed that could treat it, because hey, Big Pharma.
I shared all the factors I thought contributed to my illness, that did not affect my friend. That seemed to help her feel a bit better about her situation, that at least she didn’t have a thyroid nodule, that she didn’t have thirty-five pounds to lose. That she had health insurance!
I explained that having one frustrating diagnosis did not preclude having one or more other things going on as well. For instance, it was entirely possible to have fibromyalgia AND a food sensitivity AND a thyroid issue. It might be worth getting checked out for those. I have a friend who is allergic to onions and garlic, and another who is allergic to yeast and corn. Both of those conditions led to years of confusion, testing, and misdiagnosis, because there are a lot of symptoms that can indicate literally dozens of possible problems.
I talked her through how I tracked various metrics. This is because it can help to reveal patterns, and also because showing a doctor your metrics will grab their attention in a way that nothing else will. It says, “I believe in the scientific method” and it says “I want to get better” and it says “I will work hard to do anything that you prescribe.”
It also tends to solve problems when doctors won’t or can’t.
The last time I talked to a doctor about fibromyalgia, she said, “Well, you must have been misdiagnosed, because people with fibromyalgia don’t get better.” She tried to prescribe me anti-anxiety medicine. I suppose that’s because feelings of strength and fortitude from overcoming adversity somehow qualify as anxiety?
Whatever doctors are telling you, they aren’t talking to people/patients like me. If they’re talking to us, then they aren’t listening. I would think the obvious response to meeting a former fibromyalgia patient who does adventure races and martial arts, who has run a marathon, who goes on backpacking expeditions, I would think the response would be, “Hmm. Interesting.” Study me, I’m game!
There’s money in prescribing drugs to people. There isn’t really any money in “patients” who don’t take prescription medication and basically never need to visit a doctor. Just saying.
I told my friend that what she was experiencing is as bad as it gets, at least with this illness. She describes a feeling of broken glass under her skin. Nod, nod. It’s bad, but you’ve already lived through the worst. It’s not a wasting illness. It’s not like tuberculosis or MS or cerebral palsy. It sucks, sure! But it won’t put you on an oxygen tank and you won’t wind up in a coma.
Most importantly, I talked to her about the importance of high-quality sleep in becoming pain-free and eventually recovering. I shared all the things I do to set up my bedroom and sent her links to my preferred eye mask and white noise generator. At this point, I probably know more about sleep than her doctors do, since doctors aren’t really allowed to sleep. Whatever else happens, at least there’s one cost-free thing she can try to do that has zero side effects.
(Never mind that it’s the hardest one!)
What I gave my friend was information that has worked for me over the last twenty years. More than that, though, I gave her caring, understanding, and the knowledge that she can always come and complain to me. I share her sense of unfairness at the way illness can strike for no reason. I share her frustration with busy, condescending doctors who have no real answers. I share her desire to live a full life without the distraction of chronic pain. I can give her compassion. More than that, I hope I can give her a sense that it gets better.
It happened again. For the second time in three months, I had a night terror episode. I thought I had this thing beat - it had only happened once in the last few years. Now that I’m wearing a sleep tracker to bed, I have more information, and some validation about what happens during night terrors.
Other than this particular night, I’ve had night terrors twice in the last few years. Once was at the end of a two-week experiment I was doing, to “give myself jet lag” in advance of a trip to Europe. The other was after a women’s counter-abduction workshop. These make sense to me for different reasons.
The jet lag experiment involved trying to shift my schedule by half an hour every night, so that I was closer to the schedule I’d be living during two weeks in Europe. It totally worked! It worked except for the last night, when I ran around trying to close down the house and put off eating dinner too long. I’d been messing with my sleep schedule for weeks, then I ate a full meal and tried to go to bed ninety minutes later.
Result: Woke up standing in my bathroom, shaking and crying. Decided to end jet lag experiment a day early.
The problem with the counter-abduction workshop was probably threefold. One, PTSD, enough said there. Two, I was bruised up and very stiff and sore. Three, I had a huge meal after the workshop. My working hypothesis is that blood sugar is key to night terrors, and I definitely threw it off that weekend. The night terror episode happened the second night after the workshop, so it’s somewhat surprising that it was delayed a day.
When it happened the other night, I felt really stupid, because it clicked into place what I had done.
I drank an 8-ounce glass of juice right before bed.
I fell asleep and woke up standing in my living room, heart racing. “A spider” had been “crawling on my husband.” I looked at the clock on the microwave and felt very annoyed that I’d only been asleep for about 35 minutes. Then I went back to bed.
[I’m not really all that bothered by spiders during the day. They’re purely an issue of my sleeping brain, probably a limbic system thing].
BOOM, it happened again. “The same spider” was “crawling on the wall” on my side of the bed. I looked at the clock on my phone. Are you kidding me??? Thirty-five minutes!
Usually night terrors seem to happen within the first 90 minutes of the sleep cycle. It was a little weird for my personal experience to have them that soon after I drifted off to sleep. I blame the juice, though.
The reason I was drinking juice right before bed is that I was recovering from a stomach bug, and the juice has probiotics. I hadn’t quite hit my hydration goal for the day and it seemed like a good idea.
I got sick at the tail end of a week and a half of intensive event planning, a week in which I got very little sleep. Stress was high and I ate dinner after 9 PM a few nights.
What seems to be going on is a combination of stress level and blood sugar. I’ve had sleep issues since I was seven, and there may be some kind of genetic propensity toward this condition. I’ve been managing ever since I made the connection between blood sugar and sleep, and started timing my meals.
My main goal is to stop eating three hours before I go to sleep. I am not always able to avoid this, and eating closer to bedtime does not automatically trigger night terrors. The rare occasions that I’ve had them, though, are connected to eating or drinking something closer to the time I fall asleep.
I first became aware of this connection after going on a very strict three-month calorie restriction diet. My “reward” for making my weight goal was to eat a chocolate truffle. I saved it for after dinner, and I savored it. Then I had night terrors for the first time in months. I immediately blamed the candy, because chocolate had been on my list of possible triggers for some time. Then I thought a bit more and put some ideas together.
I had been tracking my metrics for years, looking for an answer. I kept a detailed food log, which is how I found out that paprika triggers sleep disturbances for me. I logged all my exercise. I kept a spreadsheet with all my sleep disturbances, including whether I screamed, jumped out of bed, crawled on the floor, opened doors, and/or ran through the house sound asleep in the dark.
The connection: When I went on my strict diet, I quit eating my late-night snack. I had been in the habit of eating something before bed, usually either a large bowl of cereal or a can of peaches. Whatever I had, it was always sweet and in the range of 500 calories.
A friend who works with dementia patients confirmed that many of them experience night terrors, and that it’s widely recognized as a blood sugar issue. I wish I’d known that sooner, although I probably wouldn’t have made the connection to my own eating habits.
I don’t think it has as much to do with *what* I eat as with *when* I eat. I eat candy and desserts, and they only seem to cause night terror episodes if I eat that stuff after dinner, not in the afternoon. Same with paprika: I can eat it, just not late in the evening.
Obviously people who do not have problems with night terrors (aka pavor nocturnus) can eat whatever they want. There are likely to be a lot of different triggers for night terrors besides blood sugar or meal timing. Maybe various medications, trauma, dementia, or other health conditions are factors. For me, meal timing has made a proven difference.
I just need to put a sticker on my juice bottle reminding me of that.
I did something scary in the week before New Year’s. I had just bought a new bottle of 10mg melatonin tablets, it was sitting on the table next to my hotel bed, I was about to take one... and I didn’t.
It’s hard to express the dread I felt.
If you’ve ever gone through an extended period of sleeplessness, you know what I mean. Tiredness takes over your life. Sleep is the only thing you can think about. You feel like your bones are grinding together and there’s sand under your eyelids.
Add to that the impending threat of having your one lifeline taken away. Your security blanket. Your safety option.
Cue existential yawp.
Why would I voluntarily do something to myself that scared me that much?
One, I had been feeling for the past couple of months that melatonin wasn’t doing the job for me. My sleep was wrecked and it seemed to be getting worse. I was desperate and ready to “try anything.”
Two, I have a policy of experimentation around mysterious health issues and persistent problems in general. I believe that persistent problems are complex, with multiple variables, and that fixing any one thing is never enough. That’s why people always say they’ve “tried everything” - they’ve done a lot, but they haven’t necessarily done it in the right combination or for a long enough time period.
Three, I happened to stumble across a news article just as I was about to reach for my bottle. It was “What Happens If You Take Too Much Melatonin.”
I am a big believer in kismet and serendipity. Coincidences, if nothing else, are a reliable signal that the always-on [right brain] is noticing connections and finding relevance in information that the [left brain] does not. (I know there isn’t really such a thing as a “right brain” and a “left brain,” but I still find the concept useful until we come up with better terminology or a more accurate framework).
The smart version of myself would not have been scrolling through a news aggregator while lying in bed. It’s not a good way to fight insomnia. HOWEVER! Timing is everything. I read the article, rather than bookmarking it in my Sleep Project folder. It was enough to get my attention.
Ah, heck, what’s one more sleepless night?
I had been having an on again, off again problem with stomach cramps waking me up in the middle of the night. I had been feeling wired at bedtime. I had been waking up four or five times a night, often lying awake for 90 minutes straight. I was exhausted all day and not getting any relief. This had been going on for the last several months. I’d been blaming it on the off-brand 10mg melatonin tablets I’d been taking.
(If you’ve taken melatonin for any length of time, you’ve probably noticed that there seems to be a big difference in quality between brands, or between the liquid versus tablet form).
Then I read this fortuitously timed article. It claimed that symptoms of excess melatonin include: hyperactivity, gastrointestinal issues, abdominal cramps, anxiety, irritability, and excessive sleepiness.
The article also mentioned that melatonin can interact with contraceptives, along with several other categories of prescription drugs that I don’t take.
I couldn’t rule it out. Excess melatonin was entirely consistent with the issues I’d been having. Maybe that wasn’t it, but I’d be a fool not to test this as an input.
Let me state for the record that this was THE VERY LAST POSSIBLE THING I would ever want to try.
This is a testing moment. It’s a crucible. Confronted with hard science and peer-reviewed research that contradicts our fundamental ideas about our physical health, it is human nature to reject the evidence and cling tighter to identity.
An example would be someone with a food intolerance to yeast, corn, garlic, or fructans who, due to lack of clinical lab testing, believes that the real issue is a sensitivity to gluten. This person might get sick from eating something that contained, say, vinegar or GF soy sauce. Instead of questioning whether the correct, accurate food sensitivities have been identified, this person will believe that someone lied and tainted their meal with gluten.
Another example is a migraineur who will explain, in painstaking detail, why caffeine can’t possibly play a role in their particular migraine problem.
Okay, if you say so!
(Says me, a person who was so fed up with four-day migraines that she emptied her cup and became receptive to uncomfortable ideas).
I’m teasing myself right now, because I spent nearly a decade relying on a supplement that probably became a major contributor to the very problem I was trying to eliminate.
What happened when I quit taking melatonin?
Well, that night I did finally manage to fall asleep. I had been struggling to sleep five hours a night. I slept about the same amount that I had been getting over the past few months. I did not have stomach cramps. I also didn’t wake up and lie awake for an hour or more in the middle of the night.
That meant I couldn’t rule out the melatonin as a contributor to my recently worsened sleep quality.
It was a rough week. My husband and I were on vacation, and I’d dearly looked forward to sleeping twelve hours a night. He did. I lay next to him for hours each night/morning, listening to him snooze peacefully, and feeling pathologically jealous. He was sleeping my sleep!
After a week without the 10mg melatonin, or any at all, I started sleeping better.
I ordered an older-model Fitbit to use as a sleep tracker. It showed up a little after that rough withdrawal/adjustment week.
Guess what? Suddenly I was sleeping nearly eight hours a night!
According to the tracker, it took me nine or ten minutes to fall asleep every night. I lost an average of seventeen minutes a night to restlessness.
I wish I’d had the foresight to know I would want a sleep tracker before I quit taking melatonin. This would have been an ideal opportunity to record some better metrics. I’m not a laboratory, though, and it wouldn’t be worth it to me to try to recreate my situation. I don’t think I could, really, because eight years is a long time to commit to messing around with your sleep.
As the month has gone on, I’ve felt subjectively like I’m sleeping more deeply and that I’m falling asleep more quickly. I also have a mystical connection with the sleep tracker, that after I buckle it on and start the app, it is hypnotically helping me fall asleep.
In the month before I finally quit melatonin, I had my first pavor nocturnus episode in four years. “Lobster-sized scorpions” were “crawling across my bed” and suddenly I found myself crouched on my living room floor, shaking and wondering why my husband was shouting my name. I woke up fully, promptly burst into tears, and started swearing because “it’s the night terrors again!”
Also in that month, I had a severe headache, the type that always used to indicate a shift into migraine.
I was willing to take what felt like drastic action because my daily life was starting to become intolerable. As much as I did not want to spend my nice vacation sleeplessly, it was happening anyway. I felt like I had nothing to lose.
Having gone through the process, a lot of things suddenly make sense. The pharmacy changed my pill prescription. I take my pill at bedtime, usually in the same swallow that I would take my nightly melatonin. It never occurred to me that taking two separate synthetic hormones at the same time might cause an interaction. (I don’t have any direct evidence that it did, but it’s a testable hypothesis that is worthy of further research). Anyone with any type of hormonal or endocrine issue might consider whether that is interacting with their sleep issues, migraines, appetite, thyroid function, weight gain or weight loss, skin condition, or maybe even hair loss. (I lost a patch of hair off my head again this year, which hadn’t happened to me since 2007).
Sleep is an area deserving of more respect and medical research. In many ways it’s a final frontier for medicine, because doctors and nurses have to go through such an heroic ordeal of chronic sleep deprivation as part of their training. Trial by fire. Just like nutrition, they’ll only respect sleep as something “real” when they’re encouraged to by their school curriculum. They’ll only respect sleep when they’re allowed to get some for themselves!
For the rest of us, nothing is stopping us from tracking our own metrics and testing our own ideas about sleep, activity, food intake, or anything else where we wish we felt better.
Two weeks into the New Year, and how is it going? Personally, I think all of January should be dedicated to hanging around the house, catching up on sleep and maybe reading a few articles about your resolution for the year. In my life, the first couple of weeks of the New Year always seem to include a bunch of dramatic change, and this year has been no exception.
We came home from our New Year’s in Las Vegas, carrying a stack of index cards with our carefully wrought Resolutions and plans for the year.
Then I got sick (AGAINNNNN) and lost seven pounds in a week. The hard way. On the other hand, that sure was a quick way to deal with the excess I accumulated over vacation and the holidays...
Despite this pretty annoying setback, having plans has helped both of us stick to our vision. We remind ourselves that we have a 52-week year every year, and that even a rough month is only 12% of the allotted time.
While it doesn’t show up in our Resolutions, we have some tentative ideas for camping, travel, and bicycle outings. We decided that given my hubby’s travel schedule for work, we need a new strategy if we’re going to be able to plan trips together.
How is 2019 going so far?
My personal Resolution is to submit a book proposal this year. I bought a course, downloaded some software, and started going through my notes for the book. It turns out I have 183 pages JUST SITTING THERE. This is starting to sound much more straightforward than I had thought. (Famous last words). I’m framing it as a “book report for school” that has to be done before the end of the academic year.
My career Resolution is to finish the work for my Distinguished Toastmaster. So far this year, I have won two Best Table Topics ribbons and one for Best Speaker, and I’ve completed another speech toward my ACG. I also won an award for Area Director Excellence and they made me a special custom travel mug. We also got a new member in the club I’m coaching. Considering that we’re only two weeks into the year, this is bananas! I may be able to pull this off after all.
My physical Resolution is to work on hip openers. I can honestly say that I have made zero effort toward this.
My home Resolution was to set up an outdoor writing area. My hubby ordered me a folding screen, and the weather was nice enough the first week back that I was actually able to sit out on the porch and work! It was magnificent, and then the rains came. But the screen definitely does the job and my bird loves it.
Our couples Resolution was to start doing meal prep. This is going better than expected. Marry an engineer and show him an Instant Pot and your troubles are over. Our freezer is already fully loaded with soups and stews, a nice activity when it’s rainy and cold, and we’re both remembering how much we love our home cooking. Definitely a keeper. (The resolution, and also him of course)
My Stop Goal is to stop being sick and tired. Really not making much progress here yet, at least on the illness front. If I could just go a month without coming down with something, that would be great.
My lifestyle upgrade was to get a new desktop computer. I should have done this last year but I always procrastinate on spending on myself. I went out and got it, despite my eyelid twitching, and was stunned to find out that it cost only half what I had thought it would. Well in that case!
My Do the Obvious is to schedule time blocks. This is indeed working, as I’ve been steadily chipping away at a backlog of random dumb tasks. It actually looks like I may get through everything by spring.
I’m tracking metrics, and I added a few more to see what would happen. The first thing was that I got really embarrassed about tracking how many news articles I read every day, and that’s dropped to about half. We ordered a handheld body fat measuring device, which has been motivational for my husband and a wakeup call for me, since I am nowhere near the range I was in during marathon training. I also got an older-model Fitbit to track my sleep.
My Quest is a sleep project I’m going to call SleepQuest 2019. This is going better than expected already. I quit taking melatonin after 8 years *gasp* with very surprising results. It seems that I’m getting close to managing 8 hours of sleep a night!
My Wish is to be signed by a literary agent. I keep reminding myself of this as I work on my book proposal.
That’s it for me so far. I didn’t have a great start to the New Year, in one way, but in another I did. That’s because I laid the foundation by doing so much planning throughout December. It’s also because I keep myself accountable by reading my goals over and over, and publishing my progress (or lack thereof).
There are still fifty weeks left of 2019. How are we going to use them?
The thing about goals is that they’re usually much too modest and too ordinary to generate much passion in the goal-setter. For the purposes of this discussion, that would be you. Maybe you’ve been getting stuck on the same goals for so many years because they bore you. Maybe it’s because you secretly resent being held to humdrum societal expectations. Maybe you don’t like the way magazines always use the imperative command: LOSE WEIGHT while trying this brownie recipe! GET ORGANIZED while buying a few sacks full of these objects in our advertisements! I’m tired of it, too. That’s why I’m so proud to share that there are sneaky and cost-free ways to beat the system. Here are some cheats for common goals.
Goal: DRINK MORE WATER. I struggled with this for almost twenty years. It was closely linked to my cola addiction. Advertisers will try to sell you all sorts of special bottles and jugs and jars and hydration systems and custom artisanal additives. What’s the cheat?
Cheat: STRENUOUS EXERCISE. If you haven’t been working out, and you start, one of the first things you’ll notice is that your thirst begins to take over your life, and for once Idris Elba isn’t involved. In marathon training, I found that I could drink 80 fluid ounces on one training run. In martial arts classes, I can empty a 20-oz bottle in two gulps. The concern shifts from “I should probably get around to this one day” to “maybe I shouldn’t shove people away from the drinking fountain?”
Goal: GET ORGANIZED. This is my wheelhouse, because I work with chronically disorganized people, and I know from experience that it can take three months just to have one square foot of space consistently clear. Our culture makes time scarce and material objects plentiful. As of the mid-twentieth century, it’s possible to live in clutter and disorganization the likes of which humanity has never known. What’s the cheat?
Cheat: DOWNSIZE YOUR LIVING SPACE. My husband and I rented a typical suburban house when we first got married. Three bedrooms, two bathrooms, a two-car garage, living room, family room, laundry room, dining room, and the biggest kitchen I’d ever had. We now live in a 612-square-foot studio apartment. Our dining table is stored flat under our bed. Getting an offer for the Epic Dream Job meant we had just eleven days to downsize all our stuff and relocate to a new city. The differential between a higher income on one hand, and lower rent plus no vehicle expenses on the other hand, means we could handily replace every object we downsized with plenty to spare. This is somewhat of a simplified version of a ten-year process, but this style of downsizing is not rare or radical by any means.
Goal: TOO BUSY AND TOO TIRED. Does this apply to everyone, or what? Being too tired to think straight is probably the biggest killer of goals and resolutions aside from the humble donut. This situation should not be tolerated. Even if you never make another goal or have any other aspirations in your life, finding a way to regain your energy level and get some peace of mind should matter to you. It’s the best reason to do anything. But how is it possible to get everything done without cutting back on sleep? What’s the cheat?
Cheat: GET RID OF YOUR CAR. Believe it or not, getting rid of our car two years ago was one of the most surprising and most effective ways to introduce leisure into our schedule. It takes longer to get places, and this has led to three things. One, we make fewer trips because it’s a bigger deal, so we consolidate or delegate errands. Two, we each have a BMW (Bike Metro Walk) which automatically adds more exercise, more time to listen to podcasts and audio books, and more time to sit and chill. On the bus (or rideshare, occasionally) you can text your friends, play games, read a novel, watch a TV episode, browse recipes, stare out the window, or set an alert and just nap out. Driving means that every minute, you’re either battling traffic, looking for parking, or wondering how you’ll ever find time to clean out your car. Wouldn’t you rather have that time for aimless entertainment instead? Oh, and the third thing is that because we moved and got rid of our car, we are now able to save 40% of our income, which has solved not just our leisure constraints but our financial issues as well!
What we’re talking about is how radical change can quickly and easily resolve challenges when making tiny tweaks to the standard-issue lifestyle cannot. Standard behavior includes standard problems. In our culture, those are stress, chronic sleep deprivation, clutter, money worries, sedentary behavior, and excess adipose tissue, commonly referred to as body fat.
Radical change does not have to be shocking or difficult. For instance, going to bed an hour earlier might be revolutionary for a lot of people, and it costs nothing and requires no extra equipment. All it takes is a willingness to say, I am tired of annoying myself, I am tired of facing the same issues year after year, and now I’m making the executive decision to put a stop to it. Being tired all the time is boring. Being broke all the time is boring. I don’t want the quest to remind myself to “drink more water” be my main purpose besides commuting and working at my job.
The real cheat for common goals is to wipe them off the board. Substitute some uncommon goals and see what happens.
Tiredness is one of the top reasons people give for not exercising. This is sad, because paradoxically, exercising is one of the four ways to quit being tired.* When lack of physical energy is the problem, lack of movement only contributes to it. What I’m learning in Krav Maga is that being tired is an explicit training goal. Train to be tired because fighting will make you tired. Tired is a training goal because you need to be able to focus and keep going in that state. It’s how you find the strength to do what you need to do, at the moment it really matters.
Modern life is exhausting. Our culture valorizes busy-ness and lack of sleep. Our automatic response when someone asks, “How are you?” is “Busy!” As though being busy is the only way to be relevant. It’s quite common for us to start the day with caffeine, eat lunch over our desks and dinner in our cars, and stay up an hour or two later than we’d planned due to social media and Netflix. With all that going on, who has time for sleep, much less exercise and healthy meals?
I can speak to this, because I have a parasomnia disorder (actually several) and I’ve struggled with sleep all my life. I started having insomnia problems at age seven. Being tired is miserable. In our culture, it also doesn’t get much sympathy. Oh, you’re tired? You and everyone else! Sure, but being able to sleep when you’re tired is a feature of an ordinary person. Not being able to sleep no matter how tired you are, that’s like finding out the brakes in your car have failed. It’s a problem.
As a chronic insomniac, you have to figure out how to go to work and earn a living, even if you’ve been awake for 27 hours. You have to figure out how to keep going, even though you get sick more often. You have to figure out how to concentrate even when your vision is blurring. You have to figure out how to care for children early in the morning, even when you’re so exhausted you’re literally stumbling and walking into walls. The worst part is that you have to figure out how to drive in traffic, even if your chin suddenly hits your chest.
There have been days when a high-functioning alcoholic probably functioned better than I did at work.
It takes grit. Being an adult in this world takes grim determination, focus, and perseverance. All of these qualities are very useful in physical culture. If you can get through a rough work week on little sleep or fighting a headache, if you can get through a week when your tiny kids are sick and keeping you up at night, if you can handle the stress of long hours and money problems, then you have everything you need to be a serious athlete. Everything but the block in your schedule.
Everything changed for me when I started learning how to be fit. The first thing I noticed was that I slept more. I could fall asleep much faster and sleep longer. If better sleep was the only thing I got from working out, that would absolutely be enough to keep me going!
The second thing I noticed was that I quit getting migraines. Instead of three or four days a week lost to blinding migraines, now I get... none. I haven’t had a migraine in about four years.
Then I realized I had quit getting night terrors.
I always felt like I was too tired to exercise. Most people would probably accept that as a reasonable reaction to having a sleep disorder. Instead, exercising helped fix the exact same physical problems that made me so tired. What I thought was impossible was the one thing with the power to solve my worst problems. I ruled out what I needed the most.
Strenuous exercise is not the same as walking more, or going to yoga a couple times a month. I never knew anyone who worked out at that level until I started running, going to various gyms, and meeting athletic people. Examples: training so hard you can’t tie your shoes afterward. Training so hard your fork is trembling in your hand when you eat dinner that night. Training so hard you can’t get your foot over the two-inch lip of the shower stall and you have to grab your thigh and haul your leg up. I don’t often push myself that hard, to muscle failure, but I do it often enough now that I have a really good sense of my true physical limits. The next obvious goal is to push those limits farther out.
Tired is a training goal because working until you’re tired is the only way to increase your physical strength and power. The more you work until you’re tired, the less tired you will be. You quickly reach a point where the demands of daily modern life don’t feel like a big deal. When you’ve lifted your end of a 200-pound heavy bag over your head in class, carrying groceries and laundry baskets stops feeling like work. When you’ve done enough burpees and tuck jumps, climbing a few flights of stairs barely slows you down. When you’ve done two hundred pushups and a hundred squats, and that’s just the first 15 minutes, getting through the workday feels like a rest day. Suddenly you realize that all those times you were pushing until your arms shook, your whole body was busy transforming. Who is this muscular person with great posture staring at me out of the mirror?
We never know the shocks and surprises of accident and fate until they happen. We never know when we might be called upon to drag someone out of a crushed automobile or help up an aging relative who has fallen. We never know whether we’ll find ourselves in situations when our personal strength and stamina could make a literal life-or-death difference to another person. A spouse, a child, a parent? At some point, it isn’t wrong to ask ourselves, Where do I quit? What’s the top level of physical strength I’ll ever want for myself? What is enough for me? It’s not always a personal choice how tired we’ll be, when the random events of life come to roll us over. Tired is a training goal because it’s how we build up reserves of strength before we need them.
* The four best ways to quit being tired are: consuming food with adequate micronutrients; getting enough sleep; improving physical fitness; and drinking enough plain water.
I've been working with chronic disorganization, squalor, and hoarding for over 20 years. I'm also a marathon runner who was diagnosed with fibromyalgia and thyroid disease 17 years ago.
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