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Wednesday, 04 April 2012

A New Explanation for Elder Insomnia

[CONTEST NOTE: Winners of yesterday's contest to win copies of Dr. Bill Thomas's new book, Tribes of Eden, will be announced in this spot on Friday. If you have time today, you might enjoy attending the live, online party for Bill's book. It is being streamed beginning at 3PM eastern U.S. time at the "Tribes" website.]

category_bug_journal2.gif It is conventional wisdom that sleep problems, particularly insomnia, are a common affliction of age but not according to a variety of aging experts. As renowned geriatrician Robert N. Butler tells us in his 2010 book, The Longevity Prescription:

”The old dogma that poor sleep is an inevitable part of aging is simply not true: Age in itself is not a predictor of insomnia and, when insomnia occurs, it is precipitated by other factors, many of which can be changed or compensated for.”

Diseases and conditions can contribute to sleeplessness and possible solutions for those should be discussed with one's physician. Often, however, changes in routine such as keeping a regular schedule, limiting caffeine intake and getting enough exercise, among others, can ensure a good night's sleep.

Not that you would know that by me. I've tried all the suggestions and still, I frequently fall asleep way too early and then waken in the middle of the night which then makes me tired by afternoon.

Or, I waken to pee and can't get back to sleep. Or, even when I can stay awake until a more sensible bedtime hour, I awaken at 1AM or 2AM anyway without much chance to sleep again.

Sometimes, knowing I am perpetuating a sleep schedule that is inconvenient and that I don't like, I get up when I waken at odd hours and read the morning papers online and answer email. Other times, I try reading myself back to sleep with a book or watch something on television.

Occasionally, I find myself in that cozy, little place between waking and sleep where the mind wanders on its own and unlike dreaming, I can keep track of the odd and interesting trips it takes.

But that's not sleep and I'm no more rested from it than I am when I get out of bed at 2AM.

Recently, I read an irresistibly fascinating book, At Day's Close – Night in Times Past, by A. Roger Ekirch. “Times past” refers to pre-industrial society, the early modern era from about 1500 to 1850, most especially before artificial light.

There are a lot of other reasons to recommend this book, but what I'm here to talk about today is the idea of “first sleep” and “second sleep” which may have been so common in centuries past, and in rural areas up until the early 20th century, that writers hardly thought it worth commenting upon.

”...fragments in several languages...give clues to the essential features of this puzzling pattern of repose.

“Both phases of sleep lasted roughly the same length of time, with individuals waking sometime after midnight before returning to rest...Men and women referred to both intervals as if the prospect of awakening in the middle of the night was common knowledge that required no elaboration...”

“After midnight, pre-industrial households usually began to stir. Many of those who left their beds merely needed to urinate...

“Some persons, however, after arising, took the opportunity to smoke tobacco, check the time, or tend a fire. Thomas Jubb, an impoverished Leeds clothier, rising around midnight, 'went into Cow Lane & hearing ye clock strike twelve' returned 'home & went to bed again.'”

Other people rose to study for awhile, attend to household chores or check on the well-being of a child and Benjamin Franklin, reports Ekirch, mentions that while visiting London, would spend up to an hour writing or reading after waking before returning to sleep.

Some people never left their beds during the waking period between first and second sleep and “sexual intimacy often ensued between couples.” In the lower classes, Ekirch notes,

”Because exhaustion prevented workers from copulating upon first going to bed, intercourse occurred 'after the first sleep' when 'they have more enjoyment' and 'do it better.'”

Ekirch posits that it was the ubiquity of artificial light – first gas, then electricity – that changed humanity's sleep habits:

”Heightened exposure to artificial lighting, both at home and abroad, altered circadian rhythms as old as man himself.”

What I wonder after reading all this is if some retired people like me who no longer need to rise and rush off to work in the morning as they did for 40 or 50 years, return after a time to a pre-industrial schedule of sleep that appears, thanks to Mr. Ekirch's research, to have been commonplace for most of mankind's history.

Of course, I have no way to confirm that but now, instead of fighting, lamenting and trying to change my sleep pattern, I'm going to give the idea of first and second sleep a whirl by accepting it as my personal, normal behavior.

Who knows, perhaps when I've spent those nighttime hours getting up to potter about or do some reading or snuggle into the covers for that magical half-dream/half waking state of mind, I have been on to something ancient.

And maybe if I just relax into this first and second sleep idea, give myself permission, I'll be able to fall asleep a second time like the people of yore.

I'll let you know how it goes.


At The Elder Storytelling Place today, Marvin Waldman: In Search of the Clitoris


Posted by Ronni Bennett at 05:30 AM | Permalink | Email this post

Comments

This makes a lot of sense to me, someone who has dealt with insomnia for decades. Don't forget that computer monitors and other light-emitting devices count as sources of artificial light. I notice that the length of time I spend on a computer during the day affects my sleep at night. Since the original Kindle is not backlit, it has become my favorite pre-sleep reading platform. Or, a book made the old fashioned way!

You took the words right out of my mouth. And what's more you said it all. Thanks again Ronni. Dee :)

I don't usually divide my sleep at night. I had no idea about the "waking period" between sleeps.BUT,since I read this:

"Because exhaustion prevented workers from copulating upon first going to bed, intercourse occurred 'after the first sleep' when 'they have more enjoyment' and 'do it better.'”

Tonight I am setting the alarm for Two A.M.

I'll let you know what happens....

Somewhere I read an article about Dr. Ekirch's work and had the thought: if I weren't working, I think I could fall into that pattern. My body likes to go to bed early, enter some wakefulness in the middle of the night (I seldom get up) and then go back to sleep until what others think is very early -- 5:30 or 6 pm.

But at nearly 65, I feel as if I were "letting down the adult side" if I go to bed when my body wants: 8-9 pm.

I think I could get into the 2-sleep pattern, but probably won't in this society.

Yup, up once in the night. I thought it was because I had to use the bathroom, but unknown to retired me, I'm falling back into ancient sleep patterns.

I think you are onto something here. I too fit that mold, and am heartened to see that Ben Franklin too used that 'tween-time to write.

You've done it again Ronni, another astute take on Elderkind's life experiences and commonalities with a uniquely binding twist. Let the light shine on....
-steve

I read an editorial explaining Roger Ekerich's theory and it made me feel better knowing that my second sleep is a pattern that is not that unusual. I often wake after 3 hours and stay up for another 3 hours until I get sleepy again and return to bed for my second sleep.

If the elders that I know are any example, insomnia IS a common condition of old age. I have a theory that it relates to our declining physical activity during the day.

Nancy, let us know how your waking time went. Before reading your funny comment I had wondered how both partners were going to be able to coordinate their sleep pattern. I guess the alarm clock will solve that problem. ;-)

This makes sense. My sleep patterns are erratic at best. I read somewhere about keeping a 'sleep diary' and I'm seriously considering that idea.

I'm still working so by the time I go to the gym, work on my blog or other writing, have dinner, read a bit, I'm dead to the world as soon as my head hits the pillow but I will keep the info about first & second sleep in my mind for the future. Hey one hour interval could add up to 7 hours of writing per night

I seem to fit the pattern. I go to sleep at midnight, and wake about 2 a.m. to use the bathroom. I always feel as if I have slept for hours, when in fact it is usually a one-and-a-half or two-hour period. I then go back to sleep until four-ish. If my Puritan persona kicks in, I get up and read or write. All day long I fight sleep and find myself nodding off. If I go back to sleep until 7:30 or even 8 a.m., sleepiness is not an issue; insomnia has never been a problem sine my early teens, when my "raging hormones," to quote the late Ann Landers, kept me up all night.

I think you hit a key point in your last paragraph -- "relax." I've learned if I wake in the middle of the night and just lie there fretting and telling myself I "have to" get back to sleep, I won't. If I accept that I'm awake, get out of bed and watch TV, get something to eat, check my blog, etc., for even a few minutes and stop thinking about trying to get back to sleep, "second sleep" will usually come easily. Of course, it all works a lot better when you know you don't have to face an employer at 8 a.m.

I look forward to a time when I no longer have to get up early for work so when I wake in the night I don't stress about going back to sleep, a self-defeating behavior for sure.

I generally sleep well but I am married to a man who can fall asleep when his head hits the pillow-- literally. I am more of a 15 minutes to fall asleep at best. The problem for me is he starts to snore and snoring is erratic, it's not the kind of thing you can adjust to its rhythm. So then I tell him to stop, wake him (he goes right back to sleep) and we start it all over again. Sometimes we sleep in separate rooms when he is particularly tired or having sinus problems which makes the snoring worse. I envy him his ability but do think it's a shame that the instant asleep person cannot be the one who doesn't snore...

When I wake in the middle of the night and can't easily go back to bed, I work out problems with the time. I read recently a tip which I have also tried. Count to ten slowly. Then hold breath for a count of six. I think the reason it would work is you stop working out problems and let them go although I am not sure.

I read some years ago that if you have trouble getting to sleep you should make a conscious effort to relax your tongue. It works for me and I highly recommend it.

And I keep a mystery book or other light reading on my nightstand to fill an hour or so if need be. In general I don't worry about how much sleep I get. If I feel sleep-deprived, I take a nice long nap.

I keep a big sachet of lavender next to the bed. Some other herbs promote sleep, too--a few big whiffs help. One of the great boons of retirement is sleeping in, to me.

And don't settle for less than whatever is your perfect pillow! Interesting topic, Ronni-san

I'm one of the lucky ones ... I sleep like a baby. Seven to 7-1/2 hours is perfect for me. Even when I wake up to go to the bathroom, I can usually fall right back to sleep. When I can't I just do a few mental "OHMs" which usually help interrupt any mental trumoil and then fall asleep.

Have had a few sleepless nights when my brain would not stop whirling around ... but I guess that's normal when you're under the pressure that an advertising agency's deadlines and nasty clients can produce.

Have always been like that, and so was my Father. Mom used to just shrug and tell us that we either had a clear conscience or a child-like mind to be able to fall asleep anywhere and at any time that we chose.

I just remembered a story my Mother loved to tell me about Dorothy Parker. It seems Ms. Parker used to keep a notebook and pencil beside her bed so that if she woke up at night and had a thought, she could write it down so she would not forget it by morning.

One morning she woke up very excited, certain that she had solved the problems of life the night before ... and she had written:
"Higamous, hogomous, woman's monogomous.
Hogamous, Higamous, man is polygomous."

How very timely for me: I am just trying to adjust to being off the sleeping pills I've been on for years. With the change in NY State coverage, I could no longer afford the $122 a month (in addition to many other co-pays on the drugs that I don't have the option to quit). I'm right back in the pattern (of sleeping 2-3 hours, then wide awake) that I lived with for 26 years before the sleeping pills. At least now I'm retired so I can sleep whenever the mood strikes.

hmmmm very interesting. Let us know how it goes for you. For myself I lay here staring at the ceiling. I can try to get up and honor the interval...but my dh always seems unnerved when I get up and wander around. lol

So maybe I'm not as weird (sleep-wise anyway) as I thought. I'm an "owl" at heart. Now that I work part time, I no longer have to hit the freeway at 5:30 A.M. as I did for many years to avoid the worst of the traffic.

Now I read until about 1:00 A.M. and then sleep for an hour or two until one of our two (admittedly spoiled) cats paws the covers to wake me up. I feed both cats, then read/answer email, browse the web and maybe do a little work. About 3:30-4:00 I go back to bed and sleep soundly until 8:30-9:00 A.M. Looks a lot like pre-industrial sleep patterns. . .except that they probably still had to get up earlier. My husband used to be a "lark" but has grown a bit more owlish in retirement.

Reading your blog usually assures me that I am "normal," and this post is no exception. Now, learning more (and from the comments, too!) about this up-and-down sleeping style, I can embrace it and turn upset into bliss. Or at least sanguinity.

I heard about this theory also, and tried to relax into my own patterns, letting myself fall asleep around 8 pm and wake up for an hour or so during the night, and get up around 5 a.m. But I am still tired and nodding out all day long, so I don't think it's a good solution,

I handle it by not lying down until my eyelids will simply not stay open any longer, and getting up when I feel like it.

After menopause I began needing fewer hours of sleep.

My sleep schedule went to pot just before, and then after my husband died as I got into 'computering.' My night owl tendencies persist though I have made a greater effort to establish a more regular pattern, since serious health problems can result.

I've never taken sleeping pills and don't intend to start.

I, too, have a couple sleep periods during the night that began after my husband died. I ceased being overly concerned about it, but don't use the computer, or rarely turn on a light when I awaken at night. I found reading kept me awake the rest of the night, sometimes because I became so interested in the book I lost track of time.

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