And Omaha. And Dubuque. And even Toad Suck Ferry, Arkansas. Sleeplessness is an American epidemic. Even the Centers for Disease Control think so, labeling it just that back in 2013 and claiming things have only gotten worse since. Why? What happened?
When we were kids, falling asleep was a snap. Our very own paean to unathleticism, Paul Brooks, would do it on a daily basis out in right field. “Nobody ever hits the ball out here anyway,” complained Paul. “Just takin’ a little break.” Brooks was built like an overweight fire hydrant, which may be the reason he could sleep standing up. Or he could have been a pony, brilliantly disguised.
In the first grade, Sister Joseph Ambrose made sure we took a nap every morning at eleven. “Class—just put your heads down on your desks and go to sleep for ten minutes.” Then she’d sneak out the door for a quick snort or a little morning gossip with the sisterhood. We had a funny kid named Tommy Mulcahey in there who wouldn’t wake up in a meager ten minutes. You had to shake him and tell him there was a fire drill or something, upon which he’d jump up and run hysterically out of the room. Tommy was the first comedian any of us ever knew about, preceding even Jack Benny.
The rest of us weren’t much better. It was like pulling teeth to get us up in the cold, dark mornings for another slog through the snow to school (although remarkably easier on Saturdays, for some reason). I usually slept upstairs, where my sadistic grandmother was charged with the unenviable task of waking warden. She had her methods, the first of which was to squeeze your toe until she got a recognition of consciousness. If you weren’t up in two minutes, she was back with a broom to encourage compliance. Trust me, you didn’t want to let her get that broom going. Other grandmothers, however, were much worse. Joey Posluszny’s nana would pour water in his ear. Joey said when he got older he was moving to the Polish desert where there was no water. Not every kid in school was great at Geography.
I never knew any kids who couldn’t sleep at night. Okay, there was Christmas Eve, but that doesn’t count. Everybody’s in such a panic to fall asleep before Santa shows up that they’re all still wide-eyed at midnight. It doesn’t help to have someone around like my sister, Alice. She’d sit up in bed and peer over at me. “Billy!” she’d ask, “Are you asleep yet?” “No, Alice, not yet.” “Well, hurry up then!” Ever try to hurry up and go to sleep? It doesn’t work. It’s like trying to go to sleep the night before a big event, like opening day of the baseball season or an airplane trip. So the first thing we ever discovered that caused sleeplessness was Excitement, the anticipation of what was coming next day.
I was a pretty good kid at school, except for that one time I pulled the lever on a fire alarm box—just to make sure it was working, mind you—and brought half a dozen clanging fire trucks to the scene. But good kid or not, sooner or later everyone gets one of those notes from the nuns that you’re supposed to take home to your parents, asking for a “teacher’s conference.” This was not welcome news at my house where my dubious father considered the nuns something akin to the Legions of Hippolyta or, more likely, a clandestine offshoot of the Nazi forces. I usually took the note to bed with me the first night, debating whether to deliver it forthwith or wait for the eventual phone call. Those nights, sleep didn’t come easy, if at all, and I learned that Fear of what was coming was the second reason for sleeplessness.
As time passed, I discovered a lot more. Girls was a big one. You could lie awake forever thinking about girls, especially about asking one out for the very first time in your life. If she agreed, what then? What did they expect you to do with them? Do you kiss them, or what? Supposedly experienced kids lied and said they did all kinds of outrageous stuff, but what if it was somehow true? Would you look like a schmuck if you didn’t try it, too? Or would the girl smack you around and never speak to you again? The third reason for sleepless nights: The Opposite Sex.
When we got a little older, we realized there existed in the world an “our” side and a “their” side and seldom the twain shall meet. Tempers were honed in rough basketball games at places like the Boys’ Club, where the South Lawrence Irish kids would battle North Lawrence Italians. One night, after a particularly brutal victory over a team called the Raiders, our leading scorer, Dave Kiernan, was tipped off that the captain of the other crew, a tough kid named Chris DeCaeser, was waiting on the steps outside with a knife. Kiernan told the club director, Mr. Menzies, what awaited and Menzies cajoled Decaeser back in and put the boxing gloves on the two contenders. It was a bruising knock-down, dragout of a battle but tons better than a stabbing, especially if you were Dave. In a mill town like Lawrence with plenty of ethnic and school rivalries, the air was rife with physical confrontation and sooner or later you’d be fighting, one way or another. Few kids were afraid of the brawl or even of losing, everybody just wanted to measure up, show courage, be there for the boys. The nights before the fray were wakeful ones, full of many questions and few answers as we contemplated The Possibility of Failure.
As we got older, we discovered a ton of reasons for wakefulness, some simple, some complicated. There was Coffee, undrinkable for me after noon. There was the busy mind, a whirlwind of activity sometimes untameable, mental fireworks going off in all directions. For many, there was bad health of one sort or another, or perhaps the interference of medications required to quell it. There was worry over finances, the fidelity of edgy boyfriends, whether to move on to another job or how many maple frosted Dunkin’ Donuts it was safe to eat in one sitting. We worry about children and pets and next month’s mortgage payment and whether the Florida Gators will ever have another decent quarterback. It’s a mess. Eight hours sleep? You must be kidding! Five is more like it, six on a good night, seven when the Blessed Virgin Mary makes an annual appearance and rewards us for rescuing that mutt from the pound. What can we do about it? It is all hopeless? Where have you gone, Rip Van Winkle-o….the nation lifts its sleepy eyes to you?
Reasons For The Season
Sixty years ago, there was no epidemic of sleeplessness. For one thing, the majority of people adhered to a rigid schedule. Dad worked five days a week, Mom took care of the kids and the family had dinner at 5 p.m. daily. Everybody went to church on Sunday and, there being but three or four channels on television all of which closed down at eleven, to bed at an early hour. The neighbors, most of whom had lived in the same place for decades, never held wild parties which lasted to all hours. Crime in the neighborhood was unheard of. Nobody had a job which required flying from town to town every day or so. There was plenty of time and a comfortable atmosphere for sleeping.
Nowadays, schedules are given to rampant change. Mom works to make ends meet or because she desires a career. The family is lucky to dine together three days a week. There is a surfeit of entertainment barraging us from all directions 24 hours a day, 7 days a week. We don’t know who the hell the neighbors are because we’ve never met them. Crime in the neighborhood may be an issue. Plenty of people travel here, there and everywhere for their jobs. Sometimes, there’s far too little time for adequate sleep.
Insomnia is a condition involving difficulty sleeping at night which involves up to one-third of the adult population and is associated with sleep deprivation. It is characterized by symptoms of daytime sleepiness and difficulty with concentration, memory and performing well at school or work. The causes of Insomnia and, resultantly, sleep deprivation are: (1) Anxiety, (2) Neurotransmitter imbalances, (3) Concurrent medical conditions, (4) Stimulant medications, (5) Psychiatric issues, (6) Environmental factors. Some people also suffer from idiopathic insomnia and sleep deprivation without a clear and identifiable cause.
When we were kids, we visited one another’s houses frequently. One day at Jackie Mercier’s house, we entered onto a scary scene, a strange man on a living room couch, head tilted, mouth open, making noises generally only heard in darkest Africa. “That’s my Uncle Freddie,” Jackie told us. “He has some kind of sleeping disease, I don’t remember what you call it. He’s pretty funny.”
What you call it is Sleep Apnea, a health condition involving the collapse of the upper airway while an individual sleeps, leading to reduced airflow to the lungs. Apnea often causes the individual to wake up at frequent intervals during the night as a reflex response to the insufficient oxygen supply, resulting in sleep deprivation.
Jerry Jones, our house photographer at the old Charlatan magazine, had Narcolepsy. He could fall asleep in mid-sentence, yours or his, which is, to say the least, offputting. We used to wonder what would happen if, say, Jerry was shambling across a busy intersection and—WHAM!—the narcolepsy bolt came flying out of the blue and rendered him comatose. It never happened, though, so it’s possible you can’t engage narcolepsy while in motion.
The Empire Strikes Back
While some sleep disturbances can be an indication of a larger medical condition or psychological disorder requiring the intervention of a doctor or counselor, many people can take control of the problem by making some changes in their lives. Like these:
1.—Establish a firm sleep schedule. Go to bed the same time every night and rise at the same time every morning. Allow yourself enough hours of sleep. Do not compromise on your schedule for at least two weeks before making any adjustments.
2.---Establish a pre-bedtime routine. Spend the hour before retiring engaged in some relaxing behavior. At least ten minutes of meditation at the end of this period would be ideal.
3.---Avoid caffeine entirely. Come on, it’s just for two weeks and it won’t kill you. Moreover, you may discover it’s your only sleep problem. After the two weeks, try one cup only and before ten a.m. If all remains well, extend until noon. Caffeine is a stimulant which supposedly stays in the average person’s system for eight hours, but you might not be the average person. It’s okay to still eat your donuts.
4.---Avoid alcohol entirely. Oh, calm down, we’re trying to solve a problem here. And yes, we know—it relaxes you and can even help put you to sleep. The only problem is you wake up at three-thirty a.m. and never go back to sleep again. There’s not much going on at three-thirty a.m. You have to resort to old Jerry Springer programs. Try it for two weeks, it could be a revelation. This means you, Kathy.
5.---Engage in regular physical activity. Give up your career as a slug. You don’t have to engage in The Labors of Hercules, but let’s do a little more than walk around the block a couple of times. Pick up the pace. Some of you can shovel a little snow. Just don’t do any of this stuff close to bedtime, it leaves you too keyed up.
6.---Do not dwell on your problems or blog columns too close to bedtime. Take care of that stuff first thing in the morning. If it tries to sneak in the back door, whack it with a stick and tell it hey, back in your cage, I’m taking care of you first thing in the morning. Be firm. it will behave if it realizes you’re not fooling around.
7.—No lights in the bedroom. As in NO LIGHTS IN THE BEDROOM! I don’t want to hear that you need a nightlight in case you have to get up. Stumble around in the dark, fall down if you have to, and crawl to the toilet. NO LIGHTS IN THE BEDROOM!
8.---If you’re still at it, try skipping the sex at night. A few people fall asleep afterwards but a large majority stay too keyed up. You have my permission to engage in hanky-panky in the morning, afternoon or early evening, it’s all good. Just don’t mess up her hair.
9.---Watch the napping. If you fall asleep for ten minutes doing the crossword puzzle, that’s one thing. No actual going to bed. Sitting in an upright chair instead of one of those lounge-a-rama seats is a good idea if you want to stay awake. Absolutely NO napping after three p.m.!
10.---No food after seven p.m.! I don’t care if the Mexicans do it.
11.---Put the TV timer on and try falling asleep to a boring program like the local evening news. The football game is too much excitement (ladies excepted) and CNN will make you stay awake wondering if civilized people still enjoy golden showers. Alternately, try a fan placed across the room and blowing away from you. All you want is the gentle whirr.
12.---Obviously, you’ve stopped smoking by now so I don’t have to tell you this.
Relief Is Just A Minute Away
In the long run, you don’t want to be a pill-popper but sometimes emergency measures are required. An examination of useful temporary medication follows.
Zolpidem is the secret identity of Ambien and Intermezzo. The former is the stuff most hospitals use, so it’s pretty safe. Just remember—it’s intended to be used to get a full night’s sleep, seven or eight hours. So let’s not be jumping into our semi first thing in the morning and driving it into a ditch.
Eszopiclone is known to the many fans of its TV commercials as Lunesta. It works fast, lasts seven or eight hours, but can leave you a little groggy next day. Because of this, the FDA recommends the starting dose be no more than 1 mg. If you use Lunesta, people will beat you at pinball and video games next morning.
Ramelton is another name for Rozerem and works differently than the others, targeting the sleep-wake cycle rather than depressing the central nervous system. It is primarily used for people who have difficulty falling asleep. Good news—Rozerem can be prescribed for long-term use as the drug has shown no evidence of abuse or dependence.
Zaleplon or Sonata stays active in the body for the shortest amount of time so you can use it differently. If you try to fall asleep unmedicated and still find yourself awake at 2 a.m., you can safely take Zaleplon without feeling drowsy in the morning. Not the drug for you if you have a tendency to wake up during the night.
Doxepine (Silenor) is for people who have trouble staying asleep. It helps sleep maintenance by blocking histamine receptors. This is also a seven or eight hour medication with dosage based on health, age and response to therapy.
Benzodiazepines like Triazolam (Halcion), Temazepam (Restoril) and Alprazolam (Xanax) have been around for awhile. These are useful when a person wants an insomnia medication which remains in the system longer to counter such problems as sleepwalking and night terrors. Unfortunately, they can cause a user to feel sleepy during the day and can also cause dependence.
Antidepressants such as Trazodone (Desyrel) and Mirtazapine (Remeron) are particularly effective in treating sleeplessness and anxiety but should only be taken by people actually being treated for depression.
Melatonin is a hormone found naturally in the body. Like almost everything else, it has a tendency to diminish as the body ages and may be supplemented to aid with sleep. Synthetic Melatonin is an OTC product available in most health food shops and drugstores which carry supplements. It is generally available in tablets from one gram up to five (I take 2.5) and is often used to combat jet lag, for adjusting sleep-wake cycles in people whose daily work schedule changes and even for helping blind people establish a day and night cycle.
Valerian is often used to combat sleep disorders and conditions connected to anxiety and psychological stress. I use it in combination with Melatonin, the latter to help with getting to sleep, the Valerian to help with the duration.
For people with sleep apnea, there are various treatments from $50 to $1726. The former is the SnoreDoc Anti Snoring Tongue, a simple but reasonably effective mask, the latter a newer device called the Aircurve, a bilevel goodie for patients who need extra pressure support or find it difficult to adjust to the therapy on a fixed pressure continuous positive airway pressure device. These masks, surprisingly, have a number of other uses. Our friend, Torrey Johnson, uses his to scare disobedient grandchildren. Other people disguise themselves to rob Dollar Stores.
That leaves us with the poor, unfortunate narcoleptics, who’ve been dealt a bad hand. With little warning to help combat the onset of sleep, sometimes the only answer, unfortunately, is to shoot yourself in the foot. This provides a certain level of discomfort but there is also great reassurance in knowing it almost always works.
Let’s get down to business on those sleep solutions today and save ourselves a lot of aggravation tomorrow. The penalties for bad sleep management can be dire. All of us remember what happened to those unfortunate people in “Wake Up Little Suzie.”
That’s all, folks,
bill.killeen094@gmail.com
