The Sleep Debt

Can you really catch up on lost sleep?

Sleep Hygiene for the Rest of Us

Chronic pain and illness play havoc with “good night’s sleep” advice.

Not a week goes by without an article on good sleep hygiene showing up during my Internet wanderings. I know the recommendations are good ones. It’s just that most of them don’t work for those of us who are living with chronic pain or illness. Actually, it’s more than the fact that they don’t work—they’re irrelevant to the life we must lead.

Here’s a list of typical sleep hygiene recommendations and why they might not work for the rest of us. (Note: This is intended to be a lighthearted look at these recommendations, based on my personal experience and on what others have told me. If any of them work for you, wonderful. Keep following them!)

1. Go to sleep at the same time every night.

Nice idea. Unfortunately, pain and other symptoms—not the clock— dictate when I get to go to sleep.

2. Don’t use your bedroom for any activities other than sleeping or sex.

The strictest version of this rule includes a ban on these activities: talking on the phone, listening to the radio, watching television, reading, using the computer. But then where would I be writing this article from? My bed is my office, my entertainment center, my dog playpen, my dining room.

Even the less comprehensive lists include, “Don’t use your bed for doing work.” I like to joke with my husband how I wrote How to Be Sick in a four-foot-square space. It would have been a two-foot-square space, but my printer is four feet from the bed—still close enough to reach with a good long arm stretch from the bed.

3. Don’t nap during the day.

I can’t get through the day without a nap, not because I’m sleepy but because my body breaks down the way a body breaks down when you have the flu. I have absolutely no choice here. I consider it a small victory if I only need one nap. I’ve been known to need four.

4. Exercise.

Oh yeah. If it were only possible…

5. Move the TV out of the bedroom.

Good idea—but maybe not for the rest of us. Without the TV in the bedroom, I’d not have seen a single movie released since 2001, the year I got sick.

6. [My personal favorite]. If you don’t fall asleep in 15-20 minutes or if you wake up in the middle of the night and don’t fall back asleep in 15-20 minutes, get out of bed, go into another room, do something non-stimulating for a half hour, and then try again.

Okay. First, I NEVER fall asleep in 15-20 minutes. It takes me longer than that to get comfortable. Then once I’m comfortable, I have to wait until the symptom parade calms down. On a good night, I’m asleep after about 45-60 minutes. On a bad night…we’ll, let’s not go there.

Second, (and this may be the only piece of valuable advice in this article), I’ve discovered that I feel much better the next day if I don’t get out of bed when I wake up in the middle of the night and can’t get back to sleep. I “fake sleep," meaning I lie in bed in my usual sleep position and pretend to sleep. I’ve tried both—getting up v. fake sleeping. For me, the latter makes the day to come much more bearable. In fact, I’ve become quite adept at fake sleeping. In the upper left is a picture that perfectly depicts this art form!

P.S. Fake napping can also be easily mastered and comes in handy on days when symptoms prevent real sleep from occurring. In my household, we call this phenomenon a “shutdown,” as in “all systems are shut down, even though no sleep is taking place.”

© 2012 Toni Bernhard

Thank you for reading my work. My most recent book is titled How to Wake Up: A Buddhist-Inspired Guide to Navigating Joy and Sorrow.

I'm also the author of the award-winning How to Be Sick: A Buddhist-Inspired Guide for the Chronically Ill and their Caregivers

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The Sleep Debt