Sleep

Photo by Vickie Barrett, July 7, 2023

NaBloPoMo 2023, here we goooooo!  What’s already good and what could be better?  

How do you sleep?  Has it always been the way it is now?  What affects it?  What do you know about sleep in general?  What questions do you have about it?  

Personally

I am a great sleeper.  I fall asleep easily and sleep through the night, and am also easily aroused and quickly lucid.  I do best with 8 hours, and can function highly with much less, at least for a while, given ready access to caffeine.  I love sleeping, look forward to it every night, climbing into bed, burrowing under the covers, closing my eyes, letting my thoughts and fantasies drift where they may.  If my mind is full, the relief from dumping it all into a journal is almost euphoric for me.  I use fun colored pens and observe my handwriting, which often correlates with my mood, energy, and general state of being at the time.  

I just don’t spend enough hours in bed.  Night time is when I get my best writing done, so too often I stay up too late. In past years NaBloPoMo has severely exacerbated this tendency.  I know that when I don’t sleep enough, not only do I have more food cravings, but they are for unhealthy foods and I have essentially no impulse control, so sleep deprivation poses a cascade of downstream risks for me.  If I just hit 7 hours a few nights in a row, I literally feel viscerally better.

So, NO MORE (for now)!

Adding “Lights out 11:30” to my habit tracker last month, I documented goal achievement four times.  I think I do better.  It starts with realistic expectations of what I can accomplish each day: see patients, work out, write, read, cook, etc.  I can anticipate on Sundays and find times and tasks that can flex if needed. I should probably make a list of things I will put down or scale back during this month of daily blogging… Or multitask–pair attentive with mindless activities, like phone calls with friends instead of video, so I can also fold laundry.  I’ got this. Form a plan, experiment, evaluate, adjust, repeat. 

OH and social media, ya. Jeez, gotta manage that time sink better. I’m getting there—more on that November 12!

Societally

How do we sleep as a society?  Wow, so much data at our fingertips!  Here’s what’s already good:  According to sleepfoundation.org, a majority of Americans get 7 hours of sleep or more, yay!  Is that you?  I think maybe half of my patients report this.   Also good is that only a small minority of people report chronic insomnia, about 10-15%.  Does that seem like an underestimate to you?  In my skewed perspective, most people don’t feel satisfied with their sleep.  Maybe I’m thinking of all the other sleep disruptors: apnea, hot flashes, young children, night time peeing, anxiety, depression.  Aging can be a huge factor, what with menopause, enlarged prostates, and effects of aging on circadian rhythm.  

Collectively, sleep awareness is at an all time high, I think. I credit this in large part to Matthew Walker and his remarkable book, Why We Sleep, which I highly recommend. Walker presents the science clearly and accessibly, and while dense, the book clarifies mysteries of sleep that can inform our habits in practical ways. It’s humorous and clever, and well worth a read or listen.

SleepFoundation.org

Age, menopause, and prostate symptoms are individual factors that we each must manage ourselves.  My night owl habit challenge is mine to solve.  How could we modify our systems to facilitate better sleep for everybody?

Arenas where solutions may lurk:

Media streaming guardrails.  I have timer settings on Spotify, Audible, and Scribd (soon to be Everand), but not Netflix or Prime.  We’d probably disengage from leisure media sooner and more easily, especially late at night, if the apps’ defaults were to ask us when to stop at the time we start, rather than making us do it proactively.  And how many collective hours–which I think could be measured in lifetimes–do internet browsing algorithms cost us?  All of this is unlikely to change, I know.  

Alcohol. When do the costs outweigh the benefits for individuals, and yet how often do folks drink more than they want, becauase it’s ‘what you do’? Peer pressure is no less real at fifty than at fifteen. How likely is it that our culture can depend less on ethanol to lubricate social and business gatherings? I’m gratified to see mocktails and the like increasing in popularity and acceptance. Let’s see where this goes…

Synchronous global video meetings.  Meetings in general.  I understand the importance of face to face connections.  How can we make them maximally efficient and effective, and give some time back to people?

Remote work in general.  The average American work commute time is about 30 minutes.  That’s 5 hours per week.  Cutting commute time, as happened for so many during COVID lockdown, not only gives people time back, but decreases overall stress and anxiety.  We are happier when we’re not rushing around every day; we can get more life tasks done.  We may then get to bed earlier and in a better mood.

Later school start times for adolescents.  This is ideal for growing brains, and also a bear to execute when parents must coordinate drop off with morning commute or international Zoom calls.  We can see here how some solutions collide and some others coincide–yikes.

There are many ways to move more and differently when we’re awake. Food choice, volume, and timing can also be flexible. But we can only sleep when we are sleeping. This is why I list it first among the 5 reciprocal domains of health, the last two being stress management and relationships.

I should have worn my blue blocking glasses tonight, come to think of it.  With 29 more days of increased screen time, what else can I put in place to protect my sleep?  I’ll sign off now to rest my thinking brain, give my subconscious a chance to mull it over.  Maybe in those unfocused minutes of first waking, I’ll have a stroke of insight.  Good night!

It Came Up In Conversation

Friends, how are you?

So many people are having a really hard time right now. I feel it all around, and it’s heartbreaking. So much pain, both first hand and vicarious; such powerlessness, leading to agitation, rage, and despair… or at least an angsty restlessness, a deep vibrational yearning for things to be very different from how they are. **deep breath** Whatever you have going on, I wish you all you need to suffer as little as possible.


During one clinical encounter this week, Patient and I sensed a vague yet deep restlessness in her. At the end of the visit I had no useful advice to give. Rather than disappointed or apologetic, though, I felt stimulated. From her low energy starting point, I felt wide space for potential, and a rapid slew of questions coming on. So I grabbed my notepad and scrawled as they emerged:

  1. How much do you want a life change?
  2. If change then how, in what way?
  3. Why–what will that give you?
  4. What are the steps?
  5. Who can help (assume you need help!)?
  6. How will you measure progress?

As I wrote, I changed “(do you need help?)” to “(assume you need help!)” and “success” to “progress” in real time.

Looking back, I’m not sure she really wanted to engage with these questions, which felt okay to me. I did not intend to pressure her into doing anything. I did, however, want to share my sense of possibility, openness, curiosity, and agency on her behalf. No urgency or requirement to answer anything, I told her. To “live the questions,” as Rilke wrote, is all we need sometimes. Turns out I ask these questions of myself pretty regularly. Maybe that’s why they came to mind so readily.

What/how do these questions move for you, if anything/at all? What other questions do they spark, if any? What else?


“What proportion of your daily routine/decisions/actions/default activities are driven by convention, social norms, or otherwise extrinsic factors?”

Yet another spontaneous question, this time arising while looking in another patient’s ears and talking about their very young kids’ multiple sports and activities, the intensity and schedules of which rival that of my high schooler. “It’s what you do,” they said.

Getting married, having kids, buying a house, climbing the corporate ladder; PTA, kids’ sports, yoga, pickleball, having an opinion on everything: How much do we do these things because “it’s what you do”? Please understand, I’m not necessarily judging any of it. Social norms have purpose; they provide structure and order in our messy human lives. I also think it’s good to consider, regularly and often, how our personal values and goals align with our myriad forceful cultural defaults.

Where do convention and personal integrity intersect for maximum benefit, fulfillment, growth, and contribution?

I really like this question, I look forward to living it for a while, and I’m grateful to my patient for helping me form it.


Hey, National Blog Posting Month (NaBloPoMo) starts November 1! My 2023 theme reveal will drop here on October 31, so stay tuned. This will be Year 9 for me, and I think it could be transformative…


OK friends, now I get to tell you about my Big Fat Hairy Project.

I pitched my first ever book proposal to a kind young agent in June and received generous encouragement in response. Over the ensuing months, I have found myself stymied by fear and imposter syndrome, possibly to the point of physical pain. Admonishing myself to simply plant BUTT IN CHAIR was not enough to make me produce any content. Things shifted recently, though, not sure how or why. Maybe it’s the season? Maybe it’s seeing body changes in both function and appearance after 7 months of regular strength training, convicing me that I can do new and hard things? Maybe it’s connecting more closely with readers and writers, an innately inclusive, generous, and encouraging tribe? Regardless, there is movement afoot. Yay!

On October 15 I committed publicly to a nightly book work discipline: Typed word count, handwritten journal page count, time spent reading/researching, etc.–whatever I did, I resolved to track and share. I knew at some point I would need to actually write editable words in larger numbers–the shittiest first draft is better than no draft at all. But it was not until yesterday that I committed to something concrete there, too: 500 words three times a week or 1500 weekly words, however I can get them out.

Friends, the first 871 wildly imperfect words of my book now exist. O. M. G. And I will add more tonight! HOLY MOLY, is that momentum I feel? I have a weekly skeleton schedule written out: no book work required on days I see patients, at least to start. And I still need to consume books for my sanity (176 titles started this year and ohmygoodness, some are so good!). *sigh* I feel good in body and mind, joyous, solid, and buoyant, in this resolve and commitment.

If you’re interested, follow me on Instagram at @chenger91. Every Sunday I will post a photo of the laptop and my inspriational writing mug. Each day of that week I will log book work in that post’s comments. See 10/15 and 10/22 on the page now!

I wonder how I will stick to this and also write 30 blog posts in 30 days? WHOOO KNOWS?? It’s okay, I get to invent and evolve my way–nothing to lose! And I resolve to have FUN. Let’s do this.

Talismans of Love

Barack Obama carries around charms in his pockets. People give him things when they meet him–little tokens, trinkets, you might say–offered with admiration and meaning, to feel connected. What would we expect a world leader to do with such bits and pieces? He keeps them in a bowl and every day picks a handful to tuck close, to remind him, he says, of why he does what he does. He writes about it in the memoir of his first term, A Promised Land, which I cannot recommend highly enough. What does it say about a man of such high status, who intentionally holds the well wishes of regular people on his person every day? I see it as profound humility and groundedness; I admire it and aspire to cultivate such qualities myself.

What talismans of love do you carry, visible and not?

My senior year of high school, after volleyball season ended, I started wearing one of my mom’s rings from her teen years. When it broke I replaced it with another gold band, another gift from a family member. When I started med school and had some money, I bought an intentional replacement, one with a bamboo motif, signifying my Chinese family roots. Now I also see it as a symbol of strength and flexibility, two practices I value highly, and which Ma exemplifies. I still wear my ‘one breath’ ring, and upgraded to a more solid yin-yang band. Like my wedding rings, these pieces stay on 24/7; if you find me down, you will still/already know some things about me.

When I travel, I wear a necklace with four pendants: Son’s and Daughter’s birthstones, and each of their passions. When Son left for college I got him a keychain admonishing, “Have Fun, Be Safe, Make Good Decisions, Call Your Mother.” He left it at home, but when I text him ‘HaFuBeSaMaGoDe’ he knows what I mean. It’s a shortcut. A reminder. A way to stay connected across time and distance.

Rosaries, malas, crosses, heirlooms. Poems, paper scraps, letters.
Wedding rings. Tattoos.

Symbols. Representations. Expressions, signals. This is what matters to me, the talismans say. We feel seen when someone notices, acknowledges, and admires, reminded again of our choice to mark ourselves. The objects and signs communicate visually, tactilely, beyond what speech can convey. It’s almost visceral.

Comfort. Power. Hope. Agency. Meaningful objects remind us of our core values, direction, and purpose. We get to choose our symbols’ meaning. It may or may not matter whether/how others understand them; they are for ourselves and those with whom we bond over shared significance. We rub, clench, kiss, and hold them, often in the hardest, lowest times of our lives.

What if we try harder to notice and admire one another’s talismans? Get curious and ask the bearers to share their stories, and practice kind, reverent presence with it? How might that make things just a little better?