For the Week of September 18, 2016: Sleepless Nights

Even in the cave

of the night when you

wake…

you push with your eyes till forever

comes in its twisted figure eight

 

and lies down in your head…

(From:  “Waking at 3 a.m., by William Stafford)

It’s 3 a.m.  You’re awake.  A parade of thoughts marches through your mind, worry, to-do lists, a snippet of a conversation you replay again and again.   Perhaps you keep a notepad by the bed, like I do, hoping that if you jot down the persistent nagging by your brain, you might lull yourself back to sleep.  But you can’t get comfortable, or your husband is storing, or you remember something you forgot to add to the list.  You close your eyes again, trying to focus on little but a steady rhythm of deep breathing.  Perhaps you doze off, awakening a short time later and checking the clock, annoyed to find that barely a half hour has passed since you last checked the time.  Five, ten, twenty more minutes pass.  A seeming infinity.  It’s hopeless now; you’re wide awake and throw back the covers to pad into the kitchen and try the age-old remedy of drinking a glass of warm milk.  Finally, perhaps an hour or so later, you sleep, only to be jolted awake by the alarm clock all too soon.  It’s happens to each of us some time or another.  Whether it’s the result of a tough day at work, finances, worry about a loved one or yourself– even just eating a late dinner–sleep seems elusive.  Worse, there are times during emotional upset, personal crises, or serious illness, when sleep disruption can last for weeks.

Writers know the darkness of early morning hours well.  Long, sleepless nights have been a theme in countless stories or essays or poems, for example, “Sleep now, O sleep now,” James Joyce wrote in his poem by the same name, “A voice crying “Sleep now”/is heard in my heart…”

And from Kim Addonizio’s “Mermaid Song,”

In the black hours when I lie sleepless,
near drowning, dread-heavy, your face
is the bright lure I look for, love’s hook
piercing me, hauling me cleanly up.

Even Winnie the Pooh had sleep problems:

But [Pooh] couldn’t sleep. The more he tried to sleep the more he couldn’t. He tried counting Sheep, which is sometimes a good way of getting to sleep, and, as that was no good, he tried counting Heffalumps. And that was worse. Because every Heffalump that he counted was making straight for a pot of Pooh’s honey, and eating it all. For some minutes he lay there miserably, but when the five hundred and eighty-seventh Heffalump was licking its jaws, and saying to itself, “Very good honey this, I don’t know when I’ve tasted better,” Pooh could bear it no longer.      

(–A.A. Milne, Winnie the Pooh)                       

Like those who have written of the inability to sleep, cancer patients know sleepless nights well.  I remember an early morning a few years ago when, unable to sleep, I went to my desk and turned on my computer.  I was not alone.  An email arrived from one of the women in my cancer writing group who was undergoing a new treatment regimen for metastatic breast cancer.  She too was awake and writing, trying to capture the myriad thoughts about her illness and her life, thoughts that kept her tossing and turning in her bed, unable to fall asleep.

In fact, sleep disorders are common among cancer patients.  Several recent studeies have shown that 30 to 50% of cancer patients have trouble sleeping, compared to 15% in the general population (Oncolink, July 25 , 2016). Even 2 to 5 years after treatment, symptoms of insomnia were found in 23 to 44% of patients.

Patients’ sleep disorders are caused by a number of factors associated with the disease:  physical pain, side effects of treatment, emotional stress, surgery and hospitalization.  The inability to go to sleep and stay asleep can have negative effects, including anxiety, depression, fatigue, headaches or even disrupt the body’s hormonal balance.  David Spiegel and his colleagues at Stanford University Medical School found that those who suffer from troubled sleep are more cancer prone.  When the circadian rhythm (the sleep/wake cycle) is disrupted, it may affect a person’s cancer prognosis.  They concluded that “A good night’s sleep may be one weapon in the fight against cancer” (Science Daily, October 1, 2003).

What can you do if you are one of those who suffer from sleepless nights or insomnia?  MD Anderson Cancer Center offers several helpful suggestions to help you get a better night’s sleep, among them:

  • Power down. The blue light from cell phones, tablets, TV and computer screens suppresses melatonin, which directly interferes with sleep.
  • Rituals.  Make sure you keep a bedtime and wake up ritual, even on the weekends.
  • Cool it down. Check the temperature of your bedroom. The optimum bedroom temperature should be between 65 to 72 degrees for sound sleep.
  • Leave the room. If you cannot sleep within 5 to 10 minutes of lying down, get out of bed and read a magazine or book that is soothing or boring. Spend time in prayer or meditation to calm the mind.
  • Limit your food and drink intake. Avoid heavy meals, alcohol, chocolate or caffeine products, such as soda, coffee or tea, three to four hours before bedtime.
  • Avoid naps. Keep your daytime naps to 30 minutes or less. And, don’t take a nap within several hours of bedtime.
  • Exercise.  The American Cancer Society recommends that cancer patients and survivors do at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity each week.
  • Pull down the shades. Your bedroom should be like a cave.  It should be dark, cool and quiet.  Cover clocks or other electronic devices that emit light in your bedroom.
  • Write it out. Keep a pen and paper by your bed if you are prone to wake up and worry about the next day’s events.

Although these tips are aimed at the person living with cancer, they are helpful advice for anyone who has trouble getting (and staying) asleep from time to time, just like I do!  May your nights be filled with with more sound sleep  and pleasant dreams than worries and restlessness.

Writing Suggestion:

  • Write about sleepless nights. What do you remember most about a particular sleepless night? Describe it in as much detail as you can.
  • What thoughts or images invade your mind and keep you awake?
  • Have you ever “birthed” an idea for a poem or story in the darkness of the night?  Write it.
  • What’s helped you coax yourself back to sleep? Write about your rituals or calming practices that help you overcome the agony of a sleepless night.

About Sharon A. Bray, EdD

Best known for her innovative work with cancer patients and survivors, Sharon is a writer, educator and author of two books on the benefits of expressive writing during cancer as well as personal essays, a children's book, magazine articles and the occasional poetry. She designed and initiated expressive writing programs at several major cancer centers, including Breast Cancer Connections, Stanford Cancer Center, Scripps Green Cancer Center and Moores UCSD Cancer Center. She continues to lead expressive writing groups for men and women living in the San Diego area and teach creative writing workshops and classes privately for UCLA extension Writers' Program. She previously taught professional development courses in therapeutic writing at Santa Clara University and the Pacific School of Religion, was a faculty member of the CURE Magazine Forums and at the Omega Institute in 2014. Sharon earned her doctorate from the University of Toronto and studied creative and transformative writing at Humber School for Writers, University of Washington, and Goddard College.
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