How to Sleep, or What to Do if You Can't

Dear Dr. Sunday:

I am SO TIRED. I don't ever sleep enough, and the reason is twofold. One: I stay up late nearly every day. Two: I have to get up and go to work at a grown-up hour about five times a week.

Since quitting my job in order to sleep in is a terrible idea, I am asking for your thoughts on point #1. The reasons that I stay up vary: I might be watching a movie, working on a project, out with friends, talking to fascinating persons via IM, even idle internet surfing finds the clock passing 1am on a regular basis. Sometimes I stay up because I have a peculiar, unexplained aversion to falling asleep at that time. I got Ambien from my doctor, but I'm scared to take it and would prefer non-drug alternatives.

So what do I do? I read half of The Promise of Sleep so I know about sleep debt and REM cycles and circadian rhythms and all that, but I didn't quite get to the bit where it says what to do if you CAN'T, and since I could not bring myself to finish that book (unusual for me, which speaks to the book's annoyingness) I come to you for help.

- Sweet (Day)dreams

I love a challenge. Let me just say that for the record, as if my friends and readers were not already aware. I really, really, really love a challenge.

This is one of the hardest questions to answer. How do you get to sleep? How do you deal with a little insomnia? How do you get out of a routine of bad habits and late nights, and trade that in for a nice set of healthy sleep patterns? Tricky.

It's a new year. It's a great time to get right. So. Where do we begin?

I'm about to get detailed, so pay attention, friends!

Obviously, you've heard that alcohol, caffeine, nicotine, late meals/snacking, and all those sorts of wonderful diversions can impede your body's ability to enter standby mode at the appropriate times. So take it as given, then, that we have decided not to drink, snack, smoke, etc, in the later hours of the evening. We decide, instead, to start organizing basic factors in our lives, like meals and plans and projects. We make lists, and we stick to them. We plan carefully and we focus on sticking with our plans. We recognize that we may not always, for social, health, work reasons, whatever, be able to stick to these plans, but we do our best.

Now. Key among these steps, then, is setting a time to sleep. We pick a bedtime. We pick that and make it a target. We think on a practical level. Once you have chosen your time to sleep, cut off your activity one hour before the target. Shut off the computer. Turn off the lights in the workspace. Kill the television, bid your online pals "good night," and go lay down. Give yourself an hour to unwind with more limited activity.

"But Dr. Sunday, I'm not sleepy!" I know you're not. The above were just the practical and planning steps. Here's the good bit.

First off, choose the day that you will make this happen. You have written out your list, you have plotted and planned. You know what you want to do, and you have resolved to do it right. Now, you just need to teach your body to comply.

Let's say you have chosen Sunday (because it is the best day, and not just because they named it after me). Sunday is the day that you will go to bed at a reasonable time. You will wake up Monday ready for action, refreshed, bright, chipper, all that jazz.

Wake up early Sunday morning. I'm talking 7, 8 am. You're going to have breakfast. Not brunch-- breakfast. It doesn't matter what you did Saturday night. At all. In fact, it's better if you keep a healthy social schedule Saturday night. You want to wake up bleary and tired. You'll need that later.

Wake up, make breakfast. Exercise. You're going to start incorporating some exercise into your daily routine, and unless we're talking yoga, you're not saving it until late night. You're doing it in the mornings, when you're off, or when you get home from work, through the week (and if you're really good, try to do it in the mornings through the week, too, eventually). But this Sunday, this special chosen effective Sunday, you are going to do it before lunch. You are going to have a productive day that does not involve a nap. You are going to eat normal meals, and because you stayed up late Saturday, and forced yourself to wake up early Sunday, you will be tired come bedtime.

You are NOT, however, going to decide that it's a great night to doze off at nine or ten. No, you are going to do your best to make it something more reasonable. In your shoes, I'd target midnight. That means, distractions get shut off at eleven. You're going to reflect, unwind, for an hour. Personally, I like to read, or scribble in my little pocket journal/sketchbook/ideabook. It's relaxing, and I don't get too involved in too much (when I can help it, that is, as I'm easily distracted). This is how you are now going to spend your last hour of waking, from now on.

Monday morning, you wake up early. You don't sleep to the last minute, so that all you have time to do is shower, dress, and snag a bagel on your way out the door. You make breakfast, and you want to get to the place where you can breakfast, exercise, and shower in the mornings. Every morning, where possible. You're also going to do your best to dodge the common panacea that is coffee. If you like the taste, you're drinking decaf. If you're smart enough to realize that there's really no point in decaf, you'll have a juice, or a water. You're living healthy now, and this is your new world. Don't grumble, don't complain, don't cheat-- just do it.

Monday night falls, and you are not going to busy yourself or stay up late. You are going to be tired, but you will be better for it. You will stick to the same targeted bedtime as last night. You will stick to this routine for an entire week, and you will follow it again the next week, trying perhaps even to scale it back to 30-60 minutes earlier, if you can. You are a productive person who sleeps in a healthy fashion, so you don't feel like you have to fall into the traps of viewing the weekend as "OMG GOTS TA SLEEP IN." You are not a kid. You can do this, because you choose it.

This, my friend, will get you on the right path. Between these little changes and actually getting to sleep, you will see all sorts of surprising benefits.

And I bet you're wondering what to do if this doesn't work. Well, firstly, unless you have a more serious condition requiring the attention of a doctor who is NOT just some jackass on the internet who hands out advice with a cat sleeping in his lap, it will work. If you need more tips, here are some simple recommendations that my exhaustive research has brought forth:

--Warm milk (gross, i know, but there is science there)
--Meditation
--Deep breathing exercises (you have google, figure it out)
--Exercise early in the day
--Soft music, instrumental preferably
--Yoga
--Masturbation
--Listening to an audiobook in the dark
--The sound of a fan, the ocean, the forest, or white noise (depending on tastes)

There's science behind all of the above, so I recommend whatever seems most relaxing to you. Failing that, I can say in all sincerity that I've never seen the end of Disney's Fantasia. I greatly enjoy classical music, and I like the IDEA of Fantasia, but seriously, it sends me into a coma.

I hope this helps you. Sweet dreams!


Always listening,
Dr. Sunday

How to make your eye stop twitching.

Dear Dr. Sunday...

My eye is twitching. Specifically my right eye. And even more specifically the lower lid of my right eye...just about in the center of it. This has been going on for MONTHS....way too many months. One friend said to eat a banana. I"m turning into a monkey. Another friend suggested I am too stressed out. At this very moment my eye is twitching and if I was any less stressed out I would be Buddha. Hence I bring myself to your office to inquire as to what I can do to make this stop before I put a fork in it and call it done.

Thanks so much....
~Twitchy

Dear Twitchy,

An excellent question, and one I've had cause to answer numerous times in my life. Fortunately, I come from a family that is as steeped in folkloric wisdom as it is in traditional, practical methods.

According to some sources, twitching under your right eye means you are going to see something that you should pay attention to-- something will transpire within your peripheral vision, literally or figuratively, that if you aren't paying attention, you could miss out on totally. Of course, I've also heard, from less folksy sources, that the under eye twitching (which is called, by the way, myokymia, has not ever really been linked conclusively to any one specific cause. Like zits, it's been tied to stress, caffeine, bad diet, lack of sleep, too much sleep, lack of exercise, too much exercise, lack of sex, too much... well, you get the picture.

Translation: no one really knows WHY, we just have our best guesses based on evidence which may or may not be anything more than coincidence. "Well, it only happens when I'm awake, so maybe it's being conscious that does it? Damn, I guess I better sleep more." That sort of thing. Point is, it happens, you get it, lots of people do, and it's more common in females than it is in males, but only slightly. When it happens in both eyes at once, or starts to twitch an entire part of your face, that's when to seek legitimate medical attention.

Since it's only in one eye, it's not anything TOO much to worry about. The EASIEST way to deal with it is to try the practical approach. A warm washcloth, held over the offending eye, while you gently massage with small circles the lower eyelid should relieve the twitching. This often resolves it immediately, but not always-- in which case you just do it again, later in the day. Do this as often as needed-- don't be afraid to show that pesky eyelid who really wears the trousers in your face.

If it is intense enough to really drive you crazy, you can use the kinds of allergy eye drops available over the counter at pharmacies, preferably the kinds of drops which have an antihistamine component. This won't cure it in and of itself, but it can reduce the intensity of the muscle reaction, allowing you to make some headway.

Personally, I've ALWAYS had success with the warm washcloth method, and never had to do it for more than a day or two. If that fails, try the old fashioned method-- take the oldest penny you can find, face north with the offending eye closed, and rub southward down the face of the penny, as quickly as you can. When the penny gets warm, hold it against your eye, and whisper your desire (my eye to stop twitching) fifty times. I think you have to drink cow's milk and light a candle, too, but I might have my folk magicks mixed up here.

Hmm... Probably just go get a washcloth warm/wet, instead, yeah? I hope this helps you.

Always Listening,
Dr. Sunday

Huddled in a Corner

Dear Dr. Sunday,

I've been having an incredibly tough time of things lately. I recently
found out my mom has been diagnosed with breast cancer, and today she went in to have an operation, only to discover that the cancer had spread (marginally) to her lymph nodes. My entire family has been
pulling through this in such a cavalier manner, but truthfully I just don't think that we know how to discuss it. Being the oldest, I feel like it's my responsibility to be the iron lung for my family, if you
will. However, I just found out some disturbing news of my own; not having health insurance, I have to rely on Planned Parenthood for my ladylike checkup needs. They informed me that on my last pap smear,
they found "severe dysplaysia," meaning that I could possibly have cervical cancer, or nothing at all. Doctors, right? The WORST part is that, in order to find out whether or not it definitely IS cancer,
they have to take a sample which costs $300; I can barely afford my
rent each month, and I'm supposed to pay for a $300 medical procedure?
Right. Uh huh. I haven't told my family about it, because it would only add to their worries (I guess that's the FINAL worst part).

The kicker is that I feel like my friends have, for the most part, completely drifted away from me over the last couple months. I have no one, save for my roommate and a completely close, dear girlfriend of
mine, to talk to this about. I feel like I've done something totally wrong, which would be an entirely separate 'Dear Dr. Sunday' post. I'm completely trapped, clawing at the inside of my head, with nowhere to
go. How do I talk about this to someone? Anyone? Bueller?

-Huddled in a Corner in Clifton

Dear Huddled,

There's a lot to cover here, and I'll do my absolute best to address every point. Let me start by offering you my moral and spiritual support, for you, your family, and especially your mother. Cancer is a scary prospect even in the best of times, but it's important to keep a positive attitude, because while science can't always take care of the problem, there is plenty of evidence to support the idea that a positive mindset in trying times, especially when coupled with a solid support network, such as a family being as sensitive to the needs of the survivor as possible, while remaining positive themselves.

Now, as far as the feeling that no one is really discussing the matter, or that the issue isn't being faced directly, I will say two things. Thing one, I'm playing devil's advocate: there are as many ways of facing trying times as there are people to face them. Example: I've had some deaths in my family in recent years, more than I wish-- and my father and I, in the best of times, often don't relate the best. I am one to cry when hurt, to share my feelings with my friends, and to give equal time both to confronting my emotions as to trying to be of cheer (cheering myself up, letting friends and close loved ones cheer me, or merely distracting myself to recharge my batteries, so to speak). My father, however, will talk only to my mother about his feelings, and put on the bravest face possible for everyone else, because this is how he sees himself, and how he feels it is best to meet a crisis; not just for himself, but for his family: his wife, three sons, two daughters, and four granddaughters. If this is a recent development, as you said, then perhaps the "cavalier" manner of coping that your family has thus far adopted may simply be the first phase of their response, or may simply be the best they can do-- at the moment.

Of course, this doesn't mean that you have to simply allow this to continue. While "sweeping things under the rug" may be a time-honored Midwest/American tradition, it's not the best way to deal, by any means. Without knowing the specific dynamic of your family, let me make you a few suggestions for opening dialogue within your family, and if nothing else, let the above statements remind you that sometimes, things are as they must be, thus you must rely upon your own reservoirs of strength, which are great.

Being an oldest child myself, I can relate to your position in your family. This gives you a unique opportunity, of course, to take advantage of being the oldest child-- here's how. Firstly, go to your mother-- MAKE her a card, not to say "get well" but just to say "Mom, I love you, thanks for being amazing." I don't know how she's facing the crisis, or if she's merely doing as the rest of your family, but if you spend a little one-on-one time with her, you can tell her that you're proud of her courage, and that you're praying for her/wishing her well/lighting candles/sacrificing goats/whatever the custom is in your family circumstance. It may seem like a simple thing, but making the gesture is going to do worlds of good for both of you. Then, perhaps you have lunch with your father, or a phone call, or go over to the house and make some dinner for everyone, as you have time. You can meet with siblings or daddy privately, to get into some depth, ask how they're holding up BUT MAKE SURE that you volunteer your OWN feelings in these exchanges, because it opens dialogue and loosens reticent lips. Those more direct approaches are great, but at the very least, making sure that you're visibly showing concern WITH support (making dinner, stopping by to visit, being kind and generous in the best way that you can) will go miles towards opening that door for your whole family, and helping your mother in her recovery.

These are easy things, certainly, and cost you very little financially OR personally-- but trust me, it'll make a difference, as long as you're consistent.

Regarding your concern with Planned Parenthood and the possibility of cancer in your own life, I can offer a few suggestions as well. Firstly, I wish you well, and hope for the best in your health-- but you need to get that test done. How can you do this? Here are my thoughts:

Thought one: Ask your father, privately, without informing the rest of your family. I know that you're concerned about bringing this up with your family, to spare them the worries, but let's be completely frank here-- your father would rather find out that two women he loves well are suffering BUT BEING TREATED, than find that while his wife has recovered, his firstborn daughter is facing the possibility of serious health complications, up to and including DEATH, because she didn't get treated in time. I don't say that to scare you-- please don't mistake me. I've lost two family members in recent years because they didn't want to face the financial implications of seeing a doctor when things STARTED getting scary. That's not an exaggeration. So ask your father for help, if you think he can help you, at least financially, but ask him to hold that in confidence. He'll be glad you trusted him enough to turn to him, and while he'll be concerned, he loves you enough to do the fatherly thing and take care of you.

Thought two: You're clearly working a job right now that doesn't pay you enough for your expenses. Granted, this is a tricky and trying job market/economy, but have you considered the possibility of going to work in an environment where insurance comes from day one? I've got several friends who work in "call center" environments, which, admittedly, aren't the most fun jobs in the world, but tend to have healthcare benefits attached from the first day, as do those of larger corporations-- especially national banks. You could, potentially, get a job by submitting an online application, begin training, and sign up for your benefits ASAP-- and use them. Even if you're only doing it as a means to an end, it's worth it, if it saves your health, or even your life.

Thought three: I don't know how Planned Parenthood works as far as billing/payment go, but if you throw yourself on the mercy of the office, you might be able to put yourself in a payment plan. Call and ask them, stating clearly your concerns-- speak to the doctor, and see what he has to say, what suggestions, if any he might have in this regard. Most doctors, despite being incomprehensible and baffling to the general public, ("it could be cervical cancer-- or nothing at all. Give me $300") are good people who get into their line of work because they want to HELP. I know lots of people who are in RIDICULOUSLY easy payment plans for medical procedures ($20 a month against a few grand, you can swing-- just eat peanut butter sandwiches for lunch a couple times a week, and you're there). It'd be great to think this might work, but just bear it in mind and be honest about your financial circumstances. You don't have to prostrate yourself and grovel-- just ask. The worst thing that happens, you get told "I'm sorry, ma'am" and have to use one of the other options.

Were it me, I'd speak to your father first, but only you know what is best for you in that matter, or what you're willing/capable of doing. Keep your resolve strong, make your choice, and stick with it. You will not fail, I can assure you of that.

Now. Regarding your friends, let me say-- it sucks, being isolated, for whatever reason, whether as the result of something you may have done (right, wrong, or indifferent), or merely because the world moves, shit happens, and life goes on for others. It's a terrible feeling, when you can perceive that unpleasant distance between your friends and yourself. So how do you talk about it? How do you find an outlet? There are a few ideas I would have for you, and I hope one fits you well.

You say that your roommate and a close girlfriend are there for you. Perhaps those friends are ones with whom you might spend more time. Get outside your comfortable social circle and see what the world has to offer. It's easy to lean on familiar shoulders-- but ultimately, you hear the kind of advice you'd expect from people who know you as well as you know them. Sure, your roomie probably is close, and you've met his or her crew, maybe they're right and maybe not. What about asking that girlfriend to take you somewhere new, do something outside of your norms? What about other friends who might have drifted away, not as a result of any direct action you've taken, but rather as a result of the not-quite-parallel lines that human lives lead? Call someone and ask them out for coffee. Invite them to something that takes you both to something new, or takes you somewhere that you can find an opportunity to expand who you are. You are only as alone as you let yourself be. Think laterally, think creatively. If the familiar isn't as friendly, spread out. Do something new. Change the landscape, even if you can't move out of the city. You have the power to do anything you choose-- it just takes two things: one, the choice, and two, the will to pursue. Don't forget it.

Alternatively, if you can't just ask someone to listen to you, you could always deal with your concerns in an artistic fashion. Maybe you write poetry, maybe you write prose; maybe you make ninjas out of pantyhose. Only you know what is going to bleed the pressure out of your pipes, so to speak, but don't let worry or fear impede you from doing whatever you have to do to make yourself feel right again. You're a strong and articulate person-- I don't think you're as trapped as you think you are; it's really just about how you perceive your environment. Maybe you just need to stop looking at the bars of the cage, and start considering how far apart those bars really are-- and where you can slip out, or how you can get a message to the outside, so someone can come and unlock that prison.

I know this has been a rather lengthy response, but to be fair, you started it! I'm kidding. I don't mind EVER offering the best advice I can, and I hope this has helped you. And if you have any further questions for me, as you implied, don't hesitate to ask.

Dr. Sunday is always listening. I wish you and your family well.
Sincerely,
Dr. Sunday