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Love Means Never Having to Say Goodnight

Published in The Huffington Post

liminal waterfallMaybe you’ve just made love. Maybe you’ve stumbled into bed, exhausted. Or maybe you’ve been reading or watching television and find yourself nodding off. So, you turn to your partner, say goodnight, and go to sleep. I imagine this is the most common bedtime story for couples in our world.

It reflects a ubiquitous belief that sleeping and dreaming are essentially solo experiences. As much love and connection as there may be between two people, there are some things we simply do alone. Although we might share lovemaking, dialog, or dance, when we go to sleep, we go away. We leave one another to descend into our own, private realms of consciousness.

The passage from waking to sleep takes us through a liminal dream. We wade into a shallow stream of consciousness that washes through our thoughts and feelings, dispersing the mind in preparation for sleep. We’re called upon to let go — to release tensions and, most notably, our intentions — to be able to cross the border into slumber.

Technically referred to as Stage I sleep, the transition from waking to sleep is characterized by complex neurological changes, including increased alpha EEG, decreased premotor cortical activity, and the galvanization of mirror neurons. Alpha EEG, of course, is a sign that the brain and body are relaxing. The associated quieting of the premotor cortex, a set of small areas just north of our temples, signals a critical diminishment of intention. This, in turn, engages our mirror neurons — the neural networks that mediate empathy.

What all this suggests is that in those fleeting moments when we are drifting off, we become especially empathic. It’s not a surprise that our capacity for empathy is inversely related to the extent of our intentions. As our intentions diminish, our psychological posture shifts from desire to receptivity. For many of us, our capacity to be fully present, openhearted and deeply empathic is greater during the transition into sleep than at most other times of day.

As children, we instinctively knew that the descent into sleep could be a social experience. In hushed post-bedtime conversations with our sibs or more playful exchanges with our friends at sleepovers, we would go gently into the night —together. Under the approaching cover of sleep, we would whisper dreamy thoughts and share secret feelings and far-fetched fantasies. As kids, we knew how to surrender waking, how to descend through a fuzzy and fading liminal dream dialog.

My Q and A With Sleep Specialist Rubin Naiman on Paying Attention to Our Dreams

Published in The Huffington Post

Painting of sleeping girlDr. Rubin Naiman doesn’t want to just raise awareness about the importance of sleep. He wants to change the way we think about it, by blasting through the assumptions and misunderstandings that have for so long defined — and limited — the conversation.

A clinical assistant professor of medicine at the Arizona Center for Integrative Medicine, Naiman is particularly interested in dreams. In answer to my questions, he passionately and eloquently makes the case that we can truly benefit from opening ourselves to our dreams and meeting them on their own terms rather than trying to view them through the lens of waking life.

Why do we dream?

Great philosophers have taught that we routinely mistake the limits of our personal perception for the limits of the universe. Nowhere is this fundamental error more evident than in our posture toward dreams and dreaming. Because we live in a world where dreaming is so utterly misconstrued and commonly dismissed, we fail to recognize the critical role it plays in our health and happiness. I’ve come to believe our blind spot around dreaming is at the root of so much that is wrong with our world today.

REM sleep has been shown to be essential for learning and memory consolidation. In fact, diminished REM sleep is a hallmark of dementia, including Alzheimer’s. REM sleep also actively regulates our feelings and moods. It’s not a surprise that mood disorders, depression and anxiety, are frequently associated with a pattern of disrupted dreams.

Recent research suggests that REM sleep essentially functions to process waking-life experiences. Sometimes referred to as the second brain, our gastrointestinal system intelligently processes — or sifts through, digests and assimilates — the food we consume. Likewise, in REM sleep the brain sifts through, digests and assimilates the vast array of information and experiences we “consume” by day. Acting like a second gut, it selects what will be purged and what will be permanently assimilated into our long-term memories — into who we are. We are remade and updated nightly during REM sleep.

Just as updating a computer requires temporarily shutting down its operating programs, REM sleep takes us “offline” by inhibiting the use of most of our senses and voluntary muscles. We are disconnected from the world around us, functionally disembodied as our sense of self is updated nightly.

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10 Features Of Superb Sleep

Published in The Huffington Post

woman sleepingGiven all the concern about insomnia and sleep deprivation, it’s too easy to overlook the fact that there are exceptionally good sleepers among us. They tend not to get much media attention. In fact, I’ve found they are rather reticent to boast about their joyous relationship with sleep. Frequently, one of these great sleepers will approach me after I’ve done a presentation and actually whisper, “I love sleep.”

It’s too easy, even seductive to become preoccupied with the treatment of sleep problems — with sleep techniques and sleep aides and sleep paraphernalia. It’s not that these aren’t necessary; it’s just that they are rarely sufficient.

As a sleep specialist, I’ve learned as much about healing sleep from superb sleepers as I have from those struggling with sleep. Improving our sleep health is not just about avoiding dysfunctional sleep patterns and habits; it’s also about re-envisioning ourselves as superb sleepers. My observations have taught me that truly great sleepers share a number of important sleep enhancing attitudes and characteristics:

1. Superb sleepers welcome their dreams, even the challenging ones. Because they know that dreaming is natural, healthy, and supportive of their emotional well-being, they are open and receptive to the mystery of their dream lives. Most insomnia occurs during the latter part of sleep, a time when we do most of our REM sleep and dreaming. Being on good terms with our dreams can help us stay in the game throughout the entire night.

2. Superb sleepers typically awaken without an alarm.Because they know how much sleep they need, they get to bed in time to allow for that. And, they know when they will awaken naturally. Routinely awakening with an alarm clock snips off the end of our sleep. Would we ever consider setting an alarm to limit other natural and enjoyable activities like dinner or lovemaking? Does our sleep really need to be restricted or restrained in this way?

3. Superb sleepers have an intuitive regard for routines and rhythms. Rhythms are the infrastructure of sleep. And routines are our personal way of dancing to those rhythms — of balancing activity and rest. Unfortunately, modern life is dysrhythmic and staccato. We hear little about the “rat race” anymore, but this is because we are inured to its overarching presence in our lives. It’s fine to accelerate when necessary, but too many of us have lost our breaks.

4. Superb sleepers are accepting of periodic nighttime wakefulness. They know that waking up occasionally from sleep is not a sign of a sleep disorder and won’t affect the overall quality of their night. They don’t fret and get back to sleep easily. In fact, they might get up for a few minutes and enjoy the exquisite stillness of night. Historical evidence suggests that prior to the industrial revolution people commonly awakened for a stretch in the middle of the night. This is probably a more natural pattern of sleep that we now misconstrue as insomnia.

5. Superb sleepers have good “sleep self-efficacy,” that is, faith in their own ability to sleep. Because they hold it in high regard, they are on good terms with sleep and live with confidence that it is accessible whenever needed. This is not to suggest that someone with a history of poor sleep can just throw a switch and improve their sleep self-efficacy. But this can be achieved over time through sleep-hygiene practices.

6. Superb sleepers know how to truly let go. They are adept at forgiving the loose ends of the day and trust that things which remain unresolved today can be addressed even more effectively after a good night’s sleep. Letting go is not just a psychological maneuver; it’s also a deeply personal and rewarding spiritual practice.

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Dressed For Rest: Can Bedclothes Affect Our Sleep?

Published in The Huffington Post

woman in bed wearing pajamasMost of us typically think about getting dressed as preparation for our day. We dress to accommodate waking life activities and events. We dress for work or play, for celebrations, chores or to hang out with friends. But because we see sleep as a kind of non-event or inactivity, we typically don’t think in terms of getting dressed for it. We get undressed for sleep.

The limited data we have about bedclothes suggests nearly 40 percent of Americans simply shed their waking attire at bedtime, stripping down to their underwear or birthday suits to sleep. Another 23 percent don shorts and a T-shirt to bed down. In the end, only about one-third of us actually dress up for sleep with pajamas or nightgowns.

Does sleeping nude enable us to feel thoroughly free? Does it allow us to tap into a deep sense of innocence? Whatever it might be, men do so twice as often as women, who wear pajamas or nightgowns four times as often as men. Basic PJs may set the standard for practical, no-nonsense sleep. Does the T-shirt and shorts sleeper view sleep as a stripped down version of waking? Women opt for this slightly more frequently than men do, but less often than choosing lingerie.

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Lying With Lions And Lambs: Why Clergy Should Help Heal Sleeplessness

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Lion and a LambWhether as a biblical icon or a secular notion, the image of the lion lying down with the lamb is one familiar to most of us. For some, it symbolizes an unattainable utopian state. For others, it holds the promise of a miracle in which opposite forces come to peace. This image is also suggestive of the most critical personal and cultural challenges underlying the sleep epidemic as well as the potential role of clergy in healing it.

Despite frequently being depicted in repose, the lion commonly symbolizes vigilance, power, and aggressiveness. In sharp contrast, the lamb is associated with innocence, amity, and submissiveness. Getting the lion and lamb parts of ourselves to lie together peacefully may be our greatest personal challenge to obtaining healthy sleep. Sleeplessness is strongly linked tohyperarousal — a relentless lionesque vigilance — as well as an insufficient lamb-like submissiveness to sleep.

Too much lion and not enough lamb also characterize our society’s fundamental posture toward sleep. Conventional approaches to the treatment of sleeplessness are lionesque, that is, informed by a highly aggressive medical posture. Rather than cultivating lamb-like submissiveness to invoke sleep, we are encouraged to fire heavy rounds of sleep medications to stun the lion.

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Here and Meow: What Cats Can Teach Us About Sleep

Published in The Huffington Post

sleeping catI’ve never been much of a cat person. I’ll confess that until recently I couldn’t understand the lure these mysterious creatures had for so many. Beyond their penchant for catching the occasional rodent, it seemed they were little more than hypersomnolent stoics who couldn’t distinguish a scratching post from a fine leather sofa.

After considerable observation of our feline friends, however, I’ve come to wonder if they might actually be from another world — a parallel universe where rest and sleep are held in the highest esteem. Because they are on exceptionally good terms with it, I believe cats have much to teach us about the secrets of natural sleep.

Cats commonly sleep between 12 and 16 hours a day — more than most mammals and up to twice as much as humans. Why do they sleep so much? Well, because they can. Cats are predators with few natural enemies, meaning they live under the auspices of a generous, genetically-endowed sense of physical safety. They are, after all, first cousins to the king of the jungle. It’s obvious to anyone who has ever watched a cat sleep that they feel remarkably safe and secure.

Cats remind us of the critical role of personal safety and security in obtaining healthy sleep.

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Why Sleep Tips Don’t Work

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better sleepTips are ubiquitous in modern life. We are offered cooking tips, golf tips and gardening tips. There are an abundance of management, childrearing, automotive and tax tips available. And tips for weight loss, high fashion, exercise, skin care and of course, sleep, abound.

My recent Google search for “sleep tips” yielded 333 million various and sundry results. I found simple tips, proven tips, great tips, surprising tips, top ten tips, unconventional tips and healthful tips, as well as special tips for pregnant women, babies, toddlers, teens, college kids, stressed-out adults and the elderly. There are tips provided by doctors, consultants, coaches, clergy members and clinics, as well as mattress manufacturers, pharmaceutical companies and much, much more.

Our common presumption is that such tips can help us tweak our way to healthy sleep. But can they really? Having authored my share of sleep tips and spoken to many sleep-concerned patients about them, I think it’s time we reconsider their impact and value.

The media have a curious proclivity to entice us with numbered tips. Five tips for managing jet lag, four tips for better naps, seven tips for avoiding nightmares. There are countless articles offering three tips, eight tips, 10 tips, 42 tips and yes, a couple of web sites boasting exactly 100 tips for better sleep. Such enumeration seems to imply that, like the Ten Commandments, the 12-step program, the seven deadly sins or the Four Noble Truths, such lists are exact, precise and ultimately definitive. Quantifying tips also lends them an undeserved air of scientific specificity and legitimacy. We are seduced.

Discovering long lists of apparently credible tips to help manage sleep concerns may initially be heartening to the sleep-weary. But such lists can quickly foster confusion, be overwhelming and can even produce anxiety.

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Mother’s Day and Mother’s Night: A Woman’s Sleep

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new mother holding babyThis past year, I watched my daughter-in-law, Adriana, proceed through her second pregnancy, childbirth and the care of our family’s lovely newborn, Eva. I watched her struggle with some of the most common challenges of motherhood, including of course, disrupted sleep. As Mother’s Day draws near, I’m remembering the many mothers, both new and seasoned, who have come to me with sleep concerns.

Partially due to hormonal fluctuations, women have 40 percent more insomnia than men. Both menstruation and menopause are associated with an increased risk for occasional sleeplessness as well as insomnia. It’s not at all uncommon for teen girls to encounter sleep challenges with the start of menses. The majority of middle-aged women I worked with over the years had sleep problems stemming from perimenopausal symptoms.

Obviously, women are at even greater risk for insomnia when they become mothers. Because sleep struggles are so common during pregnancy, sleep doctors facetiously refer to it as a sleep disorder. And the normal feeding schedules of healthy infants will fragment mom’s sleep for those first few months, not to mention the throes of weaning and shifting routines. Even under the very best of circumstances and with optimal support of partners, spouses or other family members, pregnancy, childbirth, nursing and infant care will, to varying degrees, disrupt sleep.

It’s not at all surprising that women come to depend quite heavily on prescription sleeping pills. IMS Health reports this dependence peaks from age 40 to 59, resulting in more than 15 million prescriptions per year. And this figure does not account for millions of additional prescriptions of off-label sleep drugs, OTC medications and the excessive consumption of alcohol and marijuana as sleep elixirs.

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Narcolepsy: What We All Should Know

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Narcolepsy. Though many recognize the word, relatively few of us know what it really means. And why should we? As far as sleep disorders go, it’s not nearly as common as insomnia or apnea. And let’s face it, it doesn’t sound very sexy either. (As one patient put it, “Combining ‘narc,’ and ‘olepsy,’ sounds like an epileptic narcotics agent to me.”) Actually, the term literally refers to sleep attacks. But it’s so much more complex and interesting than that.

Why should we all know more about narcolepsy? First, many if not most persons with narcolepsy (PWN) remain undiagnosed and, therefore, are not receiving the treatment and support they need. The majority of PWN that I’ve seen in my practice had initially been misdiagnosed with conditions like chronic fatigue syndrome or depression. Narcolepsy can be terribly challenging, and it’s critical that both the public and professionals become better informed about its signs and symptoms. Still another compelling reason for all of us to get more informed about narcolepsy is that it can teach us so much about sleep and dreams and even life itself.

So, what is narcolepsy? In short, it’s a condition in which the boundary that ordinarily segregates waking consciousness from the world of sleep and dreams becomes exceptionally permeable. For most of us, sleep is largely walled off during the day. In narcolepsy, sleep readily slips into and out of waking consciousness.

Normally, sleepiness accrues gradually through the waking day, reaches its peak at night, and is then discharged with sleep. It’s a bit like urine accumulating in a bladder and then reaching a threshold where it insists on being emptied. Metaphorically speaking, PWN have a small “sleepiness bladder.” They can’t hold accumulating sleepiness for long stretches without nodding out for short periods. Just as a small bladder might require one to get up and urinate frequently at night, a small “sleepiness bladder” can force one to get down and sleep repetitively by day.

Read the full article on Huffington Post.