https://www.thecut.com/2021/12/segmented-sleep-pandemic-insomnia-help.html

DEC. 13, 2021

Just Embrace Your Insomnia Already

By Annaliese Griffin

Photo: Buket Akbas/Getty Images/EyeEm

Finding yourself wide awake at 3 a.m. is a special kind of hell. It’s dark. It’s lonely. An ideal setting for all your anxieties to blossom into full-blown panic. But does it have to be?

There can be many, and multiple, reasons for insomnia, but worrying about sleeping, or more accurately, about not sleeping, is nearly always a confounding factor — especially once you’ve been hit with the 3 a.m. scaries a few times and come to dread lying awake. Embracing that time, and planning for it, is one way to remove the anxiety from the equation and reframe your relationship to sleep. Whether it’s chronic COVID stress, seasonal agita about the holidays, or just the company I keep, it feels like everyone I know is complaining about the agony of wanting to sleep, yet finding it impossible to do so in the wee hours. If any of that sounds familiar, behold: segmented sleep.Court AppearancesA newsletter by New York‘s Choire Sicha, covering the Ghislaine Maxwell trial.

You’re probably already familiar. Segmented, or polyphasic, sleep had a moment a few years ago, first as an item of historical interest and then as a lifehack to sleep less and do more. This is not a guide for how to do that. (Because who wants to do that? Sleep is the best.) This is a guide for those of us for whom 3 a.m. has become an hour we already dread, not sleep through. Consider segmented sleep a tool for reframing our not-enough-sleep panic, to take some of the anxiety out of the equation and find a semi-workable schedule that doesn’t leave us exhausted and enraged.

So should you even try it?

“People are notoriously bad about knowing how much sleep they need,” Elizabeth Klerman, a professor of neurology at Massachusetts General Hospital and Harvard Medical School, explains over Zoom. “It’s clear that people have no idea how tired they are.” Klerman is one of the authors of a 2021 meta-analysis published in the journal Sleep Health that looked at 22 studies investigating polyphasic sleep patterns and found no evidence that it improved anyone’s life and, in fact, found quite the opposite. “We identified no peer-reviewed published evidence that supported improvements in mood while subjects were on polyphasic sleep schedules,” the authors wrote. “Rather, polyphasic sleep schedules were associated with significant deterioration in mood in multiple studies with depression ratings increasing with duration of exposure to the polyphasic sleep schedules. Irritability and emotional discomfort are also associated with polyphasic sleep schedules.”

Here’s the thing, though: This paper focused on sleep hackers intent on whittling away the total number of hours spent in bed, including some extreme schedules totaling just two hours of sleep a day in multiple short naps. Klerman emphasizes that there’s no reason to establish a segmented sleep schedule if you’re relatively happy with your sleep. You shouldn’t feel crawl-under-your-desk-and-nap drowsy during the day; your sleep patterns should be fairly similar throughout the week — not four hours some nights, 12 others; and you shouldn’t be waking up hours before your alarm or hitting snooze multiple times. (Keep in mind, though, that Klerman says we shouldn’t need an alarm clock at all to wake up if we’re truly well rested.)

If you’re grappling with insomnia, likely you’re already experiencing significant deterioration in mood and emotional discomfort as well as the exhaustion and anxiety that accompanies poor sleep. Likely you feel pretty crap at this point. Yeah, keep reading.

First, understand what’s going on

“If you snore, or have excessive sleepiness during the day, I always encourage people to see a sleep specialist to make sure there’s nothing medical influencing their sleep,” Shelby Harris, a sleep psychologist and author of The Women’s Guide to Overcoming Insomnia, writes over email. There are a variety of factors that can contribute to sleep issues. External interruptions like pain, noise, light, and some illnesses or medications can often be treated separately, and then sleep problems are likely to resolve on their own. Sleep hormones and the circadian rhythms that control them are often affected by jet lag, changing seasons, menopause, stress — or some combination of the above.

All of the sleep experts I spoke with said that if insomnia persists for more than a few weeks, or if you’re consistently exhausted, anxious, and on edge about sleep, to seek medical attention. Make an appointment with your primary-care doctor to review any medications you take and talk through what might be going on, and the doctor should help direct you to the right specialist. Or, if you strongly suspect that the culprit is perimenopause or anxiety, start by talking with your gynecologist or therapist. Many sleep problems are very treatable, but they can also signal underlying issues, so getting a baseline with a provider you trust is important.

Next, stop telling yourself to “just relax”

Anxiety or, as Dr. Joshua Tal, a New York–based sleep psychologist puts it, “the bear in the bed” is a major sleep thief. And what an anxious moment we’re in. Our faith that the world will function in a smooth and navigable way has always been a combo meal of illusion and privilege, but over the past two years we’ve had our expectations of order upended at every turn in a way that has outpaced even the coping mechanisms of the mellowest and most well adjusted among us.

The long-term stress of modern life, whether it’s the pandemic, work, or some other circumstance, is at odds with the way humans are wired to deal with immediate threats. “If you’re activating the fight-or-flight system, your body says, ‘There’s something dangerous, I can’t sleep right now. I have to fight. Sleeping is the last thing that I want to do right now,’” Tal tells me in a phone call.

So yes, it’s infuriating to lie in bed, ready to sleep, and have your body not cooperate — that’s the true hell of insomnia — but it is also your body’s attempt to keep you safe. And don’t fear — you will eventually return to sleep, says Tal.

Another source of sleep anxiety, according to Tal? Making too much of how very important good sleep is by constantly tracking how much we’re getting and its quality. None of the experts I spoke with was a fan of using fitness trackers or apps to monitor our sleep. While sleep is crucial, Tal insists that obsessing over it doesn’t do us any favors and is one of those sneaky, competitive pressures of wellness culture. “Sleep is so important — that’s the wellness revolution,” he told me. “What happens when you put pressure on yourself to sleep? Do you sleep? No way.”

Okay, here’s how to do this already

This is where I admit that after a six-week period of my own middle-of-the-night insomnia, I pitched this story as a way of trying to find some upside to my misery. A few nights a week, I wake up somewhere between 2 a.m. and 4 a.m., get up and pee, and then … just lie there with my brain churning. The first week or two, I managed to get back to sleep eventually. Then I recognized the pattern and developed a fear of not being able to fall back asleep. In a self-fulfilling prophecy of sorts, the bear was officially in my bed.

So I’ve developed a new, less-soul-sucking routine: Upon the unwelcome waking, I first give it 20 minutes when I flip the pillow over, resettle myself and try to think about something relaxing, like what color to paint my bedroom, what kind of Christmas cookies I’m going to make this year, or how to link two different parts of an article or essay I’m working on. (“Relaxing” is subjective, okay?)

If that fails, I get up — all the standard sleep-hygiene advice indicates that the longer you spend unhappily in bed, the more you’ll come to think of it as a place where you don’t sleep — and do a brain dump where I write down all the weird tasks and concerns that are caroming around my brain. Making lists is inherently relaxing for me, and as a freelancer, and a mom, I tend to have a lot of different projects and responsibilities competing for attention in my head. The brain dump helps me plan the day out and clears thoughts that make me anxious, creating space for me to relax.

Then, I read. Usually a magazine I’ve been saving, or a novel that I only turn to in the middle of the night, both of which help me embrace being awake and banish the anxiety I feel. This might seem counterintuitive, but I also let myself get a little bit cold while reading, so that when I return to my bed, it will feel extra luxuriant when I settle in under the comforter — our bodies naturally drop in temperature at our normal bedtimes, too, so this simulates that process … or at least that’s my working theory. After about an hour, I’m usually ready to go back to bed and I almost always fall asleep again.

I’ve also pushed my bedtime earlier by an hour to make room for my middle-of-the-night times. I go to bed between 9:30 p.m. and 10 p.m., wake up between 5 a.m. and 6 a.m., which means I’m clocking around six to seven hours of sleep on nights when I wake up, which is still not quite enough, but better than the four or five I was getting when I spent more time tossing and turning. (A few years ago, I spent a few months sleeping as much as I wanted with no alarm — one upside of being self-employed — to figure out just how much sleep I need and found that between seven and eight hours of sleep a night is my body’s baseline.) I go outside for at least a few minutes every morning around 8 a.m. to activate my circadian clock with sunlight, too.

This routine is more structured than I would have ever predicted, but that’s part of making this system work. “Biphasic sleep isn’t just napping here and there to make up for a shorter night of sleep. You need to be strict with it — which will then hopefully help you adjust to the schedule,” Harris wrote. “It isn’t a ‘I’ll get six hours here and nap when I need to’ kind of thing. That just is a recipe for more sleep deprivation.”

I came up with these strategies having read about the history of segmented sleep and out of desperation, because I was starting to feel so lousy from lack of proper rest. I had a hunch that psychologically reframing the middle-of-the-night waking I was experiencing, instead of raging against it, would be helpful, largely based on the fact that when my children were infants, I often felt tired but I never felt mad about it because it was normal in the context of having a newborn. And honestly, finding time to myself is always a challenge. I don’t prefer it in the gloaming hours, but I’ll take it, for now at least.

While this isn’t a universal fix, I can say that it’s vastly improved my life and that my sleep is slowly returning to normal. I wake up too early less often than before and fall back to sleep in that 20-minute window more frequently, too, which I attribute to feeling less anxious about sleep itself. Even though I have reframed my insomnia in a way that both gets me a workable amount of sleep and a little more time to myself, I strongly recommend against this as some sort of productivity hack — I still spend more days than I would like feeling tired, and I would much rather just go to bed and sleep than engage in all these work-arounds.

Klerman told me that she didn’t like the word “tool” applied to segmented sleep because there are more rigorously tested methods, like cognitive behavioral therapy for insomnia (CBTI), that are very effective at lessening the symptoms of insomnia, so that you can go back to your regular sleep pattern. Her ultimate take as someone who has studied sleep for several decades? Get as much as you can. “You can eat when you’re not hungry,” she said. “There is no evidence that you could oversleep. And so if you can sleep, (in a safe place) sleep.”

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