I Could Use That Much Sleep, Though

Because everyone loves to hear about other peoples' dreams, here's last night's entertainment at the Theater of My Brain.

I dreamed that I was very tired (also true in real life), so I went to bed, and when I woke up I realized I had slept for three days straight, and missed my flight to Portland, OR, for Christmas (this flight is real).

I was very distressed that not only had I missed a holiday vacation of awesome familyness, but it was all my fault, and I was therefore not going to be able to get any use from the enormous amounts of money that I spent on the plane tickets (the high cost of these tickets is true in real life).

Doing a little highly sophisticated dream interpretation, I perceive that certain themes occupy my mind:

• sleep
• time/being late*
• money* 

Obviously my spirit is troubled, and vague premonitions of ill fortune disturb my peace of mind. I should take a nap.


*These themes also appear in another recent dream, suggesting ongoing preoccupation.

Sleep Tight

So we slept with the baby, the first few months, but have been gradually transitioning him into his crib as he gradually transitions into waking up fewer than four times every night, and I was just thinking how odd the expectations are with regard to sleeping.

I mean, to the extent that being partnered is considered a natural state for adults (that is, to a pretty great extent), sharing a bed is considered the natural sleeping habit for adults.

And yet, for years and years before this, all through childhood, sleeping alone is considered to be the natural state. (In contemporary US culture, at least: obviously there's a lot of variation between cultures and time periods.) You spend years accustomed to having your own bed, and then you're supposed to just naturally make this big shift and spend years sharing your bed with someone else.

When you think about it, doesn't it seem more reasonable that children should be the ones who customarily sleep with someone? After all, they get anxious and scared of the dark (unless that was just me), and having someone to curl up next to makes it somewhat less alarming. (It's a known fact that monsters don't like to pounce if there's more than one person in the bed.)

Presumably as adults we're less likely to be scared of the dark, and yet that's when we're expected to be able to curl up next to someone as a matter of course.

Personally, I often shared a bed with one or more of my sisters as a child, because there were sometimes more of us than than there were mattresses, but a lot of people don't have this experience. Thanks for helping keep the monsters off, sisters!

Now I feel kind of bad about putting the baby in his crib all alone, although I think he's too young to be scared of the dark at the moment.

Also, I'm suddenly kind of worried about monsters again. Thanks for opening up old wounds, brain.

Eww of the Day

This NYT story about dust mites reminds me why I generally choose not to think about them.

1. They're gross
2. They're not dangerous unless you have a severe allergy

Since thinking about them makes me feel itchy, and there's no real reason to worry about them considering that as far as I know I'm not allergic, I conclude that the best policy is simply not to devote attention to the topic.

Consider:

Dust mites are microscopic creatures, about 0.4 millimeters in length, that feast on flakes of human skin. Their feces contains a substance called DerP1, a very potent allergen. People who are allergic to dust mites may have asthmalike symptoms, eczema or chronic sinus problems.

Ick, right? And yet, though some people (although, in all honesty, no one I know does this) think that bedding needs to be regularly replaced to keep the mite population down:

People who have allergies to dust mites should indeed take measures to protect themselves. But everyone else can skip the expensive trips to Linens “R” Us.

Skip something expensive? In exchange for the minor effort of thinking about something else instead of succumbing to feelings of disgust at the thought of drifting off to sleep surrounded by colonies of tiny munching creatures? Done and done.

It's not like I was planning to use those skin flakes for anything. Really, I should be pleased they're being put to good use by something. It's all part of the circle of life!

The teeming, crawling, shedding, oozing, disgusting, disgusting circle of life.

Sweet dreams, everyone. Don't lets get started on the eyelash mites.

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Go Away, Morning

A post from s.e. smith at This Ain't Livin' on a topic dear to my heart: sleep schedules.

It begins crisply with the observation that "It is generally agreed upon in our society that people who wake up early are better people."

Seriously!

With the 'healthy, wealthy and wise,' thing, the early bird getting the worm, the whole idea that smart, productive people sleep little, and get up first thing in the morning, the better to beat the day into submission--while the late-sleepers are slugabeds, layabouts, and probably up to no good anyway, staying up all night.

If one person sleeps from 4am to noon, and one sleeps from 10pm to 6am, the second one will pretty generally be seen as the one who's getting things done and being a hard-working, upstanding, in-fitting member of society.

Hmph. As a person who has long been no fan of early mornings, but is trapped by the modern business day (plus an hourlong commute), I am filled with bitterness regarding this popular myth. If I could have set up a work schedule that involved being in business from about 11am to 7pm, I would have been all over that.

Of course, that would actually be possible in many libraries, but I happened on one where the librarians work standard business hours. And I have to say, I've kind of gotten used to it, and I appreciate the fact that this way my schedule more closely matches those of people with whom I may feel like meeting up after work, so there are advantages.

That doesn't mean it's not still true that the only thing that gives me the energy to get out of bed in the morning is the brisk surge of loathing with which I greet each fresh new dawn.

Pfah. I scoff at the dawn. It can keep its rosy fingers to itself.

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I'll Sleep When You're Dead

Maggie Maher on Health Beat is writing about the issue of medical residents working long shifts with little or no sleep.

There are some very sobering quotes from residents explaining how they basically just lose all interest in their work and their patients when they're running on 20+ hours of no sleep. One story in particular struck me, where the physician says that after being up all night and receiving a new patient:

I wished that my new patient would die. At that moment, I cared nothing for my patient, her family, her life. Her living got in the way of my sleep. She was one more name to go on my patient list, one more life to attend to, countless hours I wouldn’t spend in bed.

Yikes. You don't want to encounter this doctor, right? (As the quote continues, "That’s the side of a doctor no patient should have to face.")

But don't you totally understand that feeling, at the same time? Not literally, since I've never been in a position where saving a person's life kept me from sleep, but I know that when I've been up for way too many hours in a row (not often, happily), I start to operate in a complete haze. Emotions are off key, responses are slow.

Heck, I hate everyone and everything in the world if I wake up too early in the morning*. Sleep is important!

But of course someone needs to cover the shifts these residents work, and there's the question of whether hospitals can afford to pay enough people to do that if they only work for shorter periods of time. Also, there seems to be an attitude of "I survived it, so you can too--now suck it up and quit whining!" among doctors past their residency experiences.

Another post addressing these questions is promised. This one was mainly about why long shifts and sleep deprivation are an issue we should think about. And I have to say, I'm pretty convinced.


*'Too early in the morning' is here defined as 'at some point in the morning.'
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Two Unrelated Items

Well, first, everyone is all over the PubMed redesign (announced, with info on the specific changes, on PubMed New and Noteworthy, and noted by lots of people).

I'm all over it too, of course. It's big news in my world.

Now we can start making our Captivate tutorials to inform our students about how to switch over to PubMed once Ovid Medline is gone! We've been champing at the bit for this.

Having spent a little time poking around the new site, I am basically cool with it, as the kids said about 50 years ago. Things look a little different, but I think I can find what I need, and I haven't found that anything I loved is totally gone. The cool tricks we try to teach students to use (do any students use them? we can dream) are still there.

I like that you can now see the MeSH terms on an article by just clicking a little plus sign at the bottom of the abstract. It was never much fun to explain to people that they had to change the dropdown 'display' from Abstract Plus to Citation to see them: not that that's difficult, but it's not intuitive, or likely to be easily remembered by someone who doesn't use PubMed a lot.

When you're just trying to give someone a handy tip ("looking at the MeSH terms assigned to an article that's good can give you ideas about search terms to use to locate more articles!"), it's nice if the tip is actually going to be easy for the person to apply later.

I imagine we'll pretty much immediately start teaching this (sorry, class who got the PubMed presentation yesterday--that's old news!), and I anticipate getting to know it much better. For now the new PubMed and I are on cordial but still distant terms, but I hope to grow to love it in time.

Ideally, about 20 minutes of time. I'm a busy person, you know.


Second, as if it weren't enough that not sleeping well might incline one to be more susceptible to catching colds, now Genetics and Health presents the suggestion that poor sleep may be associated with Alzheimer's Disease.

Well, that's it, I'm going to bed. Perhaps I'll dream of biomedical information searches in wondrous new interfaces.

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Well Slept

Via Well, a sad story for anyone who has trouble getting that regular eight hours of sleep that we're told is optimal (does anyone actually sleep eight hours a night?): we're probably going to get sick, too.

We can tell because some people in a study who slept less than seven hours a night were almost three times as likely to catch a cold as some other people who slept at least eight hours.

As in all things, we must caution against reading too much into the one study referenced, which looked at only 153 people and their responses to cold viruses after their sleep patterns had been observed for two weeks.

This should not be taken either as license for extremes of behavior, which I contend is the main reason we like to read health news stories, or as proof that we're doomed, which is the other popular message. (We are all going to die. But not immediately as a result of poor sleep quality, if judging solely from the information presented.)

Interestingly, "percentage of days feeling rested was not associated with colds," according to the study authors, so you may not even be aware than you're at risk. You could feel just fine, but be an unwitting virus magnet!

Perhaps you're a victim of sleep inefficiency; the people with less than 92% sleep efficiency were five and a half times as likely to catch the cold as the people whose sleep efficiency was 98% or greater.

Five and a half is more than three, you'll notice, so in fact you might be better off getting seven hours of efficient sleep (sleep efficiency is defined simply enough as "percentage of time in bed actually asleep") rather than nine hours of inefficient sleep.

So it's not enough to just be in bed for eight hours. Even being in bed with your eyes closed, pretending to be asleep, will not substitute.

If only that were one of those things that you can actually choose. Yes, I'll take the restful, efficient sleep tonight, thanks! Last night's tossing and turning and waking up every few hours was a lot of fun, but I'm in the mood for something a little quieter this evening.

This actually feels like one of those "stands to reason" type findings. Sure you're more likely to get sick if you're tired and run down. Since common sense sometimes turns out to be wrong, though (thanks, lazy deceitful brain), it can be useful to get some confirmation.

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Even the Most Adequately Laid Plans...

I was going to sleep in really late today. It was my big plan for the weekend.

It's been a busy week, with some nights of fitful sleep. (When I know I'm going to have to get up earlier than usual, often I just wake up repeatedly at gradually less ridiculous hours, because I'm worried I'm going to miss the time I actually need to wake up. "Is it time yet? Can't be late! No, it's 2:30. OK. Go back to sleep. Is it time yet? Can't be late! No, it's 3:28." And so on.)

So anyway, here it was Friday night, a long and busy day behind me, yawning with weariness, and darn it, I am going to sleep forever on Saturday!

So I woke up at 8:30. Which granted is two hours later than I usually get up, but it's not late. Not like I used to be able to sleep late. I blame the fact that I can really no longer stay awake very late unless there's a darn good reason.

In college I'd still be up at 2 in the morning as a matter of course. On weekends I might not go to bed until dawn. So naturally I could then easily sleep until 3 in the afternoon.

I don't usually do that anymore.

I also blame the fact that when I woke up at 8:30 I was starving. There was no chance of going back to sleep when my stomach was shouting at me in apoplectic rage.

"What in the hell are you playing at?! Usually at this time of day we've had two full meals and three tasty snacks!* We're running on empty down here! Do you want me to cut off the glucose supply to your precious brain?! DO YOU?!"

Fine. I accept that I'm all grown up and old, and I need structure and routine. I got up and had ice cream for breakfast. That shut the stomach right up.

*My stomach is exaggerating. Usually by 8:30 I've had one meal, and at most two tasty snacks.