Fly Well: Sleepless in Oshkosh

The opposite is true: You snooze, you win. Millions of insomnia sufferers go to bed wide awake and leave it exhausted. Why do they call it beauty sleep when one wakes up looking like a troll?

First coined in the 1600s, the word insomnia derives from Latin and means “without sleep.” Prior to COVID-19, 30 percent of people complained of disturbed sleep, and 10 percent had compromised function during waking hours—a characteristic of true insomnia. With anxiety surrounding the pandemic, the numbers are considerably higher, and climbing. Clues that you may have insomnia include difficulty falling or staying asleep, waking too early and being unable to return to the land of nod, being tired when waking or during the day, being irritable, and feeling the urge to take naps.

A modern machismo claim by road warriors, politicians, and others is that they survive on six, five, or even four hours of sleep. Although required sleep differs from person to person, and at different ages, on average an adult needs seven to nine hours of shut-eye. Sleep deprivation impairs basic functions, certainly compromises aviation safety, and weakens the immune system.

If your sleep disturbance is new and unrelated to recent medication adjustments, an altered work schedule, or jet lag, see your doctor. Numerous medical conditions impair sleep including depression, sleep apnea, parasomnias (e.g., night terrors, sleepwalking), heart failure, prostatism causing frequent desire to urinate, and others.

If other causes are excluded, one can take certain steps to prepare for a good night’s sleep. Reduce daily sugar intake, control weight, and avoid stimulants. Eschew exciting or disturbing media content and blue light emitted by computers and mobile devices prior to bedtime. Ensure your bedroom is dark, peaceful, and cool; and, of course, consider Croskowsky’s exhortation and change uncomfortable mattresses and pillows.

A hot bath or shower 90 minutes prior to bedtime raises your body temperature and, as it falls thereafter, melatonin is released, encouraging sleep. Taking an oral melatonin supplement an hour and a half before hitting the sack may also help. And consider consuming a hot, caffeine-free drink such as chamomile tea, but avoid too much fluid to prevent unwanted bathroom calls.

My good friend Michael Breus, a clinical psychologist known as “The Sleep Doctor,” recommends a five-point plan to induce serene siestas:

1. Go to bed and arise at the same time every day, including weekends. Forget about “catching up” on sleep; it’s impossible.
2. Avoid all caffeine after 2 p.m.—it stays in your body for perhaps eight hours.
3. Stop consuming alcohol three hours before bed and consume no more than three alcoholic drinks per day; booze damages restorative phases of sleep and dehydrates, compounding the dehydrating effects of sleep.
4. Exercise daily, but cease exercise four hours before bedtime to allow core body temperature to drop. And tossing and turning all night is not exercise.
5. Give the sun a high-5 on awaking by spending time in natural sunlight, triggering your brain to be alert.

Should these steps not suffice, consider trying relaxation exercises and use a device to generate white, pink, or brown noise; I prefer the sound of waves breaking on the beach. Cognitive behavioral therapy for insomnia (CBT-I), which changes the way we view our thoughts and behave, is a well-accepted approach. Medications come in several classes, should be used cautiously, and obviously consider aeromedical concerns. If you are tired during the day, a proper “IM SAFE” preflight check should discourage you from flying.

Breus has developed a website (chronoquiz.com) that allows people to characterize their “chronotype” or how they react to various times of the day. You may remember learning about being an “early bird” or a “night owl;” this is the same concept but more advanced and useful. I am apparently a “bear” (neither early nor late), but not with a sore head! Understanding your type may help you plan your day better. Circadian rhythm, the internal clock that regulates sleep/wake cycles, may be disrupted by jet lag, so as a pilot, you can find a useful tool online (timeshifter.com).

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