Whenever I felt stuck or frustrated with a project, writing, finances, or my energy level my go to response was to watch the movie Limitless.
A miracle drug is created that opens up the protagonist's brain, makes him organized, gives him razor sharp focus, and allows access to all of the knowledge he has or has had. He gets his act together around this. Drama ensues.
Instead of concocting a super cocktail of herbs and medications to make myself smarter, faster, and stronger, I'm doing it the hard way: creating a list of the physical traits, learning and life skills that keep me from living up to my full potential and how to improve them. From mental apptitude, money management, and even how I sleep, this is how I'm trying to hack away at my life to be more and be limitless.
In honor of my fourth night of call in a row, I wanted to spend some time talking about a thing I'm really not getting any of: sleep.
Bolologically, I don't think anything is more important than sleep. Sleep is the ultimate antiinflammatory, better than Aleve or any steroid injection. Sleep is when we get our hormones in balance- our cortisol, our human growth hormone. It is what repairs our muscles, boosts our immunity and resets our brains to help us focus on the tasks at hand. Sleep is the force multiplier for the mind and body, and even more so when we don't get it than when we do.
At some point during my fellowship, I realized I had to get on the ball when it came to sleep. I had irregular hours being up all of the time delivering babies on call. I'll be totally honest, I never pulled it together enough to figure it out.
During my sabatical after training I got tons of sleep. I figured it would take several weeks to catch up from medical school, residency, and fellowship, but I was wrong. I never caught up. I never made up that sleep during my sabatical 1.) because you can't, and 2.) because I wasn't sleeping right. I was still tired all of the time.
So I realized I needed to learn to sleep like it mattered because with my job I was someone who needed it the most, regardless if I was going to bed at 10:30 pm or at 1:30pm after a call shift. I needed to learn to sleep like Special Forces.
If you ever have a day when you simply cannot get back on task, the issue is likely sleep. To paraphrase a great line I heard from the ever under-medicated Merlin Mann: if you are having one of those days where you roam from place to place, not sure what to work on, not sure what to eat, not sure what to watch on Netflix, what you probably need is sleep.
Here is what has helped me really streamline the process of sleep, regardless of call schedule, and regardless of time zone. I can do no thing well if my sleep is wanting.
Any apps listed below are for the iPhone and iPad because I'm not even sure what an Android device looks like.
1. Regular Meditation Practice
Since the beginning of 2013 I've incorporated a consistent and regular habit of mediation into my life 5 minutes going to bed *and* waking up. I use the Samsara app I mentioned in a previous Three Things I Love post to check the time, but any simple timer from a watch or iPhone to keep you on track. I think it is important to hold yourself to a specific time of meditation or your mind will be too preoccupied tying to manage your sit time that it will begin to wander. I like the gentle bells Samsara offers to start and end my sitting times. This mediation habit has also helped me with my posture.
2. Sleep Apps: Sleep Cycle and Brainwave
Sleep Cycle offers a number of useful functions, but it shines as the ultimate alarm clock. Most alarm clocks wake you up when you tell them to. And we thank them daily for this. But if you know anything about sleep lag it is because you have woken up in the middle of a dream and are wildly groggy. That is sleep lag. Sleep Cycle counters this by being an "intelligent" alarm. You leave sleep cycle on and set the iPhone next to you in bed (plugged in so it doesn't die and fail to wake you in the morning). Through the night the app monitors your fine motion to assess the quality of your sleep. 30 minutes before your requested wake-up time it monitors your movement closely to predict when you are least likely in deep sleep. It then wakes you up before you can drift into a deeper stage of sleep. It is amazing. It is particularly useful for mid-day napping which is where I find the greatest issues with sleep lag.
Because of all of the monitoring, Sleep Cycle is a very useful diagnostic app, and you can really see what affect changing environmental factors like position, room temperature, bedding, etc. can have on the quality of your sleep. It also lets you have an honest assessment of how much you really sleep overall. Some people think they get great sleep but discover they only get sleep 4 hours a night, address the issue and find they had room to grow in their daily activities.
To avoid any issues that may exist from radiowaves, radiation, and signals from the CIA, and for good sleep health in general I set my iPhone to Airplane Mode while it is cuddled in bed next to me.
Brainwave is just neat. About 2-3 times a year I have true issues with insomnia for some reason. I am pretty blessed because overall I'm good at falling asleep (different than making myself but down a book and go to bed!).
Brainwave uses something called binaural beats underneath ambient noise like rainfall or a babbling brook to "program" the brain to relax, wake up, etc. I searched around for a bit before purchasing this app because there are a number of iPhone apps that offer a similar technology. I have not read any literature that says binaural beats work. But this app seems to work.
My favorite two uses for Brainwave (there are many programs) are for concentration, and for very dreamy sleep. I would say the concentration program works about 90% of the time if I am using it to read, study, write, or process. That's pretty good. I also have another process of addressing concentration which I'll approach in a later post.
Dreamy sleep works 100% of the time. It's incredible. I use it about every 2 weeks to have lucid, productive dreams. There is a lucid dream program but it has never worked for me. I feel like I'm able to work through a lot of daytime issues or find insight in the dreams produced consistently after I use it.
Use is simple- plug in your headphones, select the program you want, and pick your ambient sounds. You can fiddle around a lot with all of the settings and is highly customizable. You don't use it while you sleep but instead a set amount of time before you do so.
3. Hearoes Blue Extreme Earplugs and an Eyemask
What we learned as little kids about pulling the covers over our heads hiding from monsters applies as an adult: what you can't see or hear cannot hurt your sleep. One of the key things I have learned over the years has been to block out the stimuli that doesn't want me to sleep.
This wasn't a big issue usually until I moved to the busy East Coast where delivery trucks make runs outside your apartment at 3 in the morning. Everywhere I go I carry a pair or two of these lightweight earplugs. I used to use the regular pink ones, but now that I'm a professional sleeper, I upgraded to Blue and wow what a difference.
And if you have concerns that you won't wake up in an emergency you are wrong. I use these to wake up with my alarm and have no issues hearing it on medium volume.
Incredibly, here is a five minute video on how to properly insert earplugs and it makes all the difference in the world even with the lower strength earplugs:
For the eye mask get whatever one is lightweight, blocks light, and fits you properly. I bought this little guy on Amazon and love it, but it's all about fit and personal preference.
Humans are designed to have light shining into their eyes. The sun is supposed to tell us when to wake up, and when to go to bed. I love hiking on the Appalachian Trail because I have no doubt when I'm supposed to wake up or go to bed. The Sun tells me. But when we live in homes and offices we don't have the luxury of natural light to tell us what to do.
We also face the challenge of too many false sources of light confusing our natural production of melatonin in our brains from iPads to televisions in the bedroom. Melatonin is a hormone released by the brain that tells your brain to begin the process of shutting down for sleep. When a good degree of light is presenting itself to your retina it suppresses melatonin production so you don't begin the shutdown sequence for some time after you turn your iPhone off.
Counter to this though, blue light can be effective for suppressing your melatonin when you don't want it and regulating your circadian rhythms. I originally wanted a blue light to fight the winter blues when I was doing my internship in Maine, but I later discovered that it was really quite effective for helping me wake up in the morning, and keeping me going mid-afternoon if I was having a slump.
You would think shining a blue light in your eyes would not make any difference, but it really does. The first time I used it after 10 minutes I felt my cheeks being warm for about 1/2 hour later, like I had sat out in the late afternoon sun.
Now I set the alarm to go off around sunrise so that it is on about the same time that Sleep Cycle wakes me up. I'll keep it by me while I drink my morning coffee and use it for about 30 minutes, even if the sun is streaming through the window.
Phillips offers information on their website to figure out how to effect your sleep cycle with timed doses of light.
The GoLite itself is great. Totally portable (compared to the humongous daylites of the past), it's about the size of a paperback book, and is rechargeable. It has a programable alarm, and you can get 3-5 uses out of a charge. The only think I wish it offered was usb charging so I didn't need to bring along another charger.
A note on melatonin- I do supplement with melatonin but only in the setting of extreme sleep disruption: either from traveling to a drastically different time zone or from having my day flipped as a night time hospitalist or laborist. I keep a few doses in my backpack in case there is a random semiannual bout of insomnia.
My biggest source of light interference by far is my MacBook Pro. Reading, writing, prepping photos, or watching Hulu, I've usually got light coming from my Mac into my eyes.
f.lux is a brilliant app that filters out the most effecting frequency of light, blue light, from the monitor. The process is gradual as f.lux knows what time it is where you are and what the sun is doing outside. As it gradually sets outside, the amount of blue light is slowly pulled from the screen. If you switch the color of the screen quickly it is very dramatic, but as f.lux can be set to dim gradually or immediately the hue is difficult for me to detect while I am working. There can be an issue with color correction if I'm editing photos, but f.lux lets you disable it if you are doing graphic design, image or video processing.
6. Discipline & Motivation
The most important factor in getting good sleep is good sleep hygiene, and maintaining good sleep hygiene takes motivation (the why), discipline (the will), and method (the way).
These are the things that work for me. But it doesn't matter if I don't have the discipline to stop what I am doing, put down my Kindle, and go to bed. Especially after a long call night when I come home, and it's light outside, and I'm too tired and stupid to close the curtains, not turn on the computer and go to bed, I have to remember that there are so many consequences that will effect every aspect of my life if I don't get proper sleep.
Knowing that my brain will be cloudy, my focus will be terrible, my muscles won't get bigger, my gut will get bigger, my mood will be labile, and my immune system will be in the tank is more than enough motivation for me, which leads to the discipline to maintain a healthy sleep schedule and be good at sleep.
You can't learn how to do things better, write a book, excel at your career, gain muscle, lose fat, or be happy if you don't get good sleep. And it shouldn't matter where you are or when you are trying to do it, be able to do it.
Now go take a nap.