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The Everything Guide to Sleep

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Getting sleep is not easy. For one thing, 89 percent of American adults have a glowing gadget in their bedroom, keeping us engaged and bathed in light. Despite our bad habits—our belief that sometimes we must cheat our bodies of sleep to make any progress in working life—we also know that a proper night’s rest can do wonders. Researchers are more precisely closing in on why: A study last fall in the journal Science found that sleep drives “metabolite clearance” in our brains, removing the neurotoxic junk that accumulates during the day. Finally, an answer for why we didn’t evolve out of this inconvenient habit. Sleep, in effect, takes out the trash.


Tossing and Turning
Five New York problem sleepers detail how they slept—or didn’t—during a single night. Then Alcibiades J. Rodriguez, M.D., medical director of the New York Sleep Institute, guides them toward better rest.


Illustrations by Murphy Lippincott  

Case 1:
The On-Call Doc
Alex Sankin, 32, urologic-oncology fellow; Upper East Side

Problem:
An erratic sleep schedule that he has little control over.

Midnight Bedtime. “I’m ­trying to fall asleep, but it isn’t easy because I have a pager in my underwear and jammed up into my hip bone. When it buzzes, my entire body vibrates.”
1 a.m. Paranoia wins. “There’s no way to sleep comfortably atop a pager, but it’s almost pointless anyway: I still wake up regularly to check it, just in case.”
2:15 a.m. Pager goes off. “At my former residency in Brooklyn, pages at this hour frequently meant someone accidentally shot himself in the testicle. It happens more often than you’d think. Tonight’s call is more routine, but I have to go into the hospital anyway.”
4 a.m. Find a bed. “My work is done, but I’m still on call and it’s not worth going home. So I head to one of the call rooms, with twin-bed-size rooms for doctors to sleep in at times like this. It’s not the most pleasant of places, but even a small amount of sleep helps.”

From the Expert: Conventional wisdom holds that you shouldn’t nap for less than 90 minutes. The reasoning: It takes 90 minutes for your brain to complete a full sleep cycle—from light sleep to REM and back—and waking up in the middle of it will deprive you of real rest. Rodriguez says that’s bunk, especially for someone in an ­un-predictable situation like this. “If you’re hungry and you eat a little bit, you feel good, even if you’re not totally satisfied,” he says. Sankin is doing the right thing by getting whatever sleep he can.



Case 2:
The Senior Sleeper
Arline, 90, retired; Upper West Side

Problem:
Has had trouble sleeping through the night for ten years.

10:30 p.m. Bedtime. “I’ve been to a sleep clinic twice, but nobody’s able to help me. And I’ve been told that Ambien isn’t recommended for people my age, so I don’t take it. Instead, I start each night the same—naturally falling asleep.”
1 a.m. Up as usual. “Going to the bathroom is, unfortunately, for older people, a big reason for being disturbed at night. So I’m up. To fall back asleep, I take a lesser-strength Sonata.”
3 a.m. Still up. “I can usually fall asleep after that first Sonata, but sometimes it just doesn’t work. Tonight is one of those nights. So I take the second one. That does it.”
6:30 a.m. Start the day. “I don’t always wake up feeling refreshed. Sometimes I’ll take a nap later in the day, but I set the kitchen timer for 30 minutes. My doctor told me that if I nap any longer than that, I’ll have more trouble at night.”

From the Expert: According to Rodriguez, as we age, our sleep gets lighter. Any little thing can wake us up. Arline has been screened for other sleep disorders, which is good: It’s important to make sure there isn’t an under­lying issue. But since she’s clear, Rodriguez says there’s not a lot to do for her. She should, however, make one crucial change to her routine: Unlike the younger on-call doc, Arline “shouldn’t take naps during the day,” he says. At all.


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