Singing and Snoring

A few years ago, I did a sleep study in the hospital to determine if I have sleep apnea. I do.  I woke up momentarily 80 times during the night.

Sleep deprivation is just one of the bad results of having it. Frequent waking, fitful sleep and waking up feeling like I have not slept are all results.  Maybe a compromised immune system, poor mental and emotional health, and irritability too. And then, because you stop breathing, oxygen deprivation – which can lead to you having heart disease, high blood pressure, sexual dysfunction, and learning/memory problems.

With all that, no surprise that 1 in 5 people who suffer from depression also suffer from sleep apnea, and people with sleep apnea are five times more likely to become depressed. Researchers are not sure if the apnea causes depression or vice-versa. Either way, it’s depressing.

Cures? I didn’t want to go the CPAP route (Continuous Positive Airway Pressure). This entails wearing a mask-like device while you sleep to provide pressurized air to prevent the airway from collapsing. Too SCUBA diver for me.

I tried the dental devices – a Mandibular Repositioning Device and the Tongue Retaining Device – but I felt like I was choking on them at night.

Minor sleep apnea is sometimes responsive to “behavioral treatments” which I have tried with limited success. Here are a bunch of suggestions:
Lose weight.
Stop using alcohol, tobacco, sedatives, or anything that relaxes the muscles of the throat and encourages snoring.
Sleep on your side, not your back. (Special pillows help.)
Elevate the head of your bed by 4 -6 inches. (which I had already done for acid reflux!)
Maintain regular sleep hours. (a tough one for me).
Use a nasal dilator, breathe right strips, or saline nasal spray to help open nasal passages. (all totally ineffective for me)

But here are two treatments I had not heard of before that come from a 2005 study in the British Medical Journal.

Learning and playing the didgeridoo helped reduce snoring and sleep apnea, as well as daytime sleepiness. This appears to work by strengthening muscles in the upper airway, thus reducing their tendency to collapse during sleep.

And there is also a program that uses specialized “singing” exercises to tone the throat, particularly the soft palate, tongue and nasopharynx. Dr. Elizabeth Scott, a medical doctor living in Scotland, had experimented with singing exercises and found considerable success, but had been unable to carry out a clinical trial. Alise Ojay, a choir director, began researching the possibility of using singing exercises to help a friend with snoring and came across Dr. Scott’s work. The results were promising and after two years of investigations, she designed the “Singing for Snorers” program.

If in the future you hear strange sounds coming from my house during the daytime, it might be my singing and didgeridoo practice. If you hear strange noises at night, I’m probably still snoring.

Resetting Your Sleep Cycle in Five Nights

Giorgione – Sleeping Venus

Our current tendency to be staring at screens and living in our unnatural always-lit environment is really messing up our internal circadian clocks. In a natural world, the human circadian cycle adapts to seasonal changes in the light-dark cycle. But staring at screens (TV, computer, phone), especially in the hours prior to trying to sleep, is harmful to our internal clock’s synchronization and the way our brain prepares for sleep. And sleeping in for an extra hour doesn’t really help.

You had a tough week spent in artificial light and you barely made it outside. You walked to your car or the mass transit in early morning darkness. You left work and it was already getting dark. At home, you are bathed in a brightly lit home. You watch your big screen TV and have your tablet on your lap.

You know your clock is off be because your sleep is off. Is it possible to reset our internal clock by avoiding artificial lights at night for a few days and turning off those screens? That is tough to do in most modern settings. No screens and no artificial lighting? You can’t even do that on most vacations.

Some people try using meditation or other techniques to control stress ot to “defrag” your brain. Scientists have known for quite a while now that light is the most powerful cue for shifting the phase or resetting the circadian cycle “clock.” In a study published in Current Biology, the authors describe a series of experiments where people were sent out camping to reset their biological clocks. They tested campers who spent a week and some who spent a weekend in a tech-free and only natural lighting setting. This study compared them with a control group that stayed at home to live their normal life. The scientists tracked sleep and circadian rhythms by measuring their levels of the hormone melatonin, which regulates wakefulness and sleep.

Melatonin levels are key. We know that melatonin is present at low levels during the day, begins being released a few hours before bedtime, and peaks in the middle of the night. Those levels fall and then we wake up. Unfortunately, in our current living environment, melatonin levels don’t fall back down for a few hours after we wake up. To your brain, you should still be sleeping for several more hours. It’s like jet lag.

The week-long camping trip seemed to have reset the participants’ internal clock.

I try year round to get out to at least my backyard as soon as I make my morning coffee to get at least 15 minutes of sunlight. Of course, sometimes there is not much sunlight and in winter here it’s not as pleasant to step out in your pajamas when it’s 20 degrees and there’s snow on the deck. Natural light, particularly morning sunshine, which is enriched with blue light, has a very powerful influence on setting internal clocks to daytime and waking up.

Of course, a week of real camping (not a spa week or vacation at a resort) is not possible or even desirable to everyone. Can you create a natural light-dark cycle for a weekend? It means turning off the screens and turning off all of the artificial lights.

The study found that over 60% of the shift can happen over a Friday, Saturday and Sunday night weekend. That’s a 20% recovery per night. Add 2 more nights to get 100% recovery. Five nights to reset your clock.

Of course, we’d like an easier path than three nights in the woods. One alternate path reminds me of other “detox cures” that are quite popular. For example, I read an article on how to reverse some liver damage. In brief, it suggests that you avoid alcohol and processed foods, exercise more, lose 10% of your weight, take some milk thistle and maybe some Vitamin E. That sounds like good general health advice, but other than taking some supplements, it also sounds like a tough regimen for most of us to follow. Id rather do three nights camping.

I have been taking melatonin supplements. It’s easy, and it sounds logical. You lack the melatonin to induce sleep, so you add some artificially. I tried resrtting my circadian rhythms using melatonin about a year ago. I read about what the levels are supposed to be. I made a schedule of when I would take the melatonin and when I would go to sleep. I adhered to the schedule – for two weeks.

The experiment did seem to work. I felt like I was falling asleep faster and staying asleep better. I didn’t do anything with light. I suspect that part of the improvement came from sticking to a regular sleep schedule. I was going to bed at 10 pm and waking up at 7 am but I just couldn’t keep to the schedule. I continued taking the melatonin until the bottle was empty, but I was going to bed at different times – 1 or 2 am some nights – and waking up at different times too. That’s not how to do it.

People also try using artificial lights that mimic the spectrum and the intensity of natural light, but that can be costly. It is one of the therapies for Seasonal Affective Disorder (SAD) that hits people as the “winter blues.”

You also have to remember that a reset doesn’t last forever. I didn’t find any research to back this up but i assume that if you can reset in 5 days, you can also fall back to the bad cycle in 5 days.

Maybe the new month will be an opportune time for a reset.

Seasonal

Recently, I went on a vacation to the US Virgin Islands. When I left Paradele, it was early spring, so it still felt like late winter. On the island it was summer. When I returned home, I wondered how my body and mind must have reacted to this leap ahead and back in seasons.

People who spend a great deal of time outdoors become “outdoor acclimatized.” These persons are affected less by heat or cold extremes because their bodies have adjusted to the outdoor environments. Acclimatization usually occurs over a period of about two weeks in healthy, normal persons

On the winter side of things, similar to other animals, the human body naturally transforms to undergo an insulin-resistant state. This aids our system to be more fuel-efficient and optimally perform for extended periods of time with a small amount of food. This is a natural occurrence during seasonal changes in all vertebrates. This survival mechanism has been going on for almost 400 million years of evolution. It’s clear how important it is to regulate our metabolism. When seasons change, our brain sends signals to our body to increase its insulin resistance. Our liver can boost fat production, and our adipose and non-adipose tissues can store fat to prepare for winter.

The command-and-control area of the brain is located deep in the spot between our eyebrows, close to the hypothalamus. This low brain area, which maintains the hypothalamic dopamine activity, is vital for maintaining the insulin-resistance state. It may sound weird, but a decreased level of dopamine activity has also been discovered to be associated with obesity and Type 2 diabetes. For certain people, this annual cycle of insulin resistance turns back to an insulin-sensitive state usually during late winter and early spring to prepare for the summer season and the abundance of food.

And what about our brain’s reactions? Scientists have long believed the brain is vulnerable to seasonal shifts. For instance, headaches are more frequent in the fall and spring, mental health may decline during winter, and some symptoms of brain diseases such as multiple sclerosis vary with the seasons. If a change of season affects your mood, you may also experience a loss of appetite, low motivation, and a change in sleeping patterns.

It is believed that less sunlight can affect the production of serotonin and melatonin in some people, which can cause difficulties with sleep and mood [Seasonal Affective Disorder SAD]. Serotonin production depends on daylight. Melatonin (for sleep) is triggered by the darkening of the day into night but the process actually starts its cycle when you wake p and encounter daylight. Negative shifts in production usually occur when you move into autumn and winter and spend less time outdoors and in sunlight. Of course, that’s not the case for people who live in St. John kinds of tropical climates, or for people who are outdoors during the day in the colder months anyway. Though those people may not be exposing much skin to sunlight, it often affects us through the eyes.

The longer spring and summer days allow more endorphin, testosterone, and estrogen to be released.  It has been suggested that this seasonal readjustment of hormones stresses our bodies and we react with a feeling of tiredness.

My reading on all this seems to indicate that it takes about two weeks for the brain and body to adjust. My ten days of summer on the island weren’t enough to go into summer mode, but it must have had an effect on me. And then the return to cold weather must have flipped the switch back.

I never feel affected by the setting back or forward of clocks as happens to some people. I do feel drawn to water in spring and summer. Are you feeling any spring fever this week? How about cabin fever?

We had some summer weather for a week this April in Paradelle. temperatures in the high 80s. People out in short pants and T-shirts. People sitting outside at cafes. Then the following week, it was back to the low 40s. This weekend, I had to pull in my flats of seedlings because at night it was in the low 30s.

Oh, my poor brain and body. What are these seasons doing to you?

Pebble Meditation

Now that I am back into reading to little ones, I’m looking in the boxes of stored children’s books from my own sons. My grandkids are both under three so some books are too advanced but this is one that I will eventually introduce at one of their sleepovers.

Pebble meditation is a technique to introduce children to the calming practice of meditation. It was developed by Zen master, best-selling author, and  Nobel Peace Prize nominee, Thich Nhat Hanh. In A Handful of Quiet: Happiness in Four Pebbles and A Pebble for Your Pocket, he offers illustrated guides for children and parents, so this is not just a children’s book.

Many books in the children’s section of the library and bookstore are worth being read by older people. This meditation can be practiced alone or with a group or family and can help relieve stress, increase concentration, encourage gratitude, and help children deal with difficult emotions.

A very simplified how-to of the process:

1. A participant places four pebbles on the ground next to him or her.
2. At three sounds of a bell,  each person picks up the first pebble and says, “Breathing in, I see myself as a flower. Breathing out, I feel fresh. Flower, fresh.”  Breathe together quietly for three in and out breaths.
3. The next pebble is for “Breathing in I see myself as a mountain, breathing out, I feel solid. Mountain, solid.
4. Pebble 3’s recitation is “Breathing in I see myself as still, clear water, breathing out, I reflect things as they really are. Clear water, reflecting.”
5. And the fourth pebble has us saying “Breathing in I see myself as space, breathing out, I feel free. Space, free.”
6. End with three sounds of the bell.

I would compare my own use of a grief stone to this practice. In some workshops, participants may find pebbles that can represent people in their lives and use those pebbles when they breathe in and out and feel a connection to that person.

There are pebble meditations that focus on specific areas of growth. For example, using the six paramitas, or six perfected realizations, are the elements that help us cross from suffering to liberation. The six are generosity, diligence, mindfulness training, inclusiveness, meditation, and understanding.

Another pebble meditation uses the three jewels (Buddha, Dharma, and Sangha), and another uses the Four Immeasurables (loving kindness, compassion, joy, and equanimity).

Do you have to be a practicing Buddhist to do this? Not at all. The terms used can translate to more common terms in many cases. Some people write words on stones and use them on a regular basis. (I see online that, of course, you can also buy stones with affirmations on them.)

What is there about the physicality of a pebble that helps one connect to a particular idea?

---

Thich Nhat Hanh’s meditation presented by Plum Village brother Thay Phap Huu.

Staying In Bed

Lately, I have found myself lingering in bed in the morning. I’m not a morning person. Don’t make an 8:30 appointment for me. When we have one of those early morning flights and I have to get up at 4 am to get to the airport by 5:30 and wait a few hours for a flight, it is brutal. Ruins the entire day for me.

I track my sleep with my Fitbit and even if I am in bed for 8 hours I would be lucky to get 6 hours of actual sleep. Sleep apnea is part of that but I have never been a good sleeper. I used to have a real insomnia issue. That’s been better the past few years but I probably give sleeping too much thought.

One post on the Fitbit blog described what they call the Sleep Profile animals. They say that your Fitbit Sleep Profile will tell you which animal represents your most recent sleep habits. I feel like I am all of them except for the bear and parrot.

Which animal are you?

Bear: You tend to have a consistent sleep schedule, regularly falling asleep around the same time. You go to bed earlier than most, and you tend to reach a sound sleep quickly. Your sleep tends to be long and restful, with a relatively high proportion of deep and REM sleep.

Dolphin: You tend to fall asleep later than most and sleep for less time overall — maybe due to an inconsistent sleep schedule, or more disrupted sleep at night. Compared to others, you tend to be a lighter sleeper and might take naps to catch up. Interestingly enough, dolphins are the least common sleep animals.

Giraffe: Your sleep tends to be shorter, and you are more likely to sleep later and wake up earlier. You have a relatively good proportion of deep and REM sleep despite a shorter overall duration. — this is the most common sleep animal among users.

Hedgehog: You usually fall asleep later and wake up earlier. You are a lighter sleeper — typically taking longer to reach sound sleep and may get less deep and REM.

Parrot: You tend to keep a consistent bedtime and don’t sleep too early or late. You typically reach sound sleep quickly and usually get a good amount of sleep each night. You likely sleep deeply once you drift off but can be light on REM due to waking up briefly throughout the night.

Tortoise: You tend to fall asleep at different times each night, but often earlier than most. Paired with slightly later average wake times, you tend to spend more time in bed overall but find it takes longer to reach a sound sleep, impacting. That will impact your lower-than-average deep and REM sleep.

I wish I could be consistent in getting to bed. Earlier is better for my “sleep profile” but if I go to bed at 10 pm or 1 am, it doesn’t seem to impact my desire – or lack of desire – to get out of bed. When I say “in bed” I don’t necessarily mean sleeping. I could be reading, surfing the Net, checking email, or writing.

When I went through a serious depression a few decades ago, I learned the term”dysania.” It means extreme difficulty rising from bed or an inability to leave the bed. Another term is “clinomania” which is a strong desire for staying in bed. These are not widely accepted medical terms.

Although a person with clinophilia spends more time lying in bed, the amount of time they spend sleeping does not necessarily increase. I identified with that.

I read about and wrote about Brian Wilson of Beach Boys fame who went through a period of spending “too much time” in bed. But what is “too much time”?

Well, time to stop typing in bed and get moving on this brand-new week.

Eat 80 Percent

New Jersey diner dessert case

It’s not that I eat bad foods. It’s that I eat too much. I have a Jersey diner mentality. Big portions. There is a Japanese cultural habit of healthy eating called hara hachi bu, which means eat only until you are 80% full (literally, “stomach 80%”).

That is possibly easier to follow in Japan where portions are generally much smaller than in the U.S. and the pace of eating is also slower. One thing it does not mean in Japan is leaving a fifth of your meal on the plate. It is bad form to leave food on your plate. That is a rule my mother seemed to follow. “Clean your plate” was a rule in my house and it has stuck with me – which has not helped my waistline.

Stopping at 80% might be a good way to avoid obesity without going hungry. The stomach’s stretch receptors take about 20 minutes to tell the brain that it is full. That’s why you probably feel really full about 20 minutes after you stop eating.

Pastrami Reuben with disco fries at an NJ diner – not part of the Okinawa diet.

Hara hachi bu is discussed in a diet book called The Okinawa Diet Plan: Get Leaner, Live Longer, and Never Feel Hungry. It’s based on a traditional Okinawa, Japan diet that emphasizes vegetables, whole grains, fruits, legumes, fish, and limited meats.

Keeping that 80% in mind, I looked at some health statistics for Okinawa that I found: heart disease rates are 80% lower than in the U.S; the rate of stroke is also lower and cholesterol levels are typically under 180. Their rates of cancer are 50-80% lower – especially for breast, colon, ovarian, and prostate cancers.

When I started searching online for more information on this 80% rule, I came across a blog post that wondered if this principle could relate to other aspects of life. The blogger (who writes about business presentations) related it to the length of a good speech, presentation, or meeting.

He says, “No matter how much time you are given, never ever go over time, and in fact finish a bit before your allotted time is up. How long you go will depend on your own unique situation at the time but try to shoot for 80-90% of your allotted time. No one will complain if you finish with a few minutes to spare. The problem with most presentations is that they are too long, not too short. Performers, for example, know that the trick is to leave the stage while the audience still loves you and doesn’t want you to go, and not after they have had enough and are full of you.”

Does hara hachi bu relate to anything in your life?

I can certainly see situations where I would NOT want it to be a guiding philosophy. For example, I wouldn’t want my students to give 80% of their effort. Then again, in this current economic downturn, perhaps it makes sense for all of us to use the principle in situations like our spending. Maybe, as with food, you only need to buy 80% of what you think you need in clothing, dining out, travel and non-essentials. Spend only 80%, save 20% or donate the 20% to charity.

The 80% food rule is good as long as you can tell you’re at that point. I’m not a fast eater, so you’d think that I could sense I was full and just stop. My wife rarely finishes a meal when we go out. Eat half and take half home for lunch tomorrow. I have to break the habits of my childhood. And maybe go to fewer diners.