Have you done the cognitive shuffle? No, it’s not the latest ballroom dancing style perfected by those with genius-level IQs; it’s a new method to calm the mind into sleep.
We have a new reason to lose sleep over: insomnia. And the fact that, over the last couple of decades, we have pushed our sleep timing by a couple of hours. Which means it’s now almost normal to sleep at midnight. Doctors now recommend that, like your yearly blood-pressure-cholesterol-thyroid tests, you also check in with a sleep specialist. “If you are obese, have a heart condition or diabetes, a neck size more than 16 inches if you’re a woman and 17 inches if you’re a man, snore, or wake up tired, you should be evaluated,” says Dr Manvir Bhatia, Director and Senior Consultant Neurology and Sleep Medicine, Fortis Escorts Heart Institute and Neurology and Sleep Centre, New Delhi, and author of the book The Sleep Solution.
A quick download
Panicked by this state of things and buoyed by Arianna Huffington’s The Sleep Revolution , Team Metro Plus delved into what could be done to change this state of being. First up, an app called mySleepButton which works on this cognitive shuffle principle.
Unlike the linear and sometimes-stressful counting-sheep mechanism (because you’re worried about where the counted sheep have gone), Canadian cognitive scientist Luc Beaudoin ‘prescribes’ the cognitive shuffle as a rather unusual ‘cure’ for insomnia. In this method, you think of disconnected objects — a tree, an egg, clouds — essentially, deliberately scrambling your thoughts in a way that simply doesn’t make sense. This way, the brain cannot focus on tomorrow’s deadlines and plans, triggering on the sleep switch.
Going by what Dr MS Kanwar, a sleep medicine consultant, who runs the Advanced Sleep Disorder Institute in New Delhi, says, it really could work. “The moment we lie down, we begin to focus on the next day — of things to do and people to call or meet, and we begin to associate the bed with the wrong things — not with sleep,” he says, pointing out that this is particularly evident among people who are high-strung, have a high arousal threshold (they wake up at the slightest disturbance and find it difficult to sleep thereafter) and those who have a sudden setback in life.
The app actually worked, but can we use it long-term and will mySleepButton be our sleeping med? Unsure whether we should be going to bed with an app, we decided to dig deeper — with a sleep test.
Sleeping on it
The sleep study test, or the polysomnogram, entails a night spent in a bed in a sleep study centre, either at home or in a hospital, or a clinic that is set in an apartment, so it’s easier for participants to feel at home, hence lapse into a regular sleep pattern.
The test measures various parameters, including body and muscle movement (leg movement, teeth grinding, for instance), respiratory patterns, noises (like snoring), brainwaves, eye movement, heart rate and rhythm, oxygen saturation and a host of other aspects. Every test may not involve all of these, and will depend on the symptoms.
You are then hooked onto a machine through electrodes, a mike, straps on the chest and abdomen, an oxy-meter clipped to the finger that calculates the oxygen levels in the body.
Amidst a maze of wires that takes 45 minutes to stick on to your head, forehead, chin, back, and even one protruding into the nose, you are expected to sleep — on your back or sides only. Miraculously, you do.
The most common reason that doctors put people through this test is obesity and the symptoms of snoring, night-time gasping, choking or coughing and daytime sleepiness especially in those who are obese. “Men who are obese almost always have what is called obstructive sleep apnoea, a disorder that causes interrupted breathing during sleep because of constricted airways,” says Dr Vijay Sharma, who heads the sleep clinic in Columbia Asia, Pune. While insomnia is a mix of physical and mental factors, sleep apnoea is purely physical. It can be life-threatening.
But it’s not just those who are obese — people who have a genetic problem with weak airway muscles are also prone.
Dr Kanwar explains the concept of sleeping early and sleep hygiene. “Keep a ‘worry diary’ where you write down all that’s stressing you through the day and how you’ll deal with it. Then put it away and go to bed,” he says. Yoga, meditation and physical exercise build a positive mindset, help you de-stress and allow you to concentrate on things other than work. Try drinking a glass of milk, or reading a book or listening to soft music. The idea is not to drastically shift bedtime from midnight to 9 pm, but to gradually phase it in by pushing the time by 20 minutes each, until you come to a reasonable hour.
Plus, sleep at the same time each day. Without our realising it, lack of sleep triggers physical problems that go beyond a headache — our body needs R&R (Rest and Recuperation) to heal the minor wear and tear each day. If it doesn’t get it, you may aggravate or even bring on everything from an upset stomach to painful knees. In fact, a sleep debt may even be a cause for weight gain, because of all that coffee and cake you eat to keep awake. You also just feel hungrier, because ghrelin, the hunger hormone is overactive and your metabolism is compromised.
Trying tactics
But will a lecture from a doctor about good lifestyle change our lives? For a couple of months, perhaps. So we tried something different — the Ostrich Pillow — that gimmicky-looking, soft exaggerated balaclava available online. Once you figure out how to wear this not-so-fashionable-looking headgear, you can push your hands into the holes at the top and put your head down on the desk. We tried it at home, and because it is still cold up North, it gave a pleasant, albeit short nap. But it’s good for that afternoon lull — just don’t expect it to swallow you in sleep.
“Avoid experimenting with sleep and gimmicks,” Dr Bhatia ticks us off. “People will try sleeping pills, alcohol, cigarettes, even starvation to get sleep — until they end up with severe problems. Rather than stuffing your head into bulky headgear, take a warm bath, dim the lights and turn in. If there’s one lifestyle change you need to make, it’s this.”
What is REM and Non-REM sleep?
When we sleep, we go through different stages of sleep — REM and Non-REM. Rapid Eye Movement (REM) means that your entire body is almost paralysed — about 20-25% of sleep. You cannot even move your limbs because your muscle tonicity is completely down. Non-REM sleep has 3 stages: N1, the lightest sleep (5% of our sleep); N2 (45-50% of our sleep) and N3, deep sleep (20-25%). The way we go through sleep: Roughly every one-and-a-half to two hours, we go into REM sleep, and we go into roughly 3-4 cycles; and that is needed for good quality sleep. In terms of quantity, most adults need 6-8 hours a day. If you feel active, alert and alive the next morning, you have achieved good quality and quantity of sleep.
– Dr N Ramakrishnan, Nithra, Chennai
