A friend sent me some information on sleep parameters for achieving a positive sleep regimen. These are as follows:
1. Maintain a regular and strict sleep schedule of going to bed and awakening around the same time every day (+- 30 minutes) including holidays and weekends
I was able to achieve this prior to the injury. The research on sleep habits of indigenous tribal peoples suggests a sleep time of between 3 to 4 hours after sunset. This seems an appropriate metric for my own protocol.
2. Avoid daytime naps; If very tired, schedule naps, but keep them short (no longer than 30 to 45 minutes)
I find it near impossible to sleep during the day even should I want to do so. The sole exception to this takes the form of cognitive naps described in item 8 below.
3. If unable to fall asleep within 10 to 20 minutes of lying in bed, get out of bed and do something relaxing; once you feel sleep, go back to bed; if not sleeping within 10 to 20 minutes, repeat the process, and keep repeating until asleep.
I try and follow this routine. What appears to happen is that my brain attempts to review and address events from the day, or I become stuck in the attempt to make a decision. My thoughts are going round and round the decision but I appear unable to actually arrive at a decision. I thought this was unique to me but found Elliot describing something very similar in his book.
4. Avoid seeing what time it is at night – this could cause anxiety and worsen sleep
I have no memory of my doing this. One outcome is that I am unable to reliably determine rest intervals as stated in item 3.
5. Minimize consumption of alcohol; it is best to avoid this in the first 1 to 2 years of injury.
Before the accident my alcohol consumption was confined to the occasional bottle of wine with a special meal. Since the accident I have consumed alcohol twice. The first time was at a communal potluck event where I drank what I thought was a glass of fruit juice. I did not drink more than a few ounces of this beverage before I was totally inebriated and had to work hard to retain normal composure.
The second event occurred on the evening I translated the first four paragraphs of a submission by Dr X to the Collège des Médecins du Québec. When I realized what Dr X was saying, I was shocked and dumbfounded. This was followed by the realization that his statements were the likely reason for the failure of my insurance claim. There was clear evidence of Dr X making statements at variance with the existing documented record. a bottle of gin has been sitting untouched in the fridge for a period of years. I had a glass, was immediately blotto, and went to bed.
The next day, on waking, I immediately wanted to blank out all knowledge and memory of Dr. X and again reached for the gin. I then realized such self destruction served the purposes of Dr X and went for an extended walk instead.
6. Avoid alcohol, coffee, and sodas late in the day because they may be too stimulating and delay sleep.
I do not drink soda or alcohol (the exception is reported above). I ceased drinking coffee after the accident when I discovered that caffeine, even the amount contained in chocolate bars, resulted in skin lesions on the left side of my body.
Over the past year I have gradually added caffeinated coffee back into my diet. It no longer appears to produce adverse effects. I will typically have a morning cup of regular instant and then switch to decaff for all subsequent daily consumption.
7. Stop smoking
Don’t smoke.
8. Avoid stimulating activities and heavy meals before bedtime; light stretching can help
When I am working on document creation, my general pattern of behaviour involves devoting the morning to writing or editing. This is often followed by a hike to the copy center with a return at around 1300. I will typically experience cognitive fatigue after 4 of 5 hours of effort with the onset determined by the degree of task complexity. My doctor has advised rest at this point. Continued activity will result in a headache.
A nap due to cognitive fatigue will automatically end within 45 minutes to an hour. There is no need to set an alarm. I wake refreshed and am able to undertake a second work session. I am less capable in this second session than I was in the morning session. The second session will end with dinner preparation and meal. The period from 1900 onward is recognized as being a low performance time and I will engage in low demand activities: working on images, performing some form of routine activity, researching and reading documents, or watching a movie.
9. Maintain comfortable bedroom ambiance: quiet, dark, and cool.
This represents my typical sleep environment.
10. Avoid bright lights, loud noise, and using anything with a screen (television, tablets, smart-phones, laptops) in the bedroom.
There are no screen devices in the bedroom. I rarely use the bedroom light as I maintain a nightlight in the hallway and this provides enough illumination to find my way to and from bed.
The following are other ideas for regulating sleep:
11. Wear brown or orange glasses two hours before bedtime to reduce blue light exposure.
12. Utilize recall of specific imagery at point of sleep to suppress rumination and potentially improve melatonin release.
13. Consume food items containing Tryptophan prior to sleep.
14. Use dim red lights for night lights. Red light has the least power to shift circadian rhythm and suppress melatonin.
15. Expose yourself to lots of bright light during the day, which will boost your ability to sleep at night, as well as your mood and alertness during daylight.
16. Use 5-2-5 technique to alter biorhythms at point of sleep.
17. Complete a walk routine six hours before scheduled sleep period.
18. Complete evening meal 4 hours before scheduled sleep period.
19. Add other ideas to this list. Review list and determine what works well for me.