A segmented/biphasic sleep pattern does not an insomniac make

[sue_frantz]

COVID has changed a lot of things. (Shall we nominate this for understatement of the year?) In this particular case, I’m thinking about sleep patterns. A New York Times article got me thinking about this (Braff, 2022). For the story, the journalist interviewed a few people whose sleeping patterns changed during COVID.

One mother of three reported that she would wake up at 3am and then go back to sleep for an hour around 6am. While waking up was due to her mind racing, she began to value the few hours in the middle of the night that she had to herself.

For another person, he had always split his night sleep into segments. With the shift to remote work, he was able to allow himself to fall into what felt like a more natural rhythm for him: sleeping from 10pm to 2am, awake for an hour and a half to two hours, then back to sleep for another three hours.

The story that really struck me, though, was that of Diana Hughes who spent a year working with physicians trying to find a solution for her middle-of-the-night insomnia. She happened upon the solution by doing her own research. What if being up for an hour, or two, or three in the middle of the night wasn’t actually a problem? Once she labeled her sleep pattern as another legitimate way to sleep, there was no longer a problem to be solved.

This was a powerful reminder to me that what we say in our Intro Psych courses and how we say it matters. When we talk about sleep, are we implying that sleeping seven to nine hours straight through the night is “normal” and how we should all be sleeping? And that any wakefulness during the night is “insomnia,” and thus a problem?

Insomnia questionnaires (like this one), frame waking in the middle of the night as a problem. “Please rate the current severity of your insomnia” for falling asleep, staying asleep, and waking early. The next four questions, though, address whether it is really a problem: satisfaction with sleep pattern, does the sleep pattern interfere with life, do others think it interferes, and how worried are we about it.

As someone whose sleep pattern became biphasic some time in adulthood, I’ve had occasion to give this a lot of thought. I typically fall asleep between 8:30pm and 9pm, wake up around 1am, and fall back asleep between 2am and 2:30am, and then wake up for the day between 6am and 7am. My home and work life give me the luxury to follow what sure feels like my natural sleep/wake cycle. For example, I don’t have children who need tending to in the evening. I don’t have a work schedule that requires me to set an alarm for 5:30am.

In looking at the sleep questionnaire, yes, I suppose I have “difficulty staying asleep,” except I don’t perceive it as a “difficulty.” I am satisfied with my sleeping pattern, it does not interfere with my life, my wife doesn’t think it interferes with my life, and I’m not worried at all about my “problem.”

But let’s imagine that I did have children that required my attention in the evening and in the morning, and let’s imagine that I did have a job that required me to be on the road at 7am in order to get to wherever I needed to be on time. Suddenly, my sleep pattern has become a problem to be solved. Why must I contort my biology to fit my life? That was the preferred solution pre-COVID. “You’re not sleeping through the night? Time for you to make some changes. Exercise more. Consume less caffeine. Kick your dog off the bed. Turn down the thermostat. Wear an eye mask. Turn on the white noise.”

For many people, COVID flipped the script. If children are going to school remotely and if employees are working remotely, the removal of the lengthy daily commutes (and, if we’re being honest, the removal of the need to shower and get dressed) produced at least a few more free hours during the day. For some at least, sleeping patterns changed to something that felt more normal. (For others, the anxiety created by COVID, such as income loss, health worries, death of loved ones, produced insomnia.) As we watched the Great Resignation, we have seen a lot of white-collar workers unwilling to return to their daily commute. In droves, they have left their face-to-face jobs in exchange for remote employment. Their reasons are myriad, but I have to wonder for how many is sleep quality and quantity just one more factor.

The New York Times article (Braff, 2022) ends with this:

“When practicing segmented sleep, insomniacs don’t have to worry about waking up in the middle of the night, as that’s the way segmented sleep works,” Mr. Savy said. “Therefore, they can adjust the schedule to their insomnia and reduce the stress associated with it.”

But returning to sleep patterns from the Middle Ages isn’t for everyone, Dr. Avena said, suggesting that segmented sleep should be tried only by those who are already having sleep issues.

My goodness, the assumptions. The word “insomniac” implies someone with a problem. Yes, I’m awake for an hour or two in the middle of the night, but I’m not an “insomniac.” Second, segmented sleep is not something one tries. Years ago, I did not set my alarm for 1am and stay awake for an hour just to try out a biphasic sleep pattern. I just happen to wake up naturally at 1am, I do not define it as a problem, and I fall back asleep naturally an hour or two later. Again, I don’t have “sleep issues.”

My big takeaways: I need to pay close attention to the assumptions I make about what is normal or typical, and I need to carefully consider how I talk about these concepts with students.

Reference

Braff, D. (2022, February 12). Meet me at 3 A.M. for a cup of coffee. The New York Times. https://www.nytimes.com/2022/02/12/style/segmented-sleep.html