Naps, sleep debt, and my quest for a good night's sleep
February 11, 2021
I have struggled with sleep my entire life. As a young child I was a very early riser. Later in childhood I had several extended bouts of severe insomnia. My parents took me to the doctor and psychologist, whose strategies eventually helped, though I still rarely achieved a Very Good Sleep.
From my late teens until now (early 30s) my sleep has been generally poor. I tend to fall asleep quickly, and wake up 5-6 hours later feeling groggy and poorly rested but unable to sleep any more. Most nights I wake up at least once or twice during the night, sometimes to pee but often for no particular reason.
A few years ago my partner started complaining about my snoring. At that point I weighed around 220 lbs, which is the heaviest I had ever been, so our concern was possible sleep apnea. I went to a pulmonologist and did a take-home sleep study (with a complicated device that sat on my forehead and measured breathing, brain activity, heart rate, and more).
The verdict? No sleep apnea, just loud snoring. Nothing medically wrong. The doctor told me to lose weight, as fat in the neck area can contribute to snoring. So I lost about 15 lbs, and the snoring got much quieter. Problem solved.
But not really. In a way I was kind of hoping it was sleep apnea, as that could have explained my sleep difficulties throughout adulthood, and given us a path to a solution. Not that I was particularly enthusiastic about the idea of a CPAP machine, but it would have been worth it to finally sleep through the night and feel well rested.
What about caffeine? I’ve never been a huge caffeine drinker, but I would have one or two servings (tea or Diet Coke) most days. I decided to cut it out entirely and see what would happen. So I tapered off and went for about a month without consuming any caffeine at all.
This made me grumpier and less focused at work. But it did not improve my sleep. Too bad. I started drinking caffeine again after that experiment, though I quit the Diet Cokes for the most part and now stick to home brewed tea.
I’ve been taking citalopram hbr (Celexa) as an antidepressant for the last 5 years or so. One of the common side effects is sleep disruption. And indeed when I first went on the medication, I went for around a month with only 2-3 hours of sleep per night. It was bad, but eventually I acclimatized to the medication and my sleep went back to its poor normal.
I wanted to see if getting off the medication might improve my sleep a bit. I tapered off gradually (once on my own, then again under supervision of my doctor). Coming off of citalopram is an…interesting experience, and not totally pleasant. Imagine jolts of electricity through your brain and body at random times. Not painful, just distracting and weird.
Anyway. The first time I was completely off the medication for 1 month, and the second time 2 months. Did it improve my sleep? No. And I became depressed. Duh.
Through these experiments I have determined that my poor sleep is not due to sleep apnea, not due to caffeine, and not due to my medication. So what could it be?
Around a year ago I started using an app called AutoSleep on my Apple Watch. This uses motion data, heart rate, and ambient sound to monitor sleep in detail. It’s scarily accurate, much better than phone-only apps I’ve tried before (e.g. Sleep Cycle) or fitness trackers I’ve tried in the past (Jawbone, Garmin, FitBit, etc.).
Before I started using AutoSleep, I had heard of the concept of a “sleep bank” or “sleep debt” but hadn’t paid close attention to it. In AutoSleep, the sleep bank is an integral part of its analytics. It’s a rolling total of how far you are behind your sleep goal (e.g. 7h per night) for the past 7 days.
Instead of focusing on individual nights, I started to try to correlate my mood, energy, and productivity levels to my 7-day sleep debt. And this is when things started to click. When I’m at close to 0% debt, I tend to feel good and energetic during the day. Even if my most recent night of sleep hasn’t been amazing. It’s the 7-day rolling total that ultimately dictates how I feel.
Now that’s nice to know, but what good does it do if I can’t sleep enough to erase my debt? Here’s the other piece of the puzzle: naps count toward the sleep bank.
Naps? The thing they force you to do in preschool but then shame you if you do as an adult? Yes, those naps. Since I’ve been working at home during coronatimes, I’ve been able to take short naps (1hr) during the afternoons. And this has allowed me to chip away at my sleep debt.
It’s not a perfect strategy, but if I’m consistent about it I can keep myself close to 0% debt most of the time. I feel better and work better.
Here’s a sample schedule of my days. I don’t stick to this all the time but it’s a framework I can work toward:
06:00 - wake up, get out of bed 08:00 - start work 15:30-17:00 - nap 17:00-18:00 - finish work 22:00 - screens off, start to wind down 23:30 - light out, go to sleep
As for the question of why I don’t sleep well at night, I’ve decided it doesn’t ultimately matter. Maybe my body and brain just isn’t wired for a full stretch of nightly sleep. I have learned that my body is wired for daily naps, and by accepting and taking advantage of this, I can live every day feeling happier and energized.
P.S. I have learned a few more things about my sleep by using AutoSleep:
- Alcohol affects my sleep quality, but not sleep duration. I sleep as normal after 1 drink, but if I have 2 or more drinks, my heart rate stays elevated throughout the night and the sleep isn’t as restful.
- Exercise right before bed, even light exercise (like a 30 minutes walk), makes it harder to fall asleep. Vigorous exercise, like a run, makes it hard to fall asleep, and also contributes to elevated heart rate and poor sleep quality, similar to alcohol.
- Vigorous exercise earlier in the day (morning or afternoon) tends to improve my sleep quality the following night.