WHY WORRY? CHAPTER IX
SLEEPLESSNESS
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WHY WORRY?
BY: GEORGE LINCOLN WALTON, M.D.
CONSULTING NEUROLOGIST TO THE MASSACHUSETTS GENERAL HOSPITAL
IX.
SLEEPLESSNESS
He shall enjoy the same tranquility in his sleep as when awake.
--Digby's Epicurus, Maxim xl.
  Sleeplessness is due, in the majority of cases, to a faulty habit of mind.
The preparation for a sleepless night begins with the waking hours, is continued through the day, and reaches its maximum when we cease from the occupations which have in some degree diverted our attention from harassing thoughts, and retire, to struggle, in darkness and solitude, with the worries, doubts, regrets, and forebodings, which now assume gigantic and fantastic shapes.
He who would sleep at night must regulate his day, first, by not
undertaking more than he can accomplish without undue stress, and, second,
by carrying through what he does undertake, as far as he may, without the
running accompaniment of undue solicitude, anxious doubts, and morbid fears
discussed in the preceding sections. It is futile to expect that a fretful,
impatient, and over-anxious frame of mind, continuing through the day and
every day, will be suddenly replaced at night by the placid and comfortable
mental state which shall insure a restful sleep.
Before proceeding, then, to the immediate measures for inducing sleep, let us consider the suitable preparatory measures.
The nervous breakdown which precludes sleep is oftener due to worry than to
work. Nor should the sufferer jump too quickly to the conclusion that it
is the loss of sleep rather than the worry that makes him wretched. It is
astonishing how much sleep can be lost without harm, provided its loss is
forgotten, and how much work can be carried on without extreme fatigue,
provided it be undertaken with confidence and pursued without impatience.
It is, however, essential that the work be varied and, at due intervals,
broken. Trainers for athletic contests know that increasing practice
without diversion defeats its end, and particularly insist upon cessation
of violent effort directly before the final test. Why should we not treat
our minds as well as our bodies?
The active< and perhaps, over-scrupulous business or professional man who allows no time for rest or recreation, who can delegate no responsibility to his subordinates, who cultivates no hobby, and is impatient of every moment spent away from his occupation, is in danger of eventually "going stale," and having to spend a longer and less profitable vacation in a rest home than would have sufficed to avert the disaster. Nor will he find it easy to change his sleep-habit with the change of residence. It makes sense to change that habit while still at work, as an intitial step toward averting breakdown.
It will harm few of us to take a bird's eye view of our affairs at stated intervals, and ask ourselves if the time has not arrived when it will be a
saving of time and money as well as worry for us to delegate more of the details, and more even of the responsibilities, to others, concentrating
our own energies upon such tasks as we are now peculiarly qualified to undertake. To the man determined to accomplish a lifetime of work before he
rests, there is food for thought in the following anecdote:
When Pyrrhus was about to sail for Italy, Cineas, a wise and good man, asked him what were his intentions and expectations.
"To conquer Rome," said Pyrrhus.
"And what will you do next, my lord?"
"Next I will conquer Italy."
"And after that?"
"We will subdue Carthage, Macedonia, all Africa, and all Greece."
"And when we have conquered all we can, what shall we do?"
"Do? Why, then we will sit down and spend our time in peace and
comfort."
"Ah, my lord," said the wise Cineas, "what prevents our being in peace and comfort now?"
The time to take a vacation is before one is exhausted. If one is
discontented during his vacation, he should take it, none the less, as a
matter of duty, not expecting to enjoy every moment of it, but contenting
himself with the anticipation of greater pleasure in the resumption of his
duties. He should cultivate an interest in out-door occupation or some
study that carries him into the fields or woods. Aside from the time on
shipboard, the worst possible vacation for the over-worked business or
professional man is the trip to Europe, if spent in crowding into the
shortest possible time the greatest possible amount of information on
matters artistic, architectural, and historic.
No one can acquire the habit of sleep who has not learned the habit of
concentration, of devoting himself single-minded to the matter in hand. If
we practice devoting our minds, as we do our bodies, to one object at a
time, we shall not only accomplish more, but with less exhaustion. Training
in this direction will help us, on retiring, to view sleep as our present
duty, and a sufficient duty, without taking the opportunity at that time to
adjust (or to try to adjust) all our tangles, to review our past sources of
discomfort, and to speculate upon the ills of the future.
A walk, a bath, a few gymnastic exercises, will often serve a useful
purpose before retiring, but if they are undertaken in a fretful and
impatient spirit, and are accompanied by doubts of their effectiveness,
and the insistent thought that sleep will not follow these or any other
procedure, they are likely to accomplish little.
The best immediate preparation for sleep is the confidence that one will
sleep, and indifference if one does not. It is an aid in the adoption of
this frame of mind to learn that many have for years slept only a few
hours per night, without noticeable impairment of their health or comfort.
Neither unbroken nor long-continued sleep, however desirable, is essential
to longevity or efficiency. This is illustrated by the following examples:
Joseph A. Willard, for nearly half a century Clerk of the Court in Suffolk
County, and a well-known figure on the streets of Boston, died in his
eighty-eighth year. He was active and alert in the performance of his
daily duties up to their discontinuance shortly before his death. He
kept, meantime, records of the temperature, weather, and condition of the
streets, at all hours of the night, and every night, for many years before
the establishment of the weather bureau. So reliable were these records
regarded by the courts that they were often appealed to in the trial of
cases, and their accuracy never questioned by either party in the suit. I
publish these facts by the permission of his son.
George T. Angell, the well-known humanitarian, than whom few, if any, have led a more busy life, when in his sixty-ninth year wrote as follows:
"For the benefit of those who do not [take narcotics, opiates, anæsthetics]
I will say that I suppose there are very few in this country who have
slept less than I have; but I have never taken anything to stupefy, while
thousands of good sleepers I have known have long since gone to the last
sleep that knows no waking here. It was undoubtedly wise to change my
professional life from court to office practice: but in other matters I
was compelled to choose between living the life of a vegetable, or losing
sleep; and I chose the latter."
Mr. Angell is now eighty-four, still actively engaged in affairs, and
allows me to add that during the past six years he has gone for a week at
a time with no sleep; for three months at a time he has not averaged more
than two hours in twenty-four; he does not remember having ever had a good
night's sleep. Mrs. Angell states that, with one exception, she has never
known him to sleep through the night.
It is worth while to remember these experiences before resorting to drugs for sleeplessness.
I have somewhere seen it stated that a prominent divine attributed his
happy and green old age to the fact that he slept a certain number of hours
every night. Against this statement must be set the reflection that many
another old gentleman can fairly attribute his comfort, in part at least,
to an attitude of indifference toward the unessentials, among which I
suspect must be included the question whether we average eight hours of sleep or materially less.
Let us now consider some of the faulty mental habits directly affecting
sleep itself. First comes the compulsive thought that one must sleep now,
and the impatient count of the wakeful hours supposed to be irrecoverably
lost from the coveted number. This insistence in itself precludes sleep.
The thought, "No matter if I don't sleep to-night; I will some other
night," will work wonders in the direction of producing sleep to-night.
The continuance of any given position, completely relaxed, in bed, even
without unconsciousness, is more restful than tossing about. The mere
experiment of remaining immobile in a certain position as long as possible,
and concentrating the mind on the thought, "I am getting sleepy, I am
going to sleep," will oftener produce the desired result than watching the
proverbial sheep follow one another over the wall. Training during the day
in restraining nervous movements is an aid in acquiring the ability to do
this.
This is a field in which self-suggestion is of definite value. Everyone
appreciates the effect on sleep of the "state of mind" when he has passed a
succession of sleepless hours followed by a sudden tendency to somnolence
at the time for rising. The problem is to acquire the frame of mind without
waiting for circumstances. To demonstrate the effect of faulty suggestion
combined with restlessness on awaking in the night, try the following:
EXPERIMENT I.--Place yourself on the face and from this point turn rapidly
in a complete circle backwards from right to left until you are again on
the face. Pause several times and say to yourself rapidly "I cannot sleep
in this position." The result of the experiment is practically uniform. The
rapid movement and the suggestion prevent sleep.
To demonstrate the effect of bodily relaxation combined with correct suggestion, in promoting sleep try--
EXPERIMENT II.--Start in the same position as Experiment I. Traverse the
same circle, prolonging each pause with body relaxed, and substituting at
each pause the suggestion, "I can sleep in any position," repeated a number
of times deliberately and as if you meant it. The restful pose and the
suggestion generally induce sleep long before the circle is completed.
Next comes the compulsive thought that we cannot sleep until everything is
"squared up" and all mental pictures completed. The story is told that a
gentleman took a room in the hotel next another who was notoriously fussy.
He remembered this fact after dropping one boot carelessly to the floor,
and laid the other gently down. After a pause he heard a rap on the door
and a querulous, "For heaven's sake, drop the other boot, or I can't get to
sleep."
Many find themselves unable to sleep until the whole household is accounted
for and the house locked up for the night, until certain news is received,
and the like. The same tendency postpones sleep until all affairs are
straightened out in the mind, as well as in reality. A little reflection
shows how indefinite must be the postponement of sleep under such
conditions.
No training is more important for the victim of compulsive tendencies
than the practice of trusting something to chance and the morrow, and
reconciling himself to the fact that at no time, in this world, will all
things be finally adjusted to his satisfaction.
The habit of dismissing, at will, disagreeable thoughts is a difficult but not impossible acquisition. Arthur Benson in "The Thread of Gold" relates the following anecdotes:
"When [William Ewart] Gladstone [1809-1898] was asked, 'But don't you find you lie awake at night, thinking how you ought to act, and how you ought to have acted?' he answered, 'No, I don't; where would be the use of that?'"
"Canon [Frederick] Beadon [who lived to be over one hundred (1777-1879)] said to a friend that the secret of long life in his own case was that he had never thought of anything unpleasant after ten o'clock at night."
The insistent desire to sleep in a certain bed, with a certain degree of light or darkness, heat or cold, air or absence of air, is detrimental.
This is in line with the desire to eat certain foods only, at a certain table, and at a certain time. The man who loses his appetite if dinner
is half an hour late is unable again to sleep if once waked up. This individual must say to himself, "Anyone can stand what he likes; it takes a
philosopher to stand what he does not like," and try at being a philosopher instead of a sensitive plant.
Inability to sleep while certain noises are continued must be similarly combated. If one goes from place to place in search of the quiet spot for
sleep, he may finally find _quiet itself_ oppressive, or worse yet, may be kept awake by hearing his own circulation, from which escape is out of
the question. He who finds himself persistently out of joint with his surroundings will do well to ponder the language of the Chinese philosopher [Chwang Tsze]:
"The legs of the stork are long, the legs of the duck are short: you cannot
make the legs of the stork short, neither can you make the legs of the duck
long. Why worry?"
With regard to the character of sleep itself, the attitude of our mind in sleep is dominated, to a degree, at least, by its attitude in the waking
hours. It is probable that during profound sleep the mind is inactive, and
that dreams occur only during the transition-state from profound sleep to wakefulness. It is conceivable that in the ideal sleep there is only one
such period, but ordinarily there occur many such periods during the night; for the uneasy sleeper the night may furnish a succession of such periods,
with comparatively little undisturbed rest, hence his dreams seem to him continuous. The character of the pictures and suggestions of dreams, though
in new combinations, are largely dependent on our daily experiences. Is it not, then, worth while to encourage, during our waking hours, as far as is
consistent with our duties, such thoughts as are restful and useful, rather than those which serve no purpose but annoyance.
If we wish, we can select our thoughts almost as easily as we do our companions.
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