Chapter 5 - Sleep: The Knitter of Raveled Spirits
Shakespeare gave us a dramatic picture of the most important force for rest in our lives:
Sleep that knits up the ravell'd sleave of care,
The death of each day's life, sore labour's bath,
Balm of hurt minds, great nature's second course,
Chief nourisher in life's feast.
(Macbeth II, ii, 36)
In the previous chapter we saw how depression and anxiety almost by definition are thieves of normal sleep. Sleep is the "knitter" of the spirit raveled out by anxiety, the balm of the mind hurting with indecision, hopelessness, deep indignation, and unspent anger. These, as Shakespeare said of Glamis in Macbeth, have "murder'd sleep." Your right to rest is the assurance that these things need not be. Obstacles to your nightly entering into the rest given to you by God, the Inventor of sleep, can be removed and you can claim God's blessing of sleep as your own. In this chapter, let us reflect upon what sleep is, how it works, what it does for us, and how we can enter into its rest.
The Nature and Function of Sleep
Normal sleep is the natural, almost complete cessation of consciousness, during which the activity of the nervous system is almost suspended and the powers of the nervous system are revitalized, rejuvenated, and refreshed. You will notice I have used the word "almost" twice in the previous sentence. We speak of sleeping "the sleep of the dead," but in fact our sleep is never the complete cessation of all our functions that death represents. In fact, anxiety about death may keep us from sleeping, for fear that we will not awake. The little child's prayer that begins, "Now I lay me down to sleep," also has a line in it, "If I should die before I wake . . . " We take this line for granted, but should seriously question whether teaching little children to associate sleep with death is at all wise. I would rather teach my grandchildren to pray:
Thank you, God, for the gift of sleep.
Help me to rest and make me new.
All my loved ones safely keep,
And tomorrow we will be loving you.
When you sleep, you go through four stages of rest, in which there are two kinds or qualities of sleep. In the 1950s, researchers in the physiology of sleep, using the electroencephalogram to chart the activity of the brain during sleep, noted that one kind of sleep is "rapid eye movement" or "REM" sleep. This is an active or activated sleep during which the images you see in your dreams apparently are "seen" and actively watched while you sleep. They also recorded a second kind of sleep, the "non rapid eye movement" or "NREM" kind, when you are in a quiet, deep, inactive sleep. These two kinds of sleep alternate with each other, both appearing in each of four 90-minute stages of sleep. This 90-minute REM-NREM sleep is a part of a basic rest-activity cycle in your 24-hour day. (Even when awake, you alternate on an 80-100 minute cycle of first an outwardly directed practical and logical kind of thinking, and second an inwardly directed daydreaming, reverie, or meditative kind of thinking.) The total sleep cycle consists of 20-25 percent REM sleep and 75-80 percent NREM sleep.
Sleep need varies with age: 16 hours are needed at birth, 15 hours at four weeks, 14 hours at twenty-six weeks, 12 hours plus an hour nap at two to three years, 11 hours plus an hour nap at four to five years, 10 hours at eight to twelve years, 9 hours at twelve to seventeen years. Adults need 8 hours, and elderly persons average significantly less because of frequent awakenings. Yet in the elderly, frequent naps make it difficult to assess their sleep time. My own feeling is that if older persons miss sleep at night, a deliberately planned "siesta," i.e., a nap in the afternoon, will keep them invigorated and recuperated with a good average of 7 to 8 hours sleep. Thus their youth is renewed. Where older people err is in assuming that they are fated to get less sleep and that their work schedule should be the same as that of persons in their thirties to fifties. Not so. Periodic shifts in the pattern of the day's work, punctuated by "dropping out of sight and sleeping," will enable us to be productive and creative differently in time but in a way that is qualitatively satisfying nevertheless.
Effects of Sleep Loss
Experimental studies show that total sleep loss creates both dramatic and incapacitating changes in how people act and think. False or pseudo-psychotic states can result, as was seen in prisoners of war under torture: feelings of persecution, misperception, confusion of time, place, and personal identity, and hallucinations of seeing and touching. These changes occur after about 100 hours of total sleep loss. The marvel and miracle is to see all these changes disappear once persons recover their sleep. They quickly reconstitute, and no pathological effects extend beyond the period of the sleep deprivation.
Less dramatic effects appear in your life, however, when you are heavily but not totally deprived of sleep. Your judgment is poor, you tend to "lose your grip" on your emotions, and your decisions become faulty. You may do and say some unwise things that in themselves may have permanent effects, not upon your brain, but upon your job, your marriage, your sons and daughters, and your friends and coworkers. You may make unwise financial and business decisions that have lasting effects. Therefore, the consistent pattern of not acting on major decisions until you have had a chance to "sleep on them" is a ritual worthy of all acceptance.
The Work Situation
Persons caring for seriously ill family members, especially mothers and fathers of little children and grown sons and daughters of aging parents who require twenty-four-hour nursing care (which is amazingly expensive to buy), are likely to suffer profound sleep deprivation. Likewise, persons in heavily responsible jobs may be repeatedly pushed into "forced marches" of forty-eight-hour to ninety-six-hour stints of work without sleep. Management and labor in heavy industry, physicians and nurses in understaffed situations of health care, and farmers in times of threatened destruction of their crops are just a few examples of persons for whom a sleepless existence can become a way of life. If you are in a situation such as I have described or in any other that is similar, then you need a systematic plan for interrupting your stress, getting someone else to "cover" for you on the job, and regularly taking what military personnel in Vietnam called "R and R's," periods of rest and recuperation. This is imperative now. Rotating in and out of the severe work schedule for "sack time," for rest, food, and loving care, is your inalienable right, your right to rest. Furthermore, your efficiency on the job may be low as a result of your lack of rest. Think about this. Defiance of the basic needs of your body for sleep can reach the point where you are defying the Creator, who made your body. You think you know better than God does! Oh, no!
Unsatisfactory Substitutes for Sleep
In depriving yourself of sleep, you will become so fatigued that you will fall back on a variety of unsatisfactory substitutes for rest. Take an inventory of your practices with me.
Caffeine. The most available stimulant you can find to pick you up, give you a lift, and make you more active is caffeine. It is a stimulant. Caffeine is usually consumed in the form of coffee, tea, cola drinks, and chocolate. Often, for example, parents will say that their child is hyperactive, when in fact he or she has been drinking numerous cola drinks in a day's time. The child may not be sleeping. You as an adult, carrying a burden of fatigue, can speed yourself up with more and more coffee, tea, cola drinks and chocolate in its multiple forms. Cut this out or cut it down to an absolute minimum and you will feel the need for rest sooner and be more likely to sleep well when you lie down.
Food. All things are lawful, but not all things are fitting. Food is certainly O.K. However, when you become so fatigued you can't push yourself any more, you may combine calories with the caffeine. Pastries, chocolates, snack or junk foods such as potato chips, french fries, and a long list of others you can name, along with soft drinks, alcohol, and hors d'oeuvres, are substitutes for rest in the middle of the morning, afternoon, and evening. They are supposed to refresh you and give you quick energy. You take on from 500 to 1,000 calories in these socially convivial occasions, breaks, and rat-race pit stops in your day's work. Hence, the connection between fatigue and overweight is a double one: you eat to combat fatigue; your excess weight fatigues you all the more. The rebound effect is a self-perpetuating circle of fatigue. Simple rest and preferably adequate sleep break the cycle.
Alcohol. Some people find that alcohol pushes them beyond the fatigue barrier with an initial feeling of well-being. This becomes a substitute for rest and sleep. Sooner or later it may become a substitute for food as well. Paradoxically enough, alcohol is also used by some people as a sedative in order to sleep. It is an unprescribed drug that is not a stimulant like caffeine, but a depressant. In the short run, it may seem to erase fatigue or facilitate sleep. Alcohol, just as caffeine and food, has its ceremonial, celebrative, preservative, and even therapeutic uses. I do not mean to negate it as the part of creation that it is. The one thing I want you to hear me say here is that neither alcohol, food, nor anything else is a substitute for sleep.
Sleep is like air, water, and food, a necessity to your body. There are no substitutes for these things. They recuperate, renew, and sustain your body. They are agents of health that only you can safeguard for yourself. When it comes to sleep, especially, do not take any substitutes. Demand and take the real thing.
Going to Sleep and Remaining Asleep
You may have trouble going to sleep and staying asleep until your customary rising time. Several normal obstacles cause this most often.
If you have lost someone or something extremely important to you, you will have trouble sleeping. This is to be expected. You may lose a lover or a spouse by a broken courtship or a divorce. You may lose a coveted promotion or your job itself: The best way to handle these griefs is to "talk out" your thoughts and feelings in the daytime, during waking hours, with a trusted friend, a trained counselor such as the pastor of your church, or a pastoral counselor on the staff of a hospital or community pastoral counseling service. Similarly, members of your family can talk things out with you and bring as intimate comfort to you. Yet if you live alone, you may need to have a dose friend or relative stay with you until you are able to sleep the whole night through. The "long night watches" can be very lonely. You don't need sympathy that is too sweet and makes you feel helpless. You need understanding from someone who will let you say exactly how you feel and find real sense in it. (For a detailed discussion of grief, read my book Your Particular Grief, Westminster Press, 1981.)
A second deterrent to sound sleep is indecision. You stay awake trying to figure out problems. Your mind is up in the air. You can't go to sleep because you can't settle what you are going to say to someone tomorrow, because you are second-guessing what you did or said the day before this night, or because you do not know enough facts about a given situation to make a good decision. Thus, instead of sleeping you toss and turn as you stew in indecision. You can do something about this. Let me suggest a few things.
First, you may need specific information which you do not have now, and without which you cannot decide what to do. However, you can decide how, where, and from whom you can get that information Do that. If you are afraid you will forget these details, get up and write yourself a note including all of the details about information needed and ways and means of getting it. Go back to bed and you are likely to go to sleep.
Second, you may know that nothing an be decided or done now about what is worrying you. At this time, you are in a "holding pattern." (In flying with commercial airlines, I have never been able to sleep while a plane circled in a holding pattern for up to an hour waiting for a time to land.) By analogy, you will have trouble sleeping out of sheer suspense. Yet in the ordinary course of human events, you can decide when you can put an end to the suspense of how long you intend to put up with the unsettled state of affairs. Once you have set an end beyond which you do not have to go, or beyond which you will not go, you will tend to rest more easily and sleep more readily. You will begin to relax, both when awake and when asleep.
Third, you can develop alternatives for action. In your indecision, you cannot sleep well because you are confused. Clearly defining alternatives is the best way to resolve the confusion, as surely as the sun burns off the early morning fog. Confusion cannot stand the heat of clarity. As you define the alternatives, possible actions you can take and the predictable results of each of these actions, you can rank them is order of your preference as Plan A, Plan B, Plan C, etc. If you are already in bed and cannot go to sleep, then you can reach for a light, a pen, and a pad and write these alternatives down. Then you can sleep with a more settled mind.
All that I have said here points to something missing in our daytime activities when ate cannot sleep. We need significant times alone and in contemplation about decisions that need to be thought through and nailed down. If your life is like mine, hectic and event-filled, then you may again and again be denied the luxury of a period of time for solitude, meditation, and reflective decision-making. However, if you and I nevertheless pull back, stand apart, and turn aside from the hectic, pell-mell rush of the demands upon us, we restore our perspective and do not let life demand this time of reflection out of our sleep time. We will sleep more serenely. Procrastination about overdue decisions comes at the price of sleeplessness. Therefore, as much as you can, make decisions within a day or two after the choices present themselves. Research the facts, inspect the alternatives, bite the bullet, and get on with it.
A charming example of this is found is the exquisite story of Ruth in the Bible. Boaz and Ruth wanted to get married. However, Jewish law said that her deceased husband's next of kin had first option on marrying her. Perplexed, Ruth went to her mother-in-law, Naomi, who seemed to know Boaz better than Ruth did. Naomi said: "Wait, my daughter, until you learn how the matter turns out, for the man will not rest, but will settle the matter today." Boaz did just that and removed the roadblocks in the way of his having Ruth for his wife. I find myself wanting to copy the character trait of Boaz wherein he would not rest but would "settle the matter today."
Yet Jesus reminds us that we are not to respond on our own cleverness in deciding what to say. In the intense trials that Jesus' disciples faced before authoritarian rulers of their day, Jesus told them: "Settle it therefore in your minds, not to meditate beforehand how to answer; for I will give you a mouth and wisdom, which none of your adversaries will be able to withstand or contradict" (Luke 21:14–15). You and I are not alone in settling decisions in our minds. We have a Spirit within our spirits that is more than our spirits. We can count rest in the assurances of Ps.121:1–4: "I lift up my eyes to the hills. From whence does my help come? My help comes from the LORD, who made heaven and earth. He will not let your foot be moved, he who keeps you will not slumber. Behold, he who keeps Israel will neither slumber nor sleep.
Pain and Sleep
One of the most real disrupters of your sleep is or will be physical pain. You may have a cold or the flu, and during its brief course (which seems forever) congestion in your head and chest will interrupt your sleep. You may be beset by a more continuous pain such as that of arthritis or the residue of old injuries. Instead of causing transient pain, this condition and many others like it become chronically painful disorders. By their very nature, they tend to carry with them a chronic sleep disorder. When pain persistently interferes with your sleep, you need careful, conservative medical diagnosis, treatment, and instruction. Many physicians will blandly tell you that "you are going to have to learn to live with the pain." However, either they do not know how to teach you to live with it, or they are in too big a hurry to do so. Therefore, let me suggest that you go to the kind of physicians who not only are skilled in diagnosis and treatment but also, along with their therapy, will teach you how to be a part of your own pain management. Usually these physicians will be physiatrists, who specialize in physical medicine and rehabilitation, or neurologists, who specialize in nonsurgical treatment of the disorders of the central nervous system. Their treatment aims to help you avoid as much surgery as possible. Their treatment will be comprehensive and conservative. Follow their advice as to whether you need the assistance of a surgically skilled person such as a neurosurgeon or an orthopedist.
Quite apart from relying too heavily on the hope that surgery will completely "fix" your pain, your more common hope will be that some sort of medication will solve your pain. If your physician places you on any kind of medication, follow these guidelines:
- Be sure to advise your physician of the other medications that other physicians may have you taking. This will reduce the possibility of one medication conflicting with another, creating a hazard or rendering neither medication effective.
- Have yourself checked at least once every three months to see whether the medicine is still needed, is still effective, or should be changed or discontinued.
- Whether it is pain-relieving or sleep-inducing, be very skeptical of staying on any medication regularly over long periods of time. Medication should be reserved for acute crises of pain.
Far better than medicines or surgery is to make the changes in your life habits that will reduce your stress, increase your use of carefully prescribed exercise, well-planned rest, and adequate sleep. Medicines, particularly, should be short-term aids in making these life-style changes. Throughout our country today, hospitals and other health facilities are providing what are called wellness centers, life-style centers, or health awareness centers. These can provide excellent guidance in pain control, weight control, and stress control. Seek out one of these centers and get a comprehensive approach to your life pattern in coping with pain.
Sleep, Meditation, and Prayer
Relaxation, meditation, and prayer have been the centuries old ways of assistance for getting to sleep. Let me recommend Herbert Benson's The Relaxation Response or Patricia Carrington's Freedom in Meditation. These will give detailed instructions that the limited pages of this book will not permit.
In a distinctly Christian approach, your first resource is the Scriptures, especially the Psalms, especially Ps. 3:5–6; 4:8; 121:4; and 139:17–18. Proverbs 3:21–24 will be a sustaining grace: "Keep sound wisdom and discretion; let them not escape from your sight, and they will be life for your soul and adornment for your neck. Then you will walk on your way securely and your foot will not stumble. If you sit down, you will not be afraid; when you lie down, your sleep will be sweet." Other references in Proverbs tend to add words of caution about overvaluing sleep, such as Prov. 20:13: "Love not sleep, lest you come to poverty; open your eyes, and you will have plenty of bread." A similar observation is found in Prov. 24:33–34: "A little sleep, a little slumber, a little folding of the hands to rest, and poverty will come upon you like a robber, and want like an armed man."
This latter admonition, which concentrates on the connection between laziness and poverty, nevertheless, also points to the hazard of being obsessed with the necessity of sleep. You and I can easily become worshipers or idolaters of the Greek god Morpheus, the god of sleep and dreams. Even with sleep, we are wise to keep ourselves from idols, as I John 5:21 urges us. If you find that after trying too hard to sleep you cannot sleep, then get up and read, listen to music, or engage in some other task you really enjoy. Sleep will take care of itself. It may be as simple as that you are not tired enough to sleep yet!
However, another resource for encouraging sleep is prayer. If you cannot sleep, use the available quiet time to devote yourself to prayer. Instead of being agitated and worried about problems and people, systematically lift them and yourself to God in prayer. You will undergo some deep personal changes in yourself, even as Jacob did when he wrestled all night until the break of day (Gen. 32:22–32). He was no longer the same after this night in which he said: "I have seen God face to face, and yet my life is preserved." Your relationship to God is more important than one night's sleep.
Yet one of the major differences between God and us is that we are made to rest as well as work, to sleep as well as be awake. God stays awake and watches over us and this world we know about, as well as all those worlds we do not know about at all. Hence, we can with a good conscience pray for sleep. The following prayer for sleep and rest says it for us:
Eternal God, the God and Father of our Lord Jesus Christ, the central peace and the source of all rest in the universe, I thank you for the permission you give me to rest in you, free of despair, fear, distrust, and indecision. You bless me in taking all my burdens upon yourself, that I may sleep according to the way you have intended to renew my being through sleep. Deepen my breathing, that I may have each cell of my body replenished with oxygen. Relax my muscles, that I may be healed of my fatigue. Teach my overactive thoughts to be still and know that you, and not they, are God.
In my sleep, command my dreams that they may be agents of your healing of my thought processes, instruments by which you reveal your intentions for my life. Grant that my very sleep may be that deeper communion with you.
Then, as I awake, may I face the day ahead of me with hope, anticipation, and full commitment to love you with all my heart and my neighbor as myself: Through Jesus Christ our Lord I pray.