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The Ravel’d Sleave of Care

the innocent sleep,
Sleep that knits up the raveled sleave of care,
The death of each day’s life, sore labor’s bath,
Balm of hurt minds, great nature’s second course,
Chief nourisher in life’s feast.
–Shakespeare, Macbeth Act 2 Scene 2

I slept in. This is not an apology for that – I really needed the sleep for a variety of reasons. Sleep is important, and while sleeping too much can get you a stigma of being lazy, sleeping too little can actually make you crazy. Studies also show ¹that while the detrimental effects of lack of sleep are generally known, the worst thing you can do to yourself is to have partial sleep loss – long term sleep deprivation you can actually adjust to and cope with, although you will certainly see an impact to your motor skills, mood and thinking ability. But interrupted sleep takes that and makes it three times worse (and those are numbers from the meta analysis I linked above.) Yes, coffee does actually help², although according to that study, not necessarily as quickly nor as long as people seem to assume. Ninety minutes until the caffeine in serum peaks, and 12 hours until it’s gone. But eventually psychoactive legal drugs aren’t going to help (writes the author after having taken a long sip of her hot coffee). Your mood, your performance, and your motor skills are going to be shot until you can get adequate rest. And if you’re sick, you need more sleep than normal.

Understanding the effects of the lack of sleep on the human psyche can not only help the writers among us live more rested and productive lives, but can help us model and mold realistic characters. Under the influence of sleeplessness, a normally smart person can make profoundly stupid decisions. For one thing, sleep deprivation affects our ability to think creatively – the ability to make ‘rules based’ decisions seems to be uninhibited³, but emotion is harder to control and can lead to some very peculiar and out of character actions. Sleep deprivation doesn’t necessarily affect the physiology of the sleepless person4, but their work performance is nonetheless impacted. For an author’s purpose, this means that pressure can be built up on our heroes simply by depriving them of sleep – especially sleep that allows them the deep and continuous rest their brains need. There are a number of ways this can easily and naturally be written into a story. I myself have dealt with the effects and can, ruefully, imbue them with all my own experience of having been a young mother who rarely got more than a few hours at a time… There were other experiences, but I suspect all of us can name a time when we weren’t sleeping well, and as a result made stupid decisions.

 

Other than coffee (or mocha, my preferred vehicle of maximal caffeine intake), there are other ways to try and combat sleepiness when one cannot fall asleep or Bad Things Happen. Turning on the lights, exercising… but they only work well during the normal wakeful hours5 of your circadian rhythm. For most of us, that’s during the day, although humans can certainly adapt to night shift work. However, with that adaptation is associated more health risks6, and the worst kind of sleep disturbance comes with people who have to work on moving shifts – sometimes day, sometimes night, sometimes both… like nurses. It adds up, and takes a toll. More accidents, poorer overall health, decreased alertness and cognition…

There’s a reason I wanted to sleep in. Sleep also allows the body down time to heal. Despite the fact that in the last couple of years I can look back and see that I am healthier now than I was a decade ago, by far, I still know that I’m older and will heal more slowly. But it did get me thinking about writing characters who are human: we get sick. Even if you are writing a super-advanced science fiction, it is highly unlikely to have conquered all disease. Pathogens are a slippery lot. Look, the cold virus mutates at the drop of a hat. Bernadette Durbin made me giggle the other day talking about drawing up a cartoon of the flu virus showing up at a human’s door in halloween costumes every year, and the human’s immune system lets them in, because it’s dumb and a sucker for hats and false mustaches. Which isn’t quite how it works, but close enough to make me laugh. And that spaceship crew who is immunized against all the big known diseases, with loads of antibodies… isn’t going to be any smarter. Most of us here have complained about con crud. How about planetary leave crud? Or what happens when that partial sleep deprivation we discussed above depresses your immune system7 enough for you to catch a germ you wouldn’t normally be affected by? I suddenly have a vision of a spaceship that is undermanned, has been on high alert, and an opportunistic pathogen takes hold… As an author, this is fun. As a person, it’s all too true and part of life, so I sleep responsibly.

So there’s another tool in your writer’s workbox. Yet another way to torture your main characters and influence them in ways they are probably unconscious of. Or have a spaceship’s doctor become the hero by advocation of sufficient sleep to knit up the crew. Or a way to show your villain in a murder mystery slowly falling apart because he can no longer sleep and his psycopathic wife is nagging him into madness. You know what to do.

Bibliography:

1. June J. Pilcher, Allen I. Huffcutt; Effects of Sleep Deprivation on Performance: A Meta-Analysis, Sleep, Volume 19, Issue 4, 1 June 1996, Pages 318–326, https://doi.org/10.1093/sleep/19.4.318
2.  Penetar, D., McCann, U., Thorne, D. et al.; Caffeine Reversal of Sleep Deprivation Effects on Alertness and Mood, Psychopharmacology (1993) 112: 359. https://doi.org/10.1007/BF02244933
3. Killgore, W. D. (2010). Effects of sleep deprivation on cognition. Progress in Brain Research, 105-129. doi:10.1016/b978-0-444-53702-7.00007-5
4. C. D. Rodgers, D. H. Paterson, D. A. Cunningham, E. G. Noble, F. P. Pettigrew, W. S. Myles, A. W. Taylor; Sleep Deprivation: Effects on Work Capacity, Self-Paced Walking, Contractile Properties and Perceived Exertion, Sleep, Volume 18, Issue 1, 1 January 1995, Pages 30–38, https://doi.org/10.1093/sleep/18.1.30
5. Rachel Leproult, Olivier Van Reeth, Maria M. Byrne, Jeppe Sturis, and Eve Van Cauter; Sleepiness, Performance, and Neuroendocrine Function during Sleep Deprivation: Effects of Exposure to Bright Light or Exercise, Journal of Biological Rhythms Vol 12, Issue 3, pp. 245 – 258, https://doi.org/10.1177/074873049701200306
6. Härmä, M., Tenkanen, L., Sjöblom, T., Alikoski, T., & Heinsalmi, P. (1998). Combined effects of shift work and life-style on the prevalence of insomnia, sleep deprivation and daytime sleepiness. Scandinavian Journal of Work, Environment & Health,24(4), 300-307. Retrieved from http://www.jstor.org/stable/40966779
7. M Irwin, J McClintick, C Costlow, M Fortner, J White, and J C Gillin; Partial night sleep deprivation reduces natural killer and cellular immune responses in humans, FASEBJournalPublished Online:https://doi.org/10.1096/fasebj.10.5.8621064

header image: ‘Clockwork Dimensions’ by Cedar Sanderson
16 Comments
  1. “So, after back-to-back-to-back shift switches, Nurse Happy was so sleep deprived she hallucinated that her patient was a werewolf, and killed him before he changed . . . back.”

    The Head Nurse squirmed. “She seemed perfectly rational.”

    “And then these young doctors, residents or whatever, somehow got a hold of a dog’s body and swapped it out for the patient.”

    “They say they didn’t do it!”

    “But Mr. Harbinger, alive or dead, seems to be missing.”

    She nodded quickly. “Maybe he had the dead dog!”

    “Guess he wasn’t too sick, if he was running about collecting road kill.” The Detective snapped his notebook closed. “Isn’t this investigation going to be fun. Assuming we ever find a body.”

    July 14, 2018
    • Hah! I like that. And yes, sadly, accidents happen in hospitals. Also, more than one nurse seems to have become a nurse so they could play god. Nurses are amazing, but they are also only human.

      July 14, 2018
      • Unless they’ve been replaced by pod people, of course. 😛

        July 14, 2018
  2. BobtheRegisterredFool #

    I recently heard an interesting claim about deep sleep. Apparently a couple of big nerves contract during really deep sleep. I think one to the face, and the vagus nerve. This leaves a gap between the nerve and the tissue normally surrounding it, and fluid can leak through this nerve. Apparently this is how cranial fluid is supposed to drain so it can be refreshed. Apparently some of this drainage is through the front, into the sinus area.

    If this is sound, there are applications in fiction.

    July 14, 2018
    • I’d love to see a citation on this? Link?

      July 14, 2018
      • BobtheRegisterredFool #

        I’m afraid I’ll have to ask the one I heard it from. I’ve been meaning to ask for names and key words anyway. (I may be needing to take a deeper look down the line.) But it may take me a week to get back here with a citation.

        July 14, 2018
  3. Emergency Services seems to really like to screw with their employees sleep. Law Enforcement, Fire, Ambulance, Medical…they always want to move people from one shift to another. I guess so we all share in the misery together. My current department has us rotate from days to evenings, or graveyard to evenings, every four weeks. So just as you are adjusting to the change, it’s time to change again.

    Law enforcement officers who work the graveyard shift end up in a lot more traffic crashes coming in for court during the day than anyone else (sorry, don’t have the cite for that at the moment. It was in an article I read about risk assessment for LE officers about 15 years ago) but most court schedules don’t take into account things like that. Clerk of Court for my old department was good about reserving the very first cases for the night shift officers. But many clerks just schedule them first come first served. I’ve seen officers have to sit around all day as their court cases were the first and last of the day.

    July 14, 2018
    • I was very lucky. When I flew air-evac, we had a fourteen day block of a certain shift, seven days off, then fourteen on. At my location, pilot shifts were 0500-1700, 1700-0500. Obviously, if we were away from base when shift change came, our time off started when we got back to base. Then we had 10 hours off, and came back on. Yes, when things got hectic, we could end up with the day-shift gal on at midnight and vice versa until a new rotation started. It was pretty rare that we got that fouled up, but not unheard of.

      It was assumed that you’d be asleep most of the first two days off, and people were good about not pestering you unless pay questions were involved.

      July 14, 2018
  4. I woke up to read this????? 🙂

    July 14, 2018
    • Go back to sleep! Tomorrow’s post has to be better than this.

      July 14, 2018
      • Sleep is good! Especially in my case – stupid blocked nose kept waking me up throughout the night ;_; It was very chilly in the morning as well. That was ‘nope, not getting out of bed right now’ conducive.

        July 15, 2018
  5. I’ve had two long periods of regular sleep deprivation–when the kids were little, and before my sleep apnea was diagnosed.

    The disturbed sleep of 2 am feedings, teething, and kids with nightmares was quite different from the apnea, which I thought was insomnia. Apparently I was flipping from awake to REM sleep and back so quickly that I didn’t realize I had slept at all. Just daydreamed all those scenes for books . . . possibly with a lot of breakthrough from the subconscious. I had trouble staying awake during the day–but I got a whole lot of writing done. With the disturbed sleep I got very little accomplished.

    July 14, 2018
  6. Mary #

    In A Diabolical Bargain, I needed a character to make a stupid decision.

    I heavily emphasized his sleep deprivation at the time.

    July 14, 2018
  7. *sigh*

    Really apt right now. I have a dental appointment*, but it’s not until the end of August, because summer is when everybody gets things done.

    It doesn’t seem to hurt much, but I haven’t had really restful sleep for a couple of months now.

    *A couple of my teeth are on the verge of fracturing. Life can be fun sometimes!

    July 18, 2018
    • Ow 😦 hopefully you can get rest once they are repaired. But not fun to do six weeks of broken sleep. Can you treat it like a baby and nap when you’re able?

      July 18, 2018
      • I have three kids, one of whom is three years old. I’m surprised I’ve gotten to sleep in as much as I have this summer. And yeah, based on past results (my teeth have issues; these are partial crowns that are going to get wholly capped) I should be absolutely great after they’re fixed. I just have no idea how long this has been a developing issue because my jaw has been aching off and on for more than a year now. (Thankfully, there shouldn’t be much decay to clean out. It just got worse once part of my tooth chipped off…)

        P.S. I love modern dentistry. I would be down half of my teeth if it were a century ago. As it is, I’ve had only one root canal and a whole bunch of 3D printed ceramic fillings.

        July 18, 2018

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