I’m struggling with sleep because of knee surgery. For the first week after knee surgery you can only sleep on your back (ugh!). After that, it’s a struggle to arrange pillows to make side sleeping possible. I awake with knee pain frequently. It was pretty much on the hour right after surgery and then 3-4 hours sleep at a stretch after that.
For the first while, I was staying awake until I was absolutely completely exhausted and falling hard and fast asleep at about 6 am.
To be clear, it’s not excruciating pain. There are very strong drugs for that. But it’s enough pain to make sleeping through the night a thing that just isn’t happening. It’s enough pain to wake me up and enough pain to make getting back to sleep challenging.
I’m napping most days, sometimes twice a day, and then I fret about napping because maybe it’s making it more challenging to sleep at night.
There are various life stages in which this has been an issue for me. Normally sleep is my super power. The two most obvious are new knees and new babies.
And in both cases, I think self-compassion is important. You’re not ruining your sleep habits for life. It’s not a disaster to have a patch of time when you’re not sleeping 8 hours in a row.
I’ve blogged before about placebo sleep and the idea that what we think about the sleep we’ve gotten matters more than the amount of sleep itself.
So I’m focusing less on sleep and more on relaxing about sleep. I’m not back at work until the third week of May. If it’s still an issue I’ll worry about it then.
So it’s been exactly one week since knee replacement surgery and things are going well on most fronts. Except for sleep. Which is miserable. And I feel sorry for everyone I know with sleeping difficulties. (Hey Jeff.)
Sleeping cat Photo by Akshay Bhosle on Scopio
Normally I’m an obnoxiously healthy sleeper. Certainly I usually get enough sleep and I feel good about it. I go to bed early. I get up early. It’s all pretty textbook, as recommended, stuff. If I struggle at all it’s with consistency and the hours I sleep. But I’ve even been making progress on that front.
Until knee surgery.
Argh.
I’ve been in too much pain to sleep through the night. It’s hard to even get to sleep. I have to sleep on my back right now. And the prescription narcotic drug that works best for pain (I’m only taking it at night) has as a side effect, sleeplessness. Great.
I can only sleep once I’m absolutely exhausted and then I end up sleeping during the day which only makes for more sleepless nights.
I’ve been watching The Expanse in the middle of the night. I’ve never made it all the way through before. This time, I’ll try.
Last knee replacement it was at week two that I started googling and buying special pillows to help with sleep and recovery. This time around it’s at week one. But I already own all the fancy pillows.
I’m hoping this stage of recovery doesn’t last. I remember last time it got better once I could sleep on my side again. Wish me luck and all the zzzz’s.
A cozy bed with fluffy pillows and freshly laundered sheets… a comfy couch with a four-legged friend curled up behind your knees… a hammock hoisted up in a sunny patch… a beach lounger with your toes tucked into the sandy beach in front of you… there are as many ways and places to nap as your imagination allows!
A sea lion napping on a bench. Photo by Jackman Chiu on Unsplash
We’re no stranger here at FIFI when it comes to talk about naps and rest (a small sampling of earlier nap/sleep posts: Sam, Martha, Catherine). I started thinking about this a bit ago when I realized that February 28 was National Public Sleeping Day. Winter has (finally) arrived in New England and I was dreaming about being in a place with suitable weather for outdoor public napping. Short of taking a snooze on a mall bench public sleeping isn’t usually an option for me in February, given our chilly weather. Of course we can’t tackle a silly (probably made up) “holiday” like sleeping in public day without thinking more about who is allowed to snuggle up on a park bench for a short respite and who would be penalized for doing so. It also started me thinking about where most of us would feel comfortable sleeping in public. I’ve had a couple jobs where I could close the door and grab a short nap, but I probably wouldn’t have felt comfortable doing that in the employee break room. I’ve napped at the beach, in my car, and on a blanket in the park. I’ve fallen asleep at the movies, and once in a department store while waiting for someone to come out of the dressing room. It wont come as a surprise after reading this to know that I’m a big fan of sleeping and naps.
Are you dismayed that National Public Sleeping Day has passed for the year? Never fear – Napping Day is just around the corner on March 13. According to the linked site, napping day was created to mitigate the lost hour of sleep from the “spring forward” shift due to Daylight Savings Time. That’s a “day” I can get behind, especially since my dogs can’t tell time and insist on sticking to their same breakfast time. We’re all a little tired after the switch and a day of napping is a welcome reprieve.
I almost never napped as a child. I used to drive my babysitter wonky because I would keep all the other kids up at nap time. Eventually she started bringing me into the sitting room with her, where she would close her eyes and listen to Days of Our Lives (it was the 70s!). I would ask her if she was sleeping and she said “just resting my eyes.” I napped a little bit more as a teen, but I didn’t really come to love naps until my 30s. These days I nap pretty regularly, even if it’s just a quick 10 minutes before moving on to the next part of my day.
How and when is your next nap coming? Will you be outside laying in a patch of sunshine? Curled up with the family pet? Face down next to your lunch container at your desk? Where ever you end up, I hope it is a wonderful snooze!
Amy Smith is a professor of Media & Communication and a communication consultant who lives north of Boston. Her research interests include gender communication and community building. Amy spends her movement time riding the basement bicycle to nowhere, walking her two dogs, and waiting for it to get warm enough for outdoor swimming in New England.
Good sleep means more than getting enough hours. A consistent sleep schedule matters, too. I’m not getting that these days.
Why not? Well all sorts of reasons not really in my control.
Now my right knee often wakes me up during the night with knee pain. We’ve got one family member who often works well into the night. Another family member whose shift work means he’s often up at 5 am. My preferred sleeping hours are 10-6 but between knee pain, dogs, people, and work schedules that’s just happening. So while I’m getting enough sleep in any given week it’s not happening in regular amounts at regular times.
See this article on the connection between sleep and health
“It’s a familiar question from your health-care provider: Are you getting enough sleep? Studies have shown that adequate sleep, between seven and nine hours for adults, can improve cognition, mood and immune functioning. But new research reveals that it’s not just hours of sleep that count toward mental health benefits. It’s whether that sleep occurs on a regular or irregular schedule. An NPJ Digital Medicine study published in February looked at the sleep habits of more than 2,000 first-year medical residents. The researchers found that variability in sleep habits significantly affected their mood and depression — no matter how many total hours they slept.”
Here’s what my sleep often looks like, from my Garmin watch data:
Tracking sleep
So that’s roughly 7.5 hours of sleep a night on average. Which should be okay in terms of total sleep. But it’s not. Because I’m not consistently sleeping the same hours.
A recent story in the New York Times talked about the heart health risks of inconsistent sleep.
“New research affirms what doctors have long advised: Go to bed and wake up at the same time every day for big health benefits.”
“Researchers examined a week’s worth of sleep data from 2,000 adults over 45 and found that those who slept varying amounts each night and went to bed at different times were more likely to have hardened arteries than those with more regular sleep patterns.
People whose overall sleep amounts varied by two or more hours from night to night throughout the week — getting five hours of sleep on Tuesday, say, and then eight hours on Wednesday — were particularly likely to have high levels of calcified fatty plaque built up in their arteries, compared with those who slept the same number of hours each night.”
I’m always amazed at people who can regularly get by on 6 hours of sleep or less. That’s so not me. My temperament is pretty even and I’m not very easily upset but I’ve realized that’s all dependent on getting enough sleep, in a consistent and regular way. Once I’m also battling the not-enough-daylight and absence of sun, getting enough sleep is critical.
So I’m going to try regularly going to sleep at 930 and getting up at 530.
I heard a great interview on CBC recently with Fatuma Adar, a playwright and creator in Toronto who has made mediocrity her mission. She’s written a musical play, She’s Not Special, about the pressure to be excellent as a Black Muslim woman. Adar was featured on an episode of the CBC show, Now or Never, talking about the joys of mediocrity.
The theme of the show resonated a lot with me and with some of the questions we take up on the blog. Not every active thing we do needs to be a quest for excellence. It’s okay to enjoy a sport or a physical activity and not excel at it. It’s just fine to be a bad dancer. Many of us who love running are slow runners.
“Well, it’s like… The secret of the Muppets is they’re not very good at what they do. Like Kermit’s not a great host, Fozzie is not a good comedian, Miss Piggy is not a great… None of them are actually good at it, but they fucking love it…
And they’re like a family and they like putting on a show and they have joy and because of the joy, it doesn’t matter that they’re not good at it.
And that’s like what we should all be. Muppets.”
In that post I wrote about my joy in playing soccer even though I am not a great soccer player. Being willing to be bad at a thing is a thing I’ve written before in the context of motivation.
Anyway, I loved the interview with Adar and think her dad, who appears on the show too, is terrific.
Adar has also written and directed an ode to the nap, inspired by the Nap Ministry. It’s the Nap Anthem and I love it!
Last October I jumped on the Peloton bandwagon. A lot of my friends have one of their bikes and it felt like folks from all different areas of my life were happy with the classes. I don’t have a Peloton bike, but I am able to set up my bike with trainer to be able to take some of the Peloton classes using their app (I don’t get Peloton metrics with this set-up, but I have Zwift and Garmin metrics and am happy with those.) I learned that Peloton offered an “educator discount” on their app and off I went with a whole new world of strength, yoga, walk/run, and bike classes to try out.
A neon “breathe” sign on a background of greenery. Photo by Tim Goedhart on Unsplash
Peloton offers a lot of “programs” which are classes they string together in a series. You need to complete class one before moving on to class two, etc. I quickly noticed that they had a two week meditation program called “The Power of Sleep.” As someone who struggles with both falling asleep and staying asleep, I was intrigued by this series.
I have always liked the idea of meditation, and some parts of the meditation practice, but my attempts at regular meditation had been met with a lot of mental resistance and feelings of failure for not being able to “get out of my own head.” I’ve come to understand that those feelings are common and part of the process itself, but it took me some time to get there. Soon after I downloaded the Peloton app I began exploring their meditation classes, seeing which instructors I liked and what types of meditations were available.
Once I discovered “The Power of Sleep” series I decided to give it a try. The meditations were short, most of them only 5 minutes in the first week. My partner and I go to bed at different times most nights, so I would do the meditation just before going up to bed. I found them to be a nice transition from whatever I was doing before that (usually tv or reading), but I still had chores to do after the meditation, such as letting the dogs out and teeth brushing routines. I completed the two week series and went back to my previous on/off cycle with meditation for another week or two, but I noticed it was more on than off.
My partner was away one night and I put a sleep meditation on while I was in bed, just about ready to fall asleep. It worked so well and I fell asleep almost as soon as the meditation was over. I began to brainstorm how I could listen to meditations without disturbing my already asleep partner, and I discovered a headband with headphones built-in. I was already a sleep mask wearer to block out extra light, so wearing something on my face/eyes wasn’t something new to get used to… the headband was a little more compressive, and the on/off buttons hit right on your center forehead (or over your eyes if you are pulling it lower), so that did take some adjustment. Being able to listen to sleep meditations as I drifted off to sleep made the adjustments worth it, and I quickly fell into a nightly habit.
Over the past year I’ve experimented with a variety of meditation classes and instructors. I’ve narrowed my favorites down to about 3 instructors and a strong preference for “body scan” meditations. I don’t mind taking the same class many times, but I do have to rotate my most favorite so I don’t take the same class too many times in a row – that causes my brain to think I should memorize the whole class. Instead I have about a half dozen classes that I rotate through each week, and I always try new classes to see if they will make the rotation.
My spot when I need a “nature meditation.”
I have not meditated daily for the past year, but I have been way more consistent with meditation this last year than ever before. I will often reach for a short meditation during the daytime hours now too, usually when I arrive at my office and am getting settled in to a busy day. I appreciate that my sleep practice makes meditating at other times of day easier, as my brain and my body know what to expect and I can settle in more easily without a lot of mental resistance.
We talk a lot about meditation on the blog (and in our world) and at times I have felt frustrated that I wasn’t “getting it” or able to do it right. I’m glad this was something I kept trying until I found a way that worked for me… maybe that means there is hope for my yoga practice too!
Amy Smith is a professor of Media & Communication and a communication consultant who lives north of Boston. Her research interests include gender communication and community building. Amy spends her movement time riding the basement bicycle to nowhere, walking her two dogs, and waiting for it to get warm enough for outdoor swimming in New England.
Spoiler alert/ tl:dr version: The answer to the title question is “NO”.
In the world of bad news, Monday’s popular health articles about napping, heart attack and stroke don’t rank anywhere near catastrophic. I mean, we’re used to much worse, right? Still, it wasn’t a happy thing to crank up the laptop, mosey over to CNN.com and see this:
Napping regularly linked to high blood pressure and stroke, study finds. Sigh.
The Canadian press was a bit more circumspect, but the message still wasn’t good in this article:
As usual, the real story is complicated because science is. But here’s something helpful from the Canadian article:
Compared to subjects who never or sometimes napped, researchers found that a higher percentage of usual-nappers were men with lower education and income levels who were also more likely to report smoking cigarettes, daily drinking, insomnia, snoring and being a night owl.
To me, this sounds like that sub-group suffers from or is susceptible to a bunch of chronic health problems (including insomnia) due to social determinants and some of their health behaviors (e.g. smoking, daily drinking). Frequent napping is just one of several tip-offs that persons with the general profile are susceptible to chronic health problems.
To me, these results mean that the napping in some groups is a part of a complex set of behaviors and biomarkers that picks out individuals who may need preventative medical care or other interventions to help them stave off or reduce high blood pressure or the biophysical progression to stroke. Okay. That’s good.
It doesn’t mean that there is anything at all bad or unhealthy about the napping process itself. Napping doesn’t cause hypertension or stroke (at least this study doesn’t show that, and no one thinks this as far as I know). Rather, some frequent nappers have lives and medical profiles that are a tip-off that their cardiovascular health may be at risk.
So, nap or don’t nap. Talk with your health provider about your napping patterns if you’re worried about your life and health history. But don’t let this article keep you awake– at night or any other time.
Who here are nappers? I’m a napper when I’ve been up super-late and then early the next day. Feel free to share your nap stories (after you wake up, of course).
Mostly, these days, I don’t mourn the things my knees used to do. I’m forward looking, thinking about knee replacement and about long hikes. Also, dancing. I’m excited about having dancing in my future.
Running is a thing of the past.
Four years ago I wrote that not being able to run made me sad and I admitted that sometimes I cried about it.
Now, I am anticipating dancing. I think often about long walks. I can’t wait until I can sleep without pain. But running? Meh. I no longer cry about missing it.
Still, I’m shocked at how fast all this has happened.
A few people asked if I was doing the Pride Run this year. Nope. No more Pride Runs.
I remember getting the running reprieve from the knee surgeon when we first met. He asked how much I liked soccer and if I was okay with giving it up. I was. But running short distances fast? (Well, fast-for-me.) That could stay.
Here’s my Facebook status update from May 15, 2015, “Knee surgeon appointment was uneventful. As you might wish for with a knee surgeon. I don’t, as yet, even need any of the pre-surgical options. Keep doing physio, stay pain free, ride my bike as much as I want, keep running short distances (5 km) and revisit in a year. Bye bye soccer. But we knew that. And it’s fine to work on running 5 km faster.”
And here’s Mallory and me at the Pride Run 7 years ago.
Mal and Sam post Pride run
What’s on my list of things that I can’t do now that I hope I can do in the future?
Dancing
Hiking
Walking around new places when I travel
Backpacking and back country camping
Sleep without pain… That’s a biggie
Walking around campus all day without worrying I’m doing too much
Standing up at social events and convocation
Thanks to J Williams for making this photo available freely on @unsplash
You don’t need to be on a self improvement quest. Neither do I. Sometimes the way we do things isn’t the best, but it works, it’s our way and that’s good enough. Not everything in our lives has to be perfect.
All that said, I’m aiming for better mornings as we emerge into warmer, brighter spring weather.
No more hitting the snooze button a half dozen times. I’ve struggled with the snooze button before. No more doom scrolling before the day even begins. Wordle, yes. But Twitter can wait until after coffee.
Morning hours are precious. They’re my best hours of the day.
I’d like to have spring and summer morning time for early writing and riding. Maybe even morning yoga.
Wish me luck!
An oppossum in bed says “me in my silly little need avoiding my silly little tasks.”
How about you? Do you have a time of day that needs a spring tune up?
Like the rest of the English speaking world, I’ve been Wordling. And I gather, though it started in English, it’s spread to other languages. I have friends who do the French version, as well as Canuckle, the version with Canadian themed words.
Most days I do Wordle and then Wordle2. I’ve resisted the lure of non word based variants such as Worldle, Nerdle, Heardle, etc. And I don’t do the multiple versions like Dordle or Quordle.
Like many people I share my results on social media, since sharing is part of what the game is all about. The ubiquitous squares offer a glimpse into the way others play the game. That’s a big part of the appeal.
A pretend Wordle board that’s says “Build more safe bike lanes.”
In my case though it’s also alerted friends to the fact that I’m up in the middle of the night. Why? What wakes me? I mean, aside from the state of the world. Mostly though the state of world keeps me up but it doesn’t wake me up.
What wakes me a few times each night is stabbing pain in both knees. I suffer from severe osteoartitis in both knees and the worst pain I experience is in the middle of the night. And then given the state of the world, it can be hard to go back to sleep when there’s war and a global pandemic to worry about.
“Osteoarthritis pain may feel like stiffness, aching, swelling, or throbbing. These symptoms may seem more pronounced at night since osteoarthritis pains can flare during periods of rest.” That’s from What You Need to Know About Throbbing Knee Pain at Night.
I’ve read lots about why the pain is so intense at night but I don’t find the answers satisfying. People say it’s worse because there’s nothing else going on and you notice more. Also, inflammation is worse at night because there is less cortisol. “When you sleep, your body produces less cortisol. While high cortisol levels can lead to heart disease, healthier levels can help your body reduce inflammation.”
Finally, in a really annoying kicker–lack of sleep makes knee pain worse.
There a lot of stories and studies about the connection between disrupted sleep and knee osteoarthritis. See here and here and here.
Apparently it’s a vicious cycle where not getting enough sleep makes your experience of pain worse and then the pain disrupts your sleep. The lack of sleep can also disrupt your ability to get movement in your day and that too makes knee pain worse.
On the knee pain front, I try to remember to take ibuprofen before bed. I arrange pillows in just the right way to hold my knees in the right place.
But back to where this began, Wordle. For getting back to sleep once I’ve been woken up, there are limited options. I need distraction but not doom scrolling options. Enter Wordle. It’s a five minute exercise. I can focus on it. And when I’m done I post my score and go back to sleep.
If you’ve struggled with knee pain at night and you have suggestions, other than Wordle and its many variants, let me know.
There are lots of images like this out there of bright red inflamed joints.
