Alberta Lawyers' Assistance Society

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Do Lawyers Dream of Electric Sheep?

DO LAWYERS DREAM OF ELECTRIC SHEEP?
 

One of my favourite book titles is Philip K. Dick’s “Do Androids Dream of Electric Sheep?” For those who don’t recognize the title, you  may be familiar with the movie adaptation, Bladerunner. For some reason, I have always pictured little electric sheep jumping over a pastoral fence as an insomniac android tries to sleep. What do other populations think of when they can’t sleep? What would lawyers think of? Perhaps the reasonable sheep on the Clapham omnibus.
 
I’ve been thinking a lot about sleep. It is one of my favourite things, but it seems to be getting more elusive. Perhaps it’s the long days, or the hot weather, or the idea that my idyllic work-from-home routine that lets me sleep an extra hour may be nearing an end. Whatever the reason, getting to sleep these days can be hard.
 
In the past, I reached out to a helpful resource that was readily available—sleeping pills. Just a few here and there, and then sometimes more here than there. However, the medical profession is moving away from sleeping pills—or, at least, for me—so I want to share a new resource.
 
Instead of giving me a handy dandy prescription, my family doctor is referring me to a sleep clinic where I will have an evaluation. I hope it doesn’t involve trying to sleep in a lab. I will also be doing CBT-i, a new way of treating sleep disorders, including insomnia, using cognitive behavioural therapy. I not only struggle with insomnia at times, but I also sleep-eat. If I can’t sleep for any reason, my solution is to get up and eat! In a good night, I only get up to raid the pantry once, but not all nights are good. It doesn’t matter that I know, rationally, that eating comfort food is not really necessary for me to sleep because I am not rational when I am sleepless in the middle of the night.
 
Many lawyers and law students have sleep issues. We work crazy hours, under stress, and we tend to ruminate and be self-critical. How many times have you been up at night rethinking something you did during the day—did I do the best job possible, was there something I missed, how did others perceive what I did and said, and what did it really mean a partner said something cryptic—am I going to get fired?
 
Sleep research has shown that lack of sleep can impair cognitive functioning. At 19 hours without sleep, we experience impairment on a par with having a 0.05 blood alcohol content. For a profession whose members wear long hours as a badge of honour, what does this mean? Can we all be exceptions to this who are still sharp at 4 am after a long day?
 
I have wanted to tackle sleep and include sleep resources on Assist’s website for some time. In the past, I have received emails about great sleep resources that were put together by mattress manufacturers, the industry association for mattress manufacturers, and a foundation sponsored by mattress manufacturers or their industry association. While these materials contained helpful information, they are tied to the sale of product (however much they try to be objective) and this is inconsistent with our website’s editorial policy: we only link to resources from true not-for-profit organizations.
 
But Dalhousie University—a Canadian not-for-profit organization--has launched a website called Mysleepwell.ca. You can read an overview about it here.
 
Mysleepwell.ca is based on CBT-i, the application of cognitive behavioural therapy to sleep issues. I delved into the website because I want to know more about this process I will be embarking on later in August and I urge anyone who is having sleep issues to check it out.
 
So, what is CBT-i? It is a non-medication intervention that focuses on five factors:
  • Relaxation
  • Thoughts
  • Sleep Drive
  • Control
  • Hygiene
  
Relax
 
Being in a relaxed state of mind when you want to sleep is important. Mysleepwell.ca contains links to a variety of activities you can do, including
  • Breathing
  • Progressive muscle relaxation
  • Stretching (like yoga or tai chi)
  • Imagery
  • Guided meditation
  • Storytelling and
  • Autogenic training.
 
The links on this website are to free resources!
 
We engage in several of these practices during our weekly mindfulness session (Tuesday at 12 for fifteen minutes, email program-manager@lawyersassist.ca to get the zoom link.) If you are interested in learning more about this, join us on Tuesdays. You can then try to deploy these strategies at bedtimes.
 
I had to look up autogenic training—it’s a technique of training your body to respond to verbal cues to help you relax, and control your breathing, heart rate and temperature. Learn more at https://www.google.com/search?q=new+website+promotes+tackling+insomnia&rlz=1C1CHBF_enCA805CA805&oq=new+website+promotes+tackling+insomnia&aqs=chrome..69i57j69i60.10030j0j15&sourceid=chrome&ie=UTF-8.
 
The relaxation activities on mysleepwell.ca can be very helpful when anxiety or free flowing worries nag at you—strikes. We are fortunate that we can have a laptop, tablet, or phone near our beds which we can use to access guided meditation and other tools—just remember to limit your exposure to their blue lights if you are using them at night (see Sleep Hygiene below.)
 
Thoughts
 
I highly recommend reading the entire section on Thoughts on the mysleepwell.ca website, especially for lawyers and students who tend to ruminate and engage in worst case scenario thinking!

A lot of us worry at night when everything around us is quiet, and those worries can keep us awake. One great suggestion in mysleepwell.ca is to schedule time to worry at a set time each day which isn’t your bedtime. This may sound goofy, but many people find it helpful. Say your worry time is scheduled for 8:00 pm, after you have unwound from your challenging day, but before you are engaged in a healthy bedtime routine. Take the time to identify the matters that cause worry. You can work through them with a list and think about what could happen and what you can do, and then move on to other activities.
 
When worrying thoughts become active in your brain when you are trying to sleep, you can tell yourself that you will deal with them at the scheduled time the next day and then you put the thoughts away. You can write them down so that you don’t have to worry that you will forget the things that are worrying you at night, and then you can check them off the next day. However, some experts say not to write them down. If they are legitimate, you will remember them!
 
One technique for putting your worries away is to visualize them—let them be an ugly monster or whatever you think they are—and then visualized putting them into a lockbox or banishing them to a magic island that they can’t escape from. Engaging your imagination as you visualize can be relaxing, too.
 
There are also some excellent distraction exercises involving imaging and mindful breathing. One interesting one is cognitive shuffle—where you choose a short word and then think of five words or names that start with each letter of the word.  They use the word “BENCH” as an example, so you would come up with five words that start with “B”, then five words that start with “E”, etc. I have used variations on this theme—my favourite is coming up with three names that start with each letter of the alphabet, while others count backwards by sevens from 800. These strategies can be helpful for interrupting worries which are gathering speed and strength.
 
Control
 
The “control” component of CBT-i involves breaking the connection between not being able to sleep and worrying about how you will cope the next day after a terrible sleep. Essentially, when you can’t sleep after 15 to 20 minutes, you get up and leave your bedroom to do a relaxing activity—like the ones listed in the section above or you can meditate or read or stretch.
 
The website has links to some great audio files with white noise and pleasant background sounds, like a waterfall or ocean waves, to help you start to feel sleepy.  Each audio file runs about 20 minutes, so if you are awake when the mp3 ends, you are encouraged to get up and do a relaxing activity (see above) until you feel sleepy.
 
I am fascinated by the idea of physical stretching as a sleep strategy! When we worry, we tend to hold our muscles rigid, so it makes sense that stretching would help release muscle tension. This one is on my list!
 
Sleep Drive
 
 This is the component of CBT-i that I am dreading. The theory is that many of us are inefficient sleepers—we spend a lot of time each night in bed trying to sleep but are relatively unsuccessful. Sleep drive training involves tracking the amount of time you spend in bed (for sleep) versus the amount of time you are asleep so that you then limit your time-in-bed to force you to sleep more efficiently.
 
To be honest, I tried a sleep drive control program a few years ago (not in the context of full CBT-i). You were supposed to write down when you went to bed each night, when you fell asleep, how many times you woke up during the night, how long you were awake each time, and what time you woke up for the day. I don’t like looking at the clock at night when I wake up, so I ended up guessing. Garbage in, garbage out. It wasn’t helpful. I hope that I will be getting some help from the sleep clinic to make this both viable and meaningful.
 
 The point of the Sleep Drive component is to train your body to sleep when you are in bed. After you calculate your sleep efficiency (the ratio between the number of hours/minutes you sleep per night over the number of hours/minutes that you spend in bed), you either increase or decrease the time you spend in bed. If your sleep efficiency is less than 85% (i.e., you are awake more than 15% of the time from when you got to bed to when you get up), you start going to bed 15 minutes later each night to compress your sleep into a more efficient schedule.
 
 I have heard of people doing more radical sleep restriction in an attempt to set up a new sleep cycle and this made me resist sleep training in the past. This is just one of the five steps, so don’t panic if this doesn’t change your quality or quantity of sleep by itself. And remember that, in the mysleepwell.ca model, you aren’t doing this in isolation.
 
 If you have the Sunday Scaries—a very common phenomenon where you start worrying about everything you have to do and that can go wrong during your workweek which interferes with your ability to sleep--you may want to try to improve your sleep drive. If you go to bed and can’t sleep because of free-flowing worries, consider whether compressing your sleep cycle would help.
 
Sleep Hygiene
 
Sleep hygiene is all about ensuring that both you and your sleep environment conducive to good sleep. Common sleep hygiene practices include:
  • Avoiding stimulants like caffeine and nicotine for several hours before your bedtime—say after 2 pm.
  • Setting your thermostat to a temperature that is cool but comfortable, and start dimming lights a couple of hours before your bedtime
  • Keep your bedroom dark. If you need to get up at night, use a flashlight rather than turning on a lamp or overhead light.
  • Stop using electronic devices at least half an hour before bedtime and eliminate sources of blue lights which is believed to interfere with sleep. If you have a thermostat in your bedroom like mine with a beautiful blue-lit display panel, cover it up! Same with your clock and all other devices.
  • Expose yourself to natural light as soon as you wake up to help you regulate your internal clock.
 
*****
 
We are in a profession where we essentially worry for a living. What are all the things that could go wrong? Like a law school exam, identifying as many of them as possible is the first step. We develop a pessimistic outlook (to the extent we don’t have one intrinsically) because this is the outlook that our profession rewards. No wonder many of us struggle with insomnia and other sleep issues.
 
We also work long hours, so I know that some readers will say that turning off electronics and stopping caffeine consumption are just not possible. Just try when you can and see how it goes.
 
One thing that I have been doing is using the sleep tracker on my Fitbit. I am sure that it is nowhere near as accurate as sleep lab monitoring, but it has done one really helpful thing for me. I always believed that if I didn’t get a solid sleep, I would feel awful and be ineffective the next day. But I learned that I, in fact, have nights with disrupted sleep and periods of sleeplessness without a noticeable impact on how I feel and function, and that sometimes when I feel sluggish and attribute it to a poor sleep, my sleep wasn’t as bad as I think it was. I can now soothe myself when I am lying awake with the knowledge that the next day will not automatically be a disaster. Knowing that I can still feel happy and healthy and able to think in complex and nuanced ways, regardless of how I think I have slept, has empowered me, and released me from a power that insomnia had over me.
 
I don’t know whether the techniques and resources on this website are going to banish insomnia for all of us, but it is worth exploring because it may work for you. Using the website’s resources is a bit of a DIY approach to insomnia, so remember that Assist’s counsellors can help with CBT-i. Just as some legal matters should not be undertaken by well-meaning individuals without legal training, some sleep issues may need an expert. Call Assist to schedule a session if you want to talk to about your sleep issues or to pursue CBT-i with support.
 
I hope that you have a wonderful summer and that you can deploy a couple of sleep strategies as we return to the work-from-the-office times, and we give up a bit of sleep and other personal time for our commutes. Let’s make our sleep time they best it can be.
 
Loraine

PS:  If you like Philip K. Dick or good science fiction, check out The Man in the High Castle on Amazon Prime! It may not help you sleep but it is really good!