Riding an insomnia tilt-a-whirl
Methods used to calm fussy babies could also help you sleep
Last year was when I was finally going to get a good night’s sleep. My youngest child was turning 4, and so the post-midnight disruptions for blanket fixes and stuffed animal retrieval had ebbed. My work and home life were in predictable rhythms. On Tuesdays and Saturdays, I did hot yoga. I had a firm mattress recommended by many respectable review websites.
Instead, a pandemic killed over 2 million people and disrupted the patterns of our days and nights. “COVID insomnia” was a breakout Google search from March to today, as was “Why can’t I sleep during quarantine?” Studies from India to Italy indicate that sleep quality has been negatively impacted by COVID-related life changes.
My biggest issue has always been falling asleep. On a good night, it takes me 45 minutes to drop off; on bad nights, it can be close to two hours. This is not my first ride on the insomnia tilt-a-whirl — pre-pandemic, I had struggles falling asleep that came and went during periods of stress — so I know all of the adult sleep-hygiene tricks.
So I turned to someone who is used to sleepless parents calling him: Craig Canapari, director of the Yale Pediatric Sleep Center.
When my firstborn was a baby in 2012, I watched “The Happiest Baby on the Block,” from baby sleep expert Dr. Harvey Karp. He coined the “five S’s” to calm fussy babies — swaddle, side or stomach position, shush, swing and suck — and he said that this combination of actions reminds a newborn of its mother’s womb. So I tried them on myself.
Swaddle
Canapari said I could try adult swaddling: “It’s weighted blankets.” There is good research on the efficacy of weighted blankets for insomnia and anxiety in adults: randomized, controlled studies have shown that weighted blankets improved sleep quality, and reduced feelings of fatigue, anxiety and depression during waking hours. There are no serious side effects to using a weighted blanket, and it’s a comparatively inexpensive solution — certainly cheaper than getting a new mattress.
So I bought one. I put new sheets on my bed and eagerly pulled the heavier blankets up over my body. I started sweating about five minutes into it, despite keeping my bedroom at a crisp 67 degrees. Then, I began to feel suffocated, so I kicked them off. “It comes down to a sensory preference,” Canapari said.
Side or stomach position
Adults already spend the majority of time sleeping on their side, and research has found that people spend more time sleeping on their side as they age. Still, there isn’t evidence to suggest that a certain body position leads to better sleep, and the sleep doctors I spoke to said you can’t really control your movement while you’re asleep anyway.
The average adult only spends about 7% of their sleep time on their stomach, but I already fall asleep on my stomach as a rule. I can’t drift off unless I’m in a very specific position with my arms pinned underneath me, my face turned to the right side, and my right leg in a figure four.
Shush
The adult equivalent of “shushing” a baby is white noise or a fan (which can be used on babies as well). A meta-review of 38 studies reviewing the efficacy of noise as a sleep aid published this year showed that the evidence for this is weak. There was a lack of consistency in the research — many of the studies used a different kind of background noise — and some studies found that if the noise was too loud, it actually interrupted sleep and could be bad for your hearing.
That said, “Clinically, if someone tells me they sleep better with the fan on, that’s perfectly fine, but it’s not something I would recommend to everyone,” said Jennifer Mundt, an assistant professor of neurology specializing in sleep at Northwestern University Feinberg School of Medicine. I live adjacent to the Brooklyn-Queens Expressway, so I have been using a white-noise app on my iPad and have conditioned myself to associate white noise with getting sleepy. That can be comforting, said Mundt.
Swing
Rocking an infant helps put them to sleep, and the SNOO, a bassinet that uses motion and sound to calm a baby — an invention of the aforementioned Karp — is a hot-ticket registry item. There’s a passage in a famous essay by David Foster Wallace, written about his trip on a luxury cruise ship, where he claims that heavy seas are great for sleep, because “you feel rocked to sleep, the windows’ spume a gentle shushing, engines’ throb a mother’s pulse.”
Unfortunately, none of the experts I spoke to knew of any research that tested the efficacy of rocking a grown-up on land or on the high seas, but “there is probably a market for an
adult SNOO,” said Mundt.
Suck
The American Academy of Pediatric Dentists recommends that kids stop sucking their thumbs and pacifiers once they reach preschool. My teeth are janky enough, and a grown-up pacifier seems like a bridge too far, even for the purposes of this article.
Plus: Somegrown-up solutions
There are a few things that adults can do that babies cannot: take drugs and go to therapy. Dr. Clete Kushida, a neurologist and the medical director of the Stanford University’s division of sleep medicine, cautions against medicating ourselves. “What can happen then is there are carryover effects the next day, especially in those that are older,” said Kushida. Prescription sleep medication has dependence issues, he said. But since melatonin is nonaddictive, Canapari suggested trying the smallest dose of it possible and taking it several hours before your desired bedtime.
Jessica McCabe, creator of the YouTube channel “How to ADHD,” is not a doctor or medical professional. At 38, she’s had a variety of professions including stand-up comedian, actor and restaurant server.
Through all those years, she has been learning about attention deficit hyperactivity disorder, which she was diagnosed herself at the age of 12. Explaining that information is something she has done on her YouTube channel since 2016.
“Our brains are a piece of equipment we work with every day for everything that we do, so it’s critical to understand it,” she said.
She didn’t make the connection between her challenges and her diagnosis, but things changed when she was in her 20s and found herself unable to complete college.
She began researching ADHDbut had trouble organizing all the information she learned. So she turned to YouTube, a platform with which she was already familiar, to retain the material. “Notebooks, no, I lose notebooks,” she said. “YouTube. I won’t lose YouTube.”
In the beginning she found information for her videos on Google searches, but realized that there was a lot of misinformation about ADHD on the internet. “After I made it public, I thought, ‘I’m a college dropout. I don’t have a degree in this. I should not be educating people,’ ” she said.
Rachelle LeDuc
Cairns, a registered nurse in Canada, offered to teach her how to analyze research studies for their validity. Then Patrick
LaCount, a postdoctoral fellow at the Center for Child Health, Behavior and Development at Seattle Children’s Research Institute, began to meet with her weekly to review and discuss research studies. Today, she calls upon experts to help her on each subject, though her videos are not reviewed by a professional on a weekly basis.
“She has done a fine job popularizing the scientific findings in ADHD and bringing more attention to the condition, destigmatizing it and even motivating others with the condition and their families to obtain further information about it,” said Russell Barkley, a clinical professor of psychiatry at the Virginia Commonwealth University Medical Center.
The average age of her subscribers is between 18 and 34, she said; many of the videos focus on themes relevant to young adults. One of McCabe’s main intentions is to address the stigma of taking medication for this group and about giving it to children.
“I think there are a lot of moms that are tired of being told that they are drugging their children and that they are doing something wrong by treating their child’s medical condition,” she said.
In her video “What I Want to Say to My Mom, Who ‘Drugged’ Me,” McCabe discusses being prescribed Adderall.
(When she began taking medication, her gradepoint average went up a full point.) Medicating children has been controversial, though “many of the medications used to treat ADHDhave a long track record of safety and are research proven to be effective,” said Dr. Damon Korb, a developmental behavioral
pediatrician in Los Gatos, California, and the author of “Raising an Organized Child.”
It’s adults who are often overlooked. There are twice as many research studies for child ADHD compared with adult ADHD on the National Library of Medicine website, according to Ari Tuckman, a psychologist in West Chester, Pennsylva
nia, and the author of the book “ADHD After Dark: Better Sex Life, Better Relationship.”
“It’s only recently that they started to research ADHD in adults,” McCabe said. “Before that it was thought of as a childhood issue. So who cares how an 8-year-old might be in a domestic relationship since they’re not there yet.”
To that end, in one of
her most popular videos, she talks about relationships and how people with ADHD may experience situations like becoming bored with a partner: “Getting involved with the nearest available human of the desired gender because they’re there and you’re bored? I’m pretty sure this is how Tinder works.”
McCabe thinks a lot about communication and word choice. Most of her videos open with the greeting “Hello, Brains.”
“Mr. Rogers had a whole bible of rules for how he used language on his show,” she said. “According to my community, one of the most helpful things I’ve done has been to give people the language to describe their challenges and the strategies.”
Kerrie McLoughlin, 50, is a subscriber in Kansas City, Missouri, who was diagnosed last year with ADHD. “I had never heard of rejection sensitivity before, but as I watched the video, I instantly knew what it was,” McLoughlin said. “I teared up at the recognition in myself and started taking notes.”
Celeste Perez, 33, an entrepreneur in Los Angeles, was diagnosed at 29. Perez has used the channel to help explain her “ADHD quirks” to her husband in a way that did not involve boring, text-heavy studies. “I’d spent my life feeling serious anxiety over the smallest things, overthinking words I’d said and feeling enormously upset when things didn’t go perfectly,” she said.
Like many creators, McCabe now uses Patreon, which helps her amass paying subscribers. With nearly 3,000 subscribers, Patreon said her gross revenue there is $14,551 a month.
But her first donation came from Scot Melville, an engineer in San Francisco, who gave at the top tier of $100 per month, along with a note about how the channel changed his life. “I increased my salary by over $100k per year over the course of four years,” said Melville, 36. “I credit much of that increase to the skills Jessica has given me through her videos.”
Now instead of donating money, Melville donates his time as the technology consultant on McCabe’s team.