As we get to the end of another year, and having given thanks recently for all we have, it’s time to turn our thoughts to what we don’t have, or perhaps to what we ought to have: Holiday wishes and New Year’s resolutions. I’m not one for presents, because I hate being made the center of attention, but there is something I’d like as we end the year: A good night’s sleep. Sounds easy, right? As many of you likely know, it’s anything but. I seriously can’t remember the last time I slept through the entire night. And I’m not counting that night my friends had me doing tequila shots. Seriously, that doesn’t count. (As sleep anyway.) There’s a huge industry surrounding sleep: getting to sleep; staying asleep; quality sleep. We all know how important sleep is for our physical health and mental well-being, and now, it seems, even for weight loss.

I’ve only got 650 words to work with here, not enough space to explore all the causes of and treatments for sleep problems. It’s a complex, multivariant issue. At the risk of treading where I don’t really have expertise, it can be broken down into three subtypes as alluded to earlier: Difficulty getting to sleep; difficulty staying asleep; and/or poor-quality sleep. I’ll plead to two of the three. I don’t really have trouble falling asleep—unless it’s on an airplane. For some reason I can’t sleep on a plane.

At home I wake up somewhere between 1 and 3 a.m. Sometimes I’m awake for a short time, usually for about an hour or so. And when I am asleep, I have the most complex, bizarre dreams. So, by morning I don’t feel at all rested. Must be why I’m so grumpy. I’m also notorious for falling asleep at dinner parties. 

Seriously though, I’m the victim of many of the typical causes of poor sleep: free-floating anxiety; the current state of the world; too much caffeine ... and martinis. For the last one, COVID made me do it. In my efforts to maintain a veneer of civility during lockdown, martinis each evening were my attempt to keep my world from descending into the “Lord of the Flies” … that, and clean underwear. And, though COVID has become a chronic condition of life, the martinis stayed. Somehow, I think they may be behind my poor sleep, since most everything I’ve read indicates eliminating alcohol and caffeine is a good first step. Though this might seem easy to do, I’ve learned that without these long-time crutches of civilization I might wind up trading a good night’s sleep for a stressful day.

So, before doing something as drastic as switching to club soda, I’m trying everything else.

I’m currently working on calming my head—a chaotic place under the best of circumstances and particularly unhelpful when trying to sleep. I’m attempting to decrease the stimuli as the evening goes on, which is kind of tough to do when my job involves a fair number of after-work Zoom meetings, texts and emails. As we all know, this is when we’re finally free to clear our desks.

But, this activity gets me thinking too much—that and social media. Somehow, I’ve gotten hooked on Twitter. Well, Twitter before Elon Musk. Maybe by the time you read this he’s driven it into the ground. But before Elon, I found it the timeliest of places to find news from a variety of sources. I know there is a lot wrong with it, and to be honest, it does drive my anxiety (see the infamous “doom scrolling”). I’ve vowed to not look at anything potentially upsetting after dinner, and have downloaded a brown noise app. Yes, that’s a thing, and it’s supposed to be better than white noise. At least you don’t have to clean it as often. I have also sworn to resist the urge to pour myself a nightcap, especially before surgery days. Wish me luck.

And, instead of counting sheep I think I’ll try counting reindeer. It’s that time of year after all. 

Dr. Blecher is an attending surgeon at Wills Eye Hospital.