No Shame for Extreme Night Owls

Author of An Occupational Therapist’s Guide to Sleep and Sleep Problems, Andrew Green is an occupational therapist specialising in sleep disorders. In a bid to clear the air about the myths that surround the early bird and nightowl stereotypes,  Andrew gently introduces the sleep disorders that are the root of the stereotypes that haunt those of us who just aren’t very good at sticking to ‘normal’ sleeping hours, if such a thing exists.

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In 1735, Benjamin Franklin made known the saying ‘Early to bed, early to rise makes man healthy, wealthy and wise’. Over two centuries later it turns out that the opposite may be nearer the truth. By comparing health and socioeconomic data relating to ‘owls’ and ‘larks’, Gale and Martyn (1998) found no evidence that early rising is actually more beneficial, and concluded that early bedtimes and rising times are not linked with ‘health, socioeconomic, or cognitive advantage [and] if anything, owls were wealthier than larks’ (p.1677). It is possible that Franklin learned in his long life that the earlier saying was inaccurate since the following is also attributed to him, presumably in his later years: ‘I wake up every morning at nine and grab for the morning paper. Then I look at the obituary page. If my name is not on it, I get up’.

In any case, the reality is that people are different and the tendency towards being an owl or a lark is inherited. For most people it is just a tendency – part of natural variation that can be accommodated in normal lifestyles, but at the extremes are circadian rhythm disorders. Circadian rhythms are the natural cycles that determine the timing of numerous body functions, including the sleep-wake cycle. When someone’s rhythm is advanced – when they are an ‘extreme lark’ – they tend to wake earlier and go to bed earlier than the norm; it is a very rare condition and Schrader et al. (1993) found no cases of advanced sleep phase disorder in a sample of 10,000 Norwegian adults. However, the same study found 17 individuals who met diagnostic criteria for delayed sleep phase syndrome (DSPS) – or who were ‘extreme owls’: it is therefore still an uncommon condition although the prevalence in adolescents and young adults may be as high as 10% (Wilson and Nutt 2013).

To have DSPS means that a person is unable to sleep until two hours, or longer, after a more conventional bedtime and naturally tends to wake correspondingly later. It might not seem much but is extremely disruptive to life. Someone with DSPS may not know they have it and think they have insomnia, perhaps going to bed at 11 p.m. in the hope of having eight hours of sleep and not sleeping until 2 or 3 a.m. However, they will still need to get up at 7 a.m. for work or school and have to get through the day. Whereas most people can manage after one short night, perhaps because of an early start for a journey, having DSPS is like having to get up at 4 a.m. every day, having gone to bed at 10 or 11 p.m., and then feeling sleepy every afternoon.

Individuals with DSPS complain that it is difficult to get to work reliably in the morning and that employers, and others, do not understand that they are not just being lazy. Some people are very embarrassed by staying in bed for half the morning. Others are able to adapt to some extent; for example, a research student might be able to work in the library during the night, arrange meetings in the afternoon and still have time to meet friends in the evening. The experience of DSPS has been investigated by Wilhelmsen-Langeland et al. (2012) in a qualitative study involving nine young people (age 16–23) in Norway. Participants talked about the difficulty of staying awake at school, and conflicts with others through being late when meeting, or unavailable to help with chores, for example, during the day, but the failure of others to understand was a key observation. Other people might suggest that they could just go to bed earlier – as if they could just try harder to sleep ahead of their biological preference.

Delayed sleep phase syndrome is a disruption of activity cycles and could be considered a disorder of occupation; it should be of interest to occupational therapists. Medical management could involve use of melatonin at night to encourage earlier sleep (supplementing naturally produced melatonin) and bright light (daylight or full spectrum artificial light that mimics natural light) on rising in the morning in order to help ‘reset the body clock’. In addition to these, chronotherapy involves going to bed successively later, a strategy that seems counter-intuitive, until the desired hours of sleep are reached; it is easier to adjust the timing of sleep by lengthening the day – in the same way that is easier to adjust to jet lag when flying east to west. It is then important to consider how the person keeps to more conventional hours.

In many respects maintaining more regular hours is like following advice for managing insomnia: keeping a consistent rising time (essential) – and seeing daylight on waking; avoiding daytime sleep that might delay night time sleep; doing regular exercise and having regular activity; having a clear winding down routine. In winding down it is preferable not only to avoid the mental or emotional stimulation that might accompany use of a computer late at night (and the temptation to play ‘just one more game’, for example) but also to avoid the blue light that is emitted by computer screens and televisions, which can suppress the production of melatonin.

Despite all such effort, however, it is likely that the individual is always going to be later than average and well-advised to avoid work that involves early starts. Finally, extreme owls might remember that there is no need for shame in rising late, which they cannot help. As Gale and Martyn put it, ‘there is no justification for early risers to affect moral superiority’ (p.1677).

References
 Gale, C. and Martyn, C. (1998) ‘Larks an owls and health, wealth, and wisdom.’ British Medical Journal 317, 1675–1677.
 Schrader, H., Bovim, G. and Sand, T. (1993) ‘The prevalence of delayed and advanced sleep phase syndromes.’ Journal of Sleep Research 2, 1, 51–55.
 Wilhelmsen-Langeland, A., Dundas, I., West Saxvig, I., Pallesen, S., Nordhus, I.-H. and Bjorvatn, B. (2012) ‘Psychosocial challenges related to delayed sleep phase disorder.’ The Open Sleep Journal 2012, 5, 51–58.
 Wilson, S. and Nutt, D. (2013) Sleep Disorders, 2nd edn. Oxford: Oxford University Press.

Andrew Green trained in occupational therapy in York and is now a specialist occupational therapist in North Bristol NHS Trust’s sleep disorders service at the Rosa Burden Centre. Learn more about his book An Occupational Therapist’s Guide to Sleep and Sleep Problems here.

Why Neuroscience for Counsellors?

Rachal Zara Wilson is a counsellor, social worker and author of the new Neuroscience for CounsellorsWe caught up with her for a quick chat about the book and why she wanted to write about such a complex topic. 

1.  Who do you think would benefit from reading this book?

Definitely counsellors, but also any other therapists as well.  The book is designed so that it has sections where the neuroscience is explained, and separate sections for counsellors and other therapists with suggestions on how to use this knowledge for the benefit of their clients in the session room.

Families of people who are experiencing mental health dysfunction may also be interested in the knowledge contained in this book, and also in the implications for how they can support their loved ones.

2.  Why did you write this book? Wilson_Neuroscience-fo_978-1-84905-488-1_colourjpg-print

I’ve always been interested in neuroscience; the brain is so fascinating and amazing, and capable of so much more than we’ve always been led to believe.  And of course, as a counsellor working with people, how the brain works has always been top of my mind.  The final motivator was having a child who was experiencing problems with their mental health, and I guess I just hoped to find something that would help him and others in a similar situation during the course of my research.

3.  So what’s so exciting about what you learned?

Probably the most exciting thing would be the brain’s capacity to change itself, known as brain plasticity.  The brain isn’t static, it’s more like a dynamic organ that is constantly changing for better or worse.  And what we do plays a huge part in how it changes.  How much stress we’re under, what we eat, the quality of our sleep, whether we exercise and how much, our living environments, and the presence or absence of early trauma in our lives are some of the things that contribute to the way our brain functions, and to its capacity for change, or plasticity.  I guess the most exciting thing is that we have control over this plasticity to a large degree, and we can therefore improve the quality of our brain function, our health and our lives.

4. Why don’t we know this stuff already?

Because neuroscience is a field in its infancy.  There’s a lot of learning coming through, but much of it’s wrapped up in scientific jargon, making it inaccessible to those of us who are not scientists.  And because there’s lots of different levels of looking at the brain, (both micro and macro,) different neuroscience specialties do not always integrate their specialist knowledge.  I think the benefit of this book is that it integrates the neuroscience into an overall big picture, while also drawing on this resource to come up with practical ways for integrating it into therapy.  It hasn’t been done before because it’s new, because it’s complex, and because integrating neuroscience with counselling and other therapies requires a knowledge of both fields.  I believe that in the future, all practitioners providing talking therapies are going to need to understand what neuroscience offers our professions, or risk becoming irrelevant.

5.  Why put it in a book?

This knowledge is meant to be shared.  All counsellors and therapeutic practitioners want best outcomes for their clients, and the more knowledge we have that can help people make positive change in their lives, the better.

6.  Is it complicated?

The neuroscience is complex, but the book is designed so that people who just want to know what it means for their practice can just read those sections, while those who want to understand how it all works can read up on the explanations for how all the scientific evidence fits together.  The book is written in the plainest English possible, and there is a glossary and diagrams at the back to help you fit it all together.

You can find out more about the book, read reviews and order your copy here.

Browse our latest collection of new and bestselling titles in counselling and psychotherapy

Here are our new and bestselling titles in counselling and psychotherapy. For more information on any of the books inside, simply click the title or cover image to view the full book page.

Introduction to the Psychology of Ageing for Non-Specialists – a free extract.

Stuart-Hamilton_Introduction-to_978-1-84905-363-1_colourjpg-printIn this extract from the Introduction to the Psychology of Ageing for Non-Specialists author Professor Ian Stuart-Hamilton explains a little about the idea behind this edition and the audience he wrote it for.

For a free sneak peek, just click the link below to read the preface from the book.

An Introduction to the Psychology of Ageing – preface

You can find out more about the book, read reviews and order your copy here.

“Asleep for ages”: Perspectives on sleep in history

Andrew Green, co-editor of Sleep: Multi-Professional Perspectives writes on how ideas about sleep have changed over time, and how sleep has been historically regarded in different ways.


Despite centuries of speculation and research, we still do not know what sleep really is, or exactly what it is for. Allan Rechtschaffen suggested that ‘If sleep does not serve an absolute vital function, then it is the biggest mistake the evolutionary process ever made’ (1971, p.88) and it does seem reasonable to conclude that unless it gave a species an advantage, sleep would have become extinct by now. Noting that all animals sleep, Paterson (2012) shows how the sleep of some animal species has adapted in surprising ways in order to meet to particular needs. She also discusses some of the functions that we now think sleep serves, although these modern ideas contrast with theories that have developed through the ages.

According to Scrivner (2012), in ancient Greek mythology sleep

“…was made the jurisdiction of anthropomorphic deities and weird demons whose actions determined both our shifting states of consciousness as well as the endless shift of day into night and back again. The Greek god of sleep, Hypnos, and Nyx, the goddess of the night, are chased away each morning by … Eos, the dawn” (Scrivner 2012, p.271).

However, in ancient Greek philosophy, in one of the earliest explorations or the causes and purposes of sleep Aristotle (384 BCE–322 BCE) made what now seems like a statement of the obvious:

“It is inevitable that every creature which wakes must also be capable of sleeping, since it is impossible that it should continue actualizing its powers perpetually. So, also, it is impossible for any animal to continue always sleeping.” (Aristotle)

He went on to explain how sleep relates to the cardinal humours (blood, phlegm, black bile and yellow bile) and to changes in body temperature that result from eating and digestion

“… in every animal the hot naturally tends to move […] upwards, but when it has reached the parts above [becoming cool], it turns back again, and moves downwards in a mass. This explains why fits of drowsiness are especially apt to come on after meals; […]. When, therefore, this comes to a stand it weighs a person down and causes him to nod, but when it has actually sunk downwards, and by its return has repulsed the hot, sleep comes on …” (Aristotle).

Zimmer (2005) shows how Thomas Willis, though a pioneer in neuroscience, was still a man of the mid-seventeenth century and held that sprits flowed through the nervous system; emotions were produced by movements of the sensitive soul (as opposed to the humours of the heart) and spirits, which expand in happiness, could not flow without rest – hence the need for sleep. Willis attributed narcolepsy (although it was not formally identified then) and sleepiness to an excess of blood in the brain which cramped the animal spirits, making them unable to flow; he prescribed bleeding and newly available coffee. Sleepwalking resulted from spirits travelling down the spine causing the person to walk. Although such ideas might seem quaint now, Willis, like Aristotle, was at least finding explanations for phenomena in sleep that excluded supernatural intervention.

In the nineteenth century Robert Macnish, a Scottish physician and surgeon, was referring to the phenomenon of night terrors – known then as nightmare (see Green 2012) – not as the visitation of evil spirits, but as an illusion; however, he noted that ‘Many a good ghost story has had its source in the illusions of nightmare’ (Macnish n.d., p.130; first published 1834). Evenso, while a rational scientist, Macnish still did not know what sleep was for:

“Sleep, being a natural process, takes place in general without any very apparent cause. It becomes, as it were, a habit, into which we insensibly fall at stated periods, as we fall into other natural or acquired habits” (Macnish n.d., p.17; first published 1834)

Early in the twentieth century Addington Bruce reviewed some of the theories about the function and causes of sleep. He observed that explanations had ‘usually resolved themselves into descriptions of states that accompany sleep rather than demonstrations of the factors that cause it’ (Bruce n.d., pp.2–3; first published 1915). For example, he noted that ‘deficiency of blood in the brain’ (p.3) did not signify a cause, but proved only that circulatory changes occur in sleep. Bruce also dismissed theories that sleep can be attributed to accumulation of toxins in the blood or that monotony (see Sidis 2010; first published 1909) was the cause. He asserted that sleep:

“…is an active positive, positive function, a protective instinct of gradual evolution … its object being not so much the recuperation of the organism … as to save [it] from the destructive consequences of uninterrupted activity” (pp.8–9).

He did, however, suggest that ‘most us sleep longer than is really necessary’ (p30).

While research on sleep flourished during the twentieth century, and into the twenty-first, – see Kroker (2007) for a detailed account – suggestions that we could sleep less, or barely at all, have persisted and the idea that sleep is a waste of time remains widespread. In the 1950s and 60s writers looked forward to times when we might sleep less – the most bizarre suggestion being the ‘electrosone’, a device that was to allow us to have only two hours’ sleep a night (see Green 2012a).

At the present time debate continues about unprescribed use of modafinil, a stimulant used for treatment of narcolepsy, and whether it can allow us to get by with less sleep (for example, see this Guardian article.) But whatever the short-term benefits may be, it seems unlikely that we can safely reduce our sleep substantially in the longer term.

We know that sleep is essential for memory, learning and performance of many activities (see Green 2012b, for example) and that the links between sleep and good health are many. Put one way, we might say that if the Good Lord did not intend us to sleep He would not have given us the night – or put another: millennia of evolution are unlikely to have got it so wrong.


References:

Aristotle (2011-09-30). On Sleep and Sleeplessness [Illustrated]. Kindle Edition.
Bruce, H.A. (n.d) Sleep and Sleeplessness. Kila, MT: Kessinger Publishing, LLC. (Original work published 1915).
Green, A. (2012a) ‘Sleeping on it.’ In A. Green and A. Westcombe (eds) Sleep: Multiprofessional Perspectives. London: Jessica Kingsley Publishers.
Green, A. (2012b) ‘A Question of Balance: The Relationship Between Daily Occupation and Sleep.’ In A. Green and A. Westcombe (eds) Sleep: Multiprofessional Perspectives. London: Jessica Kingsley Publishers.
Kroker, K. (2007) The Sleep of Others and the Transformations of Sleep Research. Toronto: Toronto University Press.
Macnish, R. (n.d.) The Philosophy of Sleep. Bibliolife. (Original work published 1834).
Paterson, L.M. (2012) ‘The Science of Sleep: What is it, What Makes it Happen and Why Do We Do it?’ In A. Green and A. Westcombe (eds) Sleep: Multiprofessional Perspectives. London: Jessica Kingsley Publishers.
Rechtschaffen, A. (1971) ‘The Control of Sleep.’ In W.A. Hunt (ed) Human Behavior and its Control. Cambridge, MA: Shenkman Publishing Company, Inc.
Scrivner, L. (2012) ‘That Sweet Secession.’ In A. Green and A. Westcombe (eds) Sleep: Multiprofessional Perspectives. London: Jessica Kingsley Publishers.
Sidis, B. (2010) An Experimental Study of Sleep (Kindle edition). Evergreen Review Inc. (Original work published 1909).
Zimmer, C. (2005) The Soul Made Flesh. London: Arrow Books.

VIDEO: Rudy Simone’s 22 Things a Woman with Asperger’s Syndrome Wants Her Partner to Know

Rudy Simone is on a mission to prevent AS/non-spectrum relationships from breaking down because of a lack of information. Check out this video to find out more and for a great overview of her latest JKP book, 22 Things a Woman with Asperger’s Syndrome Wants Her Partner to Know.

In her latest book, Aspergirls author Rudy Simone covers 22 common areas of confusion for someone dating a female with AS and includes advice from her own experience and from other partners in real relationships. She talks with humour and honesty about the quirks and sensitivities that you may come across when getting to know your partner. All the pivotal relationship landmarks are discussed, including the first date, sex, and even having children.

20 years and 5 editions: The evolution of ‘The Psychology of Ageing’

By Ian Stuart-Hamilton, Professor of Developmental Psychology and Faculty Head of Research at University of Glamorgan, Wales, and author of The Psychology of Ageing, now in its fifth edition.


This sounds like a typically tedious middle-class academic’s remark, but the truth is that this book’s life started at a drinks party at Cambridge University. In 1991 I was attending a conference and was asked by a publisher’s rep if I’d like some more of the warm liebfraumilch, and by the way, did I have any ideas for new books? I have a dim record of the ensuing conversation and a vague memory of giving her my address before going into the traditional conference dinner of rubber chicken. A few days later, a letter arrived from Jessica Kingsley asking me to submit a more detailed outline with a view to publication. The rest, as the cliché says, is history.

Thus, more than two decades later, the fifth edition of The Psychology of Ageing: An Introduction is to be launched on the world.

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The significant changes in the new edition can be summarised as follows. First, it is a lot bigger – about a third larger in size than the previous edition. This is in part because of the new chapter (of which more below), but also because nearly all the chapters have been considerably expanded to take account of the growth in the research literature over the recent past. In part this is a matter of updating what new things have been found within an existing area of study. However, new fields of research are now opening up, and these require critical coverage. For example, the greater availability of brain scanning equipment means that studies of neuropsychology are becoming commonplace, particularly in intelligence and memory. Although these have been mentioned in previous editions, this time the topics are given far greater prominence.

Within chapters, topics are broken down into reasonably bite-sized portions, each of which can typically be read without having to read too much of the preceding text. I am, however, aware that a lot of readers will not have an extensive (or indeed any) background in psychology, so I have included a few explanatory notes (that more experienced readers can easily skip over) or in the case of longer explanations, appendices (e.g. describing basic anatomy of the brain and how nerves communicate with each other). I firmly believe that if you can understand a science documentary on television, you should have no conceptual difficulties in reading this book.

Before this deters any academic readers thinking that this is a lightweight book – it isn’t. For students (undergraduate and postgraduate), lecturers and academics in cognizant disciplines, this will serve as (I hope) a respectable primer in the field – the challenge for these readers is what they do with the knowledge in forming their own, more detailed studies.

I mentioned earlier that there was a new chapter – this is on Death, Dying and Bereavement. I have previously resisted including this chapter, not because of any aversion to the subject, but because researchers are divided on whether the topics should be considered as part of ageing, or should be regarded as a separate discipline. In this edition, I have decided to include a chapter. It covers the key issues of the processes of dying (including a critique of Kubler-Ross’s theory), differences in approaches to death and dying, etc. In short, the key psychological topics are covered. I have avoided straying into what I see as being the preserve of sociology and history (e.g. cultural differences in funeral rites and similar) to keep the psychological flavour of the book undiluted.

However, not all has changed. The glossary of technical terms has been saved, the writing style is (I hope) not all that drastically different, and I have tried to keep the level of explanation the same as in previous editions. These are the things that critics have liked about my earlier books, and I am not about to start biting the hand that has stroked my fur so nicely over the years.

Anyway, I hope you enjoy the book. I am currently writing another one for Jessica Kingsley, which will be out at some point in the future, probably dependent upon when my parrot permits me to type without pestering for food.

Ian Stuart-Hamilton

Copyright © Jessica Kingsley Publishers 2012.