Shhhhh. Don't wake the baby (you). Illustration / Marta Sevilla, The New York Times
Can the "five S's" used to calm fussy babies — swaddle, side or stomach position, shush, swing and suck — also help grown-ups snooze? A reporter finds out.
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 online-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.
Right now, I get five to seven hours of sleep on most nights, which is not enough for me, or for most adults, who typically need at least seven hours. Regularly getting fewer than seven hours of sleep is associated with greater risk of basically every terrible disease imaginable.
I do all the other physical-wellness tweaks that are supposed to help you get better sleep, too. I stop eating by 7pm, I have no caffeine after noon, I barely drink alcohol, I even work out more than I did before the pandemic because I don't spend 90 minutes a day commuting anymore. I have tried melatonin and prescription sleep aids, and while both helped me fall asleep, they left me groggy enough that it wasn't worth it. "Have you tried …?" Yes. I have tried it. Nothing seems to help.
So I turned to someone who is used to sleepless parents calling him: Craig Canapari, director of the Yale Paediatric 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.
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: randomised, 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 (19C). Then, I began to feel suffocated, so I kicked them off. "It comes down to a sensory preference," Canapari said.
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 per cent 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.
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 specialising 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.
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.
The American Academy of Paediatric 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.
There are a few things that adults can do that babies cannot: take drugs and go to therapy. Dr. Clete A. 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.
One type of therapy that has good, research-backed outcomes is cognitive behavioral therapy for insomnia (also known as CBT-I), which was recommended by several sleep doctors. Although the most effective dose of CBT-I involves several sessions, there is research that suggests even a single session can help.
In the meantime, I'm exploring another solution not available to infants: pillows. It has been three weeks since I got my new memory-foam pillow, designed for stomach sleepers, and I do think it has helped me wake up with less pain in my neck and jaw, although I don't think it has helped me get to sleep much faster.
Also, when, like me, you've tried "everything," Mundt said what you really need to do is "decenter sleep" from your life, because focusing so much on it is just perpetuating anxiety — and insomnia.
So I bought a new book today, a beach-type read even though it's currently 34 degrees (1C) outside. If I can't sleep tonight, I'll get out of bed and curl up with it, and try to transport myself to a yacht in my mind. It's better than tossing and turning for hours.
Written by: Jessica Grose
Photographs by: Marta Sevilla
© 2021 THE NEW YORK TIMES
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