Archive for January 2016

Sundowning and the witching hour

January 14, 2016

As the light fades, they become agitated. Freaked out, confused, angry. And it’s your job to absorb all those feelings and manage the consequences of those feelings, somehow without becoming agitated yourself.

In people with Alzheimer’s disease, we call it “sundowning”. In babies, we call it “the witching hour”. As far as I can see, it’s exactly the same thing: agitation in the late afternoon and the early evening, usually presenting in people who have an early bedtime and wake up early in the morning. An adult with Alzheimer’s might pace around or shout at their caregiver; a baby will just keep screaming.

The advice for dealing with both sundowning and the witching hour is eerily similar. Adjust mealtimes. Use soft music/white noise. Set the heating to a comfortable temperature. Speak in a reassuring tone of voice. Identify triggers for the behaviour so you can avoid them…wait a minute, is the internet really telling you that the daily setting of the sun is a trigger you can avoid? Well, no. But the “avoid triggers” advice, just like the “look after yourself and take breaks” advice, is a way of clueing you in that there’s nothing you can actually do to stop the behaviour, only stuff you can do to make yourself feel like you’re doing something, so you don’t go crazy.

In my post about the politics of sleep I wrote that it’s initially hard to understand why one person would try to control another person’s sleep patterns – until you realise that the person whose sleep is being controlled is work for the first person. Attempting to control someone else’s sleep patterns probably means that their very existence constitutes work for you. And vice-versa: if there is someone who can’t be awake without being work for you, of course you’re going to obsess about when they sleep.

And so the advice for dealing with sundowning old people and wailing witching-hour babies also includes stuff on not “letting them nap” for X hours before bedtime. Congratulations! You are now in charge of another human being’s circadian rhythms. It is your job to repeatedly wake them when their body and brain are telling them to sleep, because their body and brain are telling them to sleep at the “wrong” time. Oh, but it’s also your job to worry when they won’t sleep at the “right” time, because if they’re not well-rested they will supposedly kick off even more. (If you’re currently dealing with a old person wandering around the house turning all the taps on, or a screaming witching-hour baby, you might wonder exactly how it could get any worse.)

My hunch is that sundowning is linked to advanced sleep phase disorder (ASPD) and that advanced sleep phase disorder is itself an extreme manifestation of the tendency to become more of an early-bird as you get older. I don’t know where the cut-off point is between “natural lark” and “person with ASPD”; it seems kind of arbitrary to me. Human circadian cycles vary, but we’ve defined a specific range as “normal”, which means everybody whose body-clock is outside that range must be suffering from a disorder. (A bit like what happened with the BMI.)

The President of Starbucks is a successful go-getter because she sets her alarm for 4:30am, while an elderly person who wakes up between 3am and 4am is suffering from advanced sleep phase disorder. Is the difference between “person with a disorder” and “successful go-getter” really about the actual times they wake up, or is it about the context?

Maybe the real difference is that Michelle Gaas and Howard Schultz wake up early so they can do more work, while many of the elderly people with advanced sleep phase disorder become work as soon as they open their eyes.

When we obsess about a person’s sleep, we forget about the real problem: the work we have to do every moment this person is awake. We forget that sundowning and the witching hour are both emotionally draining ordeals. We say “He won’t settle” when we mean is: “Someone I love is screaming at an ear-splitting volume for hours on end, and there’s nothing I can do to console him.” We say “She won’t sleep and I need a break” when what we mean is: “My mother yells abuse at me all evening, using foul language I never thought she even knew.”

I don’t know what hell is like. But imagine being in a room where a fire alarm is going off at ear-splitting volume. Your body is saying: “Emergency! Run!” but you know you can’t leave because it’s your job to be in this room. And the alarm isn’t a normal bell sound. It’s been fine-tuned to a frequency that will upset you more than anybody else who hears it. Oh, and the message the alarm is sending is that you’re a shitty failure because you can’t stop the alarm. Well…that’s basically what we call “sundowning” or “the witching hour”.

(With sundowning, there’s also the possibility of being physically attacked or having a fire or flood in your home. The advice about adjusting mealtimes and getting fresh air is almost comically inadequate when you understand that context.)

The obsession with sleep is driven by the desire for a break from what would be called abuse or torture if it was inflicted by people who have full agency. What if we stopped talking about naps and mealtimes and lighting and started asking why we expect parents and carers to just take that daily abuse and bear all the emotional costs of it?

Obligatory New Year decluttering blogpost: 2016 edition

January 4, 2016

“I rarely look at the photos unless they are on the wall.”

“Since college, I’ve hauled from flat to flat an increasing number of boxes containing concert tickets, postcards, press passes and more. And I’m not entirely sure why.”

Does this sound like you? It definitely sounds like me. I keep old letters, old photographs, old birthday cards, essays from university and even one or two from school. And now, of course, there’s the digital memorabilia too.

I’ve just quoted a woman who’s taken a squillion photos of her young daughter but rarely bothers to look through them, except the ones she’s had printed and put on the wall. She’s doing better than me, then, because I have squillions of photos and but I don’t think I’ve ever framed a single one. I’ve been given photo frames as gifts many times; photo frames were the scented candle equivalent of the 1980s and 1990s, gifts you gave to people when you didn’t know what else to get them. But I don’t use them. Then I feel guilty about not using them and they go in a box.

Sometimes people even give me photographs ready-framed, but I don’t put them on display in my home because I don’t really want to look at them. I would like to have some photos of loved ones around the house, and maybe a photo or two of myself to remind me of moments when I was really happy (and looking great, obviously). But the framed photos I’ve been given as gifts are all of myself, sometimes with my partner or the photo-giver themselves, taken at times which would never have occured to me as a photo-worthy moment.

When I first moved in with my partner, I asked my parents to give me a group photo of the extended family as a housewarming gift. Instead, they gave me a picture they’d insisted on taking of my partner and me standing outside our new house. As she handed it over, my mum looked at it and said: “Why do you always do that silly thing with your mouth?” Needless to say, it joined all the other photos in the Bottomless Box of Stuff That I Don’t Want But Can’t Throw Out and I never got the photo of the family that I actually wanted.

What’s odd is that I’ve willingly posed for so many photographs because the occasion is happy and memorable, or I’m with people I won’t see for a while, or because I feel great about how I look that day, or because it goes with the territory – e.g. I’m giving a talk at an event where pictures of the speakers are A Thing. And those photos disappear into the ether – I never see them. And I’ve asked many times for copies of photos I like – cute photos of people’s new babies, funny group photos, etc, etc – and never got them. But the times where I’m bored or tired or tense or sad and someone says my name so I turn my head and then realise they’re taking a photo and think something between “Oh, fuck” and “Oh…whatever” – those seem to be the magic moments captured for the framing-and-gift treatment.

I’ve tried. I’ve fucking tried. For my partner’s birthday last year I decided that I would for once be the person who does the printing and framing. I bought a three-picture frame and got three pictures printed for it that I actually loved. For various reasons that I mostly understood, my partner wasn’t happy with the gift. The frame sat around unused for months and then (presumably) went into my partner’s Bottomless Box Of Unwanted But Unjettisonable Stuff, while the photos I printed went into mine. At least now I’ve proved that the photo-as-gift concept doesn’t work for me when I’m the giver any more than when I’m the recipient.

So that woman who says she doesn’t look at the photos of her daughter because it’s more fun spending time with her actual daughter? Honey, you have your priorities much straighter than mine. At least if you did look through your photos you would enjoy it.  I don’t look at my photos because just opening the boxes I keep them in makes me feel somewhere between mildly annoyed and physically sick. Ditto the boxes I keep my memorabilia in – and yes, I’ve moved house with this crap many times.

I’m trying very, very hard to internalise the idea that I’m “allowed” to not keep things I don’t want in my living space. I’ve found Marie Kondo’s way of thinking quite shocking – the idea that your home should contain only things that spark joy. If someone goes to the trouble of buying something specially for me, or getting a photo printed and framed for me, shouldn’t I keep it, even though I don’t want it or even like it? If someone is trying really hard to declutter and they give me a bottle of non-alcoholic liqueur and a cotton tote bag branded with the logo of a festival I didn’t go to, shouldn’t I help them declutter by taking it off them and using it? Don’t I need to keep evidence of the kind of person I used to be 10 or 20 years ago in case the High Court of Personhood challenges my claim that I was once skinny, once fluent in French, once pink-haired, once queer? I guess the answers to the last three questions are no, no and no, but dammit, it’s hard.