How We Sleep

We sleep like rocks, Roman ruins.

That was what I said in a Facebook post to friends in the first week of living in our Roman apartment. Anyone who has gone through a period of sleep deprivation or worse, insomnia, can attest to the restorative power of getting a good night’s sleep.

Sleeping Hermaphroditos, a Roman marble restored
by Gian Lorenzo Bernini in 1620 by adding a
marble mattress. Paris, Louvre Museum. 

I got interested in sleep science a long time ago when I was part of a sleep deprivation study at the University of Washington, where I had been temping in a women’s health office. Someone had dropped out of a three-day study looking at thermoregulation and it paid pretty well, plus did not involve any drugs, so I agreed to participate. The researchers were trying to figure out how new mothers, suffering from sleep deprivation, also had thermoregulation problems that could be quite acute. They had rigged a way to measure thermoregulation using a sort of shower system that took subjects from sweating to shivering by altering water temperature, and needed three days to test because subjects had to forego a whole night’s sleep between tests two and three. I didn’t need to see the published results to know that I had a much shorter time between sweating and shivering on day three after no sleep. The whole thing fascinated me.

One benefit of moving to a new place with no furniture is getting to start over. I knew that mattress technology had improved a lot since the last time I bought a bed, so I did a bit of research and decided to splurge on new mattresses from Eve, a UK-based company that shipped their high-tech foam mattresses in a box and gave you a 100 days to try them out. I was sold after the first night. In fact, I continue to be amazed at how well I sleep on this mattress, but I don’t want to turn this into an infomercial. Suffice it to say, proper support for the body and head (pillows matter too) make a difference in how we sleep and how well-rested we feel. My mother has radicular pain in her neck that had recently required physical therapy and medication, and she has been able to stop the pain meds altogether. 

My cat Mimi sleeps with me and
during the day likes to nap under
the covers, right in the middle of the bed.

It has been claimed that there is nothing that will prevent, delay, or reverse Alzheimer’s disease. Most of the mainstream medical establishment is focused on diagnosis and treatment of disease, and limits attention to matters of general wellness to stating the obvious. For example, the California clinical care guidelines for Alzheimer’s Disease give hardly any space to issues of healthy living, and only suggest that lifestyle modifications may lower risks and help the brain.

In her latest book and personal crusade to enlighten the public on the worsening sleep deprivation crisis, Arianna Huffington documents new findings from research that show the benefits of sufficient sleep to brain functionality, what she describes as “memory consolidation, brain and neurochemical cleansing, and cognitive maintenance.” Certainly for those with compromised brain health, these benefits are even more vital. Dr. Gregg D. Jacobs, a renowned advocate for Cognitive Behavioral Therapy to cure insomnia, warns that commonly prescribed medications such as Lunesta and Ambien have risks including elevated mortality for long-term use and are only mildly effective. I shudder to think what Alzheimer’s patients, already dealing with sleep disruption side-effects from Aricept and Namenda, do to themselves if they add insomnia medication. I only recently read that the vivid nightmares can be mitigated by taking Alzheimer meds earlier in the day instead of before bedtime. It’s no wonder that people turn to online forums for suggestions and advice in the absence of clear medical guidance.

One doctor’s blog called Eating Academy that I have been following since my own health issues in the past few years, provides an important source of health information that will soon be revamped into a book and website, peterattiamd.com. Sleep and recovery, what Dr. Attia calls “sleep hygiene” require a deliberate effort, especially as technology alters our habits and routines in ways that may have important consequences for health and wellness. In this post he shares how movement, and preparing the body for a workout, are crucial aspects of maintaining the body and being free of pain. I find his arguments and explanations to be very helpful and enlightening.

 There’s no clear number of hours of sleep we need for optimal health, although some argue evidence points to seven as the magic number. All I know is, we are now sleeping better than before, and we wake up pain free. We are lucky to have plenty of Roman sunshine to start the morning off on the right track, although a grey cloudy morning has its own kind of beauty too.

How We Got Here

On my mother's 89th birthday we arrived in Rome. We had two suitcases each, Irish passports, my cat Mimi in tow, and a plan to rent a spacious two-bedroom apartment with a large terrace surrounded by pine trees in the northern part of the city.

We had many good reasons for leaving our previous lives behind. My mother, Maureen, had been diagnosed with Alzheimer's Disease in April of the previous year, and although she was tolerating low doses of both Aricept and Namenda, her decline was more evident. Her partner since the death of my father in 1998, Julius (Julie for short), died shortly after his 90th birthday, and I had moved back home to be with her. We were both depressed about politics, the state of our field of education, and the growing difficulties of life in general. The 1936 colonial house we had happily lived in since 1970 in the town of Great Neck, just outside the Queens border on the north shore of Long Island, began to feel like a burden; it was just too big, too full of memories, too many stairs, too full of stuff. Chinese families were buying up real estate in Great Neck as investments, renting to other Chinese families who wanted their kids to go to top public schools. It seemed like a good time to sell.

Before Julie's death, I had applied for an elementary principal job in a private school in Rome. When they decided to hire internally, I felt disappointment, but more because of Rome than the job. We began to wonder about just moving to Rome. Why not? My parents had married there in 1960, and we had spent all our vacations in Italy, plus I had previously lived in Florence and Milan for several years. Some friends began to think our idea was not crazy. We wondered aloud about the pros and cons, and suddenly, we had put the house on the market and that was that. It sold in two weeks.

There is much more to our story, and every day since we got here, there have been stories. But the real reason I am starting this new blog is because I want other caretakers of elders with dementia and Alzheimer's Disease to have hope. Well-meaning doctors prescribe medications, make health recommendations, try to show they care about their patients and their families. But our system of health care is not set up for a true personalized approach to chronic, neurodegenerative diseases. Alzheimer's Disease is now the third leading cause of death in the United States, and it affects more women than men, both as patients and caretakers. I have only just begun to dig into and research available sources of information that speak to non-experts, and so far, it's been pretty grim. Mostly what I've found is not what I was looking for. That motivated me to write.

Promising research by Dale Bredesen of UCLA at the Mary S. Easton Center for Alzheimer's Disease Research, published in the journal Aging in 2014 and 2016, led me to consider enhancements to my mother's treatment beyond the obvious notions of healthy diet, sufficient sleep and rest, exercise, and reducing stress. It was clear that reading the New York Times every morning, and watching the PBS Newshour every evening was creating a toxic anxiety for both of us as we wondered just how much worse things could get with each passing day of bad and then worse news. We both play and love music, but even Bach, Sinatra and Ella were not getting us through the dark times. The fresh flowers and farmer's markets of summer, plus visits from friends and family provided temporary relief, but as our departure date neared we couldn't wait to get to Italy.

In our first days in Rome, driving in our unfamiliar neighborhood, my cellphone service went out and we lost our navigation guidance (which was hilariously mispronouncing Italian street names). "Oh well," my mother said cheerfully, "usually when you get lost you learn something new." We made our way home using instinct and street signage, and it wasn't until the next day when I was driving alone that I realized how profound her sentiment was. In fact, I found myself driving on the previously unfamiliar streets that were now familiar as the ones I had taken back home the day before. I realized I was learning a new way to get back home. I vowed then and there to get lost every day in the hopes of learning something new. That is why I titled this blog Roads to Rome. I plan to get lost and learn something new, and share it with all of you.

Like the sampietrini stones of Rome, the road will likely be bumpy and full of holes. But that bit of green will poke through and give us hope. I just know it will.