What are you apologizing for when you apologize for getting sleepy?

What do you say when you yawn? Don’t overthink your answer. And you, trying to pretend you punctuate your yawns by shouting “Dog scrotum!” I am on to you and you are not so cute. When we yawn, we say, “Excuse me.” But why? One school of thought is that your are apologizing for having shown someone your epiglottis. But I don’t buy that, because even if you cover your mouth, you still excuse yourself afterward. Another common objection is that yawning may be interpreted as a sign of boredom. Miss Manners has a helpful etiquette tip for that situation (ā€œIā€™m afraid I was up late last night. Please do go on with what you were saying. I find it fascinating”), but she still says you shouldn’t yawn. Which would be super helpful if yawning were a voluntary reaction.

That’s right, folks. For this, my 25th blog post (not counting the one where I just embedded the video for “Everything Comes Down to Poo”), I’m finally going to write about the thing I actually study all day long, which is sleep health. Western culture has a pretty perverse relationship to sleep, and most of us seem to be convinced it’s a guilty pleasure. That’s why you apologize when you yawn; deep down you think sleepiness is a character flaw, and if you were really motivated, you’d be more awake. You are wrong.

Sleep is one of a list of important homeostatic activities that are under voluntary control only to a point. We get this intuitively; when a healthy adult needs to pee, she can wait to the end of her meeting to do it. But if she waits long enough, eventually she is going to lose control of her sphincter and void her bladder, no matter how socially inconvenient the time or place. The same is true of the need to drink, or eat, or breathe, or stop touching hot things. Everyone knows that if you stay up long enough your brain is going to take over and you will go night-night. Yet I hear people apologize for feeling sleepy, or for needing to go to sleep, all the time. What are they really apologizing for? Here is list of possible translations.

I’m sorry I’m sleep deprived. Here’s some 101. Broadly, there are two physiologic processes that make healthy people tired: sleep deprivation and circadian rhythm. Sleep deprivation is pretty simple; the longer you go without sleeping the greater your need to sleep. If Elizabeth wakes up at 10 pm because her hospital shift starts at midnight, come noon she will be way more tired than her identical twin Jessica, who woke up at 6:30 am for Crossfit. Duh.

BabyAsleeponFace

If you think this guy is tired, imagine his parents.

Here comes the one and only concession I will make to so-called personal responsibility. If you know you have a breakfast meeting tomorrow but you voluntarily stay up until 1 am putting the finishing touches on your Golden Globes Best Dressed list,* that is on you. But there are lots of serious reasons to stay awake: you’ve got one or more jobs to work, maybe you have a late shift, maybe you have a second shift (or a third), maybe you have a kid, maybe you have laundry, maybe you have homework, maybe you need to exercise, maybe you’re in a long-distance relationship with someone in Iran…Sleep deprivation is nearly ubiquitous in our time. So maybe what you’re really saying is “I’m sorry I am alive right now.”

I’m sorry I can’t stop time. The second normal biological process that induces sleep is circadian rhythm. Sleepiness is tied to specific times of day, so that even if you are well rested, at some point in the night you will want to sleep, and at some point in the afternoon you will want to nap. What time that is varies from person to person, and may be largely genetic. My friend Rachel is a “lark.” She wakes up around 4 am whether she wants to or not. She gets to work at 6 am sometimes, not because she’s trying to make you feel inferior, but because it’s boring to lie in bed waiting for the rest of the world to wake up. Some time around 8 in the evening, Rachel starts to fall asleep. Though she can put off bed time for a while to come out for a girl’s night or some such, as she sits still and relaxes she will probably pass out.

Then there are the owls, whose preference is to stay up late and sleep late. When I asked my friend Josh if I could tell the world about his circadian preference, he said, “Sure. I got to work at 11:30 today!!!! šŸ˜¦ ” I wasn’t surprised, since Josh routinely stays up till 3 am, and can only fall asleep earlier when he’s deeply sleep deprived. When Josh has to be at work at 6 in the morning, he can wake up with an alarm, but he has described it as physically painful, especially when he has stayed up late the night before. Josh and his fellow owls experience a certain impairment from the mismatch of their internal clocks and mainstream expectations of when human beings should be active, and when they are forced to conform they suffer from “social jet-lag.”

Most people will be somewhere in the middle of these extremes, but may still have distinct tendencies to be morning people or evening people. Nobody is doing this on purpose, so it’s pretty unfair to expect someone to apologize on behalf of their inherited body clock, or to apologize because it is 8:15.

By the way, Josh and Rachel are a couple. As far as I can tell they see each other for about an hour in the evenings, until Rachel falls asleep at the dinner table.

I’m sorry I’m not on uppers (variant: I’m sorry I’m crashing from the uppers I took before). You can’t overcome the biological pressures of sleep deprivation or circadian rhythm by will power, but there are always stimulants. Caffeine is a popular option, as are nicotine and cocaine. Adderall (speed), Provigil, and Nuvigil are all name-brand pharmaceuticals with important medical applications and a robust black market. With such a variety of consumer options around every corner, what’s your excuse?

I snapped this photo at a sleep clinic. No joke.

I’m sorry I used the medication I need. On the flip side, pharmacologically speaking, are the numerous drugs that make you sleepy when you’d rather not be. Perhaps you have taken one of these medications to treat allergies, autoimmune disease, seizures, Parkinson’s, incontinence, depression, anxiety, schizophrenia, or–that old canard–pain. How could you be so selfish? I want to interact with you right now. With no yawning.

I’m sorry I’m not a freak of nature. As with circadian preference, how much sleep you need varies from person to person. 8 hours of sleep a night is one of those nice round numbers from magical fairy land; empirically estimated averages range from seven to nine hours and are the topic of much scholarly debate, but it’s kind of irrelevant to you. You just need what you need. Some people need as much as 12 hours every day (which is a pretty tough disability to live with in an 8-5 world). Other people (like, it is rumored, President Obama) can get by with four. But those are the extreme outliers, and you’re not going to make yourself into one of them through discipline any more than you’re going to make yourself suitable to serve as Commander-in-Chief.

I’m sorry I was born when I was born. Both sleep need and circadian preference can change with age. Toddlers are notorious larks who need a lot of sleep. Teenagers are notorious owls who also need a lot of sleep (so much so that there is a developing body of research trying to determine if school performance could be improved by delaying school start times). Many adults sleep earlier as they get older, and find that they need more sleep and are less resilient to sleep deprivation than in their youth.

I’m sorry I have an undiagnosed sleep disorder. It’s hard to diagnose yourself with a sleep disorder, because most of them take place while you’re asleep. You probably know if you’re experiencing insomnia symptoms, and you might have a shrewd idea that you have narcolepsy (but you also might not). Given that most of us blame ourselves for our sleepiness, just how sleepy would you have to get before you sought medical advice? Passing out behind the wheel? Then once you get to the clinic, will your primary care provider be astute and recently trained enough to recognize the potential for an underlying sleep disorder? Sleep medicine is a pretty young field, and is highly specialized. There’s a strong social pattern to who gets referred for sleep testing, and a lot of people get missed.

https://i1.wp.com/www.rottenecards.com/ecards/Rottenecards_80447284_35nyzw258g.png

In summary, sleep is not a luxury. You cannot prevent yourself needing sleep through self-control. Every time you apologize for getting sleepy, you tell the person whose pardon you are begging that he too should feel ashamed of his own need to sleep. It all contributes to a culture in which people blame themselves more and take care of themselves less.

*Zoe Saldana, Emma Watson, Amy Adams, Lily Rabe, and Julianna Margulies, in that order.


Image credits:
1. Rebecca and Bernhard via photopin cc
2. Myself
3. Rotten eCards

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