Dr Neil Stanley Independent Sleep Expert
          BACK ‘The Way We Did up Things in Hamilton County’, The Spirit of the Times, 8 July 1848, 234.  Valentine Hammann, ‘On Sleep’, The Health Reformer, iv (1869), 99; here On Sleep. THE matter of sleep is of much importance to the invalid in order to secure health, and for the healthful person in order to retain it. Sleep is that state of the body in which the internal and external senses and voluntary motions are not exercised ; or, it is a temporary suspension of the relation of the brain to some parts of the body. Nature has designed sleep for both renewing, during the silence and darkness of the night, the vital energy which has been exhausted through the day, and for assisting nutrition. We recognize the necessity of sleep when a general feeling of fatigue and weakness overtakes us; when our motions become more difficult, our senses lose their activity, the mind becomes confused, and receives sensations indistinctly, and we therefore seek obscurity and silence, and sink into the arms of oblivion. During sleep we lose successively the use of our senses. The sense of vision first ceases to act, by the closing of the eyelids; then the taste; the hearing becomes dormant only after the smell ; the respiration and circulation become slower and more deep, and, in consequence, digestion becomes less rapid. The first question which arises is : Where shall we sleep? The room in which we sleep should be well ventilated, for, if this is not the case, we re-breathe the air already exhaled from our lungs, causing sickness and often, death. It has been stated with truth, that there are more victims annually who have fatal and dangerous diseases engendered from this cause than have occurred in any cholera epidemic in this country. The windows in the room should be kept open during the day, and kept slightly open all night. It is a popular error to act on the presumption that the smallest room in the house is large enough to sleep in. The bed-chamber should not be used for any other purpose than for what it is intended : it should not be your reading-room, or your workshop, or your sitting- room. Leave nothing in it which can diffuse disagreeable odors, or that can exhale deleterious gases; neither vases of flowers or fruit. Keep everything out of the room that has any odor whatever. Eight hours' sleep out of the twenty-four is indispensable to many or most persons to retain health and vigor. Some persons seem to imagine that every hour taken from sleep is an hour gained. Sleep is prolonged by the fatigue of the muscular system, strong exertions of the mind, lively and multiplied sensations, as well as habits of idleness, and the immoderate use of strong aliments. Infants and youth, whose life is very active, have need of longer repose. Riper age, more frugal of time, and tortured with cares, devotes to it but a small portion. The best mode of regulating sleep is to go to bed at regular hours, and rise the moment you awake in the morning, and do not take a second sleep or drowsing. By uninterrupted and peaceful sleep, restrained within proper limits, the powers are restored, and the organs recover their facility of action; but, on the other hand, if sleep is troubled by disagreeable dreams, and painful impressions, or even prolonged beyond measure, very far from repairing, it exhausts the strength, fatigues the organs, and very often becomes the occasion of serious diseases. Sleep is a great antidote for irritability of temper, peevishness and uneasiness. To an overworked brain it will restore to vigor more effectually than any other remedy known. But very often it happens that we cannot acquire sleep. If the habit of sleeping well is broken up for any length of time, it is not easily regained. This is often cured by taking sufficient exercise to produce weariness, bringing the muscular system a little more into use. If this be done, together with the provision of a good, clean bed in a well-ventilated room, the stomach kept clean, and conscience clear, there would be no cause for those who are overworked, haggard and nervous, to pass sleepless nights. A most common error is to load the stomach before retiring. Four hours, at least. should elapse before going to bed after having eaten. If this is not done, the food would not be well digested. Nightmare is generally caused by the presence of undigested food in the stomach while asleep. Plain, wholesome food, therefore, should be eaten at regular hours, and in moderate quantity. The turn which the ideas assume during sleep, or the nature of dreams, depends much on the state of the organs. If the stomach is overcharged with undigested food, the respiration difficult on account of position or other causes, dreams, fatiguing and painful, are the consequence. The character of dreams is no less influenced by habitual occupation of the mind. Sleep may be induced, frequently, by brushing the hair briskly, so as to redden the scalp in a slight degree; or, by the friction of the skin. In some persons, soothing sounds will have a similar effect. A warm bath may also be employed with advantage for the same purpose. If more care would be taken in where, how, when, and how long, to sleep, there would be brighter and merrier faces seen in our midst than there are now, and it would fit a person more fully to enjoy the higher walks of life with less trouble and anxiety.  Acton, The Functions and Disorders of the Reproductive Organs, 228; here Let me further remark, that if a man is disposed to emissions he should not allow himself to fall into a second  sleep, but should rise early; in following out this plan there is no difficulty if the patient goes to bed at a  reasonable hour. No doubt can exist that emissions most frequently take place in this second sleep ; and it is equally certain that although a man awakes thoroughly refreshed from his first sleep, he may arise after having taken a second doze thoroughly prostrated. An early call, or an alarum clock, may cure many a patient better than all the preparations in the pharmacopoeia. At first these early hours may disagree with him, but they soon become as natural as late ones were, and the patient feels a disinclination to lie in bed, equal to his old  disinclination to get up early. Of course large numbers of patients will tell you that they feel so fatigued in the morning that they cannot get up. If more sleep is required—should be the answer—let it be taken in the daytime. It would be a curious and important question for physiologists to investigate why the second sleep refreshes us so slightly when compared with the first? On awaking the first thing in the morning, most persons, and especially convalescents, feel refreshed by their night's rest ; but if they go to sleep again, and rise say at ten, they remain languid all day. Perhaps it may depend in a great measure upon the first sleep being sounder and quieter, and not being disturbed by the dreams to which those who indulge in the second are liable. The recommendation may be difficult, then, for young men to follow, but I have often thought of advising some of my confirmed cases to take a voyage on board ship, and keep the watches with the sailors, which allow of taking only four hour's sleep at a time, in the belief that this interruption of rest would break through the almost inveterate habit ; but it is difficult in these, the worst forms, to induce the patient to use any self- restraint to cure himself ; he wishes to rely on medicine, and will not give himself the trouble to exert self-will. Another very valuable suggestion is to desire the patient to practise the habit of waking early in the morning, turning out of bed, and emptying the bladder. It is in the early morning, when the bladder is full, that emissions and erections take place. In such cases, if a patient rises at 5 or 6, and goes to bed early, he may altogether avoid emissions. ‘Getting Up Early’, Philadephia Public Ledger, 15 Apr. 1859; ‘The Art of Early Rising’, Young England (June 1885), 267; The proper time to rise says the Lancet, is when sleep ends. Dozing should not be allowed. True sleep is the aggregate of sleep, or is a state consisting in sleeping or rest of all the several parts of the organism. Sometimes one and at other times another part of the body, as a whole, may be the least fatigued, and so the first to awake,or the most exhausted, and therefore the most difficult to arouse. The secret of good sleep is, the physiological conditions of rest being established, so to work and weary the several parts of the organism as to give them a proportionally equal need of rest at the same moment; and, to wake early and feel ready to rise, a fair and equal start of the sleepers should be secured; and the wise self-manager should not allow a drowsy feeling of the conciousness, or weary senses, or an exhausted muscular system, to beguile him into the folly of going to sleep again once he has been aroused. After a very few days of self-discipline, the man who resolves not to doze,that is, not to allow some sleepy part of his body keep him in bed after his brain has once awakened,will find himself, without knowing why, and early riser. The Family Physician: a Manual of Domestic Medicine, new edn (London, 1886), 191; here Early rising favours the natural action of the bowels. By early rising we mean rather the avoiding a second sleep in the morning than getting up at any specified hour. From the difference of habit in different classes, and of those who reside in town or country, the hour which is early to one may be late to another, and vice versa. it is lingering in bed, the going to sleep a second time after having enjoyed a good night’s rest, that does the mischief. A person awakes refreshed, light and cheerful, but instead of at once getting up he dozes to sleep again, he afterwards rises with unwillingness, and find his head heavy, his spirits dull, and his bowels indisposed. Joseph W. Howe, Excessive Venery: the Etiology, Pathology and Treatment of the Diseases Resulting from Venereal Excesses, Masturbation and Continence (New York, 1887), 219;  here I am accustomed to order the first meal to be taken in the morning as early as half-past six or seven o’clock, even if the patient does not rise to eat it, but takes it in bed. I do this because the second sleep in the early morning, if allowed to run on to eight or nine without disturbance, is liable to make a marked difference in the feeling of congestion which most patients experience about their genitals, at that time, especially if they have not had an emission during the night,. Campbell, Headache and Other Morbid Cephalic Sensations, 218–19. here An individual wakes, let us say, at 6 A.M., and feel inclined to get up, but this being earlier than his usual time for rising he elects to stay in bed, and falls asleep, to wake later with a headache, - a result all the more likely to occur if his second sleep has been light and fitful BACK
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