How Sleeping Saved My Brain

When I was discharged from the hospital, the doctor suggested that I take a nap every afternoon. I didn't think too much about this, but in hindsight I realize that this was not just a friendly suggestion. Sleeping -- and naps in particular -- were critical to my recovery.
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Nine years ago this month, I woke up in the middle of the night to go to the bathroom -- a fact of life with which many of us are familiar -- and on the way back to bed I passed in front of the bathroom mirror. I am sure there are many people who look fabulous at 3:45 a.m., but I am not one of them. My hair was frantic, my right eye looked funny, and the harsh light over the mirror created shadows under my eyes and emphasized every wrinkle in my face. I was glad that turning off the light made the image vanish.

I went back to bed and lay there for half an hour, but I could not get back to sleep. Once I start thinking about things, it is hard for me to stop, and my mind was clear as a bell. So I got up again to quietly work on email while my husband, Armistead, kept sleeping. However, I had some trouble opening the lid on my laptop, so I went back to bed again.

I still could not get back to sleep. Trying to get comfortable, I kept changing my position, but my right arm would not cooperate. I had to treat it as if it belonged to someone else.

I got up again and attempted to brush my teeth but immediately dropped the toothbrush. I remember being very annoyed that I could not pick the toothbrush off the floor because my arm was flopping around and I couldn't control it. I decided to wake up Armistead to solicit his opinion about what had started to worry me.

Clearly and succinctly I said to him, "Armistead, I believe I am having a stroke, and I need you to take me to the hospital." While I did not think he would complain about being awakened in the cold and dark, I was certain he would at least ask me some questions. Instead, he leaped out of bed, got dressed, and immediately went to get the car.

Weeks later, Armistead told me that what I really said to him was, "Ashminish missuhupshum shimushimmin..." I still have trouble believing his version of events, because in my head I knew exactly what I was saying and I was certain I was speaking perfectly. But his version would explain the alacrity with which he got out of bed, the speed at which he drove to the hospital, and the occasional side-eye looks he gave me on the way.

It turns out I had suffered a stroke, or what my neurologist calls a brain attack. It knocked out both the Broca's and Wernicke's areas of my brain -- the parts that are responsible for language. Overnight I lost my ability to speak, read, and write.

For me, losing control over the right side of my body was not nearly as devastating as losing my ability to speak. Among the global population, I fall in the 95th percentile for expressiveness -- and I can state this with confidence because my company, Emergenetics International, is in the business of statistically analyzing how people think and behave in comparison to the population at large.

In some ways, I was fortunate. I still understood what people were saying to me, and I could still talk to myself in English inside my own head. I physically could write -- a list of words, for example -- but I could not compose sentences. Ultimately, my speech therapist realized that I had completely lost all of my prepositions and pronouns. Through the miracle of neuroplasticity I was able to relearn them, but even today I occasionally have to ask people what letter the words "you" or "for" starts with.

When I was discharged from the hospital, the doctor suggested that I take a nap every afternoon. I didn't think too much about this, but in hindsight I realize that this was not just a friendly suggestion. Sleeping -- and naps in particular -- were critical to my recovery.

I had heard about power naps for CEOs, but I was interested to learn from Arianna Huffington's interview with Dr. Stuart Quan and Dr. Russell Sanna, both of the Division of Sleep Medicine at Harvard University, that top athletes are now getting into the game. In particular, NBA players routinely take two- to three-hour naps to rest and recover before their basketball games, which are often held at night. Competing and traveling often prevent them from getting a good night's sleep, and research suggests that just sleeping late for a couple of days on the weekend is not enough to counter the effects of a week's worth of sleep deprivation.

A "particular part of sleep occurring in the early part of sleep is most important for [brain] recovery," notes Jim Horne, Ph.D., director of the sleep research laboratory at Loughborough University in England. "Rather than trying to extend one's sleep, perhaps we should take short naps instead."

For five years, I took a nap every afternoon. I have never slept so much in my life. A healthy brain takes 20-25 percent of the body's energy, and my injured brain needed extra time off to re-organize itself. [1] Because of the miracle of neuroplasticity, it was able to shift tasks from the area of the stroke to other areas as it healed. Depending on the severity of their stroke or accident, many people with brain injuries make astonishing recoveries, relearning how to eat, walk, talk, and a lifetime of other skills.

I received intensive speech and language therapy and was on disability for four years while my brain re-wired itself. The first book I read was by Dr. Seuss. From there I progressed to anything easy or trashy. One Saturday morning I picked up a Time magazine and decided I was going to read every word, from cover to cover. This victory took three hours. Afterward I was so exhausted I went to bed for a week.

As luck would have it, my stroke occurred as I was right in the middle of my writing my first book, Emergenetics. I can only imagine how the publishing house felt when they learned their author had become nonverbal. But having to finish the book gave my recovery another level of urgency. I knew what I wanted to say, but I had to learn how to unlock the thoughts inside my brain.

My son took a semester off from law school to help me finish the manuscript, and it was published on Jan. 6, 2006. I had promised autographed copies to many people, so I went to my office each weekend to autograph the books and cried through the whole process. Each Monday I needed someone from my staff to proofread what I had written.

Eventually I returned to work at a slightly reduced schedule that allowed for my afternoon naps. Then I reached a point where I could push through a couple of days of hard work, but afterward I would be wiped out. I resumed giving workshops as soon as I could, even though my verbal skills were still somewhat shaky. I would open each lecture by saying, "Four years, eleven months, and two days ago, I experienced a brain attack -- also known as a stroke. I could not read, write, or speak. Today I can speak, but I am never sure exactly what will come out of my mouth, even though in my brain everything is perfectly organized."

During one lecture, I noticed that the audience was listening attentively but also looking perplexed. I turned to Armistead and asked him what was going wrong. "You're doing fine," he said encouragingly, "But we are all trying to figure out what you mean by the 'shits.'" For the previous 10 minutes, I thought I had been talking about charts.

One great day six years later I was at work and I realized it was afternoon and I was still feeling energetic. My body was no longer begging me for a nap. Nine years later, I am able to work from 4 a.m. until 8 p.m., but don't expect anything out of me after that! I still need a full night's sleep to allow my brain to rest and recover at the end of each day.

Today I am back to traveling, lecturing, and reading difficult texts, and I am even in the middle of writing another book. This one is going to be about how the way we think and behave affects our experience of illness.

Reference:

1. Mink, JW; Blumenschine, RJ; Adams, DB (1981). "Ratio of central nervous system to body metabolism in vertebrates: its constancy and functional basis." American Journal of Physiology 241 (3): R203-212.

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