Some people turning to 'segmented sleep' for a better night's rest

NEW YORK (NYTIMES) - About a year into the pandemic, Ms Marcela Rafea began waking up consistently at 3am, her mind racing.

She would creep out of bed and tiptoe into the living room, where she would meditate, try a few yoga poses and open the window to hear the leaves rustle, the cars rush by and the dogs bark.

Then, at 6am, she crawled back into bed and would sleep again until her youngest child woke her for the day at 7am.

"I needed that night wakefulness to make up for the time I didn't have for myself," said Ms Rafea, 50, a photographer and mother of three who lives in Illinois.

Unbeknown to her, she had naturally reverted to a sleep cycle believed to be standard in multiple cultures in the late Middle Ages through the early 19th century.

During that time, many people went to sleep around sundown and woke three to four hours later.

They socialised, read books, had small meals and tried to conceive children for the next hour or two before going back for a second sleep for another three to four hours.

It was only when artificial light was introduced that people began forcing themselves to sleep through the night, said Professor A. Roger Ekirch of Virginia Tech and author of The Great Sleep Transformation.

Now that many people are making their own schedules, working from home and focusing more on self-care, there has been a return for some to the idea of a segmented sleep cycle.

So are people simply reverting to their long-forgotten, natural sleep cycle? And could this be the cure for those deemed middle-of-the-night insomniacs?

Prof Ekirch, who has studied segmented sleep for the past 35 years, said there are more than 2,000 references to it from literary sources: from letters and diaries to court records and newspapers to plays and novels, from Homer to Chaucer to Dickens.

"The phenomenon went by different names in different places: first and second sleep, first nap and dead sleep, evening sleep and morning sleep," said Professor Benjamin Reiss of Emory University who wrote Wild Nights: How Taming Sleep Created Our Restless World. He said rather than being a choice at the time, this was simply something that people did, as it fit agricultural and artisanal patterns of labour.

The wakeful period was also believed to be a prime time for taking potions and pills and for aiding digestion, Prof Ekirch said.

There were negative reasons for segmented sleep as well.

"Sleeping surfaces - often a sack stuffed with grass or, if you were lucky, wool or horsehair - made it harder than it is today to sleep for a long stretch without interruption," Prof Reiss said.

And there were, of course, health issues. For example, "without modern dentistry, a toothache might start throbbing in the middle of the night".

Everything changed with the Industrial Revolution, emphasising profit and productivity; the belief was that people who confined their sleep to a single interval gained an advantage.

The growing prevalence of artificial lights permitted later bedtimes, leading to sleep compression.

Fast-forward a few hundred years and people have grown accustomed to compressed sleep.

Well, some of them have.

Thirty per cent of people report waking up at least three nights in a week, according to one study published in 2010 in the Journal of Psychosomatic Research, and 25 per cent of adults suffer from insomnia each year, according to a recent study by researchers at the University of Pennsylvania.

For some people, the pandemic has spurred more flexible schedules, which has led to experiments with the old-fashioned sleep method.

That is the case for Mr Mark Hadley, a 52-year-old finance manager in North Bend, Oregon. In the past 20 years, he said he does not remember a time when he slept completely through the night. "I always woke up halfway through the night and just lay there," he said.

He had heard of segmented sleep, but did not have time to stretch his own until his job went mainly remote during the pandemic.

So in August last year, he started going to bed at 10pm and waking up naturally at 2am. He gets up for 11/2 to two hours to read and to pray. Then he goes back to bed around 3.30 or 4am and sleeps until his wife wakes him at 6.30 or 7am.

Doctors are conflicted about how healthy segmented sleep is.

"We don't really know the long-term impacts of segmented sleep because we don't really have much data on it," said Dr Matthew Ebben, an associate professor of psychology in clinical neurology at Weill Cornell Medicine and NewYork-Presbyterian.

It may make some people feel more fatigued and drowsy throughout the day, said Dr Nicole Avena, a health psychologist and assistant professor of neuroscience at Mount Sinai School of Medicine.

In cases of anxiety around insomnia, segmented sleep is often an ideal solution, said Mr Alex Savy, a sleep science coach and founder of SleepingOcean, a sleep product review site in Toronto.

"When practising segmented sleep, insomniacs don't have to worry about waking up in the middle of the night, as that's the way segmented sleep works," he said.

"Therefore, they can adjust the schedule to their insomnia and reduce the stress associated with it."

But returning to sleep patterns from the Middle Ages is not for everyone, Dr Avena said, suggesting that segmented sleep should be tried only by those with sleep issues.

"I think that while it may promote better sleep for these individuals, it probably has more consequences than benefits for those who do not have a hard time sleeping," she said.