Sleep Loss and Grief

How to Cope with Grief and Sleep Alone

Nothing will ease your grief—at least, not for a while. But these tips will help you sleep, and sleep will help you heal.
By Ellen Michaud with Julie Bain
From Sleep to Be Sexy Smart and Slim

A Time of Turbulent Emotions
Grief is hard. There is no easy way to move through it. Most of us will lose someone we love, will feel bruised right down to our soul. We’ll feel worry, fear, sadness, guilt, anger, frustration, confusion, and loneliness. Some psychologists say that those feelings are stages through which we move. But the truth is, moving through these stages is circular. We’ll begin to move on, spot a glove or a book left behind, and slip right back into a puddle of despair.

Unfortunately, a consequence of these uncontrollable feelings is something that makes it even harder to handle: Most of us simply don’t sleep. We lie down, turn out the light, close our eyes—and our minds remain sharply alert. And when we finally slip into unconsciousness, we frequently wake through the night.

Disrupted sleep makes it harder to handle our grief, our lives, and even the day-to-day duties of making the bed or paying the bills. And it may also affect our health. In a study of 4,395 married couples at the University of Glasgow, for example, when one spouse died, the risk of the other spouse dying from anything ranging from heart disease, stroke, and cancer to accidents and violence increased by 27 percent.

14 Tips to Help You Sleep Alone
1. JOURNAL. Limit writing to 15 minutes a day, and just write about how you feel. Periodically read back through what you’ve written. Over time you’ll be able to see how you’ve moved through the grieving process. Somewhere around 80 percent of us will move through the worst of our grief within a year.

2. NURTURE YOURSELF. Pay attention to your body’s needs. Prepare balanced meals, and serve them on your best china and linens. Exercise for 30 minutes every day, even if it’s just a walk with the dog. And every morning center yourself in a prayer of gratitude for the people in your life, the sunshine outside your window, and the fact that you can make a difference in the lives of others.

3. CONSULT SOME EXPERTS. Check with your attorney and a financial consultant about the effects a death has on your legal and financial situation. No, you don’t want to deal with it. On the other hand, you’ll sleep better knowing exactly what will—or won’t—be coming at you in the months ahead.

4. USE GUIDED IMAGERY. “Mind/body stuff really works in helping you get to sleep,” says therapist Belleruth Naparstek, M.S. “The imagery has enough cognitive recruitment to seduce the brain into seeing and thinking about other things, while the voice tone, pacing, music, and images will persuade your parasympathetic nervous system that it’s time to calm down. It will shut down the adrenaline and shoot some calming hormones into your nervous system.”

Slip a CD of guided imagery into your CD player, snuggle into bed, turn out the lights, and follow the imagery into sleep.

5. BAN THE BOTTLE. Alcohol simply prolongs the grieving process and makes it harder to get good, restorative sleep.

6. SCHEDULE A MASSAGE. “Massage interrupts the neurohormones connected with sleeplessness and almost manually imposes sleep on you,” says Naparstek. “If you can’t afford a massage, go to a massage school. You can get one there for $15.”

7. GET WHAT YOU NEED. “For some people six months of Ambien is a good thing,” says Naparstek. “If you need to take medication to interrupt the adrenalization of your life, so be it.”

More Sleep Tips
8. FIND NEW FRIENDS. Preferably other widows. Several women who belonged to the same church in Spring Hill, Florida, banded together after the death of their husbands and called themselves the Merry Widows. One was an artist, another a real estate agent, and two others were homemakers.

At first they weren’t merry at all—like everybody else, they were devastated by their losses. But gradually as they met for lunch or dinner, picked each other up for church, and brought takeout or chicken soup to those who were sick, things changed. They joked—with a sometimes macabre humor that could startle those still married folks who overheard them—providing an understanding and caring for one another that soothed their adrenalized state.

9. READ. Books on grieving, particularly memoirs of survivors, can reassure you that many of the intense feelings keeping you up will someday ease.

10. WRITE A LETTER. What would you tell your partner if you had a chance? Even if you don’t share the letter with anyone, the process of writing it may help you unload some of that adrenaline. If you’re angry, feel free to vent.

11. ACCEPT YOUR GRIEF. Allow yourself to move through all the emotions associated with grieving—sadness, longing, guilt, anger, betrayal, the whole range of passionate emotion that allows you to be the loving, caring person you are. Don’t try to stiff-upper-lip it. You’ll only make getting to sleep harder, prolonging the grieving process.

12. BE CLEAR. So many people will want to talk with you about your spouse and your grief. Friends will want to process their own grief by talking about it over and over. Be tough and tell them very clearly to leave you alone. Same goes for those whom who know only slightly. “I got very comfortable saying, `I don’t want to talk about this,’ ” says Naparstek.

13. COLLECT THE STUPID THINGS PEOPLE SAY. Write them down, share them with close friends, and joke about them. “I had a friend—a nurse—whose husband died of a heart attack,” Naparstek says. “I knew that she’d had a snootful of all the things people say. So I called and said, `Wanna get together for dinner? I’m buying. And we can talk about all the stupid things people say to new widows!’ “ She laughs. “We had a blast!”

14. FIND SOLACE IN ONLINE COMMUNITIES When you simply can't sleep, talk to someone who can help you deal with the thoughts running through your head, such as another widow. Log on to the Web site http://groups.msn.com/forwidowsonly or www.groww.com/Branches/branch.htm or if you're a young widow, try www.ywbb.org/index.shtml. Chat, get a cup of tea, then go back to bad.

Grief can lead to health woes if not addressed

I often appreciate Dr. Wilkes inside take on the medical community's blessings and faults in his Inside Medicine column of the Sacramento Bee newspaper. Here is a portion of today's article on complicated grief and the health issues it can lead to. He strongly recommends the medical community sit up and take notice of the risks for recently bereaved individuals to become ill, and to take advantage of the appropriative support services, perhaps even before things get out of hand. In our community these services include bereavement workshops and one-on-one counseling with trained volunteers with Sierra Hospice (530-258-3412); as well as bereavement & health information counseling with myself, Janis Davies, Cert. Whole Health Educator (530-258-0377, #2). One can also seek local services from Plumas County Mental Health, or Kathleen Hughes, LCSW (530-596-4857).

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Inside Medicine: Grief can lead to health woes if not addressed

By Dr. Michael Wilkes -
Published 12:00 am PST Sunday, January 13, 2008

Excerpts from the article published today in the Sunday Scene section of the Sacramento Bee:

Is bereavement – a profound sadness – a disease? While it probably is not, the death of a spouse ranks as one of life's most stressful events.

Research has shown that the period following the loss of a significant loved one is associated with premature death, the onset of other illnesses, intense suffering and a high use of doctor's services.

Such physical and mental ailments are by no means universal, and studies suggest that profound grief reactions (such as suicide) are more common among certain groups based on risk factors.

(The author goes on to list these risk factors.)

Perhaps we need to think about "preventive bereavement" – an attempt by the medical community to reach out early to those at risk for serious reaction to grief.

I do not mean to suggest that all bereavement requires medical attention, because it does not. Grief is a normal reaction after a profound loss. But when bereavement becomes severe, or there is reason to worry that a person is at high risk for mental or physical deterioration, then physicians, social workers, hospice workers, clergy, counselors and even an occasional prescription drug can help ease the suffering.

For doctors, the message is that the loss of a loved one should raise a red flag that there may be a need for close follow-up.

For patients, remember that you don't need to go this alone. Doctors can help you find well-trained experts who can help. (See the resources noted above.)

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Stress Breaks Hearts

Emotional Stress Alters Heart Function, Ups Heart Disease Risk

By Daniel J. DeNoon
WebMD Medical News

Reviewed by Louise Chang, MD

Sept. 20, 2007 -- Here's a health fact most of us understand better than our doctors do: Emotional stress really can harm our hearts.

Intense grief, acute anger, and sudden fear can have direct -- sometimes fatal -- effects on the human heart. And long-term emotional stress shortens lives by increasing the risk of heart disease, notes Daniel J. Brotman, MD, director of the hospitalist program at Johns Hopkins Hospital, Baltimore.

"What is intuitive to people is not necessarily intuitive to physicians," Brotman tells WebMD. "Emotional stress, conceptually, is the same thing for cardiovascular risk as physical stress. But a lot of doctors blow that off, because they think emotional stress is a psychological problem, not a physical problem."

To overcome this false impression, Brotman and colleagues reviewed recent studies looking at the short- and long-term effects of emotional stress on the heart. Their resulting report, "The Cardiovascular Toll of Stress," appears in the Sept. 22 issue of The Lancet.

"In the hospital, I see people under all sorts of stress all the time -- and I see what happens to bodies under stress," Brotman says. "Our study illustrates how important the body's stress responses are in precipitating cardiovascular effects."

Heartache, Heart Harm

Psychological disorders, personality types, and other psychological stressors are linked to various heart problems:

• People who suffer from depression, hopelessness, or a pessimistic outlook are more likely than others to suffer heart attack and sudden heart death. They are more likely to develop conditions that increase heart risk, such as obesity, diabetes, high blood pressure, and impaired heart rate.
• People who suffer chronic anxiety are more likely than others to suffer heart attack, atrial fibrillation, and sudden heart death. Their propensity for high blood pressure and impaired heart rate increases their heart risk.
• Emotional trauma -- such as the death of a spouse, mental or physical abuse, or posttraumatic stress disorder -- increases risk of heart attack and heart death.
• People with type D personalities (characterized by pessimistic emotions and inability to share emotions with others) and type A personalities (characterized by anxiety directed outward as aggressive, irritable, or hostile behaviors) are more likely than others to suffer heart attacks.
• People with angry or hostile temperaments are more likely than others to suffer heart death.
• Acute fear, grief, startling, or anger can cause "stunned heart." Wallops of emotion also can cause sudden death due to life-threatening abnormal heart rhythm.

Even when intense bouts of emotion don't kill, they may cause long-lasting heart damage.

"Most people who suffer the death of a loved one are not coming to medical attention, but that does not mean their hearts are not stunned for a period of time," Brotman says. "We doctors only see those with heart failure, or those with already-damaged hearts whose defibrillators fire. But probably, in every body, what stress hormones do today have some impact on how healthy your cardiovascular system will be 20 years from now."

It would seem to be wise for all of us to learn to deal with stressful emotions. But Brotman warns that there does not seem to be any one-size-fits-all way to do this.

"We don't have concrete evidence to suggest that if you manage your stress levels you will reduce your cardiovascular risk," he says. "People are different and have different ways of reducing stress. It is disingenuous to suggest that stress reduction is going to be simple."

Meanwhile, he urges doctors to pay more attention to what their patients are telling them when they talk about stress.

"Real-time physical effects correlate with intense emotional states," Brotman says. "We should think beyond cholesterol, beyond blood pressure, when thinking about what it means to live a heart-healthy lifestyle."

View Article Sources

SOURCES: Brotman, D.J. The Lancet, Sept. 22, 2007; vol 370: pp. 1089-1100. Daniel Brotman, MD, director of hospitalist program, Johns Hopkins Hospital, Baltimore.

© 2007 WebMD, Inc. All rights reserved.