I need a nap!

I was never a napper before my heart attack. Naps, I used to believe, were only for old people like my Dad, whose custom was to doze off after lunch for half an hour or so on the LaZBoy recliner in our farmhouse living room. But now, I love naps! And because I live with ongoing cardiac symptoms (thanks to a subsequent diagnosis of coronary microvascular disease), I need those naps. When I skip my daily afternoon nap, I pay for it later by feeling sick and shaky.

Author/napper Toni Bernhard recently described in her wonderful Psychology Today column why naps are so important:

    “Most people who are chronically ill benefit from scheduling at least one rest period into their day because it helps keep symptoms from flaring.” 

Yet paradoxically, she also notes that taking a “time out” by pausing to rest can be one of the hardest challenges that chronically ill patients face.

Sometimes we just don’t want to admit the need to rest, and sometimes, if we’re still in the workforce, we don’t even have the option to rest when we need to. But as I wrote here, humans (whether they are living with a chronic illness or not) experience two periods of what sleep scientists call “forceful, persuasive sleepiness”:

  • around 2-4 a.m.
  • around 1-3 p.m.

An afternoon nap during that latter period, like the traditional siestas of hot weather countries, allows us to grab some of the benefits of the sleep cycle without committing to a full eight hours.

Toni offers two possible reasons that may explain why so many chronically ill people resist that need to nap when other people are around:

  1.   We don’t want to miss the opportunity for in-person contact

Toni describes her own life with chronic illness as pretty isolated.

”  When people come over, it’s special, even though I can only comfortably hang out for an hour or two. Most of the time, I go over the limit that my body can handle. When I do this, the symptoms of my illness start to intensify, but I ignore the signals because I’m enjoying myself so much.”

When two family friends came over for an early dinner recently, for example, she was having such a good time that she ignored her husband’s prompts that it was time for her to lie down. (She says he can always tell when it’s time because he’s spent years observing changes in Toni’s face and body posture that tell him she’s used up all her energy stores). 

“Because I stayed too long, I was unable to go to a wedding two days later – a special event for me personally because, not only have I known the bride since she was born, but my husband was conducting the ceremony. Lying on my bed during the event, I realized that had I left the Friday gathering when I should have, the likelihood was high that I could have gone to the wedding, even if just for a short time. Hopefully, I’ll do better in the future.”

2.  We’re concerned that others will judge us negatively if we get up and leave the room.

Several years ago, a person who’d been visiting Toni and her husband (who is also named Tony), said in a negative tone to her: “You just disappeared!” After that incident, she started to wonder if she should leave the room when she needs to rest:

   “I became reluctant to leave a social gathering because I was afraid people would think I was being rude and anti-social (my illness is invisible to all but the few who are with me a lot).

Even though she acknowledges that she could simply say something like, “Excuse me, but I have to lie down,” she also hates interrupting “especially with something that switches the topic to my illness.”

But most of the time, she says she’s finally reached the point where she doesn’t mind negative judgement for leaving when she needs to rest. She sees this as an act of self-care and self-compassion – and a top priority for all of us.

But sometimes, we also resist resting even when we’re alone. Here are Toni’s thoughts on two reasons for this, too:

♥  Resting brings our symptoms to the forefront of our attention because we’re no longer distracted by the world around us.

Sometimes, says Toni, she can put off lying down to rest because, when she does, she immediately feels her symptoms more intensely (for her, that typically means pain, heart palpitations, or a headache).

“But, of course, by not resting when my body needs to, those symptoms are already intensifying; this, in turn, increases my resistance to lying down since lying down brings those symptoms to the forefront of my attention. It’s a vicious cycle.”

♥  Resting goes against our cultural conditioning that we should be doing as much as we can at all times.

Toni reminds us that we live in a culture that values doing over being.

”     I was taught that I wasn’t making the most of each day if I wasn’t working hard all the time, and that resting or napping was a sign of weakness.”

But she now believes that, for those who live with a chronic illness, “making the most of each day” does in fact include resting or napping. This may require us to overcome years of cultural conditioning and habit, although she adds:

“It’s definitely worth the effort for all of us to change this harmful habit.”

It may be especially worth that effort to get into the habit of napping in order to benefit our heart health. Research published in the Journal of Applied Physiology suggested that an afternoon nap can provide cardiovascular benefits, including lower blood pressure. Timing is also important, and so is being able to actually fall asleep (not just lying there resting); the time period between lights out and the onset of actual sleep was associated with the largest acute reduction in blood pressure.(1)

As I wrote here, a few basic guidelines if you’re a novice napper might help:

  • Best nap length: short. Naps for longer than one hour will make it harder for you to wake up and resume your daily activities – even a 20 minute snooze can enhance alertness, concentration, mood and coordination. Try not to nap too close to bedtime so your normal nighttime sleep won’t be affected.
  • Best position: lying down.  But if you’re not able to make it to a bed or a couch, it is possible to nap in a chair; it can, however, take longer to fall asleep sitting up.
  • Best surroundings: dimly lit, safe, quiet, and just a bit on the warm side – but not so warm that you slip into a too-deep sleep. Sleep masks offer both the darkness you need as well as gentle pressure to relax tense muscles around the eyes. White noise like a fan or quiet music in the background can help mask noisy distractions from those annoying people who are not napping.
  • Best state of mind: a nap intention, such as “I will relax into a 20-minute nap.” Allow yourself to disconnect your thoughts for a few moments, breathing deeply and steadily. Set an alarm for yourself so you don’t snooze beyond your nap goal.

Toni Bernhard was a lawyer and a law professor for 22 years at the University of California-Davis until a serious chronic illness forced her to retire. Her three highly recommended books are How to Be Sick: A Buddhist-Inspired Guide for the Chronically Ill and Their Caregivers,  How to Wake Up: A Buddhist-Inspired Guide for Navigating Joy and Sorrow, and How to Live Well with Chronic Pain and Illness: A Mindful Guide.   She writes a regular column in Psychology Today, called Turning Straw Into Gold: Life Through a Buddhist Lens, and lives in Davis, California with her husband Tony and their gray lab, Scout.  Visit www.tonibernhard.com for more information about her writing.

(1) G. Atkinson et al., “Acute Changes in Cardiovascular Function During the Onset Period of Daytime Sleep: Comparison to Lying Awake and Standing”, Journal of Applied Physiology,  2007 Oct; 103(4):1332-82007.


Q: What’s your position on napping?


NOTE FROM CAROLYN: In my book, A Woman’s Guide to Living with Heart Disease (Johns Hopkins University Press, 2017), I included much more about how we learn to adapt after becoming a heart patient. You can ask for this book at your local library or favourite independent  bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from Johns Hopkins University Press (use their code HTWN to save 30% off the list price).

See also:

Still too tired to put away the Halloween costume…

Are your sleep problems linked to heart disease

Sleep problems can lead to heart problems in women

In praise of the afternoon nap

25 tips to manage the crushing fatigue of heart disease

Exhaustion: the “leaky emotion” of heart disease

15 thoughts on “I need a nap!

  1. Good post (as always) Carolyn. I frequently nap, I frequently sleep 10 hours/night. Unfortunately, I never feel rested since I do not get restorative sleep.

    I too have been reading a lot on inflammation and its link to many conditions. I suspect that when the body/mind goes into disequilibrium because of ANY kind of “assault” there are repercussions that science hasn’t even thought of, much less explored.

    Liked by 1 person

    1. Hello Judy-Judith! Just curious – it sounds like you have had a sleep assessment done? Any clue about that 10-hour non-restorative sleep issue?

      You are so right about this disequilibrium/assault business: yesterday, I slipped on a rain-soaked curb while out with my Wednesday morning walking group. Down I crashed to the sidewalk in an ungracefully embarrassing heap! This was more shocking than damaging – it was only much later at home that I started *feeling* my right hip, right knee and both wrists that had somehow absorbed most of the fall. Although uninjured, I could not believe how immobilized I felt – everything hurt, including my hair. We adults are just not used to falling down on the sidewalk like kids are…


  2. Dear Carolyn,
    I have followed your blog for 4 years. I do not have heart disease but had 2 cardiac workups for sudden hypertensive episodes with palpitations. That was after a long time of being told to “take a Xanax”, even though I was unable to eat and was losing a pound a week.

    What I actually I had was H. Pylori gastritis diagnosed by endoscopy.

    Now, medical personnel do not seem to believe such two things can be related. I believe !! However, after being successfully treated for the H.Pylori, all symptoms gradually subsided. Persistence toward correct diagnosis is paramount.

    Yes, I nap for dx. Fibromyalgia, spinal stenosis and facet degeneration, and psoriatic arthritis. Toni’s scenario of what happens if she does not listen to her body is spot on for me also.

    Thank you for all that you do. I am a retired RN. Still love to learn and to get the word out via your blog.

    Liked by 1 person

    1. Thanks so much, Carol. I just love hearing from longtime readers (especially when they’re nurses!) I was just reading about the link between heart disease and inflammation. H. pylori bacteria are apparently suspected to be organisms that may incite this inflammatory response. And YES we can have more than one condition at the same time! Best of luck to you…


  3. I have been sleeping 11 hours per night, and I do nap. My condition has been so much better. My hubby think I sleep too much. How much is too much when you have Coronary Artery Spasm and Microvascular Disease? I wonder sometimes. I feel like I could sleep lots more.

    Liked by 1 person

    1. Hi Sue – I’m not a physician so can’t answer that specific question (how much is too much?) for you, but I can tell you generally that if you can say “my condition has been so much better”, that seems to be a good sign. Every person is different, and every marriage is different (e.g. is your hubby saying you sleep too much simply because it’s more than he sleeps? More than he’s used to seeing you sleep? Because he wants you to go out and do things with him you’ve been able to do in the past that you’re now too sleepy to do? People who do not normally experience this level of fatigue find it almost impossible to understand what it’s like – so you need to communicate clearly with him about your unique needs now since your CAS and MVD diagnoses.

      Personally, every morning after I’ve made the bed, I look at it longingly, wishing I could just dive back under the quilts and sleep some more! On the other hand, I have said YES to certain functions even knowing I was going to be utterly wiped out afterwards because I figured “I’m going to be pooped later whether or not I do this, so I might as well do it and have fun!” Naps are great – but you have to squeeze in some quality life in between to keep yourself grounded and happy.

      Liked by 1 person

  4. Toni Bernhard….where have I heard that name before?……and then I realize that I am currently (as current as yesterday) reading her book, “How to be Sick”!! I like it very much. It is like a support group for me: someone else’s experience. I long ago gave up the notion of remembering the most current things!!

    Liked by 1 person

    1. I loved reading “How To Be Sick” too, Pauline! Speaking of forgetting authors’ names, I have taken out Guy Vanderhaeghe’s book “The Englishman’s Boy” out of the library THREE DIFFERENT TIMES! The last two times, I stood there in the library reading the back cover blurb thinking, “This sounds good!” – but it was only once I was back home settling in with my new library book that, about two chapters in, I thought “Hey… wait a minute…” And this happened not once, but twice!


  5. There was a point in my life where I would ignore the signs of fatigue and refuse to rest. But now my body forces me to stop and nap. And I am more mindful of napping and resting when I should, because the cost is too high otherwise.

    Liked by 1 person

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