When it comes to sleep and energy, which bird are you?

Hospital rounds are usually morning visits from a patient’s healthcare team to review their condition, treatment plan, and progress. The patient is examined, vitals are checked, and additional tests are ordered if needed.

Tests can range from blood work or imaging to more invasive procedures such as cardiac catheterization. Depending on how stable or critical a patient is, they can be scheduled for any hour.

Nurses continue to check vitals, usually every four to six hours, and medication or other treatments are provided as scheduled or as needed. It may feel like there is no rest for the weary in a hospital, but these necessary evils are steps toward healing, recovery, and ultimately, being discharged.

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March 19, 2025 Columns by Jen Cueva

Listening to my body to better prioritize health and joy with PH

If you’ve been diagnosed with pulmonary hypertension (PH), experiencing rest at home may also be sporadic. Your survival and quality of life will rely heavily on medical compliance.

Medications will be taken at specific times every day and night, and follow-up appointments, routine checkups, tests, and procedures will be scheduled to monitor progress or decline.

The battle of the circadian rhythm

Are you a lark or an owl? How does your internal clock affect your ability to handle these medical experiences?

I’ve learned through online research that a circadian rhythm is your body’s internal clock, which helps control your daily schedule for sleep and wakefulness. It varies from person to person and can affect digestion, temperature regulation, and the release of hormones. How well we abide by our circadian rhythm can affect our mood, health, and other important factors of life.

Our circadian rhythm can be influenced by food intake, medications, metabolism, stress, physical activity, social environment, temperature, and age, but what I find most interesting is that our true circadian rhythm is genetically predetermined. In other words, I was born a night owl with blue eyes and chestnut brown hair.

According to the Harvard Medical School’s Division of Sleep Medicine, “Humans are a diurnal species, meaning that we are generally active during the day and sleep at night. Some individuals feel more awake, alert, and able to do their best work in the morning. We typically refer to these people as ‘larks,’ or morning-type individuals. Others have a hard time waking up or feeling alert in the morning and feel that they are most productive in the evening or night. We refer to these people as ‘owls,’ or evening-type people.”

I think most people battle with their internal clocks because society doesn’t care which bird you are. You are expected to be on time and present for school, work, and appointments, even if they begin early in the morning. Friends and family won’t always schedule social events around you, so you will sometimes find yourself out past your bedtime.

Such is life, but when you add serious health issues to the mix, it’s time to break out the spoons.

How many spoons do you have?

I encourage you to read the full spoon theory written by Christine Miserandino, but to summarize, imagine you have 12 spoons, and each one represents a unit of energy. People with chronic illnesses must ration their spoons throughout the day to manage their symptoms and complete tasks.

Sometimes spoons are already used up before the feet hit the floor due to restless sleep, waking up late, missing a morning dose of medication, or experiencing symptoms or medication side effects. By the time a PH patient is showered and dressed, they might be down to six spoons. The day has barely started, yet plans are already changing. For example, instead of meeting a friend for morning coffee, those spoons of energy are now reserved for an afternoon medical appointment, leaving the person with perhaps three spoons to get through dinner and a bedtime routine.

My 25-year-old son, Cullen, has always been a night owl. Since receiving a heart and double-lung transplant in 2014, he has a lot more spoons to get him through the day, but when he was living with PH, as his caregiver and a mutual night owl, I found ways to help him reserve his spoons and respect his internal clock.

When he was hospitalized, I requested morning rounds to take place in the hallway when possible so that Cullen could continue to sleep. I’d meet the team with questions and updates I’d prepared the night before, and review their responses with Cullen later in the afternoon.

At home, I tried to schedule medical appointments and tests for the late morning or afternoon when I knew Cullen would be more alert.

When Cullen was a child and his circadian rhythm and PH symptoms kept him awake late at night, I’d rub his back and sing to him until he fell asleep.

As a caregiver, I became a hybrid of a lark and an owl, but that is because I had spoons to spare. What about you?

Note: Pulmonary Hypertension News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Hypertension News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to pulmonary hypertension.