A 4-year-old to her mother: "Mom, do you believe in God?"
"I'm not sure if I do."
"Well, does Daddy believe in God?"
"No, Daddy does not believe in God."
"Not even at night?"
Even at the tender age of 4, we all know there is something very different about the night. It has something to do with the settling darkness. But there is more to it.
For many people, problems--both physical and emotional--seem worse at night. From the parent who overreacts to a child's 101-degree temperature to an adult who panics at 2 a.m. about a
business report due next month, the night can seize reality and warp it.
"There are a lot of psychological reasons why things seem worse at night," says Dr. Barbara Korsch, a pediatrician at Childrens Hospital of Los Angeles, who supplied the story of the 4-year-old. "At 2 a.m., everything seems so intolerable. We're isolated with our thoughts. It's the solitude, the loss of other stimuli. Structured, everyday activities are a great support to people."
Mental-health experts and sleep researchers say there are several explanations why problems become exaggerated at night.
For one thing, the night and its problems may loom large simply because of the stillness. During the day, we don't notice how a ringing telephone or a child's needs divert us from pain, anxieties and problems.
At night we are free to drift into "worry cycles," says Eric Klinger, a psychologist at the University of Minnesota, Morris Campus, and the author of a book on daydreaming.
"Throughout a 24-hour cycle, peoples' thoughts get pushed around by emotional cues. Your mind jumps around depending on whatever reminds you of something. Your mind wanders off pretty fast," he says.
At night, without distractions, he says, "You're more likely to get into a circular thought pattern, where you keep staying on that subject. It becomes a vicious circle and your emotions become more intense."
Moreover, physical fatigue translates to a weakened defense against an invasion of relentless thoughts.
"Night is when people start to sag," Klinger says. "When your arousal system is low, you are more at the mercy of spontaneous thoughts. They may be less inhibited and you have less control over what goes on mentally."
The lack of distractions is why chronic pain sufferers dread the night, says Tom Norris, 45, of Los Angeles. Norris has chronic back and leg pain resulting from radiation treatments for cancer years ago.
"It's like as the noise of the day calms down, the pain doesn't," says Norris, who leads a Santa Monica support group for the American Chronic Pain Assn. "Your mind stops dealing with other things in life and the pain creeps out of the corner of your mind and becomes Frankenstein."
In a real dark night of the soul it is always three o'clock in the morning.
--F. Scott Fitzgerald, "The Crack-up"
Alone at night with a problem, it's sometimes difficult to know what to do. Call Mom? Call the doctor? Go to the emergency room? Go back to sleep? Pace? Pray?
"It's difficult if there isn't extended family around," says Korsch, the pediatrician, who notes that parents of sick children are particularly vulnerable at night.
"If you are an inexperienced parent or a single parent, you are already alone. There is much less social support. Who is going to call someone at 2 a.m.?"
Few people pick up the phone first. Children wake up sick and often panic at their symptoms, triggering the same reaction in their groggy parents. As a result, there are many unnecessary emergency room visits, Korsch says.
Amparo Rodriguez of Santa Ana has made many midnight trips to the emergency room with her 7-year-old son, Ruben Vasquez, who has severe asthma.
"I used to be a real heavy sleeper, but since Ruben was diagnosed with asthma, it's one cough and I'm awake," Rodriguez says.
She tries to remain calm because she knows Ruben won't be.
"Having an asthma attack at night is really frightening for him. He'll wake up coughing, and he can't catch his breath. He's already scared of the dark. So he just panics more at night."
After-hours medical clinics that cater to such events as asthma attacks and earaches have been one of the kindest inventions of the night, but this trend has seen its heyday, Korsch says. Health-care reform measures frown on the inefficiency and high costs of operating late-night clinics.
"It's going to become even harder to get access to health care when it's out-of-hours," Korsch predicts.
Even now, there is a witching hour in doctors' offices: 5 p.m. on Fridays.
"People suddenly take their problems much more seriously because they get anxious about the night. They know they won't be able to get the doctor at night or on the weekend," Korsch says.
Bodies don't break down during daylight only. In fact, fevers tend to rise at night. Croup, a respiratory infection common in young children, flares up at night and can restrict breathing. People die more often during the early morning hours than at any other time.
The perception is that night is somehow riskier. Susan Cefinger, a night nurse at Childrens Hospital, hears it all the time: "If we can just get through the night. . . ."
"If you look in the research, a lot of deaths occur in the early morning hours. So there is always a fear of that when someone has been critically ill all day," Cefinger says.
She is a nurse in the bone-marrow transplant unit, where parents of very ill children often sleep on cots and night becomes a time of postponed reflection after the chaos of the day. So, it's especially difficult to deal with a crisis when one is yearning for respite at night.
"People think of night, with the dark and quiet, as more of a calming time, but if a child is sick all day that doesn't mean that, when nighttime comes, the child will be OK and get some sleep."
In no place does the morning seem so welcomed as in a hospital. The intrusions, fatigue and fears of night fade with the sunrise.
"You get a sense of 'OK, this is a new day.' It's another day for renewing hope of complete healing," Cefinger says.
You can also blame your body when nights play devilish tricks on your mind, says Dr. Dale Edgar, a researcher of circadian rhythms at the Stanford Sleep Research Center.
Fatigue is one factor. When you've been awake all day, it becomes much harder to function at night.
"Sleep deprivation exacerbates everything," agrees Norris, who deals with the chronic back and leg pain. "It's like someone put too much on your plate."
Rested or not, the human body is simply not at its best at night, Edgar says. Research shows that when body temperature is at its lowest, the person inhabiting that body is at his or her worst.
"For most people, the body temperature is hitting its minimum between 3 a.m. (and) 6 a.m. It's that time of day in which both mood and performance hit their lowest," Edgar says.
So, if you are forced to wake up at 4 a.m. and you're cranky and you drop the coffee pot, blame your body temperature, which may be 1 to 1.5 Celsius (about 2 degrees Fahrenheit) lower at night, Edgar says.
"But it's not clear that it's the temperature that is responsible for mood impairment and performance detriments," he adds. "The temperature is more of a marker for your body clock."
Our body clock, which resides in the brain, governs alertness. And, generally, it dictates sleep from roughly sundown to sunrise.
When you have to deal with problems at night, "You are out of sync with your external environment. You just won't function as well," Edgar explains.
"Who will make more light?" Wind asked.
"I will do so," said Moon. Then Moon shone down, but his light was not enough. There was more light on the new Earth, but it was still night."
--From "Keepers of the Night"
Things may seem worse at night because we have evolved from societies where things actually were worse at night, says Joseph Bruchac, co-author of the book "Keepers of the Night" (Fulcrum, 1994), which teaches children about the night environment in order to alleviate their fears. Much of the material is drawn from Native American cultures, where the night was appreciated as part of nature's balance.
Long age, Bruchac says, "a walk away from . . . the campfire was, rightfully, a time for caution and heightened awareness."
For modern people, "The reflex is the same when caught unexpectedly in an unfamiliar place at night. Tiny muscles try to raise the fur that we no longer have, producing goose flesh as a shiver runs down our spine."
We are instinctively more cautious at night, Bruchac says, because we cannot see as well.
"We rely on our senses to feel secure. But at night, our sense of sight is altered. In urban cultures, that is the sensory apparatus that we seem to rely on most. We don't listen well anymore. We don't use our sense of smell. So when sight becomes limited, the darkness becomes even more frightening," he says.
In his book, Bruchac retells stories about the night from Native American cultures.
"A good story sees you through the long night," he says. "It helps you conquer your fears or honors your logical fears."
The stories teach a simple truth about the night, Bruchac says.
"You have to be able to recognize that the darkness is simply the lack of light, not the presence of evil," he says. "You can see things within yourself and around yourself. You don't need your eyes to see them. If you have self-assurance and understanding, the darkness does not have to be a fearful thing."