Seven tips for Joe Biden on how not to fall asleep in public

Staying maximally alert despite insufficient sleep will take practice, patience, perseverance, and faith.

Joe Biden joined the ranks of President Bill Clinton, Hillary Clinton, Sen. John McCain, and others who were caught napping at the wrong time and wrong place.  How can we prevent this from happening again? Well, the surest and most natural cure for abnormal sleepiness is sleep, but what do you do when you cannot get sufficient sleep because of hectic schedule and unavoidable demands? Going against the might of Mother Nature, you can summon the help of these seven friends.

Seven Friends and a Foe

  1. physical exertion
  2. PREM nap
  3. light
  4. caffeine
  5. smart snacking
  6. massage
  7. faith (my all-time favorite)

And beware of a formidable foe in alcohol when faced with insufficient sleep and long days. Let us discuss them one by one.

Exertion Enhances Alertness

Regular exercise improves REM sleep and hence alertness and the executive function. Here we discuss the role of physical activity in improving alertness when sleep deprived.

Learn How to Deskercise

On average, executives spend seven and a half hours per day sitting in meetings, sitting at their desks, sitting in an automobile, or sitting in boardrooms. Our bodies do not like staying still for long periods. That much sitting causes tension to build. Muscles become tight, and joints become stiff. Alertness starts declining the longer you stay still.

One way to prevent these otherwise inevitable results of physical inactivity is to “deskercise” every hour. Deskercising will help you to reduce muscle tension and stress while helping you preserve the flexibility, strength, and muscle tone you already have. The following are some simple deskercising techniques to try:

The Wrist Muscle Stretch

Most executives spend a good deal of time in front of computer screens. Computers have become essential tools in the management of business. However, with this increased use of computers, executives are becoming more susceptible to carpal tunnel syndrome, an ailment that used to be the exclusive domain of secretaries and other office workers who used typewriters and word processors most of the working day. Carpel tunnel is a painful wrist difficulty produced by repetitive motion.

When working at the computer, stop occasionally and deskercize using the wrist muscle stretch. Not only will this give you a well-deserved break, it will go a long way in preventing carpel tunnel. Slowly stretch your wrist muscles by using a full range of motion. Joints that have become sore and stiff because of repetitive motion activity will respond to slow stretches. Don’t risk pulling a muscle by attempting the stretch rapidly. Get the full benefit of the stretch by doing it slowly.

The Pectoral Stretch

The following is an easy stretch you can do at your desk. Simply clasp your hands behind you head, and slowly move your shoulders and elbows back. Repeat this a few times. It is a great way to stretch your pectoral and chest muscles.

Wrist Flexion

Using your left palm, gently apply force to the right hand, causing the right wrist to stretch toward the underside of the right arm. Hold it there for five seconds and then release and repeat on the left hand. Repeat the exercise five times.

Wrist Hyperextension

Using the left palm, slowly apply force to bend the right hand backward. Hold it there for five seconds and then release and repeat to the left hand. Repeat the exercise five times.

Sitting Bend

In a sitting position, with your feet flat on the floor, your knees about ten inches apart, and hands at your sides, bend over as far comfortable with your hands reaching toward the floor. Hold the position for five seconds and then slowly pull yourself back into a sitting position while tightening your abdominal muscles. Repeat four times. This exercise stretches your lower back muscles and hamstrings.

Vertical Stretches

Vertical stretches provide an excellent way to reduce tension and activate all of your major muscle groups. With your feet shoulder-width apart, lift yourself upward on your toes and extend your arms over your head. Reach each hand as high as possible for about seven seconds and then relax. Repeat four times.

Get Up and Walk Around

Sitting too long can have several negative effects. It puts stress on the lower back and can lead to muscle atrophy and diminished flexibility. It’s important to get up and walk around at least once each hour. A ten-minute walk around the office would be excellent. But, when that’s not possible, shorter walks to the water cooler, filing cabinet, or restroom are better than nothing.

Even when you’re involved in meetings, seminars, or workshops, get up at least once every twenty minutes and move around. You’ll feel better, you’ll be healthier, and you’ll sleep better.

  • A PREM (Patel’s REM) nap can improve alertness for three hours. Studies have shown that a fifteen-minute nap can improve alertness and last for almost three hours. 
  • Massage especially when combined with a PREM nap can improve alertness because it relieves muscle aches, back pain, headaches, burning in the eyes, and other distracting physical symptoms precipitated by sleep deprivation. Untreated, these symptoms can drag your energy level and your alertness down.
  • Caffeine has alerting property, but it has the duration of action of twenty-four hours, so a cup of coffee consumed at one o’clock is still in your bloodstream at midnight when your brain is trying to get into REM sleep. Because of this reason, caffeine should not be used indiscriminately. It should be used as a medicine, at the right dosage, at the right time, and for the right reason. The surest indication for caffeine is driving when sleep deprived. This can be lifesaving.
  • Bright light has tremendous alerting influence. Use this to your advantage. Sit facing the window. During long meetings in the boardroom, look up at light often. Especially on cloudy days, put a bright light lamp behind your desktop while working on it. Every fifteen minutes, turn off the PowerPoint presentation and turn on the lights.
  • Small protein snacks every two to three hours will maintain your energy and alertness while eating a large starchy meal will degrade your alertness. Grilled fish or chicken is fine. Avoid rice, pasta, and dessert.
  • Spiritual support has helped me the most during my post-call days in the clinic. Going from one exam room to next, I would look up and ask for divine help. “Give me energy, my Lord, to serve my patients well.”
  • Even the legal limit of alcohol will impair your leadership when sleep deprived. Avoid even a small glass of wine or a beer when sleep deprived. Resist that temptation.

LAMP will improve your alertness and hence your life significantly. It will help you avoid disastrous decisions too.

Here is the summary of what we just discussed.

Leader’s Alertness Maximization Plan (LAMP)

  • Keep moving.
  • Face the light.
  • Take a PREM nap.
  • Get a relaxing massage.
  • Snack smartly.
  • Consume caffeine judiciously.
  • Seek spiritual support.
  • Avoid alcohol.

This blog post is dedicated to my good friend Mahesh Patel MD who has devoted his life to saving premature babies in Bismarck, ND, and millions like him who have spent nights after nights serving others. God Bless You All.

Adopted from the book “Sleep Well, Lead Well” now available on Amazon Kindle and at



2 Comments so far. Leave a comment below.
  1. Fabulous advice, as usual Dr. P. I especially like the “deskercises”. I would write more but it is time for wrist flexions! Thank you so much.


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