Friday, December 23, 2005

Five Years of Insomnia




I woke at 3 a.m. for almost 3 years. Three times in those three years I slept what I now call through the night—straight through until 4 or 5 pm, once after a long walk that left my muscles twitchy and sparking like Pop Rocks, another the first time I took Sonata my g.p. prescribed, and the third a fluke or sheer exhaustion even the insomnia couldn’t interrupt. After each of these nights, I felt clearer-headed but physically weaker—a mild sore throat or headache, a few more muscle aches than usual, yawning by 5 pm instead of 8.

Year 4 was more irregular. 3 days of sleeping until 4 or 5 followed by a 2 am awakening and a 3 am awakening, another night of sleep (which still ended between 4 and 5 am), a 1 am wake-up, a 3 am wakeup, and a stretch of 5 days I woke no earlier than 4:30 am no matter what time I went to bed, at 8:30 or 11 or in between. I’ve tried everything but sleeping pills twice. In year 5, I started trying it all over again. I’m still waking up at 3 or 4. I consider myself lucky if i get to 5 am.

“Sleep hygiene” is the first front of attack suggested. Hygiene makes it sound dirty, like the insomnia is caused by sour sheets, unwashed hair, unclean thoughts about sleep or beds or other people or the president. It implies your sleep problems are all bad habits acquired that the body and mind need to be purified of. I hate sleep hygiene. It seems developed by someone who had nothing to do but regulate sleep; if all I had to do in a day was regulate my sleep, I’m sure I’d sleep 12 hours a day every day 7 days a week:

Establish a regular sleeping schedule

If I could do that, if I could wake at the same time every morning, I’d have no insomnia and if I could wake at the same time every morning, in less than a week I’d go to bed at a regular time since I’d know when I’d be getting sleepy, not guessing I’ll feel tired and yawny sometime after lunch.

Get out of bed if you are awake for more than 15 minutes, read or do something quiet and/or boring until you are sleepy again

I hate this one the most. Only someone who sleeps through the night almost every night thinks that getting out of bed, away from the anxiety about not sleeping, does any good. Or that reading is boring. When I wake in the night I am AWAKE. Reading doesn’t make me sleepy. TV is said to be too bright and stimulating. Physical activity, like sweeping, makes me more awake. What usually happens is this: I wake at 1, I roll back and forth a few times, hoping to feel sleepy, trying to avoid looking at the clock. Then I finally do. Lately it’s said 1:25 or 1:17 more often than 2 or 3. I wait another 15 minutes. Sometimes I feel too physically comfortable or exhausted to get up right away but eventually I do. I go to the bathroom sometimes. I sit on the sofa and read. Maybe it’s a quirk that I don’t find reading boring or don’t have books in my house I think are boring, plus, my reaction to a boring book is to throw it across the room, hopefully into the garbage, and pick up an interesting book. But trying to stick to the sleep hygiene plan for the 20th time in 5 years, I sit and read. 2:30 not a single yawn. 3:30, still not tired. By a quarter to 4, I’m sick and tired of sitting on the sofa and tired of reading and tired of being the only person in the house awake. I go back to bed. I look at the clock only once when I get back in bed. Then I wait. I try to relax. I try to empty my mind. Even with a relaxed body and empty mind, I am awake. By 5 am, sunlight haloes the Venetian blinds and I am still awake. By 5:30, I get up, get dressed in stinky clothes and go for a walk. By 4 PM, my eyes are sometimes sore with tiredness. By 6 PM, I’m yawning my way through dinner. After my daughter goes to bed, I sit or lay on the sofa, groggy but awake, occasionally slipping off into a 10- or 30-minute nap, sometimes completely unconscious until my husband, around 10 or so asks me if I am ready to go to bed.

I fall asleep almost immediately; I always feel like I have been awake for 3 days instead of 1. I hope I am tired enough this time to sleep to 5 am, a full 7 hours, but I wake again at 1 after 3 hours of sleep (or 4 or 5 if I count my sofa time). I try to stay awake past 10 at night to push my sleeping time forward but I can’t make it past 10:30 with any coherence. If I hold out until 10:30, I find I drop my toothbrush brushing my teeth or don’t seem to have the muscle strength to take off my bra. I weakly toss clothes that end up not in the dirty clothes hamper but stuck on the Venetian blinds, half in the closet, hanging off the edge of the bed a foot away from me. And I still wake at 1. Or 2.

Don’t stay in bed longer than you need to sleep

Another piece of advice from someone who has never had chronic insomnia. It’s like “cheer up” advice from someone who’s never been depressed. If I could go to bed at midnight and wake at 5 feeling like I’d slept, I’d do it. If I go to bed at 10 and wake at 3, I’m incoherent with sleepiness by 10 am but can’t take a nap (see the next bit of sleep hygiene “advice”) because I’ll ruin what sleep I do get. I have gone to bed at midnight and woken at 3 am. I have gone to bed at 1 or 2 am and woken an hour later, painfully tired, and stayed awake the rest of the night, except for 20-minute intervals when I pass out. And getting out of bed for 1-3 hours a night means I’m NOT spending too much time in bed, right?

It’s not just about sleep. It’s about the pain I feel in my body from too little rest. Burning pain in one shoulder. Hip stiffness. A dull headache though my sinuses are clear. Yawning if I sit still more than 10 minutes. When I read during the day, I nearly fall asleep, the words blurring until I see just white space and shake my head like I’ve been in a trance. Stiffness like I need to be stretched on a rack.

Reserve the bedroom for sleep and sex

As soon as the insomnia started, I stopped reading in bed even though it relaxed me more than made me alert or tense. Why do these guidelines seem to be written by people who think reading is boring, sleep-inducing AND too stimulating? And sex? I’m afraid I’ll fall asleep and make a comment that I don’t mean. There’s no TV in my bedroom (most people I know have a TV in their bedroom and sleep like rocks 6-9 hours a night).

Make the bedroom comfortable

Another guideline that pisses me off—do you really think I am so stupid as to complain I can’t sleep because the window is open and sunlight streaming in? Because my stereo is on? Because I wear a bike helmet to bed? I sleep as badly with fans and no AC as I do with central AC. I sleep as badly alone as I do with my husband deeply unconscious next to me. Being furious at the guidelines don’t help my sleep.

Relaxation techniques

An admitted weakness. I do not relax easily. I have tried for over an hour to relax, instead of getting out of bed, and it makes me feel like Sonata—relaxed enough to not be able to move, groggy enough to think disjointedly but never sleepy or asleep.

Find your optimal sleep length

How did I do this with insomnia? This implies I can sleep, right? And that I just get too little or too much? And I hate sleep diaries. They tell me what I already know—that I woke at 2, 3 or 5 and felt lousy 6 days out of 7.

Don’t nap

Even as a child, I didn’t like to nap. The only times I sleep during the day are when I have the flu and only the first day or two when I feel worst. Yet when I have been awake since 2 am, gotten a 2d grader ready for school, prepared for and taught 3 classes and still have 2 office hours, 28 emails, a meeting and 40-plus papers to grade, a nap seems like a vaguely religious experience. Instead I yawn, snack, smear eucalyptus oil on a tissue and breathe until I can feel the smell coming out of my eyeballs and dig in for the rest of the day. How do you resist a nap without caffeine? Another indication these guideline writers don’t know what the fuck they are talking about.

Make sleep a priority

Another one I hate so much I can taste sulfur. If it wasn’t a priority, would I care? And what does that mean? Do I put sleep before my daughter? Her homework or her dinner? Before work? Should I cancel classes? Not wash my hair in favor of sleep? Remove windows from the bedroom—though that doesn’t make a difference because I wake up in the middle of the night when it is already dark. Put sleep before my husband? Tell him it’s over because I have got to focus on all this sleep I am not getting?

Replace your coffee break with a 20 minute nap

Aren’t I not supposed to nap? And what coffee break? You mean the bag of microwave popcorn I have while talking to a student, with 3 hovering outside, and the chair of my department emailing and phoning? What coffee break? Who are these people?

Depression

If you had only a dozen nights of solid sleep in 5 years, you’d be depressed, too, pissant bitch.

Put away the clock, don’t obsess about the time you spend awake

If I put away the clock, how the fuck am I supposed to know I’ve been awake more than 15—20 minutes? How do I know what time I woke up if there is no clock? If I do end up falling asleep again, I need the clock to know if I have even fallen asleep. When I do go back to sleep at night, the only indication I have that I slept is the time on the clock. I “wake” every day tired, cranky, slow, craving caffeine or some other pick-me-up to get me moving. Once I’m moving, sheer force of will keeps me awake and going (I said “awake and going,” not “alert”).

I yawn everywhere. 10 am doctor appointments, 5 pm faculty meetings, dinner, lunch, over the one cup of tea I allow myself every morning (once I cut down from 3 cups), while reading to my daughter, while driving, esp. mid-afternoon when I pick her up. When my head nods beyond my control while I’m driving 40 mph, I get scared. By my second or third yawn in conversation, usually so big my eyes water and I have to dry them to see, I say I’m not bored or forgive me, I’m a chronic insomniac. I yawn all day and night except in the idle of the night when I have an alertness I wish I had mid-afternoon driving across town with my kid in the back seat.


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2 Comments:

Blogger Professor Zero said...

It is more fun to read your site than it is to write my paper, so I will allow myself to browse for 15 more minutes. I didn't read the Sunday papers, so...I guess I can say your site is taking their place today.

I'm not an insomnicac, and I considered myself a heavy sleeper until I met my husband. He announced that I was actually a light sleeper; when I saw him sleep, I understood what he meant. He really is out like a light. So is my cat, and this is weird for a cat.

Anyway, sleep problems aren't my regular issue, but I get them. I get them from being overtired. In my job, which is similar to your job, I have to work while exhausted;
I go into overdrive to get through it, and then cannot relax. This causes me to wake up at 4 AM, etc. etc.

Exercise, and I mean lots of exercise, helps a lot, as does relaxation time during the day. If, for instance, the weather were reliable and I could go down to the Fly every afternoon at four and dreamily watch the ships...and then take a long long run along the levee...and then have a relaxed, pleasant dinner conversation instead of the ones I have, in which we are both vituperating about our jobs, the legislature, etc. ... and then take a pleasant stroll ... and then do some interesting writing ... and then lie in bed, and read something interesting ... and the have sex ...
well, if all of this could happen each day, I would then fall asleep and sleep and dream and wake up refreshed.

I don't have that life, though, and sleeping medications don't lull me any more than I can lull myself. Sometimes I just get up and give up on sleeping. Other times I decide to just doze.

But what DOES work, when I can get it, is XANAX. This is hard to get because it is supposed to be for anxiety and it is supposed to be addictive. But a small amount of it puts me directly to sleep. I sleep as I did when I was a teenager, and wake up refreshed, and with no body pain...

Sun May 21, 02:20:00 PM  
Anonymous Anonymous said...

I think you are hilarious. I am 25 years old and I spent Monday and Tuesday at the sleep clinic. It was horrible. Anyway they told me I have chronic insomnia and circadian rhythm blah blah blah. They said to try yoga and everything short of standing on my head. I don't think it will help. I mean some people are just built different. Why do we all have to fit into the mold of this society. I am tired of always being compared to this type A personality that I am not. I remember being in 1st grade staying awake for two days. I don't know why I have just always been like this. You can turn all the lights off and I am still awake. Except during the day I could sleep all day. Anyway good luck fellow insomniac!!! Sweet dreams!!! J/K

Thu Sep 14, 12:21:00 AM  

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