Insomnia
What Do You Mean By ‘A Good Night’s Sleep’?
People are always talking about getting a good night’s sleep. I don’t think that I ever get one of those. If I’m lucky, I’ll get about half a night’s sleep. But I wouldn’t necessarily label it ‘good’.
On a decent night, I’ll go to bed at 10:00 pm, and wake up about noon the next day. Yes, that’s fourteen hours. No, that’s not fourteen hours of sleep.
What typically happens is that I’ll sit there awake for several hours before finally dropping off to sleep. Then I’ll sleep for a few hours. Then I’ll wake up again, and end up catnapping for the rest of my stay in the sleeping chair.
And that’s with prescription sleep medications. Without them I just sit there awake until the next morning, and finally succumb to exhaustion sometime the next day.
I’m not even going to talk about the weird dreams in this post. [Memo to myself: Add “The Weirdness of Dream Time” to the list of Blog Topics.]
I don’t ever seem to get what my therapist refers to as ‘restorative sleep’. Normally when I wake up after a night’s sleep, I’m about as exhausted as you’d get at the end of a long hard day of work.
CFS / SEID, etc.
Back in 1993, I was diagnosed with Chronic Fatigue Syndrome. (Also known as Chronic Fatigue Immune Dysfunction Syndrome, Myalgic Encephalomyelitis, and most recently, Systemic Exertion Intolerance Disease. Whew!)
One of the symptoms of CFS / SEID is ‘unrefreshing sleep’. Yeah, I’ve got that. Other sleep-related problems include having difficulty staying awake, or falling asleep (and staying asleep). Neither one of those options is good, but I think I’d much rather have difficulty staying awake than falling asleep.
Sleep time is at least relatively peaceful. Sure, I wouldn’t get anything done, but it’s got to be better than staring into the darkness all night long listening to your brain running on its hamster wheel.
A History of Ridiculous Sleep / Wake Schedules
I’ve never really slept normally.
I’m not a morning person. I definitely tend more towards night person territory. Sometimes I take that to extremes. Although never without good reason.
The summer between Junior and Senior year of high school I started working night crew at a grocery store. When summer ended, I somehow managed to convince everybody involved that I could stay on.
I got the last period of school off (technically for work release) so that I could go home and sleep. But it turned out that only getting six hours of sleep just made me more tired. Since I was working four days a week, which is basically every other day, I just started sleeping every other night.
So I’d be awake for forty hours, then sleep for eight, then start the cycle all over again. Not exactly a normal sleep schedule, but it worked for me at the time.
Back during my seizure years, I spent a period of about six months constantly seizing anytime I was exposed to light. I could tolerate the computer monitor so long as I had everything set to light blue text on a black background. But having the lights on in my room made me seize. And I couldn’t even think about going out into sunlight.
So, I started being up only when it was dark out, and sleeping during daylight hours. Just like your average vampire.
Sleeping in Chairs
Then there’s the whole sleeping upright thing.
After my first pulmonary embolism (that’s doctor for “blood clots in the lungs”), I couldn’t breathe when I laid down. So, I started sleeping in a chair. I slept in that chair for a couple of years before I once again ventured into the prone position for slumber. I had decided that enough was enough, and I wanted a bed at bedtime.
Standing up the next morning, I immediately threw my back out. I went to the doctor for pain pills and muscle relaxers, and told him my story. And he confirmed that at my weight, transitioning from sleeping in a chair to sleeping in a bed was going to wreak havoc on my back. Good to know.
After my second pulmonary embolism, I went back to sleeping in the chair, this time permanently. I do still have trouble breathing on the rare occasions that I lay down somewhere (most recently to let them x-ray the infamous bad knee), but it’s nothing compared to the back pain I get when I do it. So, I continue to sleep sitting upright in a chair.
Depression vs. Sleep
I recently experienced a four-month long period of extreme depression. (Far more depressed than normal, anyway.) During that time, all I really wanted to do was sleep. And I couldn’t. At least, not nearly as much as I wanted to.
I was trying to use sleep as an escape from my depressed state. The choice between depression and sleep was a no-brainer. I could sometimes get a nap to work during the day. But nighttime was the usual sitting there wide awake with intermittent bursts of sleeping.
Lack of sleep is considered not quite a cause, but certainly a contributing factor toward depression. It’s also a symptom of depression. It’s a weird kind of vicious circle. Can’t sleep, more easily become depressed. Become depressed, can’t sleep.
The Rotating Pill Selection
I’ve been on some kind of medically prescribed sleeping aid for probably twenty years now. I’ll be on one for awhile, and then it will lose effectiveness, and they’ll move me onto something else. Sometimes something new, sometimes something that I’ve been on in the past.
Lately it’s been harder and harder to get something to work from one month to the next. So my prescriber currently has me sitting here with three pill bottles on my desk for sleeping. Trazodone, Mirtazapine, and Doxepin. I take one for a few days to a week, then switch over to one of the others for another few days to a week. Then switch again. And again. And again.
My new regular bedtime pill-taking regimen is the three non-sleep pills my doctor has me taking once a day at night, plus two over-the-counter sleep aids with melatonin, two acetaminophen (to try and keep my bad knee and ever-present headache somewhat at bay), and the prescription sleeping pill of the day.
The Current Sleep / Wake Rotation
For the past few nights, I’ve had a horrible night where I keep giving up on sleep and getting back up to try and tire myself out before going back and trying again. Sometimes during these nights I’ll manage a few hours of sleep, sometimes I get no sleep at all.
The next night, I’m apparently exhausted enough that I sleep normally. (Normally for me, that is.) Then the night after that is another horrible one. Rinse, repeat.
So I’m looking at another round of forty hours awake, eight (or so) hours of sleep. I’m having high school night crew flashbacks!
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