|The Ongoing Sleep Experiment That Is My Life
||[Nov. 20th, 2012|06:55 am]
Kelly J. Cooper
A couple of months ago, I asked my psychiatrist that given the amount of work we’d done over the past 2 years, diagnosing my ADD and determining that my depression is anxiety-based, good stuff that had NO noticeable effect on my sleep issues, should I go back to the neurologist? She suggested talking it over with my primary care physician.
When I asked my PC whether, given all the work I’ve done in the past 2 years without any improvement in my sleep, should I go back to the neurologist, she suggested going to see pulmonary specialist Dr. E instead (name available via private email). She liked him. (At that time, Dr. E had recently joined the practice where my PC, gyn, and endocrinologist work.)
On Wednesday, 26 September 2012, I had an appointment with Dr. E.
In preparation for the appointment, I put together a timeline document most of my medical history and a few major life events. To be honest, it was depressing. But it also forced me to review my records which, while voluminous, were not always regular or in a good order.
I also contacted that neurologist and asked that my records be sent over. They sent me a release form, I signed and mailed it back within a couple of days. I also signed and mailed one to my pshrink. Of course, neither of them actually sent him information in time. My pshrink sent him a paragraph about me that morning, since I’d bugged her via email the day before, but it hadn’t shown up in his digital database yet. (Reminder to me: Contact the neurologist and remind them they said they’d send the data over.)
The appointment was more or less the Dr. E show. He talked, I listened. It was difficult to get a word in edgewise. He asked a series of questions about a variety of aspects of my sleep, my health, and came to the conclusion that either my circadian rhythm is broken or easily influenced away from what’s healthy.
He instructed me to do several things. When I pointed out I’d done most of these things, he responded that I hadn’t done them all at once.
1. Keep a sleep log (include wake-ups during the night, wake time, bed time, sleep time, naps, and work)… he wanted a spreadsheet next time I saw him.
2. Set a stable wake & sleep time.
3. Begin using a light box – specifically, he wanted me to get a Philips goLITE BLU – for 30 minutes a day.
4. Exercise intensely soon after waking.
5. Socialize regularly during the daytime (to remind my body that this was the time to be awake).
6. Get black-out curtains for my bedroom and sleep in complete darkness
7. Two hours prior to my desired sleep time, take melatonin, dim the lights, and stop using technology (definitely no iPod, iPhone, or computer but TV should be OK). When I mentioned melatonin has previously given me a headache, he suggested getting the 3mg pills & cutting them in half.
When I pointed out that getting up was the big problem, he said to make myself.
When I pointed out I didn’t have the energy to exercise, he explained that sleeping at the wrong times, outside of the normal circadian rhythms, meant bad sleep. If I slept when I was supposed to, my sleep quality would improve.
He closed saying that insomniacs what a single solution right now, but fixing one’s sleep is more of a process. Once I’ve reorganized my life as prescribed, then we would do sleep test and he could examine the results.
Anyway, it was kind of insulting. But I bought some 1mg melatonin, and in that does it’s still effective but doesn’t give me a headache. Mostly. About once a week to every two weeks, I get a spectacular concentration headache – y’know, the kind you get when you watch TV for 8 hours? Only I get it if I don’t do anything at all or if I watch any TV or use the computer or concentrate on pretty much anything. It really sucks.
I’ve tried to stop using the computer at least 45 minutes before headed to bed, hoping to inch it back, but sometimes I have late-night work to do for crazy clients, so that’s hard. I drafted a random notebook into being my sleep log (I have a LOT of blank notebooks… turns out that one of my stress purchases/anxiety soothers is blank notebooks) and I’ve kept up with it.
I tried to set my desired wake-up time to be from 11am to 2pm and my desired bed time from midnite to 2am. It’s still hard. When I wake up and I don’t have the energy to get out of bed, it’s not an easier to “force” myself with a doctor’s orders than it was before I saw him.
As I consider the list he gave me, it’s like going back to when I worked a 9-5 job (well, 10-6 when I could). I got up at a regular time, fell asleep at a regular time, and socialized during daylight hours. I hadn’t the time or energy to exercise. Granted I didn’t track my sleep/wake times and I definitely used the computer until it was time to fall over and go to sleep. And since I didn’t suffer from Seasonal Affective Disorder, I’ve never used a light box.
I don’t know. The quality of my sleep is improved when I avoid the computer and go to bed at a “reasonable” hour. But my ability to wake up is not improved. My pshrink says it’s a lack of dopamine – that’s the stuff that makes you want to get up or go do stuff. If it’s low, you literally don’t have any get-up-and-go.
The lite box was expensive, but the BF used a gift card he got somewhere and picked one up for me from Amazon. I’ve only just started using it. I’m really reluctant to spend the money on blackout curtains. It’s hard enough to get up as it is without the light to help. And I use a sleep mask most nights (I’ve gotten good enough that if the light hits me, I put the mask on without really waking up… it’s kinda tough to fall asleep in it, unfortunately).
Anyway, I’ve been noodling on this post for a while and I should just friggin’ publish it.