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Wednesday, July 12, 2006

Insomnia: When Sleep is Just a Bedtime Story

I was recently involved in a discussion on insomnia and thought I'd post my story of how I was able to overcome it and how you can to, without medications and fancy products.

Disclaimer: Of course, this is my story, my experience and you shouldn't ditch your drugs without talking to your doc about it first, ok? So, don't get all huffy with me if you act like a fool, ditching your meds and quitting cold turkey, and you get sick, because I'm warning you that that could happen if you don't detox under a doc's supervision. I'm not responsible for you, you are, so take care of yourself, ok? Ok, Disclaimer over.

I had insomnia ever since I was 12, but it was controlled for the most part and didn't get worse until I was in an incident when I was about 19 or so. It's something I never talk about, so I'm not going to make an exception about it now. Suffice to say I had Post Traumatic Stress Disorder (PTSD) for years before I was diagnosed with it, or even knew what that term meant. I always assumed it was something only soldiers got from being in war and was a modern term for being "Shell Shocked".

PTSD really can affect your sleep, and I wasn't the exception to this rule. When I had become really desperate, going up to 5 days without sleep, I sought out a sleep clinic. (By the fifth day, I was so desperate that I'd just take all the sedating type over the counter medications, drinking nyquil, took benadryl in big quantities, and consumed some high proof alcohol (ick!), I could find in the house to knock myself out. That was before I started seeking professional attention for my sleep disorder, but even after I sometimes needed that in addition to the prescription sedatives/downers in order to get a full night's sleep.)

They recommended that I keep a sleep diary for a month or until my appointment. I was kind of skeptical about that and warned them that there wasn't going to be a whole lot of "sleeping" in it, but I did it anyway. What I found was that keeping the diary could really help in and of itself, because you may be able to target the source or cause of your sleeplessness just by looking at the diary.

I kept my appointment and saw a sleep disorder specialist at a clinic who referred me to a sleep lab overnight. Of course, I couldn't sleep and they really want you too, so I did what I did every night, took a butt-load of prescription sedatives, hoping they’d knock me out—yep I was that bad off.

Well, that freaked them out, because I guess I actually stopped breathing in my sleep. The lab tech said he was about to come in and give me CPR when I suddenly started breathing shallowly again. Scary. That probably happened every night and I’d never have known. Still, I told the sleep doctor, "You can't have it both ways, Doc." *sigh* I either don’t sleep or I have to knock myself out. I couldn’t sleep without sedating myself, ever, not even to nap.

Because I’d been complaining about the insomnia for years, my previous doctors, all primary care physicians, just kept prescribing more medications in stronger doses to knock me out. Well, that’d work for awhile, but when their effectiveness decreased, they’d prescribe stronger doses. This just kept going on for years. No one ever mentioned that I could fix my insomnia, naturally, chemical-free. What a concept! But, then, I wouldn’t have to go back to those doctors every 6 months or so to get my prescription increased, now would I? And they wouldn't get their kickback from the drug companies for prescribing the latest miracle drug, would they? “What a racket!” That’s what I thought when I found out differently from the sleep specialist. But, that's because I'm a cynic. A nicer person would probably be more charitable in her thoughts and give them the benefit of the doubt, "Gee, I wonder if my doctor knows that you can fix this problem without medication?"

Anyway, I was delighted, if skeptical, that I'd be able to sleep sans drugs. It was fantastic! And I was able to sleep, really sleep, and get through all the sleep stages (quality is as important as quantity when it comes to sleeping and you can’t do that when you’re depending on drugs to help you sleep. So, if any pharmaceutical company claims that with their medication you’ll go through all the stages, they’re lying).

For a couple of years, I slept like that until about 5 months ago when I started triggering real hard. (A "trigger" is something that makes your mind remember or takes you back to the incident that caused the PTSD in the first place. For some people, it could be a car backfiring reminding them of a gun going off, or an image on tv, something they read, etc. Triggers can last anywhere from a few hours to days to months, depending on the trigger, the event and the survivor/victim/whatever).

That’s where PTSD can really sabotage your efforts, so keep that in mind. However, I know I just have to go back to following the Plan they gave me to get back onto my sleep schedule. I just don't want to sleep right now, because when I do, the nightmares are so real that it’s like I’m right there going through that whole event again. I'm afraid I'll end up attacking my dh in my sleep, thinking I'm defending myself, you know? And then he gets hurt, poor guy. It was horrible enough going through it the first time around IRL, so I’d rather stay awake and be exhausted than to relive it every single night.

Of course, that has it’s own potential problems and I don’t want to get so tired that I start having waking nightmares, which really suck and can be dangerous for other people if they’re around. It’s a fear of mine that I’d mistake them for being a part of this certain event and now that I’m better equipped to deal with it, should I find myself in a similar circumstance, I could really do some damage. So, it becomes this balancing act for me. I stay up as long as I can and then I crash and sleep and do the nightmare thing, getting only a few hours of sleep, so I don’t end up accidentally acting out against any innocents during the day. I was really hoping that if I gave it time, they'd just go away, but that hasn't been the case, so far. Don't know how much longer I'll wait before I have to aggressively work on this again, but my patience is beginning to wear rather thin with it. So, that’s how PTSD can really screw you if you have to deal with it along with or as the primary cause of your insomnia.

But, that’s my choice and it feels good to know that it is a choice and when I’m brave enough & can figure out a way to deal with the nightmares, I’ll go back to following the sleep schedule again. So, yeah, I can relate to both the insomnia and the nightmares/triggers/PTSD that keeps you up and aware all night long. It sux, but there are ways to deal with both.

I had a psychologist for awhile who was really helpful with the PTSD, but I’ve still got a long way to go. However, the nightmares did calm down, change pattern and weren’t every night, like they are now, for about two years after going to therapy. So, if you go through this, I’d recommend therapy. It’s kind of weird, baring your soul to a stranger. I mean, as a general rule, I don’t do that well , soulbaring, with people I’m really close to! And, not being Catholic, it’s not like I was used to confessing to a priest or anything, but I imagine, it’s probably similar to that. The difference is you’re not confessing only your own sins but those committed against you and random acts of crapulence that occur, too. So, it's time well spent and I'd recommend trying that out if it won't interfere with your other goals.

The thing about PTSD is that, even if you don’t think it’s really bothering you or causing problems for you, at some point all that pissed-offedness, the insomnia, the ultra-vigilance 24/7, the inability to completely relax-because you know, as no one else does that the enemy is out there and you're the only one capable of defending or protecting your domain/territory/loved ones,etc.-does eventually mess with your goals, the things you want to accomplish in life. From what I've read, the sooner you seek therapy, the better the results are from it. Jmho and this is most certainly a case of do as I say and not as I do, cuz I'm not seeing anyone right now, (my insurance doesn't cover it), but I sure wish I was. Even the few months of treatment that I received helped alot.

My next blog will give you specific steps you can take to get onto a proper sleep schedule. These are the things I had to do and they really do work, but you have to be dilligent and follow them religiously every single day.

Now, here's the hardest thing. Be patient! This process can take anywhere from 6 months to 2 years. It took me almost an entire year, but I was sleeping better and better throughout the whole process. So, keeping in mind that it’s a process will help you to deal with the frustrations and hiccups along the way.[Geez, I've almost talked myself into getting back on my program again. Ha!]

I was the biggest skeptic, too. I mean, if all the junk I was taking wasn't knocking me out for more than a couple hours a night, then why in the world would they think doing it sans drugs was going to work? But, I just did it anyway, cuz I wanted more than anything to be chemical free for one thing and to sleep was like a fairytale come true. Insomnia was really messing up my game and I didn't like it. And, contrary to what some people think, you’re alot more effective on your job if you can get the right amount and best quality of sleep you need.

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