Last night I was feeling kind of...odd. Even though I was wearing my comfy jammies and about to geek-out on some Sci-Fi, I felt a little anxious. I tried not to think too much about it, and instead I opened up a bottle of wine and fell into my usual pre-bedtime routine. Thirty minutes and one glass of cheap Pinot Noir latet, I was completely engrossed in Pacific Rim and feeling a little bit better. When the movie was over, I was a little tired, but not ready to go to fall asleep just yet. I set the timer on the television, laid down on my pillow, and attempted to catch the bus to Sleepytown while watching the late night adventures of Jerry Seinfeld and George Costanza.
All seemed well- my eyelids were getting heavier...and then I woke up with a start. Suddenly, I was wide awake. So I tried to doze off in front of the tele again. And yet again, I dozed off for a few minutes, then snapped awake. After the third time, I thought that I had just as well get in bed. Only this time, I didn't drift off to sleep. I thought a lot about how I wanted to go to sleep, but it just wasn't happening. I tried to clear my head by focusing on breathing deeply and relaxing my body. For some reason, this only made me more self-conscious that I was awake. Finally, I decided on a little light reading. And so I read, hour after hour after hour. Eventually, I noticed that it was 5:00 AM. I normally wake up at 5:30. Dammit, dammit, dammit.
Since I have about 800 hours of sick time saved up, I opted to take the day off work. I sent in my notice to the office via email and went back to bed. By 6:00 AM I was fast asleep.
So, where did I go wrong? Well, looking back on it, I think it would be easier to see if I did anything right. It turns out that switching to a little light comedy was the right idea, and trying to ignore the alarm clock wasn't a bad idea either. Everything else was a classic example of What Not To Do When You're Anxious About Not Being Able to Fall Asleep.
Cognitive Behavioral Therapy is a means of changing the way you feel by changing the way you think. One of its precepts is that oftentimes, people distort the way they look at the world. These distortions can cause depression, anxiety, and even insomnia (I should mention here that I am NOT a therapist or a psychologist, and that I have NO medical training. What I do have is a keyboard, internet access, and the occasional bout with insomnia).
So where did I go wrong? Well, for starters, I had already taken a lengthy nap earlier in the day. This can raise your sleep threshold and make it difficult to initiate your "sleep trigger" later. Since I was coming off of a vacation, my sleep schedule was already misaligned with work. I was exhausted when I got home, but I should have fought off the nap, or limited it to 20 minutes. You will also notice that I shrugged off the anxiety that I had early in the evening. This was probably my second, and biggest, mistake. I knew, somehow, that I wasn't really looking forward to going to work the next day, and I was worried that this would interfere with my ability to fall asleep. However, pushing these feelings to the back of my head always catches up with me. I realize that eventually, I'm going to have to get a new job. In the meantime, I can change the way I think about it.
Cognitive behavioral therapy is currently helping me cope with my negative feelings about work and insomnia. Although going to a therapist is probably the most effective plan, I really can't afford one now, so I opted for self-help instead. There are many books on the topic, but it seems that shrinks are in agreement that the ones by a guy named Dr. David Burns are the most accessible (the psychiatrist, not the lead singer of the Talking Heads). It's a lot like homework- you have to do a lot of journaling, and often times I find myself writing about unpleasant realities that I'm used to pushing into my subconscious. CBT is effective if you keep after it, but it's not a panacea, however. Relapses happen, but at least they're easier to nip in the bud as long as you've been persistent. Some people experience remarkable, spontaneous recoveries with CBT. Most people, however, keep whittling away at their demons until they're small enough to drown in a bathtub.
Looking back on the previous evening, I realize now that I had been psyching myself up for days about how much I was dreading going back to work, and I was also dreading that I would have another bout of insomnia when I did go back. This created a sort of self-fullfilling prophecy- something that clinicians refer to as "excessive nocturnal arousal." Although the term sounds pornographic, it's neither fun nor satisfying. And while there's nothing wrong with a little television in the evening, Pacific Rim might not have been the ideal choice. Sleep experts suggest something soothing before bedtime, and a movie about giant robots that battle monsters from another universe is probably not going to get me where I need to be. I've read different opinions about using alcohol to to help you relax- sleep experts say that it interferes with your deep sleep cycle. I think on that night, however, I probably should have had a second glass. Setting the sleep timer, however, was one of my few good moves that night. Having the television shut off automatically can help preserve that blissful slumber a little bit longer.
Attempting to read myself to sleep in bed is another mistake. Behaviorist have noted that people develop associations and habits rather quickly. The bed should only be for sex and sleeping- it's important to associate it with pleasure and rest, not frustration. I don't know if getting out of bed and reading in the living room would have helped, but I certainly know that staying in bed didn't help me fall asleep, either.
I was in the fortunate position to skip out of work the next day, but that's not always an option. It was obvious to me that dreading a day of being sleep-deprived at work was the problem- once it was not longer an option, I fell right to sleep. I know, however, that my negative thoughts about sleep, combined with my rather unrealistic expectations of always being 100% on point at work, were the cause of my insomnia last night. After all, insomnia is often unpleasant, but from a medical standpoint it usually isn't dangerous. And everyone has a bad day at work occasionally. Eventually, the body is going to flip the switch to "off" (it's important, however, that you're not operating a back hoe or a crane when you've been on a 72 hour insomnia jag).
I certainly have my work cut out for me, but confronting these thoughts and feelings has been beneficial.Until last night, I had been sleeping relatively well for the past six weeks. As for hating the drudgery of work- well, there's a support group for that. It's called a bar. They meet everyday, from 5:30 until 2 AM. So yes, last night was certainly discouraging, but that's no reason not to keep trying.
To all my fellow insomniacs out there, I encourage you to find your own answers. No doubt, your insomnia is caused by some idea or set of ideas in your head that are self-defeating. Get on that, and you'll sleep better.
Tuesday, December 3, 2013
Sunday, November 3, 2013
OTC's- A Complete Fail. Also: Travel and Work-Related Insominia Sucks, Am I Right People?
A few months ago, I was hundreds of miles away from home for work. Our employer had paired us up with random roommates in a giant hotel that was connected by a walkway to the convention center in which we would be working for the next seven days. It was like living in a giant habitrail sweatshop. And since we flew out and arrived on a Saturday, I was already tired from working all week.
The stress of traveling was typical- long lines, crowded planes, bumpy take-off. I was pleased, however, to find that my roommate was a decent enough fellow. The food was awful, but it was free. I had done this the year before, and there were no surprises. Yet, in spite of the fact that I was tired from working and traveling, I only got three hours of sleep on my first night.
The workday was long, but not so bad. I did my best to offset all the time I had spent sitting during the day by running a few miles after work. And yet, later that night, I did not sleep a wink.
The next day I managed to make it through the day. After work, I was determined to get on a normal sleep schedule, so I avoided taking a nap and went to the drugstore to purchase some over the counter sleep aids, benadryl and melatonin. After making my purchases, I went running again, and I treated myself to a filling dinner and a glass of wine at a restaurant. Later that night, my roomate and I watched an old movie until about midnight, after which time we decided to turn off the lights and get some sleep. He was sawing logs in a few minutes. But despite the fact that I was exhausted, I couldn't fall asleep.
If I was had been at home, I would have turned on the television or began reading, but I didn't want to wake up my roommate. I had already taken a melatonin capsule, but I decided to take another one and I downed the benadryl. The hours passed. I didn't sleep a wink that night either.
I won't go into anymore detail about the next day, except that I finally collapsed before lunch. I was diagnosed by the medics as having a stomach virus. I knew that wasn't right, so I saw a doctor. I pleaded with him for something to help me sleep. He refused to give me a sleep aid, and instead wrote me a script for something to help settle my stomach.
I was able to get some sleep that night, but the next night I tossed and turned again. Finally, I decided to knock myself out with booze for the remainder of the trip. The over-the-counter sleep aids where completely useless. Where drugs and hormones failed, bourbon whiskey triumphed.
If this episode taught me anything, it was that insomnia is almost always caused by the inability to relax. Melatonin doesn't help me relax. Benadryl makes me drowsy, but it doesn't help me relax. Jack Daniels, on the other hand, definitely helps me relax. Sometimes, it also makes me want to hoot and holler, and let out a big rebel yell. It doesn't warn you about that on the label, but it should.
If only booze didn't cause hangovers and carry so many other health risks, I would say problem solved. However, I'm not of the age when I can afford to have four or five whiskeys every night after work. So what to do? I believe the long term solution for me is to learn to relax without the help of any substance. I'm still working on that. In the meantime, here is a short list of sleep aids, tested or witnessed by me, ranked in the order of effectiveness.
Ativan, Temazepan, and other benzodiazepines- The gold standard for treating insomnia, I have found that these little pills will take me to sleepytown without fail. Unfortunately, they're highly addictive. Take one every night for a week and then try to stop, and you'll see what I mean. Another drawback is that doctors are understandably stingy with these. Go through a bottle too fast, and you might find yourself cut off. Still, as a temporary solution to insomnia, the tranquilizers do their job like nothing else.
Ambian- I've never taken this myself, but I did date a girl once who took them regularly. They made her loopy as hell, and she was somewhat fogged-over for a few hours the next morning. Still, they eventually knocked her out. Evidently, they're not as addictive as the benzos, but doctors are still pretty stingy with them. From what I've seen, I would rather stick with the tranquilizers. Ambian is actually a hallucinogen, and I have no idea if it's effects are pleasant or unpleasant.
Booze- Yes, good old fashioned booze sometimes does the trick. There's a sweet spot that you have to hit, however. Too little, and you'll end up wide-awake with a full bladder. Too much, and well...you might decide to steal a police car, sleep with a stranger, or both. Also, there's the hangover, which sometimes can be worse than getting no sleep at all. Unfortunately, when insomnia strikes in the middle of the night, I am faced with a cost-benefit analysis that usually disqualifies drinking a bottle of wine at 3:30 am.
Benadryl- Really, the only time this crap makes me sleepy is when I have a cold. Chances are, it's really the virus that's making me feel like my veins are full of Log Cabin syrup and not this weak antihistamine. I've taken this before out of desperation, but it only seems to make me have to pee every ten minutes. Like too much booze, it can also raise your blood pressure. I'm not a big fan.
Valerian- I don't know if this stuff works. I find drinking it as a tea with a little honey before bedtime to be mildly soothing, but it definitely won't knock you out if you are looking for something to shut down your brain for a few hours.
Trazadone- Doctors sometimes prescribe this ancient antidepressant for insomnia because one of its side effects is supposedly drowsiness. Didn't make me drowsy at all. What it did do, however, was make my sinuses swell up so that I found it impossible to breath out of my nose. In my opinion, this stuff is garbage.
Melatonin- Some people swear by this. A hormone that is associated with our body's natural sleep rhythm, this stuff is supposed to tell your body that it's time to shut down. For me, however, melatonin is slightly less effective than Pez.
That's it folks. I'll let you know how the relaxation techniques work.
The stress of traveling was typical- long lines, crowded planes, bumpy take-off. I was pleased, however, to find that my roommate was a decent enough fellow. The food was awful, but it was free. I had done this the year before, and there were no surprises. Yet, in spite of the fact that I was tired from working and traveling, I only got three hours of sleep on my first night.
The workday was long, but not so bad. I did my best to offset all the time I had spent sitting during the day by running a few miles after work. And yet, later that night, I did not sleep a wink.
The next day I managed to make it through the day. After work, I was determined to get on a normal sleep schedule, so I avoided taking a nap and went to the drugstore to purchase some over the counter sleep aids, benadryl and melatonin. After making my purchases, I went running again, and I treated myself to a filling dinner and a glass of wine at a restaurant. Later that night, my roomate and I watched an old movie until about midnight, after which time we decided to turn off the lights and get some sleep. He was sawing logs in a few minutes. But despite the fact that I was exhausted, I couldn't fall asleep.
If I was had been at home, I would have turned on the television or began reading, but I didn't want to wake up my roommate. I had already taken a melatonin capsule, but I decided to take another one and I downed the benadryl. The hours passed. I didn't sleep a wink that night either.
I won't go into anymore detail about the next day, except that I finally collapsed before lunch. I was diagnosed by the medics as having a stomach virus. I knew that wasn't right, so I saw a doctor. I pleaded with him for something to help me sleep. He refused to give me a sleep aid, and instead wrote me a script for something to help settle my stomach.
I was able to get some sleep that night, but the next night I tossed and turned again. Finally, I decided to knock myself out with booze for the remainder of the trip. The over-the-counter sleep aids where completely useless. Where drugs and hormones failed, bourbon whiskey triumphed.
If this episode taught me anything, it was that insomnia is almost always caused by the inability to relax. Melatonin doesn't help me relax. Benadryl makes me drowsy, but it doesn't help me relax. Jack Daniels, on the other hand, definitely helps me relax. Sometimes, it also makes me want to hoot and holler, and let out a big rebel yell. It doesn't warn you about that on the label, but it should.
If only booze didn't cause hangovers and carry so many other health risks, I would say problem solved. However, I'm not of the age when I can afford to have four or five whiskeys every night after work. So what to do? I believe the long term solution for me is to learn to relax without the help of any substance. I'm still working on that. In the meantime, here is a short list of sleep aids, tested or witnessed by me, ranked in the order of effectiveness.
Ativan, Temazepan, and other benzodiazepines- The gold standard for treating insomnia, I have found that these little pills will take me to sleepytown without fail. Unfortunately, they're highly addictive. Take one every night for a week and then try to stop, and you'll see what I mean. Another drawback is that doctors are understandably stingy with these. Go through a bottle too fast, and you might find yourself cut off. Still, as a temporary solution to insomnia, the tranquilizers do their job like nothing else.
Ambian- I've never taken this myself, but I did date a girl once who took them regularly. They made her loopy as hell, and she was somewhat fogged-over for a few hours the next morning. Still, they eventually knocked her out. Evidently, they're not as addictive as the benzos, but doctors are still pretty stingy with them. From what I've seen, I would rather stick with the tranquilizers. Ambian is actually a hallucinogen, and I have no idea if it's effects are pleasant or unpleasant.
Booze- Yes, good old fashioned booze sometimes does the trick. There's a sweet spot that you have to hit, however. Too little, and you'll end up wide-awake with a full bladder. Too much, and well...you might decide to steal a police car, sleep with a stranger, or both. Also, there's the hangover, which sometimes can be worse than getting no sleep at all. Unfortunately, when insomnia strikes in the middle of the night, I am faced with a cost-benefit analysis that usually disqualifies drinking a bottle of wine at 3:30 am.
Benadryl- Really, the only time this crap makes me sleepy is when I have a cold. Chances are, it's really the virus that's making me feel like my veins are full of Log Cabin syrup and not this weak antihistamine. I've taken this before out of desperation, but it only seems to make me have to pee every ten minutes. Like too much booze, it can also raise your blood pressure. I'm not a big fan.
Valerian- I don't know if this stuff works. I find drinking it as a tea with a little honey before bedtime to be mildly soothing, but it definitely won't knock you out if you are looking for something to shut down your brain for a few hours.
Trazadone- Doctors sometimes prescribe this ancient antidepressant for insomnia because one of its side effects is supposedly drowsiness. Didn't make me drowsy at all. What it did do, however, was make my sinuses swell up so that I found it impossible to breath out of my nose. In my opinion, this stuff is garbage.
Melatonin- Some people swear by this. A hormone that is associated with our body's natural sleep rhythm, this stuff is supposed to tell your body that it's time to shut down. For me, however, melatonin is slightly less effective than Pez.
That's it folks. I'll let you know how the relaxation techniques work.
Sunday, October 20, 2013
The Origins of Insomnia
Years ago, as a freshman in college, I was required to take a class in cultural anthropology. To help us understand what life in a primitive, stone age culture is like, our professor showed us a documentary of an isolated tribe who lived deep within the heart of some endangered rain forest.
They rose with sun and emerged from their simple huts. In no particular hurry to go anywhere, they dawdled over breakfast, laughing and talking in a language that probably no one else on earth could understand. Once breakfast was over, the tribe began their labors. The women cared for the children and gathered vegetables, nuts, and fruits. The men, meanwhile, prepared darts for their blow guns and discussed the upcoming hunt.
Later in the day, the women prepared some sort of fibrous tuber by pounding it into a white pulp. The men emerged from the forest with some unidentifiable small mammal tied by its legs to a pole. A fire was lit, and the men tended to the roasting of the animal while the women continued to prepare vegetables and starches for the evening meal. Everyone seemed to be in good spirits in anticipation of the roast meat. Speaking in their unknown tongue, the tribe laughed and joked as they feasted on the bounty of the forest. Later, when everyone had their fill, the men produced a giant pipe that looked like it had been fashioned from a hollow branch and half of a coconut, filled it to the brim with the flowering buds of the native hemp plant, and lit it up with a flaming branch from the cooking fire. They passed it to each other while telling the story of the hunt, repacking the giant bowl when it became empty. Huge clouds of thick blue smoke hung about the tribesmen. Everyone looked happy and satisfied.
At this point the narrator cut in to say that for the remainder of the day and night the tribe would continue to tell stories and sing songs before retiring to their huts. He also mentioned that this was a particularly busy day for the tribe; on average, even the most industrious among them only "worked" about twenty hours a week.
Now, I'm not saying I want to live a life like the members of this lost tribe. But I'm pretty sure that the professor's point was that this is the life that most humans lived for thousands of years. It is, in a sense, the life that nature designed us to live. And I'm willing to bet that unless they suffered from some sort of aberrational medical condition, the members of this tribe didn't have any trouble getting a good night's sleep. For that matter, I bet that they didn't suffer from many stress-related conditions, either. In any case, I think about that movie a lot when I'm driving to work after getting a crappy four hours or less of sleep.
Just like most people, I don't have a twenty hour work-week. On most mornings, I'm scrambling to stuff toast and coffee into my face before rushing out the door and fighting the morning traffic on the interstate, which seems to be governed by the same laws as The Road Warrior. And then, as soon as I get to work, it's go, go, go until quitting time. Then, it's another stressful half-hour of Mad Max auditions before I'm home and it's time to catch up on cooking, cleaning, washing, and thinking about getting another, less stressful job.
I'm not a doctor, and there are dozens of websites on the causes and treatments for insomnia. I have no intention of competing with any of them; if you are seeking clinical solutions to your problem, then you can try your luck with Google. Rather, I intend to share this solipsistic account of my experiences with insomnia. And the first point that I would like to make is that it's the unnatural and accelerated pace of the modern world that causes myself and others to toss and turn at night. Certainly it's natural to experience some level of insomnia when you worried about something, but I think that the prolonged bouts of inadequate sleep that many of us suffer from originate from the pitiless institutions that govern our lives and the stress that they impose upon us. As they say, there's no rest for the weary.
So in the future weeks, I invite you to read and to share your own experiences on this blog. Since I can't go join the natives in my professor's documentary (I bet that they've since been displaced by some international lumber conglomeration), I am wide open to any ideas that might bring about a good night's sleep. In the next few weeks, I intend to share my personal experiences with OTC's, prescription medication, various relaxation techniques, and fucked-up anecdotes about insomnia from my the lives of myself and my friends.
In the meantime, pleasant dreams everybody.
They rose with sun and emerged from their simple huts. In no particular hurry to go anywhere, they dawdled over breakfast, laughing and talking in a language that probably no one else on earth could understand. Once breakfast was over, the tribe began their labors. The women cared for the children and gathered vegetables, nuts, and fruits. The men, meanwhile, prepared darts for their blow guns and discussed the upcoming hunt.
Later in the day, the women prepared some sort of fibrous tuber by pounding it into a white pulp. The men emerged from the forest with some unidentifiable small mammal tied by its legs to a pole. A fire was lit, and the men tended to the roasting of the animal while the women continued to prepare vegetables and starches for the evening meal. Everyone seemed to be in good spirits in anticipation of the roast meat. Speaking in their unknown tongue, the tribe laughed and joked as they feasted on the bounty of the forest. Later, when everyone had their fill, the men produced a giant pipe that looked like it had been fashioned from a hollow branch and half of a coconut, filled it to the brim with the flowering buds of the native hemp plant, and lit it up with a flaming branch from the cooking fire. They passed it to each other while telling the story of the hunt, repacking the giant bowl when it became empty. Huge clouds of thick blue smoke hung about the tribesmen. Everyone looked happy and satisfied.
At this point the narrator cut in to say that for the remainder of the day and night the tribe would continue to tell stories and sing songs before retiring to their huts. He also mentioned that this was a particularly busy day for the tribe; on average, even the most industrious among them only "worked" about twenty hours a week.
Now, I'm not saying I want to live a life like the members of this lost tribe. But I'm pretty sure that the professor's point was that this is the life that most humans lived for thousands of years. It is, in a sense, the life that nature designed us to live. And I'm willing to bet that unless they suffered from some sort of aberrational medical condition, the members of this tribe didn't have any trouble getting a good night's sleep. For that matter, I bet that they didn't suffer from many stress-related conditions, either. In any case, I think about that movie a lot when I'm driving to work after getting a crappy four hours or less of sleep.
Just like most people, I don't have a twenty hour work-week. On most mornings, I'm scrambling to stuff toast and coffee into my face before rushing out the door and fighting the morning traffic on the interstate, which seems to be governed by the same laws as The Road Warrior. And then, as soon as I get to work, it's go, go, go until quitting time. Then, it's another stressful half-hour of Mad Max auditions before I'm home and it's time to catch up on cooking, cleaning, washing, and thinking about getting another, less stressful job.
I'm not a doctor, and there are dozens of websites on the causes and treatments for insomnia. I have no intention of competing with any of them; if you are seeking clinical solutions to your problem, then you can try your luck with Google. Rather, I intend to share this solipsistic account of my experiences with insomnia. And the first point that I would like to make is that it's the unnatural and accelerated pace of the modern world that causes myself and others to toss and turn at night. Certainly it's natural to experience some level of insomnia when you worried about something, but I think that the prolonged bouts of inadequate sleep that many of us suffer from originate from the pitiless institutions that govern our lives and the stress that they impose upon us. As they say, there's no rest for the weary.
So in the future weeks, I invite you to read and to share your own experiences on this blog. Since I can't go join the natives in my professor's documentary (I bet that they've since been displaced by some international lumber conglomeration), I am wide open to any ideas that might bring about a good night's sleep. In the next few weeks, I intend to share my personal experiences with OTC's, prescription medication, various relaxation techniques, and fucked-up anecdotes about insomnia from my the lives of myself and my friends.
In the meantime, pleasant dreams everybody.
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