Inside My Head – Part III
It would seem that I’ve hit the trifecta of brain damage. First, I told you about the one I don’t talk about: anxiety and panic. Then, I told you about the one I talk about all the time: concussions and post-concussion syndrome. Now, I’m going to tell you about the one I’m tired of talking about: insomnia.
Part of the reason I’m tired of talking about it is because, quite simply, I’m tired. So very tired. Every person out there who has lived with a newborn baby knows the feeling. Anyone who has had a bit too much to drink on Sunday night and had to get up for work on Monday morning knows the feeling. I can say with one hundred percent confidence that everyone on Earth has had at least one bad night’s sleep in their lifetime, and they know the feeling.
Think about how you feel after you haven’t slept well. Imagine feeling like that for an entire week. I want you to think really carefully. Imagine how you feel after one night of poor sleep then compare it to what you think it might feel like after a week. Really get a feel for how much worse seven days would be compared with one. Now, imagine that instead of a mere seven crappy nights of sleep that you experienced 150 of them – in a row.
One hundred and fifty nights.
Twenty one weeks.
Five months straight of feeling tired and cranky and falling asleep on your keyboard at work and waking up with a jolt only when your computer squawks at you because your face has just written an entire document filled with “jjkak;jjkadjkjkkj;akdskkjdf;alkjkladnnbbnosdiods”.
That’s how long I suffered from insomnia before I went to see my doctor. One of the first questions people ask me when I tell them this is, “Why didn’t you go to the doctor sooner?” It’s a good question. The only reasonable explanation I have is that you start to behave like a degenerate gambler. Every night you throw your money into the slot machine, pull the handle, and genuinely believe that this time it’s going to pay out. Only it never does. At least, it didn’t for me. Sure, once and a while the machine will set off a few bells and whistles and toss you a couple quarters just to give you hope, but in the end it just takes all your money and leaves you cranky and miserable as you shuffle your way to the nearest ATM.
By far, though, the most common reaction I get is, “Oh man, that sucks. I slept poorly once and it was terrible. Have you tried [insert one of the 8,000,000 remedies the Internet says helps you sleep]?” The first on the list of 8,000,000 remedies is melatonin and my response is always, “Yes, I’ve tried it, in varying doses and at various times before bed, and no, it didn’t work.”
Next comes, “Huh. Worked for [me / my cousin / my hairdresser / my co-worker / …]. What about [insert another one of the 7,999,999 remedies remaining]?” With the exception of a few, the answer will be, “Yes, and it didn’t work.” This usually continues for about three or four possible remedies (the really persistent will rhyme off more if they just absolutely have to have the answer) and then ends with, “What do you do? How do you function?”
My internal monologue and my frontal lobe have an epic battle at this point, with my frontal lobe almost always ending up victorious in defeating my internal monologue’s raging desire to blurt out something I’ll regret saying. People mean well, I genuinely believe that, and appreciate that they care, but I have tried so many things and am so thoroughly frustrated I just don’t have the patience to keep going through exchanges like the one I described above.
I’m getting ahead of myself here a bit, though. Let’s get back to my doctor. The first thing she did was give me some drugs to just plain knock me the hell out. It was important to get me functioning again before we could start to treat the greater problem. We tried a couple along the way. There was the one that, every morning, greeted me with the awesome taste of metal in my mouth. I was like I was grinding my teeth on metal spoons all night. It also made it so that getting out of bed was near impossible. I’d get some sleep, sure, but every morning I’d have to drag my ass out of bed and force myself to go shower. It felt like I was really hung over (but without the nausea) and that I was waking up after being drugged. It was a very uncomfortable feeling.
The other drug was only slightly better in that I wouldn’t have to struggle to get out of bed and there was no taste of metal in my mouth, but it would, however, drop me like a sack of potatoes without warning exactly 20 minutes after taking it. It wouldn’t matter what I was doing either. Twenty minutes would pass and I would fall over (or pass out if I was lying down or tip over if I was sitting). It was something right out of a movie. One second I would be doing whatever it was I was doing and the next I was out cold. Have you ever seen the video of those goats that fall over any time they are startled? Here it is. Now, imagine that 20 minutes after I take this pill I am one of those goats and you walk into the room and blow one of those big air horns.
At any rate, it got me a few decent nights’ sleep, or at least got me enough sleep that I avoided the full-on zombie state at work. Then, my doctor recommended I enroll in a sleep class. Yes, a sleep class. It turns out the university near my house offers a 6-week course on sleeping and sleep hygiene. It was really good, actually. During the last class we were doing this one exercise and I fell asleep! It turns out that part of my problem was I would have trouble getting to sleep and when I’d wake up in the night – which was a lot – I’d struggle to get back to sleep again. This sleep class really helped with that but didn’t solve the problem of persistent wake ups so it was off to do a sleep study.
If you’ve never done a sleep study you’re really missing out. They hook your head and chest up to something like 20 wires and then monitor you while you sleep. As if the discomfort of all the glue and tape and wires wasn’t enough you’re in a room that closely resembles the cheapest motel room you can find and there’s a camera mounted on the wall at the foot of the bed. You sleep as best as you can and a few weeks later you meet with the doctor. As near as I can tell there are only two possible outcomes from this meeting: 1) you get diagnosed with sleep apnea and they give you a CPAP machine; or 2) you don’t have sleep apnea and they prescribe you drugs. As my apnea score was in the normal range, the sleep doctor went with Option 2.
After more than a year on the medication I was functional, but still not getting the sleep I felt I needed. Then, I got a concussion. That solved everything! I was instantly sleeping for 14 or more hours a day. Unfortunately, my head healed (or at least established a new normal), and the sleeping problems persisted. I could go on and on with various things I’ve tried (“chocolate” flavored pumpkin seed flour was the most interesting – and actually worked for a while, but then my body started to adjust and it was less effective).
I’m on Amitriptyline now, just like I was before the concussion and after the sleep study and I get enough sleep most nights to function. If I get five hours straight without waking up I feel like I could conquer the world. If I don’t the symptoms are not hard to spot: yawning, forgetfulness, irritability, impaired cognitive abilities, forgetfulness, bags under the eyes, decreased reflex responses…
The symptoms are bad and their impact on a person is as severe as any other illness out there, physical or mental. The problem is there are 8,000,000 remedies and a person who is at the end of their rope will gladly fork over whatever money they have, and probably a bunch they don’t, to finally find The One That Works. I’m just about done trying things. There are a couple of options left to try. One is a mouth guard that keeps my jaw in a certain position to help reduce snoring. Another one is a Kickstarter headband thingy that apparently maps your brainwaves and plays some sort of magic drum beat into your ears. Yep, a magic drum beat headband. This is what it’s come to.
I’ll close with a quick word of advice to anyone interacting with someone suffering from insomnia. First, try asking the person if they would like to hear some suggestions before actually offering them up. Hold off on the did-you-try/you-should-try talk and instead say something like, “That has to be really frustrating for you. I might know of a remedy, just let me know if you want me to share it with you. Is there anything I can do to help your day go more smoothly?” Second, if you see someone sliding on a magic drum beat headband before bed, don’t laugh. A hundred and fifty sleepless nights in a row and that could be you.
Andrew sometimes lets his love of attention override common sense. Evidence of this can be found at http://potatochipmath.com.
Andrew, this is an amazing post and description of insomnia, far better expressed than I could have done. Thank you for sharing.