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Wednesday, February 27, 2013

An Actual Solution for Insomnia

I need to blog about Ethan's birth, but this needed to be posted tonight, seeing as many of you have prompted me to share what I learned from the Sleep Therapist today. So let me start at the beginning...

For the past ten years, I have had chronic insomnia, and before that, as my mother has shared with me, I wasn't such a great sleeper either. I toss and turn for hours and hours, until finally I fall asleep, only to find that it's usually 4 am, and I usually have to get up for something or someone, and cannot get the amount of sleep needed. My brain just won't shut off. That chemical that turns your brain off and helps you drift to sleep, just doesn't function. I have always slept better in the morning, and been wide awake late at night. I can't pin point when and why this really developed, but I have been off and on sleeping pills since I was 16, but for almost 3 years, I have been on Ambien every single night. If any of you know anything about sleeping pills, you know you are only supposed to be on them for a few nights, never long term. They aren't made for a chronic problem, and over time, you eventually develop a resistance to them, and need a higher dose in order for them to still work. Sooner or later, you are needing such a high dose, way more than recommended, and you are faced with either running out of your prescription too soon, or going to the doctor and getting on a different kind. When you've been on sleeping pills for this long, when you run out of your meds, you don't sleep...AT ALL... for a couple nights. Your body can go through withdrawal, and insomnia temporarily worsens. By the third night of hardly any sleep, your resolve to quit the sleeping pills diminishes. You NEED the can't function without sleep. right? So you HAVE to be on them. It's just part of who you are, and what you need to function...right???  In an article I was reading, I found this quote. "The only effect sleeping pills have," says sleep expert Dr. Kripke at UCSD, "is they make you feel good about not being able to sleep." Even your doctor tells you it's fine that you need it, and if it isn't working, lets load you up with more drugs. It's a hole you feel stuck in. YOu just wish you could shut your damn brain off and sleep like the rest of the normal people out there, but no one has an answer, and REAL solution to your problem.

This is where I am at right now. My baby is finally starting to sleep longer stretches, and here I am, wide awake. And just as I'm finally falling asleep, I look at the clock and realize my toddler will wake up in a couple hours, and I'll have no choice but to get up and be his mommy, no matter how tired I am. Then someone offers to give me a nap, and I take it. I feel better when I wake up, but I find that I have the same problem later that night, and I can't sleep unless I'm heavily drugged.

I have been wanting with all of my heart to get off of these meds, but with desperation and a priesthood blessing, I was prompted to wait until I was no longer pregnant, since my pregnancy was so complicated. I was told that I would be able to find a solution, even though it may be hard to go through. So here I am, almost 8 weeks post pardum, and last weekend, I ran out of Ambien, and of course, I had been taking too much and couldn't refill it yet. I went to my doctor, and he said I could start on a different medication, but he advised that I figure out why I am not sleeping. I asked him if I should see a sleep therapist, and he seemed to think that was a good idea. So I did the hard thing. I went home without a prescription, knowing all too well that I would not be sleeping a wink that night. But I was done. I was done with being so dependent on these pills. And with my body going back to normal, I was ready to take this on. The weekend was rough. My hubby let me sleep in on Saturday and Sunday and Monday, after no sleep the previous nights. Then Tuesday night, I finally fell asleep at midnight and slept for 3 1/2 hours, then woke up and fed the baby and could not go back to sleep, even though I was utterly exhausted and the baby was sleeping. That was last night, and today I went and saw the sleep specialist. I told him my history, and after going through many questions, he first told me that he was very impressed that I wanted to find a solution, and that I was brave enough to get conquer my dependence on the meds, and that I wasn't there just to convince him I needed a higher dose. Then he proceeded to tell me about this treatment called Sleep Restriction Therapy.

First he started out by explaining that our minds can be compared to a computer. When you go to shut it down, you have two ways of doing so. You can shut it down the correct way by clicking the button, and then it proceeds to go through the normal procedure of closing programs and turning off correctly. Or, you can push the start button and hold it down, till you force it to shut off. Forcing your brain to shut off at night is exactly what sleeping pills do. You are not shutting down the normal way, you are just skipping that whole process and forcing it to sleep. Pretty soon, this is the only way your brain knows how to sleep at night, and it completely relies on it. So, you are up all night, and then you sleep in the morning, or take naps during the day, so then you aren't tired so you have to take a pill to sleep, and the whole process repeats itself.

So this is what you do. First, you have to figure out how much sleep you normally get without sleeping pills. Get and average over a few nights, and log it. Then you must do a "hard reset" on your brain, and you stay up for 24 hours straight. This means no sleeping pills. Sleeping pills will harm any chance of retraining your body to know when to sleep and how to stay asleep. Sleep fasting reboots your internal sleep computer. This resets your circadian rhythm, and starts a clean slate.

Then you must figure out when you need or want to get up every morning, and subtract that from the number of hours you normally sleep at night, and that is the time you go to bed. So for me, I usually only get 4 hours of sleep at night, and I have to get up by 7 every morning, so my bedtime after the sleep fast would be 3 am. I MUST get up at 7 am, even if I feel like sleeping in.

Next, you must use bright light therapy. You can buy these at stores, but my hubby actually made a light box for me after researching how and what kind of light you needed. You have to be near the light for a half hour right after waking every morning. Using light therapy is absolutely essential, and this whole process is not near as successful without it. This helps to teach your system when to sleep and wake at the right times.

Next, you gradually increase the amount of sleep you get each night.This is one of the most important steps, because if you jump back too quickly into trying to sleep all night, you'll lose any benefit you gained up to this point. Once you find that you are falling asleep quickly (within 20 minutes of lying down) and you are sleeping the full amount of time, you can add 15 minutes of sleep. So if my bed time is 3 am, I could try going to sleep at 2:45 am, and if that night is successful, then 2:30 am and so on. But if I find that I cannot sleep at 2:30 am quickly, then I must go back to sleeping at 2:45 or 3 am, and start at the time I could sleep for a few days, and try it again.

And last, NO NAPPING. This is extremely important. Napping messes up your circadian rhythm and you won't be able to sleep when you need to. If you have chronic insomnia, like me, you should never ever nap again, it's that important. This kinda makes me wanna cry. If you feel tired during the day, use your light box or get out in the sunshine and exercise until the drowsiness is gone, but don't give in to napping.

In reading Dr. Spielman's studies, most people gained at least a couple hours of sleep each night after doing this therapy. That can make all the difference. 6 hours of sleep is a heck of a lot better than 4.

When he explained this to me, it felt right. I felt peace that this is the course of action I should take in order to beat this problem. It's definitely not the easy route. It's going to kill me, I am sure. But in my mind, it makes perfect sense. This is the only real solution I have ever been given to treat my chronic insomnia, and I am so grateful that it exists.

I'm debating whether to start this tonight, or wait until after Ethan's baby blessing this weekend. I have so much I have to do, and I think I need to plan for this. It's going to be a week or two of hell. I'm not sure how my kids will survive, especially my poor 2 year old Carson. His mommy is going to be dead and boring, and I'm sure very short tempered. But I feel this is right. Now I just need the strength to do it. But I am blessed to have many people praying for me. My mother in law felt prompted to put my name on the prayer roll of 16 temples. Bless that woman. Her faith is unwavering. I look up to her in so many ways. And I know my Heavenly Father will not leave me alone. I know he will provide a way that will make this possible.

So whether I start tonight, or Sunday night, I will keep you updated. I'm going to log everything on this blog, and let all my fellow insomniacs see how well it works for me.