Fat Lady on a Bike: My Journey to Peace and Fitness

Join me and my wonderful Electra Townie bike on my continuing journey to inner peace and both inner and outer fitness.

Wednesday, September 22, 2010

Knitting Up the Ravelled Sleave

When I came home after my first semester of college, my parents took one look at me and offered to rush me to the doctor.  I was deathly pale, had huge bags under my eyes, and presented a generally dull and lackluster affect.  I told them I was fine, but that I had been getting by on about two hours of sleep a night.  It wasn't that I was a partyer -- on the contrary, I was studying and talking into the wee hours, not wanting to miss a single moment of the intense experience.

That was the last time I so cavalierly tossed away opportunities to sleep.

My real love-hate relationship with this most essential activity began in my early thirties, when I developed asthma.  For more years than I like to contemplate, I was up until 3-4am every day, hacking my guts out.  It was partly a side effect of taking theophylline (a close cousin of caffeine), and partly the result of the disease itself, which tends to be more active nocturnally.

Eventually, my asthma got better controlled and I went off theophylline, but that was about the same time that I became a gigging musician, with a band out in Western Massachusetts.  At least once a week (for rehearsals), but often two or three times, depending on our gig schedule, I was driving home in those same sleepless wee hours, totally disrupting any chance of having a reasonable sleep schedule.  I felt as though I was always catching up, trying to fill a deficit that never stayed filled for more than a day or two.

When I finally got to the point where I couldn't deal with that any more, I began staying at motels after gigs so I wouldn't have to lose so much sleep.  That was fine, until menopause struck.  That brought me two years of 3am awakenings.  These weren't the usual, sleepy arousals that usually lead peacefully back to bed; these were springing into action awakenings.  I thought I would go mad, as I tried to deal with that in the context of trying to maintain a "normal" schedule.  Eventually, I consulted a therapist, who advised me to get up and do my work at 3am, if that was when I was awake, and take naps in the afternoon.  Duh.  That advice got me through the hormone frenzy.

I had a few peaceful years.  But for the past couple of years, I have had the worst sleep problems of all.  Half the time I can't fall asleep, even though there's nothing particularly urgent on my mind.  It's partly discomfort from my various physical aches and pains, and, to be honest, partly anxiety about sleeping.  The other half of the time I sleep for many hours, but I wake up feeling exhausted.  The result is that I'm tired all the time.  It takes me forever to get moving in the morning, and I'm often too tired to sleep when I do go to bed.

For a long time, I thought that I was deliberately keeping myself awake past the time I first felt sleepy so that I could have the house to myself for private eating.  Night time was always worst for me in that regard.  But since I cleared out the emotional mess that was behind most of my inappropriate eating, I've still been unable simply to put myself to bed at the first yawn.  Despite fairly rigorous exploration of other possible motives for me to keep myself up, I've come to the conclusion that sometimes I just can't sleep.  Of course, the most frustrating part of all is that even when I do sleep, it doesn't seem to do any good.

Lately, I've spent some time researching insomnia, everything I've read suggests that the best way to deal with it is "good sleep hygiene," by which they mean going to bed and getting up at the same time every day.  The trouble with that, of course, is that if I get up really early after a night of insomnia, I'm useless for the entire day.  And if I go to bed at the designated bedtime and can't sleep, I have to keep getting out of bed until I get sleepy, which does away with the whole notion of a standard bed time.

Fortunately, the physician's assistant who provides most of my primary care is a very smart and supportive person who believes that her job is to keep me safe while I work my way through to better health and fitness.  At my annual physical in August, she again suggested that I have a sleep study to see if I had a disorder.  Last year, when she suggested that, I put her off, since my experience of Carol's severe sleep apnea didn't seem to resonate at all.  But this year, she convinced me that an undiagnosed disorder could be putting additional stress on my heart and lungs, and I agreed that checking it out would be prudent.

Lo and behold -- I have sleep apnea.  It's on the mild side, but still significant.  I had a second study done to titrate appropriate CPAP levels and am now waiting -- impatiently -- for the follow-up appointment at which I will get my equipment.  Interestingly, though the night of the second sleep study was not exactly restorative, in the sense that I went to sleep later than usual and got up way earlier, I felt much more refreshed than after the first sleep study and the next night definitely felt sad that I didn't have the CPAP to put on.  I interpreted that as my body telling me that it liked the experience.

So, I am in a month-long limbo, knowing that relief is coming and feeling its lack even more intensely than before I knew that it was possible.  I have learned that in addition to fatigue, apnea can adversely affect both blood pressure and muscle/join achiness.  October 8th looms large as my day of salvation.  And then I worry that having the CPAP won't really help and I'll be stuck in this cloud of tiredness forever. 

Clearly, the best thing for me right now is to go with the flow and try to stay as functional as I can.  Trying to get on a reasonable bedtime/waking schedule certainly won't hurt, and it might prepare me for the good things to come.  And worrying never helps.  Maybe if I say that out loud enough times, I'll actually believe it!

A hui hou, and sweet dreams!

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