Sleep Hygiene
I was once told by my former therapist, in response to my telling him about my achieving a state of consciousness or enlightenment, that he wasn't surprised because my "whole life is about experiencing extremes."
As I gain more awareness and communication and collaboration on the inside, I find these extremes to be more difficult to handle.
The one area which is most difficult is sleep.
I'm struck by how disordered and variable sleep is for me. I can go days of sleeping all the time on one extreme and days forced staying up on the other. And I can also be somewhere in the middle, which is perhaps a more normal way of sleeping.
When there is forced staying awake, it's usually because there's a sense of internal panic that I need to protect against. Becoming slightly manic avoids the inevitable. When I do get to bed on those nights, it usually ends up being a twisted form of hell. There's almost a direct window into the terror felt by parts of me. I know that to be the case, but I cannot really write about it now because I don't have the experience of it. It's more like I'm reporting on what happens. I've talked before about intellectual knowing versus emotional knowing. On these nights, the activity level of my system is very high.
Then there's the opposite extreme. I can sleep for days on end. I think mostly my system activity is very low and I don't generally have any sense of what's going on inside. I'm usually in some form of depression and disconnected.
I don't live in these extremes all the time. I often do get to experience a middle ground. I find that practicing good sleep hygiene helps. Now that baseball season is here, my children are about to end school for the summer, and it gets dark later, I find myself up late and find it difficult to practice good sleep routines. But for me, I find it best to attempt to de-stimulate at night. I often try to go to bed with the kids at 9. Kids have elaborate bedtime routines. When I become involved in theirs, it helps me.
Medication has mixed results. I tend to not take medication at all if I can help it. But on the nights which become hell, I eventually load up on benzodiazepines very late to stop the crisis. This often leaves me snowed the next morning.
I self assess at night. If I go to bed with the kids, read, listen to music, draw a little, write a little, and still can tell that the system is too activated to sleep or there's a growing panic inside, I'll take some medication. What I take changes depending on the circumstances. I had a real difficult time withdrawing from benzodiazepines last summer, so I don't take them regularly. But I do find they work most quickly and effectively. I have trazodone, chloral hydrate, lunesta, risperdal, and klonopin. They all work to various degrees, but it's hard to tell exactly how because the ground rules are always changing. Even still, medication is not a perfect, or even a good, solution.
I just started a sleep log. Not only am I keeping track of how many hours I sleep, but I'm also writing down where I'm at before sleep, what I've done from my hygiene routine, and what I take for medication and why.
I posted this to start a discussion about what works for you with respect to sleep.
13 Comments
Welcome
"Healing from Trauma and Dissociation"
I'm Paul, a father, husband, scientist, educator, photographer and musician. I'm also a survivor of childhood sexual abuse.
Mind Parts consists of my own insights on the aftermath of childhood sexual abuse, namely trauma stress and the full spectrum of dissociative coping mechanisms, including dissociative identities. Through a blog, I explore the healing process in a variety of ways—using creative contributions of original art, photography, poetry, and music as well as, hopefully, though-provoking essays. Mind Parts is also home to two support services. The quarterly Ezine Trauma Recovery Highlights is a look at some of the best online resources. Also, the monthly Expressive Arts Carnival makes available activities which are published as a group "Carnival."
Comments are welcomed, but if you prefer, you may contact me offline. My belief is that sites like this one can contribute by offering unique perspectives and knowledge, thereby enhancing opportunities not only for survivors but for readers and society as a whole. Namaste!
I have spent my life fighting with sleep. For most of my fifty years on this planet I have slept between zero and four hours a night, including when I was a child. I still don't really understand all the reasons for this, but I suspect my father's night visits to my room may have been part of the reason that it all began.
For many years, I just told people sleep was over-rated and didn't try to sleep. I was so sleep deprived that I never felt tired - I didn't know what it was not to be tired. I just lived on the anxious kind of energy that is leftover when you never have any real energy. I sometimes experienced psychotic events - waking dreams - because I didn't have enough sleep-dreams.
I take a low dose of seroquel every night now, which has completely turned my sleep pattern around. It is an extremely low dose, so it has not caused any side effects like weight gain or grogginess the next day (as long as I take it early enough). I also take an herbal sleep combination containing valarian root and melatonin. I take HALF the recommended dose, which I think is an important thing to mention. For people with chronic sleep issues who are, as I was, running on anxiety, taking too much of any sleep aid can actually make the anxiety worse and thus counteract the benefits. This has been my experience, something I have read about, and also something I have heard others say.
I still have an occasional night of restlessness or sleeplessness, but these are down to once a month or less, which is really about like most normal people (people without sleep issues).
I know people who use only the herbal sleep aid with good results, but I need the seroquel for mood stabelization - it keeps me in the "grey area" and out of the black and white of extremes.
This regimen has worked well for me for nearly a year now. It has been the most stable and comfortable year of my life.
Everything you said in your article rang true to me, from the description of your sleepless nights, to your thoughts about how you can't really describe the feelings when you aren't in them. My personal feeling is that if we had more sleep studies we would solve a lot more of the mental health issues people face.
Sleep. Such a complicated yet necessary evil. I have a very regimented sleep routine and the even the slightest deviation causes devastation. I actually talk on the phone with my best friend for 45 mins to an hour as a part of my routine. Something about her voice keeps me relaxed. I also have certain signals for myself that tell my body we are slowing down and heading for bed and every night I take benedryl.
I have used sleep medication in the past and I don't like it. I have a need to be able to wake up and get going if I need to, and the thought of a chemical restraint makes me queasy.
Anyway, routine is key for me...
Shen, it is really wonderful that you've found something that works for you. I am positive that my increased sleep problems have to do with how everything is reorganizing inside at such a fast pace.
Tempy, Yes, I have sometimes imagined how much better the world would be for me if I just didn't have to sleep. Wouldn't that be great? I have tried the long phone conversation thing and it's a bit anxiety provoking for me. I'm glad it works for you.
Paul, that seems really likely.
I remember when my children were babies, and were on the brink of learning a new skill (like crawling or walking). They never seemed to sleep at those times. There was something going on inside them, some kind of change, that kept them from sleeping well until they had mastered the task.
Your "reorganizing" seems like that, to me. If you are like me, you are driven to push forward and find the peace of mind that you are working for.
Sometimes people tell me that I should take a break, not work so hard, but how can I do that when the issues are right here, staring me in the face? Do you also find that it is nearly impossible to put your "recovery work" on the shelf?
Can I put my "recovery work" on the shelf? No. Here's why. There was a time when I was so completely stuck. I suffered all the co-morbid (love that word) conditions that come with PTSD/DD which I won't list here. But, I am on some hugely fast healing trajectory now. This has been a lifetime in the making. It's incredibly painful. But it's progress. When you've waited your whole life for this change, there's absolutely no way to slow down. Yes, everything is reorganizing inside. Parts who were so fixed in their ways for 20-30 years, have changed. I never imagined in a million years that this could happen. This was the reason for the blog here in the first place. I wanted to share with others this process. In part to give words of wisdom to others, in part to celebrate how far I've come, and in part to learn from others. Thanks for commenting.
It wasn't until my College Biology class at the same time as my therapy in which my T explained that sleep is not just to regenerate our bodies, it is to regenerate our emotions and mental states. He told me that sleeping is when our minds process everything that couldn't be dealt with or coped with during our waking hours - because waking hours the world moves too fast.
So, I tried to set regular sleep hours, even if I didn't want to (and I'm a night owl). Then when I started working, I was tired enough to sleep when I wanted to. Exhausted, really. But, that is when I realized that my dreams took a different turn and I was able to remember them and I processed them with Mr.S.
After a few months, I had released a few bad nightmares into the darkness, banned from my dreams forever (I hope). My dreams were memories trying to process that I never allowed to process because I forced myself to stay awake or was just sleep deprived. I have Buspirone, if I can't shut my mind off enough to sleep. In the beginning, I used it often, now, not much at all.
Short of it - a consistent sleep habit is a must. I think our bodies look forward to shutting off and giving our minds a chance to do their thing!
Thanks for your perspective, Ivory. Yes, I know it's important. It seems as though lately I've been having problems with basic necessities like eating and sleeping.
I have rather different sleep issues, which I'm going to note here in case this experience is useful to other DIDers who pop over here. I don't usually have a lot of trouble sleeping, and I'm rarely troubled by my dreams, even when they are unpleasant. However, since the age of 10, I have never felt that I get enough sleep, no matter how long I sleep. I am perpetually tired.
My therapist suggested the very bizarre idea that only part of my brain sleeps and/or dreams, and the rest of it is still awake, which is why I'm always tired. This made sense, especially considering that my primary switch lives in another country, in a time zone eight hours ahead of me.
My sleep hygiene routine involves putting everyone to bed, and getting them all to agree to go to sleep, or at least to stay quietly in their safe places so my body can actually turn off. This is a continual negotiation with my primary alter, whose social life in his own world has pretty much been ruined by this new schedule.
I've been lazy lately about asking everyone to come to bed with me, and despite getting plenty of sleep, I notice that I am, once again, suffering from extreme exhaustion.
I've had long term sleep problems; experiencing the rather typical PTSD symptomatology of difficulty getting to sleep, frequently waking and then difficulty getting back to sleep. I grind my teeth during the few hours of sleep that I get each night to the point where they're cracking under the constant pressure. So the sleep I do get is rarely restful for the mind or the body.
I know that part of my sleep issues are because of the fear of the night and what will happen - a totally irrational fear now that I live alone. The mind keeps going at 100 miles/hr to try and soothe or keep busy until the last minute - my hope is to go from totally awake to a deep sleep within seconds, none of that drowsy vulnerable state. I must be either totally aware or totally oblivious.
I've tried various methods to assist my sleeping - medication, herbal remedies, relaxation tapes, music, routines, mindfulness, night lights etc. None has worked. I've been told that maybe the sleep that I get is normal for me and that I shouldn't compare the amount of sleep I get to the rest of the population. I'd accept that if I didn't crash every three months or so from exhaustion.
There are parts who are active at night and I have no idea what's been going on - except for finding new photos or friends on our communal chat client. This oddly enough gives me hope. Possibly our sleep issues are tied to the need for greater internal communication and agreements. So this is something that can be worked on. Meanwhile, I'm very much like Shen describes - sleep deprived and on the fake high that comes from that state.
Take care...
I can certainly understand this, especially the fake high from sleep deprivation. I remember that from college staying up all night studying. It takes a toll. I hope you get a mouth guard for your grinding. This is a solvable problem for sure. I sometimes have luck with the fear of sleep problem. But I don't seem to be able to predict it well. I try to assess when I do go to bed. I think I make an estimate as to how fast my mind is going (how many miles per hour so to speak) and depending on the number, it will guide what medication, if any, I take. Luckily, once I get past the getting to sleep, I am out for the night. I think whoever told you that maybe you get enough sleep for you, just tried to sell you short. Based on what you've said, I don't believe that to be true at all. I think it is all about communication inside. There's a certain harmony that comes from communication and collaboration and I wish that for you (and me too).
Sleep is a significant problem for me as well. With the exception of avoiding vigorous physical activity for a couple of hours before sleeping to avoid worsening the difficulty in falling asleep, it is my experience that nothing at all helps me now. Sleep hygiene just has no effect and drugs often worsen the problem. I've given up and have accepted day sleeping as my norm. I wish you luck.
I discovered that alternate nostril breathing has an effect on my sleep. Tossing a turning perhaps a way to attempt to balance the brain to prepare for sleep.
Practicing alternate nostril breathing is easy. Simply hold one nostril closed then the other.
A word of caution if the brain and body are prepared to process what needs to be processed what needs to be processed may not be easy.