Clinical management of insomnia

Cartoon man lying in bed with thought bubble counting sheep in thousands

I didn’t know I could count that high.

You know this title is a joke, don’t you? Am I the type to lecture you on anything? But I am well versed in dealing with insomnia, as much from my clinical work as from my vast personal experience. Ah, the glory of a good night’s sleep.

I’ve been a crappy sleeper ever since I left my mother’s womb. Six full weeks of colic, she asserts. She’s surely exaggerating since the exhaustion of caring not just for sleepless screaming me but also for my two not-much-older siblings clearly impaired her memory.

My sleeping has improved to some degree especially over the past 10 years, especially as I’ve gotten more tired from illness, but I have learned that insomnia and chronic fatigue unfortunately can co-exist. Anemia has its benefits–I’d never slept so well until that bombshell hit–but I had a bad insomnia relapse this week. Two bad nights in a row, the second a personal best, stretching from 12:30 to 6:30 a.m. Despite my extensive clinical knowledge of what to do to manage insomnia–don’t stay in bed if you can’t fall to sleep, bozo, get up and go to a different room, keep the lighting low, and listen to music or read something not overly stimulating until you are tired enough to return to bed, and never, ever, ever turn on your computer/TV/cell phone–I didn’t heed most of it. I didn’t touch the electronics, at least. I could say I was too tired to do all those other things but I’d be lying because I was wide awake.

So what did I do instead? I stayed in bed and planned out the rest of my life, in the process disturbing J.’s sleep as well. I’m terming last night’s bout “happy insomnia”. (Apologies to my sister in liver disorders, who recently introduced me to the term “happy tears” when she was reading something in her car that made her cry from happiness. I’ve adopted her notion for my own selfish purposes.) I don’t often have this type of sleeplessness; mine is normally anxiety fuelled.

“Happy insomnia? Why?” you ask. In fact, I had a lovely visit with Dr. Liver Wednesday, in which he graced me with his time and kindly addressed my long but reasonably organized list of questions, as he always does. (Patience of a saint, that man.) He gave me as clean a bill of health as he was able given recent investigations and bloodwork. If he’s cool, I’m cool. I left feeling hopeful and positive, and decided I’d better make the most of my time, starting at 12:30 a.m. the next morning. How else to milk the time I do have but intrude on my sleep hours? Unfortunately, I was more than a little tired yesterday–I’m amazed I didn’t land in Tuktuyuktuk instead of Vancouver–so last night I committed to better using my daylight instead of nighttime hours.

The beauty of exhaustion is that eventually it overwhelms sleeplessness. I was so tired last night that I slept like a baby (absurd analogy given mom’s reports, I realize). But if that insomnia devil rears her head again, I swear, as you are my witnesses, that I’ll get out of bed and do what’s advised until I’m ready to try sleeping again. Either that or draft my next blog entry on the computer.

P.S. Pretty clever how I snuck in the lecture, no?



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