Sunday, April 27, 2008

An explanation of sorts

As some of you know, I have been battling with a sleep disorder for years.
I was put on medication once the girls were no longer a factor and that helped a great deal .... for a while.
Lately, my condition seems to be worsening .. or maybe it's just that the medication is no longer helping .. either way, it's definitely starting to get the better of me.

One of the biggest problems is my sleep. My brain never enters the restorative sleep phase. The normal process of sleeping is grouped into stages: (taken from sleepdisorderchannel.com)

Stage 1 sleep, or drowsiness, is often described as first in the sequence. Polysomnography shows a 50% reduction in activity between wakefulness and stage 1 sleep. The eyes are closed during Stage 1 sleep, but if aroused from it, a person may feel as if he or she has not slept. Stage 1 may last for five to 10 minutes.

Stage 2 is a period of light sleep during which polysomnographic readings show intermittent peaks and valleys, or positive and negative waves. The heart rate slows, and body temperature decreases. At this point, the body prepares to enter deep sleep.

Stages 3 and 4
These are deep sleep stages, with Stage 4 being more intense than Stage 3. These stages are known as slow-wave, or delta, sleep. During slow-wave sleep, especially during Stage 4, the electromyogram records slow waves of high amplitude, indicating a pattern of deep sleep and rhythmic continuity.

Non-REM Sleep
The period of non-REM sleep (NREM)is comprised of Stages 1-4 and lasts from 90 to 120 minutes, each stage lasting anywhere from 5 to 15 minutes. Surprisingly, however, Stages 2 and 3 repeat backwards before REM sleep is attained. So, a normal sleep cycle has this pattern: waking, stage 1, 2, 3, 4, 3, 2, REM. Usually, REM sleep occurs 90 minutes after sleep onset.

Stage 5, REM
REM sleep is distinguishable from NREM sleep by changes in physiological states, including its characteristic rapid eye movements. However, polysomnograms show wave patterns in REM to be similar to Stage 1 sleep. In normal sleep (in people without disorders of sleep-wake patterns or REM behavior disorder), heart rate and respiration speed up and become erratic, while the face, fingers, and legs may twitch. Intense dreaming occurs during REM sleep as a result of heightened cerebral activity. The first period of REM typically lasts 10 minutes, with each recurring REM stage lengthening, and the final one lasting an hour.


My problem is that I enter REM sleep and dream from the second I fall asleep.. and continue on in that stage until I wake. Thus, my brain and body never get the chance to rest and recuperate. Another lovely part to this is that during the day, my brain doesn't get the message to produce enough of the excitatory neurotransmitters. It's constantly longing for that much needed deep sleep.
Combine the two and ...
ouch.

I can sleep for 1 hour or 15 .. it makes absolutely no difference. When I wake, I feel exactly the same... as if I never slept.
I can maneuver the snooze button on my alarm a hundred times while still asleep... and that sound is often placed into my dreams where I'm constantly wondering why I can't stop whatever noise I dream it up to be. That part of it is actually a tad comical from time to time, depending on what my brain turns the alarm sound into in my dreams.
The not so amusing part is that this leads to an often debilitating fatigue and the feeling that I'm walking through my life in a complete fog.
I'm now late for everything, lose things constantly, my thought process is a jumbled mess, and I feel like I've lost the crazy, fun, spontaneous person I used to be.
Some have commented on how I seem different .. quieter .. not as happy... probably because I'm concentrating so hard on keeping my eyes open and making sure the girls aren't affected by my exhaustion.

The best way I can describe the feeling I have every minute of every day is as follows. Have you ever curled up on the sofa, started watching a movie or tv show, only to find yourself starting to drift to sleep during the last few minutes? Of course, you want to see how it ends, so you fight hard to keep your eyes open, and use every ounce of your being trying to concentrate on the dialogue. Your eyes are heavy, your brain is starting to shut down .. so you lose most of what's being said and the act of keeping your eyes open actually starts to become painful.
Welcome to my life.
It's frustrating, it's exhausting, it's maddening.

The qualitative effects of never getting any restorative sleep are what's getting me right now. The medication that I am on used to help perk me during the day .. but that does nothing to help my body recover from not getting a minute of deep sleep. So far, the only thing that they have to help with the sleep problem is a medication called Xyrem.
Maybe you have heard of it by another name ... GHB.
No? how about this .. the date rape drug.
Thanks, but no thanks.

I'm not big on the prescription I already have .. and refuse to take more than the absolute lowest dose. No way am I taking the date rape drug to help me sleep.
Of course, I don't know how much more of this I can take and remain sane. (Relative term people .. no comments from the peanut gallery)
My plan is to first talk to my doctor at Emory .. who is fabulous... about my concerns. The next step is to visit a Naturopath and try some holistic alternatives.
We'll see.

I guess the babbling above is my way saying to everyone that I swear I'm not lazy... I'm not forgetting about you ... I'm doing the best I can to not have you stuck waiting on me to arrive... My constant screw ups are not purposeful ...
I'm trying.
Be patient with me.
Hopefully in time I'll be able to better regulate this and find my way back.

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