24 June 2013


When I was young, up through my 20s, I had no problem falling asleep and sleeping deeply.  As I've grown older, insidious invaders have conspired to interrupt the degree to which I sleep soundly.  They include ~

  • Stress.  Starting in my mid-30s during an ugly and protracted child custody dispute, I found myself obsessing over the emotional warfare as soon as the lights went out.  That was the origin of my habit of reading in bed until my eyelids will no longer stay open.
  • RLS and PLMD.  After a sleep study at around age 50 I was diagnosed with not one, but two neurological disorders ~ Restless Legs Syndrome, which manifested as a skin-crawling sensation at night, and Periodic Limb Movement Disorder, during which my leg muscles would involuntarily jerk, waking me up without knowing the cause.  A single medication, clonazepam, has proven effective in controlling both conditions.
  • Chronic pain.  Starting in my mid-50s, I began to notice the onset of osteoarthritis.  This discomfort was magnified to chronic pain by a herniated lumbar disk, a result of on-the-job working conditions.  A variety of treatments ~ including epidural and facet injections, use of a TENS unit, and others ~ failed to provide lasting relief.  My injury isn't severe enough to warrant spinal fusion surgery, to which I would not submit anyway, since it has only a 50/50 success rate.  The only course was to retire on disability, which I did. I take a muscle relaxant at night, and ibuprofen as needed, which controls my pain, but does not erase it.  Ever.
  • Aging.  As we grow older, our circadian rhythms shift, and the amount of sleep we need usually changes.  One result can be yet another disorder, CRSD.  You guessed it, I've gained another companion.  Left to my body's own devices, for a long time I was staying up until 1 a.m. and sleeping until 11 a.m.  I've been trying gradually to shift both times to an earlier hour, to be more in sync with the quiet or noise of my human surroundings.  In addition, within the past six months I've developed increasingly pronounced hand tremors which interfere with any fine motor skill like typing or eating, and also may delay falling asleep.  I'm seeing a neurologist this week, to rule out the possibility of Parkinson's disease
  • Speaking of noise, I've always been a light sleeper, and find it useful to run a small fan to provide white noise to mask the sounds of night.  Without it, I would be startled awake half a dozen times nightly.
In today's NYTimes online there is an informative article on sleeping better.  Among the author's recommendations ~
  • Do not exercise within 2-3 hours of bedtime (but do exercise).
  • Avoid stimulating medications like decongestants, caffeine, or beta-blockers.
  • Avoid large amounts of food, as well as any alcohol, close to bedtime.
  • To overcome stress, try a nightly ritual like a hot bath, meditation, progressive muscle relaxation, or other soothing activity (like reading!).
  • Other tips include drinking 8 oz. of diet quinine-containing tonic water daily, and taking a 3 mg supplement of melatonin after sundown.
I have two further suggestions.  First, a high quality bed is essential.  Second, in the absence of a nurturing relationship (I am single), having a furry friend can be quite soothing.  My two cats love to nestle next to me, or even on my legs.  The warmth and body contact are quite helpful.

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