Teaching an old dog new tricks

It has been a good ten months since I stopped taking my sleeping pills. I have used sleeping pills to fall asleep on and off for a good 10 years – almost constantly really, except for the time I was pregnant with my son. I have tried to get off them several times over the last five years, but I was never successful. Now that it is almost a year since I stopped, I cautiously hope that I finally kicked the habit.

It has not been an easy journey. In the past, my only motivation to quit the sleeping pill was a vague belief of “chronic use of sleeping pills is bad for you.” But this time, I knew for sure that the pill was messing with my memory. My memory skills are very important to me. It is one of my strengths and something that I am proud of. The threat of losing my memory and my mind was a strong motivator in this quest to conquer sleep. Sometime ago, my doctor wrote me a prescription for a different sleeping pill assuring me that it was safe. I was hesitant about it and so she just shrugged and told me that I could use it if I want. I got the prescription filled but I have not used it at all. Every time I am tempted, I recall the feeling of intense embarrassment that I felt every time I couldn’t remember what happened the night before.

I have now come to see my chronic insomnia to be a disorder akin to alcoholism. I don’t think I will every be rid of it, but I can take steps to control it. I believe that using a sleeping pill even for one night will lure me back into the addiction. So, how do I control this beast that I have to live with? The answer lies in learning a few new tricks and following them diligently. Over the summer, I read a whole bunch of books on insomnia – from the helpful to the ridiculous. The first solution that is commonly recommended is the disciplined practice of sleep hygiene. Now, this is something that I have read so many times on various websites that I could probably recite it all in my sleep.

  1. Avoid or limit naps.
  2. Avoid stimulants like caffeine, especially after 3 PM.
  3. Do not eat too close to bedtime.
  4. Exercise regularly.
  5. Stop using screens with blue light for several hours before bedtime.
  6. Expose yourself to more natural light in the morning.
  7. Establish a regular sleep routine or ritual.
  8. Associate your bed with sleep – no watching tv or reading in bed.
  9. Ensure that the bed environment is ideal, not too hot or loud or bright.
  10. Go to sleep and wake up around the same time every day, including the weekends.

I have always shrugged off these suggestions because I believed that I was either already following most of them, or that some of them were impossible to follow. But after my research all summer, I wanted to give it a real try. Some things I was already doing – like no caffeine after 3pm, no screens for several hours before bedtime, somewhat regular exercise, morning sunlight exposure (as much as that is possible in the state of Washington!), and no tv in bed. I have always been against tv in bed. We have never had a tv in our bedroom. But I would always watch tv for an hour or so in the family room before bed,  (when kids are in bed and peace and quiet prevail) especially the shows that are not kid-friendly.

The first thing I did was start sleeping in a quieter room (aka no snoring from hubby). Then, I started turning down the lights at least two hours before bedtime. I stopped eating anything except for a small snack (to keep my blood sugars stable at night). Next, I started limiting or avoiding naps as much as possible. This was a bit of a challenge because I had to nap whenever I had a bad night’s sleep. I then tackled establishing a regular sleep routine. For this, I tried several things like a warm shower before bed, milk, or chamomile tea before bed and such. Nothing really caught on, so instead I settled for brushing my teeth, filling my water bottle, setting my phone to charge, and tucking the kids in bed. One change that made a huge difference was setting my phone on airplane mode during the night time. No more waking up because of notifications for every little thing! As my Fitbit vibrates for a silent alarm in the morning, I also made sure that I put the phone far away from the bed.

There were two suggestions on the list that were very hard for me. The biggest of them was sleeping and waking up at around the same time every day. As a night owl, this would be easier if I could go to sleep at 2 AM every night and wake up at 10 AM everyday. Alas, that is not possible in our world! So, I sacrificed the tv time that I used to enjoy after the kids went to bed and started going to bed pretty soon after the kids were asleep. This helped me establish a somewhat regular bedtime because I strictly enforce a regular bedtime on my children. Although it was difficult, I even managed to reduce the gap in bedtime on the weekends, to something more reasonable than four hours. But, even with all this, there was one more piece to the puzzle.

I resisted this last change the most because I never believed that not reading in bed would really make a difference . Reading in bed was my bedtime routine for years. In fact, that was how I realized that my sleeping pills were messing with my memory. I would have to go back and read the same section every night. My Kindle has a built-in light so I can read at night without disturbing others. Also, Kindles do not emit the blue night found in backlit screens, like phones and tablets. So, I believed reading in bed was okay and never made any effort to change that habit. However, over the past month or so, I have come to recognize my sleep window (that time just before falling asleep when your mind quiets and readies itself for sleep). I only learned to recognize this because of my regular bedtime. My sleep window is so small, such a light dip, that I would overcome it with the slightest stimulus (even reading). I never even realized that I had a sleep window before! But now that I knew I had one, I started waiting for it when I got into bed and give it a chance to develop before picking up my kindle to read. As weeks went by, I found myself avoiding the ritual of reading in bed and suddenly it all made sense. It was true – even reading in bed is disruptive to sleep (at least for someone like me). I really need to reserve my bed only for sleep. It just means that I will have to carve out some other time for reading. But, because reading is important to me so I am sure I will work that out.

Nowadays, I am falling asleep much faster than ever before. I picked out other small bits of advice, from books and websites, that have also helped. I keep a pad and pen near my bed to write down things that I want to remember the next day. That way I can let go of it in my mind. I surround my bed with everything I need. A full bottle of water, the pad and the pen, some headache meds and/or pain balm etc, all within a hand’s reach. To make my sleep “den” even more conducive to sleep, I set my thermostat a little lower than optimum. Did you know that one of the processes involved in falling asleep is a fall in your core body temperature? That’s why a warm shower before bed or a colder bedroom works. It makes your body temperature drop faster.

So, with all these lifestyle changes, I have made my insomnia bearable. I still wake up in the middle of the night sometimes and have trouble falling asleep again, but I am miles away from how bad it used to be. I still go to bed each day having no idea if I am going to get a good night’s sleep or not, but I am more hopeful. As each strategy brought me closer to my goal, I became more motivated to add more lifestyle changes to see if they will help. The downside of this type of management is the inherent fragility of it. Deviating from my sleep routine even for one day ripples into bad sleep for the next few days.

It helps to have a family that supports you. My family members, even my children,  know to never wake me up unless it is an emergency. My mother instilled in me a respect for sleep during my childhood. If I fell asleep before dinner (when I was a kid), she would rather let me sleep than wake me up to make sure I ate. She always said that missing that sleep would be more disruptive to my body than missing dinner. This is a unique attitude in an Indian mother (so many of them are obsessed with feeding their kids)! This family habit of “never wake a person who is sleeping” has even cost me a friendship. Just after college graduation, one of my best friend’s father arrived at my house to invite us all to his daughter’s wedding. I was out and my mother was napping and my 11-year-old brother refused to wake my mother and told him to come back some other time (as he was instructed to do with most people). He did not realize that it was an incredibly rude thing to do in this situation. Even after I apologized profusely on this behalf, my friend and her family took serious offense. Although I went to her wedding, she never spoke to me after that. Even after this incident, I stand by my “don’t wake up someone without a good reason” policy. I have heard it said in the Hindu culture that your soul communes with God when you are asleep. I believe that is the reason many of us wake up with a clearer head and more stable emotions after a good night’s sleep. Whenever a baby smiles in its sleep (and many babies do), my mother always said that the baby is smiling because God is playing with the child in his sleep!

Even after this incident, I stand by my “don’t wake up someone without a good reason” policy. I have heard it said, in the Hindu culture, that your soul communes with God when you are asleep. I believe that is the reason many of us wake up with a clearer head and more stable emotions after a good night’s sleep. My mother always says that whenever a baby smiles in its sleep (a lot of babies do), it is because God is playing with the child during sleep! I doubt most people think or write about sleep this much. But, for me, sleep is sacred. This morning, I tiptoed past the bird cage, because one of the birds was fast asleep! As I did that, it occurred to me that is an indication of how much I respect sleep. Its what prompted me to write this post.

So, please don’t wake a sleeping person unless you have a good reason. Here’s wishing everyone peaceful sleep.

-AB

 

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How my Kindle saved my mind

I promised myself six moths ago that once I had settled down in the US, I would try to wean myself off my sleeping pill… again. Six years ago, I was prescribed a popular sleeping pill when I was suffering from acute carpel tunnel syndrome. Soon after I fell asleep, my hands would cramp, hurt like hell, and invariably disrupt my sleep. After several medical interventions the carpel tunnel was solved by surgery. I had carpel tunnel release surgery in both hands and it was the only thing that finally fixed it. The pain stopped on the day of the surgery six years ago and never returned. Unfortunately, the sleeping pill stuck with me. Having been an insomniac all my life, prescribing a notoriously addictive sleeping pill to me was like writing a prescription for alcohol and handing it to an alcoholic. Since then I have tried to wean myself off the medicine twice. The first time, I almost succeeded and then got pulled back, probably because I wanted just “one” more night of good sleep. The second attempt was so half-hearted that it is not even worth mentioning. So, I was hoping the third time will be a charm. When I set myself this goal half a year ago, I only wanted to do it because I was ashamed to be addicted to sleeping pills. This is such vague motivation that I doubt I would have gone very far with it . Now I have developed some real motivation to stop taking it. I started having some real troubling side-effects from it.

I realized that I have trouble remembering events that happen after I take the sleeping pill for the night. Initially it was off and on, but now it occurs all the time. The first indication that something was off was when I would sit down to watch an episode of a show on TV and the DVR would tell me that I had already watched it. I would watch it again and still not recall having watched it previously. I brushed it aside thinking maybe my husband watched it and that’s why it was marked “watched”.

Then my husband started telling me I was repeating myself – that I had already told him something the night before. But to me it was the first time I was saying it. I had such a hard time believing this because I have a really good memory. So much so, that I always thought of my good memory as more of a curse than as a gift. I always remember all the times I was hurt, what people said to hurt me, word by word. Its hard to forgive when you genuinely cannot forget! To top it off, it is a generally accepted fact in my family that my memory is better than my husband’s and it was simply ridiculous to me that he remembered things that I had forgotten (ah! pride does goeth before a fall!).

Even with these signs, I never really believed it. It is amazing how our mind conspires to fool us when we we don’t want to believe something. What finally convinced me was my Kindle. I always read before bed and lately I have been doing it less and less.  I knew I was reading less but I never questioned why. Last month, I got Stephen King’s “Bazaar of Bad Dreams” on my Kindle. A King book, and that too a short story collection! I would have had it finished in days. And yet, I still have about 40% to go. The reason finally dawned on me. It was because I was reading the same story over and over again! I would read before bed and stop halfway into the story. The next day, I would pick it up and have no memory of reading it. So I would go back and start reading it again. I would finish it and remember if I read it during the day. But if it was at bedtime, the same thing happened again and again. If this had been a real book, I would have never realized it as I almost never use a bookmark. I usually memorize the page number and come back to it. But this was my Kindle, and it opened to where I left off. Still, I initially dismissed it thinking my son had been fooling around with the Kindle and had turned the pages! But too much evidence was piling up and I finally had to face the fact that this was really happening.

I must have been subconsciously aware of it, because when I scrutinize some of my behaviors I realize that I stopped doing some things after dinner (like watching some shows or reading or anything that required me to remember it the next day) . When I finally faced up to it, it scared the bejesus out of me. There is a reason why  Alzheimer’s is my worst nightmare! Now, I have some real motivation to get off that drug! Over the past couple of weeks I reduced my dosage from 10 mg to 8 mg. Its been a hard couple of weeks and I know its only going to get worse before it gets better. But I do know one thing for sure. This time, I will get successfully get of it because now I have something that scares me worse than a bad night’s sleep.

On a side note, I think it is interesting that both the first thing that alerted me and the final thing that convinced me of my problem were both modern technological inventions (the DVR and the Kindle). So, there is something to be said for modern technology after all.

-AB

 

A post for Carl Jung

Just before I woke up this morning, I had a vivid dream. I was on a beach with my mom and I was asking her help with a problem that was bothering me. She gave me the perfect advice that solved the problem and I woke up. My head was turned to the side where she would have been sitting and my hand was reaching out to her. I was surprised that she wasn’t actually there, (she is still in India) and I realized that I had a solution for a problem that I hadn’t even be consciously analyzing. So it got me thinking about how my dreams help with my mental housekeeping all the time.

This isn’t the first time that I have found solutions to my real-life problems in my dreams. Many a times I have woken up with solutions to problems that I have been actively working on and to those that I wasn’t really thinking about. The ones that always fascinate me is when I wake up KNOWING the exact place where a lost item that I had been searching for was hiding. I recall a dream from a year or so ago.In this dream, I was wondering where something was and thinking about the possible places it might be. I considered each possibility and eliminated them one by one until only one remained. I woke up and went and looked at that place and found it was exactly there as I had dreamed. The item was something I had been searching for days. It was eerie and though it had an air of the paranormal, I knew it was just my mind harnessing bits of information from different parts of my memory and putting two and two together to come up with the logical solution.

My husband always complains that he doesn’t have enough dreams or that he doesn’t remember them on waking. I dream every night and remember most of them upon waking. It is such a routine occurrence that most days I don’t give it a second thought. However, a majority of my dreams are borderline nightmares. Pleasant dreams are very rare. I am not talking about intense nightmares that cause night terrors, but more like ones that mainly deal with my fear of something and many a times I am just glad to wake up. My husband often tells me to “take charge” in these dreams and realize that I am dreaming and “direct” my dreams the way I want. I have tried to do that and I have gotten as far as realizing that I am dreaming but I have never been able to direct the course of the dream. Sometimes the fear goes away on the realization, other times I just feel like I have to wait it out.

I have patterns/themes to these dreams that manifest in recurring nightmares. When I was an adolescent, I frequently had nightmares of standing atop something high and being on the verge of falling. Another common nightmare is one in which my chemistry teacher from high school derides me (teachers really need to consider that they can  traumatize adolescents with their words, the effects are very far-reaching). Many of my nightmares have an educational theme to them; I attribute it to my academic struggles in high school. Although I was a straight-A student in college, I was pretty much at the bottom of the class in high school. I often have a nightmare in which I am told that I have to go back to high school to redo my last two years in order for my Master’s degrees to be valid!  Another educational-themed nightmare which really scares me (during the dream) is having to take an exam for a class I never attended. Almost always this dream involves a language class in Tamil. Recently I had this version of  dream with a math class (I blame common core math). Obviously, I have a huge fear of failure in the academic realm.

A few months before I left India, I had a recurring nightmare in which I had come to the US and had lost touch with all my friends in India. In this dream, I had friends in India who think I don’t care for them anymore, that I have forgotten them. Interestingly, after coming here I don’t get that dream anymore. My husband, when he remembers his dreams, talks about crashing his car. I might have had that kind of dream once or twice but it is not a predominant pattern.

My real nightmares, the ones that leave me feeling upset for hours after waking are the so-called pleasant dreams. In those dreams, I am living the perfect life, the one in which I never faced the turning points in life that took me in a direction I hadn’t planned. In these dreams, I am loving my life and I wake up and feel incredibly disappointed that it was just a dream and it wasn’t real. Then I feel upset about the disappointment, because it means that somewhere deep in my mind I  have regrets. Yet another type of dream is one that leaves me frustrated. These are ones in which I have brilliant insights that I don’t recall in the morning. Sometimes I think of amazing story plots that disappear like early morning fog. I have tried to remedy these in two ways. I have tried keeping a notepad next to my bed and writing down stuff either in the middle of the night or immediately upon waking. This has never helped for I cannot make any sense of my notes when I look at them at in the morning. Sometimes, I realize that I am dreaming and I instruct myself to hold on to that brilliant idea. This has a better rate of success. I sometimes remember bits and pieces. I do wonder if the reason I don’t remember these dreams is because I am not supposed to.

I think I will finish up this post with the best dream I have ever had. It was roughly two years ago. In this dream I was lying down listening to music from Lord Krishna’s flute. Someone came up to me and told me to wake up. I replied that I would not wake up, not until Lord Krishna himself came and told me to do so. Next thing I know, HE was next to me addressing me by my name and whispering in my ear to wake up. I woke up and my eyes fell on the picture that hangs in my bedroom in India depicting Lord Krishna playing his flute. I believe that there was something truly supernatural about this dream. Even now I draw strength from it.

What do you dream of?

-AB

If I were a bird, I would be an Owl

After trying and failing many times before, I have successfully completed a week of regular meditation. Seven consecutive days with just 10 minutes each day. So far, I haven’t noticed a difference in my stress levels or a feeling of ‘zen’. However, I did notice that meditation itself became easier each day. My mind does not wander as often as it used to and when it does, I catch myself much faster. It is also easier to refocus.

My sustained motivation to keep meditating this time is because my insomnia has recently taken a turn for the worse. I suffer from severe and chronic insomnia. It takes me an average of 45 minutes to fall asleep and I almost always wake up after 4 hours of sleep. It is easier and faster to go back to sleep the second time around but, there have been days when it has taken me more than an hour to fall back to sleep. Naps are a different cup of tea. Depending on how sleep-deprived I already am, I will fall asleep in about 20 minutes or not at all. The concept of a power nap or even a nap shorter than 2 hours just never made sense to me, because I just can’t fall asleep that fast. On weekends, especially Sundays, I will take a 2 hour nap.

A few months ago, I had a pretty the levels of vitamin B12 in my body hit a long time low. During that period, I used to be so exhausted all the time that I would literally fall asleep at my desk at work. Unlike most people, my dip in energy does not come after lunch. For me it hits earlier in the day around 10 to 11 AM. If I can get through that hour of the day without falling asleep I don’t need/ won’t be able to sleep at all during the day. Now that my B12 levels are back up I don’t feel that pull of sleep as much during mid-morning.

I think my weird sleep patterns primarily stems from my innate night-owlness, which makes it so hard for me to fit into a world that largely works in favor of morning larks. I just don’t feel sleepy at bed time. In fact, I feel fresher and more active and creative in the late evening. When I was younger and could get away with it, I would just stay up until I felt sleepy, usually around 2 AM.  When I lived by myself in Australia, I regularly went to sleep at 3 AM and woke up at 11 AM and it worked so well for me. Unfortunately, it just was not a long term option.

To make matters worse, being a night owl is looked down upon in Indian culture. All my life, I have had my parents berate me for waking up late and going to sleep late. So much so, that I instantly feel guilty if I wake up past 7 AM on any day. If I am up past mid-night, I have a nagging fear in the back of my mind that my mother will wake up and come and yell at me to go to bed. This happens even if my mother is half a world away! When I was in 12th grade, my mother would wake me up at 5 AM, hand me a cup of tea, and leave me in a room without a bed so that I can study. In 10 minutes, I would be asleep in the chair and will wake up with a start to face her wrath when she got up an hour later. My mother is a big believer of “its better to study in the early morning because your mind is fresh at that time”. She herself is a Lark and just could not figure out that I got my deepest sleep between 3 and 6 AM. Out of sheer desperation, she dragged me to a doctor to find out why I was incapable of waking up or staying awake at 5 AM. That doctor did me a big favor and I am still grateful to him. He sat my mother down and explained that being a night owl was just hard-wired in to me and that I would probably learn better at midnight than at 5 AM. He encouraged her to allow me to study late nights instead of early mornings and it made all the difference when I was in college. My mother trusted the doctor, but I think even now she is not fully convinced that it is not just a bad habit or laziness.

For the longest time, I struggled only with a displaced sleep. I tried everything I could to set it right. I would go out into the sunlight in the early morning, dim lights in the evening, follow a bedtime routine, have a warm shower, drink a glass of warm milk, take the herb feverfew, the works. The one thing I could not do was keep the same bedtime. I did not take any sleeping pills for a long time and just stumbled along. Motherhood made me an even lighter sleeper as my firstborn used to wake every 4 hours until she was 11 months old. Then, about 5 years ago I was diagnosed with carpel tunnel syndrome. My hands would go stiff and hurt all night long and it made me more sleep-deprived than usual. My GP prescribed a common sleeping pill to me- the magic of a good night’s sleep in a little blue pill (here in India, its a bright orange pill). No sleeping pill is meant for long term use, and the doctor should have cut me off after 6 weeks, but he didn’t. A year later I had carpel tunnel surgeries in both hands and the pain was gone, but I still take that pill.

I have successfully weaned myself off that pill twice in the last 5 years. The second time, I actually shaved a little bit of the pill every night to lower my dosage. However, every time life hits me with a stressful event, my sleep is the first to go and eventually I go back to that little pill. A couple of years ago I discovered Melatonin, which is non-habit forming and does not seem to have any known dangerous side effects. With my medical history, it is likely that I might be melatonin-deficient.  Melatonin also helped me get off that pill. You cannot get Melatonin in India and I ran out of my stash a month ago.

I have not had a full night’s sleep in a month, even with my bright orange pill. For the first time in my life, I increased its dosage on Friday nights just to get one good night of sleep a week. I am starting another stressful journey in my life right now. The big move back from India to the USA. Did you know that moving is a life event that causes very high stress levels? Only death and divorce are greater. So moving from one country to another is a pretty big life stressor and like always it is eating into the little sleep I get.

My brother sent me some melatonin yesterday and I got a good night’s sleep after a long time. For once, I woke before the alarm feeling rested instead of wondering how I was going to get through the day. But, I am sick of being dependent on medication for sleep. I also know that is is very harmful to me. The pill I take is known to cause memory loss and that is one of my biggest fears. So this time, I decided I needed to do something else, something safe and long lasting. Hence, the motivation for the meditation. It does help slow down the monkey that is my mind at bedtime. So hopefully with its help, this third time will be the charm and I will finally get rid of getting my sleep in a pill or a capsule. Wish me luck!

I believe that those who are truly blessed in life are those who fall asleep the minute their heads hit the pillow!

-AB