For decades (sucks that I can actually say that) I’ve had trouble sleeping. I remember back in high school, getting up to get showered and out the door was always a chore that involved my mother almost pushing me around the house through each step. In college, it was no better, and the only times that I ever seemed to sleep normally was the few months I worked the night shift at a gas station (22:00-06:00) and any time I was left to my own sleep schedule. I’d go to bed anywhere between 2 and 4am, sometimes as late as 6, and wake up roughly 8 hours after falling asleep with no alarm clock or outside influence. But even recently if I tried going to sleep between 9-10pm I still had trouble getting out of bed at 6:30. Finally, I may have found the answer to what was going on, and a solution to keep me awake during the day – and sleeping all night – on what “normal society” considers a regular schedule.
The first piece of the puzzle came when I complained about my insomnia on Facebook, and a couple friends chimed in about their success with taking Melatonin. I’ve never been much on taking pills for anything – it’s sometimes difficult to even get me to go to a doctor unless I know what I need is something I can’t get over the counter – so before asking Stephanie to pick some up on her next trip to the grocery store I decided to start doing a little research. I began my trek through Wikipedia, which is a good resource if you don’t take everything as gospel but instead use it as a launch point to further research and studies (often times finding an interesting bit in Wikipedia – and clicking through to the citation – gives more information than the Wikipedia article ever could, and from a more credible source). Scrolling down to the section on circadian rhythm I read that which I pretty much knew: melatonin is produced in the body in the evening to make you drowsy, and is scrubbed from the body by morning. Okay, so far so good I think, now are there side effects of taking it? The section aptly named seems to indicate that at least in the short term, there’s nothing bad about taking it – and they don’t talk about long-term effects simply because there’s been no studies yet. Fair enough, now what other uses does the drug have? After all, a well-known medication for pulmonary arterial hypertension has a rather.. stiff side effect. So it’s a good idea to see what else a drug is used to treat, so you get ideas of what other things might happen which are considered primary effects and wouldn’t be listed as a side effect. Of course the first listing is for circadian rhythm disorders, which makes sense. But one of the ones listed right away catches my eye. Delayed sleep phase syndrome. Something about it makes me click the link to read more, and that’s where I get that strange feeling. The one that says, “someone’s been watching you and decided to write a little article about the last 20 years of your life.”
Holy shit is that what’s been going on here? Teachers, bosses and professors who used to tell me I was just being lazy and not getting out of bed, or partying too much at night instead of going to sleep.. I suddenly wanted to walk up to each one, slap them across the face, leave a copy of this on their desk and walk out. Wearing assless pants so while they stare at me dumbfounded I’ll get an additional smirk knowing the last they see of me.
Well, let’s not jump the gun. I don’t want to be one of those people who sees a list of symptoms on a website and screams, “OH MY GOD I HAVE THAT!” I’m reminded of the Jeff Foxworthy bit about his wife doing the same, where he has to inform her, “You do not have testicular cancer. You don’t even have testiculars!” So before I go further, I have a look through the article and some of its references and citations. Here, it helps being able to change your IP address via a VPN to use one on a college campus, since many scientific and medical journals are available to students without subscriptions. Let’s go over the symptoms first (all times referenced against “socially acceptable norms”):
- Often cannot sleep until late, but left to their own sufferers will go to sleep around the same time
- Has a normal need for sleep, and sleeps well
- Because of a normal need for sleep and not being tired until late, has trouble waking up early
- If left to their own, sufferers will wake up a normal amount of time (~8 hours) after falling asleep, without outside intervention
- Also if left to their own, sufferers do not feel sleepy during their waking daytime
Okay, yeah. That’s all me. But again, a list of symptoms is not a diagnosis – if I said I was achy, lethargic, and had a runny nose and hacking cough that doesn’t mean I have a cold if my leg has also been chopped off and I’ve lost too much blood. Reading on:
- A normal (and sometimes greater than normal) ability to sleep during daylight
- Falls asleep quickly if going to bed around the person’s normal bedtime, but may lie awake until then if going to bed early
- Sleeps normally and fully if left to their own, such as on weekends or vacations
- The condition is chronic (symptoms must have existed for over a month before it’s typically called DSPS)
Yeah, and that works fine for me until our kids were born. No more can I get away with sleeping until noon on Saturday, but all the times before now that I did just that are coming back. I would be dead to the world first thing in the morning all week, and then come the weekend I’d stay up late on Friday, sleep late on Saturday, stay up late Saturday, sleep late Sunday, then try to go to bed early on Sunday night – usually staring at the ceiling until midnight or much later. Continuing through the information about the disorder, everything seems to fit me; it’s as if I wrote this about myself. Compared to constantly living with 6 hours of jet lag. Night owl. Feels most alert, and functions the best, when staying up late (hello, 3am coding sessions!) Tried using sedatives at night, which just makes me groggy but not necessarily puts (or keeps) me asleep, and I feel no better in the morning. Multiple alarm clocks to wake up (for me, because I turn them off while I’m still asleep) and/or asks family members to wake them up.
Okay, so what’s the treatment for DSPS. I start reading through the next section, and see some things like light therapy, cannabis (PA doesn’t have medical marijuana laws, and even if it did Stephanie said our grocery bill couldn’t handle the influx of Doritos), sleep hygiene, melatonin. So maybe I’m on the right track with what was suggested; melatonin would help either way. Then I read what I consider the coup de grâce on any doubts about my self-diagnosis.
Chronotherapy, which resets the circadian clock by manipulating bedtimes. Often, chronotherapy must be repeated every few months to maintain long-lasting results. It can be one of two types. The most common consists of going to bed two or more hours later each day for several days until the desired bedtime is reached. A modified chronotherapy (Thorpy, 1988) is called controlled sleep deprivation with phase advance, SDPA. One stays awake one whole night and day, then goes to bed 90 minutes earlier than usual and maintains the new bedtime for a week. This process is repeated weekly until the desired bedtime is reached.
Um, yeah. That “modified chronotherapy” bit there? I do that every so often. And it works for a couple weeks, until I fall back into the “normal” schedule for my body again. So once again I say, holy shit. I talk to Stephanie about it, and we read over some of the treatments to see what might work. Well, normal chronotherapy means I’m taking a couple weeks off of work every so often to reset my clock, so that’s pretty much out. Not to mention it’s hard to sleep until 2pm when there’s two kids who want to see their daddy (and a daddy who wants to see them while they’re awake too). Modified chronotherapy would be okay, except it means at least one weekend out of a month is a complete waste for me: if I get up on Friday, stay up Friday night (might get some things done that evening), on Saturday I’ll be unable to do a lot of things and by Saturday evening I’ll be a zombie. Granted, when I get up Sunday morning I should feel great, but what if that only lasts for a week before I’m back in the normal routine for my body? Then that means every weekend is wasted, and we can’t do that.
So the idea of melatonin plus light therapy is the next thing I could try without major incident. After doing some research on light therapy, I started looking at some lights I could use. It didn’t take long before I found another possible correlation; we put blackout curtains in our bedroom to help make it darker in the room for sleeping, but those curtains also keep out the morning light that helps wake us up at a normal time. So I wanted to find a light therapy device that provided a “simulated sunrise” too, which could also be useful in the winter time. One of the higher-rated devices I found was the NatureBright Dia2 on Amazon. Alarm clock, light therapy device, simulated sunrise, portable! Okay, I’ll take one. Ordered it with overnight shipping so I could have it by Friday and start using it Saturday morning. At the same time, Stephanie picked up some melatonin supplements from the grocery store, and I figured I would try that Friday night too.
So how has it all been working? I’ll let you know tomorrow :> Suffice it to say, “so far, so good” is the verdict. But just saying it works isn’t quite doing it justice, and my fingers are tired now – if you’ll pardon the pun.