Friday, January 22, 2016

Learning to sleep, part 1

There are stories in my family about what a night owl I was, even as a baby. I was once found sitting on top of a bookcase that was just a bit too close to my crib, some time after I'd been laid down to sleep. When I started having sleepovers, at first, I called to get picked up because I couldn't sleep. I've never slept well away from home, but I guess that's not too unusual. Eventually, I learned to just lie there and wait. My friends would fall asleep pretty quickly (I could tell by breathing patterns or probably poking them) and I would be left to stare at the ceiling or try to covertly read/occupy my time.

For some reason, it never occurred to me to talk to anyone about this. I wonder what might've been different if I had. I have always thought it was mind-boggling that people claim to fall asleep within a few minutes!

I would like to sleep this restfuly.

As a teenager, and especially starting around the time I began experiencing depression, I felt perpetually tired. I could stay in bed until noon or later, just dozing. I remember staring at the clock and getting a very good sense of how much time had passed in the night without looking, being awake for hours at a time in the middle of the night. It's really no wonder that I was exhausted.

Finally, during my college years, I started falling asleep faster (maybe within 30 minutes instead of an hour or more) and stopped waking up during the night as often. If I did wake up, I could usually fall back asleep within 30 minutes. During my junior year, I started waking up once per night, several times during the week, feeling as though I'd stopped breathing. I would cough and catch my breath, then go back to sleep. I brought it up to my doctor and she suggested I might have "mild sleep apnea". It wasn't a problem as long as I slept on my side or stomach, just on my back. I had always preferred sleeping on my stomach anyway.

The apnea seemed to go away, or I wasn't woken by it anymore, after a few months. It would happen only a few times a year that I could remember. After college, my chiropractor told me to stop sleeping on my stomach because it was hurting my back, so I made back-sleeping my primary position. The apnea still didn't seem to be an issue. I was still "always tired", but sleeping through the night.

Over the past couple of years, the frequency has changed. I'm woken up by the sleep apnea at least once a month. My new psychiatrist asked me about my sleep quality about a month ago and I told him the usual: with a history of insomnia, I feel like my current sleep quality is adequate. How could I know what is really a "good" night of sleep if I've rarely had them? I can only remember a couple of times that I felt like I had good sleep, and those were very short periods of time (a month or two here and there). I have no idea what helped during those times. I refuse to make coffee-drinking a habit, especially because it seems like it is just covering up the issue without actually dealing with it.

With my husband's comments in mind (that I never seem to sleep well and that I do snore a bit), I went back to the psychiatrist and talked to him about my sleep history. He concluded that the sleep apnea may not be "mild" and it's very common to not remember being woken up by it, if the wakening is very brief. Even if I'm not being woken up by it, it's very possible, given my general affect of someone who is sleep deprived, that my sleep apnea is really affecting my quality of life. 30 minutes to fall asleep is not too terrible, but it is a bit long.

Next month during my annual physical, I'll be asking for a referral to a sleep clinic. My insurance will cover 80% of the costs after my deductible, which is $500. Fortunately, I have an FSA this year, so it'll probably all go on that. I'm now wishing I'd put more into the FSA.

Quite honestly, I'm excited about this. I would really like to wake up in the morning and feel like I'm ready to just get up and start my day. I don't know if I've ever felt like that before. I'll write a follow-up post when I have some more information from my primary care physician or the sleep clinic!

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