Insomnia

I am a life-long insomniac- I remember having trouble sleeping from as young as 7 or 8 years old. Any change in time zone or location could throw me off. I remember a girl scout lock-in when I was 9 or 10 where I didn't sleep the entire night.  But those were occasional nights, rarely night after night. The anxiety about not sleeping would creep in early in the day, almost ensuring that I certainly wouldn't be able to sleep that night.

In my teenage years I tried melatonin- aka a sugar pill that only works for people susceptible to the placebo effect (this isn't me). In college I began receiving prescriptions for sleep medications- Sonata, old tri-cyclic anti-depressants like Elavil; then SSRIs like Zoloft and Lexapro. I took Trazodone for a period of time. I had a prescription for Ativan at the end of graduate school. I would usually get to a place where I was sleeping better and would then stop taking medication, but I would always have something in the medicine cabinet (Tylenol PM, Unisom) just in case, and eventually I would start taking something regularly again.

After the boys were born, I found it impossible to sleep, but was afraid to take anything because I was breastfeeding. Eventually I got over that fear, and by their first birthday I had started taking Ambien.  Somewhere along the way, maybe when Charlotte was about 2, I got a prescription for Lunesta.

Some nights I take a next-to-nothing dose, sometimes, if I am having trouble sleeping, I take a larger dose. But it has gotten to the point where I always take something.  If I don't have anything, I become anxious to the point of panic- heart pounding, mind racing. It becomes impossible to let go of the fear that I won't sleep at all, and there have been many nights in my life that I have watched turn into day, and many days where I have dragged myself along in fatigue and misery until I can go to bed and try all over again.

My doctors are completely aware of my regular, nightly use of sleep medication. In January, my primary care doctor told me she will continue to prescribe for me, but I need to have a "plan" for discontinuing my use of medications.

In April, I decided I was ready to try. I began the lengthy process of becoming a patient at the University of Pennsylvania's sleep medicine department, and finally, in September, started treatment.  I was ready and eager- I was going to be free of my enslavement to medication and anxiety around sleep.

It didn't play out the way I had hoped. The psychologist started by cutting back the hours I was allowed to spend in bed in an effort to "maximize sleep efficiency." My main concern with sleep is that I won't get enough sleep, so that put me into anxiety overdrive. Rather than maximizing my sleep, I began waking up earlier and earlier. This went on for 2 weeks, and I went from getting 7 hours and 20 minutes of sleep in a night to 6 hours and 20 minutes a night. Some nights even less. I became tearful, and exhausted. I had trouble paying attention to my clients. I had trouble being patient with the kids. And one morning I packed Asher a lunch and then put his packed lunchbag away in the cupboard. It became impossible. I went to my appointment and the psychologist was completely unsympathetic and not at all encouraging.

So I quit. I went back to my medications, my early bed time, and my almost 8 hours of sleep. I stopped crying, I became a much more pleasant person and much better therapist. Sometimes quitters DO win.