I jerked back to attention, turning my focus back to the screen in front of me. The pixels danced in my vision, refusing to form coherent shapes until my eyes reluctantly did their task of bringing things into focus. The blurs merged into proper words, characters really, the combinations of letters, numbers, and symbols that formed the lines of code that powered a web application. I took a swig of coffee, at least that was the goal. The action ended up being a slow, methodical reaching for the cup, grasping it firmly, and carefully drinking several swallows before returning it to its coaster with the same ridiculous, meticulous care.
Tired wasn’t even the word anymore. Exhausted? Fragged? Drained? None of them seemed to do justice to the bone-deep aching that filled every inch of my body. I wasn’t to the point of complete uselessness, I could still hold a relatively decent conversation and I could read and remember code, as long as I wasn’t nodding off while doing it. Still, during all but my most lucid periods, I was on autopilot as I moved through the day, and economy of motion was the name of the game.
Even a sigh seemed a waste of precious energy. After another drink of coffee and a glance at my screen to confirm I hadn’t missed any messages or email, I forced myself to my feet then trudged to the bathroom. My whole body felt heavy, far heavier than my 190 lbs. It was if someone had hung invisible weights on all of my extremities, every move taking more effort than normal.
When I reached the bathroom, I headed into a stall to tinkle. Might as well take care of it then, it wasn’t like I wouldn’t need to soon enough. I swear my bladder was the size of a potato, for as often as I needed to pee during the day.
After washing my hands, I splashed water on my face once, then once again, pointlessly trying to will myself to alertness. As I dried my face and hands, I glanced at myself in the mirror. The dark circles under my eyes seemed glaringly obvious, as did the puffiness in my eyes and jaw. That no one had said anything about my looking like crap seemed to point to either a complete lack of attentiveness on the part of my coworkers or in my grossly overestimating how obvious my exhaustion was from a visual perspective.
With a mental shrug, I headed back to my office and eased back into my chair after double checking that my butt was aimed in the right vicinity. In my current state, I was oddly worried I’d miss and land butt first on the ground like some idiot in a cartoon.
I forced myself to focus on my screens. The particular app I was working on was a simple contact manager and was just being updated for the newer version of its language and overlying frameworks, so it was easy work, nothing that required me to be on my A game.
Which was good, because really I was probably at my C game at this point. It wasn’t F level since I could still drive competently, manage my finances, even drag to the gym to do my hour of strength training each day. Though I was a little slower, I could still answer questions and think through solutions. So I’d say yeah, low C, maybe high D.
It was getting worse, of course. I was going on two weeks straight of averaging four hours of sleep a night, at best, and not very good sleep at that. Broken, too light, and most definitely not long enough. I didn’t yet know how much sleep I truly needed a night, but I could say for sure I needed more than four hours.
For a twist, my lack of sleep was something I’d done deliberately. You see, I have insomnia. Yeah yeah, no shit, right? But yeah, I’ve had it all my life. It got particularly bad the last two years though, to the point I was waking up almost every hour of the night and would sometimes take 1-2 hours to fall asleep.
So I’d be in bed for 9 or 10 hours, but really only sleep 5 or 6. Like most people, I just lived with it for far too long before finally talking to my doctors about it. My GP had me try melatonin and over the counter sleep aids. That did nothing.
Talked with my shrink next, figuring it might be an issue with my meds or my anxiety issues, based on the racing thoughts when I tried to sleep and the wack-assed anxiety-laced dreams I had most nights. He ran me through a variety of sleep aids which ranged from meh results to no results to shit let’s make your depression really bad to oh my fucking god what is this shit that kept me up literally ALL night? Yeah, that last one was a trip.
When we ran out of drugs to try with none offering any real improvement, he referred me to a sleep clinic. They presumed I had sleep apnea, even though I only had one actual common symptom for it, and arranged a test for me for that. But they also started working on my sleep hygiene and sleep therapy, including the point of this rambling: sleep restriction.
While it may seem like an oxymoron to prescribe for someone whose issue is not sleeping enough, sleep restriction is just what it sounds like: your sleep is restricted to a very specific schedule. The schedule is based on how many hours you are sleeping, on average, a night. So for example, if you really only sleeping five hours a night, you might be allowed to sleep from midnight until 5 am, and that’s it. You get up at 5, no arguments, no going to bed early, and no naps outside of that sleeping time.
Oh, and if you can’t sleep, get out of bed and do something non-stimulating until you feel sleepy enough to try again. Ditto if you wake up in the middle of the night and can’t go back to sleep quickly. The basic point is to train your brain how to sleep again, and to do so in an efficient manner that results in recuperative sleep, versus my brain’s version of daisy-chained cat naps.
So did that, with an initial window of 7 hours and started a CBT-I (Cognitive Behavior Therapy for Insomnia) course to further teach me how to improve my sleep and all. During the course of the course (snicker), my schedule was restricted further, to just a 5 hour and 45-minute window, based on how much I actually slept at night. But my brain is kind of an asshole, so it still kept waking me up during the night. Not for as long as before, perhaps, but still often enough that in the end yeah, 4 hours or so of sleep and pseudo-zombie me was the result.
Going back to earlier, yeah, it was to the point I was starting to nod off in particularly low parts of the day, even while having a conversation. And no, I never drove when I was like that, mostly I just sat and vegged. Because I was still trying to keep to the rules about no napping, figuring being so exhausted would mean I’d fall into bed, go right to sleep, and stay asleep all night. Thus getting good sleep efficiency, and “earning” more sleep time!
I did mention my brain was an asshole, right?
It finally got to the point, I had to start violating the no nap rule to function. And after loved ones gently expressed their concerns, I said fuck it and gave myself a cheat day, really two. The first I turned off the alarms and just slept as long as I wanted. The second, I set the alarms, but then killed them when I woke up and stayed in bed an extra two hours anyway. I also allowed myself to nap anytime I felt sleepy enough during the day. You’d think that the latter bit would have messed up my going to bedtimes, but I still went to bed around the same time, and still fell asleep relatively quickly.
After that, I felt more human again, no more achiness. And fortunately, the CBT-I course let me change my sleep schedule that very weekend so I upped it back to a 6.5-hour window. I am still a bit tired in the day, but not to the extent of that utter exhaustion. Ironically, my daytime sleepiness is considered a good sign, because before despite my lack of sleep and tiredness, I wouldn’t get sleepy even though I clearly needed sleep – so my brain has at least figured out that signaling about the whole sleepiness thing is good.
As for what now? I keep at it…doing my 6.5-hour sleep window until my sleep efficiency (i.e. the time you are in bed versus the time you actually sleep) hits 90% regularly. Then I get to up my window 15 minutes. Rinse, repeat until I get the sleep window to the point where I’m getting the actual amount of sleep I need per night to function well, feel rested, all that jazz.
It’s slow going, for sure, but still, unlike with just throwing drugs at it, this will actually fix the underlying issues that were causing the insomnia and, as I mentioned before, retrain my idiot brain how to sleep. And I’ll have techniques I can use to deal with insomnia in the future if it happens again, including ones to help deal with the racing mind issues and that fragmented sleep crap.
Dealing with insomnia yourself? Seriously try CBT-I for it. It’s tough, but it is effective. Pick up a copy of No More Sleepless Nights and read it. It’s a really good read, highly approachable for the layperson, and you’ll learn tons about sleep. It will also cover almost everything I learned in the CBT-I course, except for avoiding using devices (phones, tablets, TVs, etc) for at least 30 minutes before bedtime and another technique for dealing with racing mind issues: mentally repeat the word THE to yourself every two sections. It’s an emotionless word so it won’t cause thoughts on its own and while you’re repeating it other thoughts can’t intrude! Seriously, I laughed, but it actually works.
Here’s to better sleep!
(oh, and for the curious the test was negative, i.e. I do NOT have sleep apnea)