Lessons learned from insomnia

It took me about 4 months to go from normal (though light) sleeper, to full-fledged insomniac, and back again, and let me tell you—sometimes it felt like 4 years! Time does have a way of dragging out when you're awake for 20 hours a day, and so much of that time was wasted in delays and false starts. If I could go back into the past and apply my 20/20 hindsight, I think I could have shrunk those 4 months down to just one, or maybe to none at all.

But the next best thing to saving myself from 4 months of sleepless torture is to save someone else! So all you fledgling insomniacs out there, take note!

Here's what I would do differently if I had to live through my insomnia all over again.

Get intervention sooner

The longer you have insomnia, the more difficult it becomes to treat. I slept poorly for 6 weeks before I even considered seeing a doctor, 7 weeks before I was able to get a prescription for sleep aids, and about 8 weeks before I actually took my first dose. By then, my insomnia was so entrenched, it had become a part of me, and no pharmaceutical was going to take it out. Looking back, I am confident that if I had had just a little help getting me over the stress of the first few days of my breakup, my sleep would never have become so disordered in the first place. I wish that I'd sought treatment for my sleep troubles as soon as I started worrying about them. It may have been difficult to get a prescription for sleep aids at that early phase, but I think I could have persuaded my doctor to give me a small supply of Lunesta if I emphasized that my sleep was getting progressively worse instead of better, and I wanted to break the cycle.

If you are getting medical care, advocate hard for yourself

I felt like I was swimming alone in the ocean during my brief stint as a psychiatric patient. I was given very little information about how to take my prescriptions and no information about what I should do if they weren't working. Since my appointments were 4 weeks apart, I wasted precious time, allowing my sleep to deteriorate even further, waiting to find out what I could try next. In retrospect, I wish I had been a lot more proactive. First, I should have only filled a small portion of my prescriptions, rather than a whole 30-day supply which subsequently went to waste along with my money. I should have also asked my doctor for a lot more information, such as: How long should I wait before I can expect to see an improvement in my sleep? In my experience, a sleep aid works best on the first night, and if that's not happening, then you need to try something else. If that were the case, I should have asked my doctor what I should do next. Try  changing the dosage? Try changing when I took it? Could I possibly have small quantities of multiple drugs to try on successive days, to make the most of the time between appointments? I don't feel like the psychiatrists I saw were invested in finding a solution with me, so I wish I had put less faith in their expertise at the beginning and worked harder to chart a course that would work for me, even with minimal participation from them.

Don't believe the numbers you hear—believe how you feel

When I finally diagnosed myself with insomnia, I took great stock in the published dichotomy – acute if it's been occurring for less than 3 months, chronic if more – and patiently waited for it to go away on its own, until it was officially chronic. Three months is an awfully long time to wait when you have a health condition where time is of the essence. Pretty early on, I knew instinctively that my insomnia had become self-perpetuating, but still I waited to get serious about treatment until I had crossed that arbitrary 3-month threshold. It is also helpful to remember that each individual has her own individual sleep needs. Many people start to develop insomnia because they start worrying about their sleep, even though there's nothing to worry about. They hear that you should be getting 8 hours of sleep a night (or you will die a horrible, slow death of cognitive decline and cardiac failure!), and they start to panic because they're not sleeping that much. Some people feel like they're not sleeping at night when they really are, and so they worry about it incessantly even though they're not tired during the day. When it comes to sleep, what's most important is how you feel. If you're not tired, you're probably getting enough sleep! Stop watching the clock and counting the hours, and just let your body do its thing!

You don't have to get out of bed if you've been lying awake for 30 minutes.

Another case where the numbers you hear are all but irrelevant is what I'm going to call the 30 minute rule. It goes like this: If you've been in bed for 30 minutes and you're still not asleep, get out of bed and do something relaxing until you feel sleepy. I saw this rule everywhere as soon as I started having sleep troubles, and it is by far the worst insomnia advice I ever got. I followed it religiously, which was silly, because never in my life had I been able to fall asleep within 30 minutes, and now I was expecting it to happen when I was having more trouble with sleep than ever before! For me, following this rule was 100% counterproductive. If I had been in bed for close to 30 minutes, I'd start to get anxious, knowing that in a few minutes, I would have failed in my endeavor and would be forced to get up. It put me in a constant state of anxiety that of course made it impossible to sleep! I believe that following the 30-minute rule actually made my insomnia even worse. A much better wording of this rule, and only one I learned after several months of doing it the wrong way, is "If you've been lying in bed for a while and you're starting to feel stressed out or increasingly awake, get out of bed and do something relaxing. But if you're lying in bed and you're still comfortable and relaxed, feel free to stay in bed!" This rule follows stimulus control principles, without the stressful feeling of being in a race to get to sleep.

So there you have it: 4 ways to make 4 months of insomnia a much less likely prospect. If only my past self could have read this blog...this blog wouldn't even exist!