5/15/2011

The Daily Train Wreck

[The first part of this, before my night at the sleep lab, was drafted back on April 24th.  I added an update today, May 14th.]

I've referred to my sleep patterns as a "train wreck" before, but it's gotten worse the last few months. There are a number of reasons for this.

I don't sleep a continuous eight-hour stretch, but in scattered shorter sections, which only rarely add up to that recommended eight.

I can't really blame too much of this on working graveyard shifts, midnight to 8:00 AM, five nights a week. Lots of people work graveyard, and arrange their lives to where they sleep soundly during the day.

But that daytime period is also standard business hours for most people, and sometimes you have to be up and awake to take care of business. Doctor's appointments, phone calls, shopping, etc. So I can usually depend on staying up after getting home from work, or having to get up after a few hours sleep, at least two or three days out of those five.

There are also my other jobs, beside the one that actually pays. As Hilde's become progressively more disabled over the years, I've had to take on more and more of her care-giving, of being her hands and feet. That usually runs about five to six hours per day, and those are hours that really can't be cut back on. (I love my wife like crazy, but I hate her disease.)

(We have Tabbi living with us, who takes care of Hilde while I'm at work, but considering the pittance we pay her -- a babysitter would get paid more -- I'd feel guilty asking her to take on more work.)

In amongst all that, my third job is struggling to get things done, to keep up with paperwork and housekeeping, with shopping and yardwork. And the only category where it seems I can cut back on to make time for everything is by cutting back on sleep. Which leaves me in a walking fog half the time I'm up, which means I don't get as much done in that waking time as I would if properly rested, which means I end up trying to stay awake longer to try and get enough done, which means... well, just Google "diminishing returns".

(Which all makes writing my fourth job, at best.  I suppose for a fourth job, I've done pretty well, but it help explains why I haven't finished or sold a story for over four years.)

A few weeks ago, I took a treadmill stress test. This happened to be at the end of a workweek, so I'd only had about 20 hours sleep the previous five days. (That was less than usual, but not by much.) Have you ever ("Keep your eyes open, Mr. Arthurs!") started to fall asleep ("Keep your eyes open!") on a treadmill?  That kinda goes beyond "walking fog" into "situational narcolepsy".

(You might wonder, how do I ever manage to drive a car without falling asleep at the wheel?  Because my doctor's aware of my sleep pattern, or lack of same, and prescribes Provigil, an anti-drowsy drug that turns off the "sleepy" switch in your brain for a few hours.  I try to take it at times when I'll be able to drop into bed after it wears off, so it doesn't keep me awake in bed.)

In all, I'm kinda feeling like there are no good options to improve this situation.  I'd like to be able to ditch the outside job, but we still need that to stay in a positive cash-flow status.  I can't cut back on the time spent with Hilde, or on the time spent handling the day to day tasks of living; I barely keep up as it is... and far too often I'm not keeping up.

Except for sleep, the only place where I could cut back is the time I spend on the Internet... and I'm reluctant to do that as well.  I browse about a half-dozen blogs daily, and about another dozen less frequently; I check my email; I check my bank account and pay most of my bills online.   I try to keep my online time to 90 minutes or less daily (not always successfully, I admit).  But if I gave up those social aspects of being online, I'd feel like there wasn't much of me left.  Gaining extra time for not-fun stuff isn't a trade-off I want to make.

I'm having a sleep study done at the end of this week, but I don't really expect too much out of it. I had one done about five years ago, which came back with completely normal results.  Probably because having that sleep lab was one of the rare times when I was able to get an uninterrupted eight hours of sleep.  If they really want to test my typical sleep period, they'd wake me up a few hours in, have me perform a variety of tasks for a few hours, then have me get back into bed and try to go back to sleep again. 

(That's another thing:  Sometimes I can be bone-tired, barely staying on my feet, but when I get back into bed, sometimes I lay there for hours before I actually get back to sleep.  This is incredibly frustrating, to say the least.)

- - - - -

Update, May 14th:  Somewhat to my surprise, the results from my night all wired up at the sleep lab were... informative.

I originally went to the sleep lab, not because of my broken sleep patterns and overall lack of sleep, but because there had been scattered occasions when, first laying down to go to sleep, I would suddenly be unable to take in a breath.  It was as if the autonomic breathing impulses were suddenly turned off.  Kinda alarming.  But when I'd react by rolling over from my back to my side, I could suddenly breathe again.  This wasn't common enough to be considered an emergency -- it happened about five or six times over about a two-month period -- but often enough to be of concern.  I described it to my regular doctor as "It's kinda like what sleep apnea is supposed to be like, only without the sleeping part." 

To make sure I didn't have a tumor or growth starting in my throat, my doctor first sent me to an ENT specialist , where I got to watch a scope-on-a-rope send back images from my sinuses down to the top of my esophagus, with normal results.  After that came the appointment with the sleep lab.

This time the results were not "completely normal".  The results showed I was having the scattered stops in breathing during my sleep as well.  Overall, I was diagnosed as having mild sleep apnea; however, whenever I was on my back that night, instead of on my side, the number of incidents-per-hour jumped, from about half-a-dozen to over forty.

The recommendation was for me to start using one of those CPAP machines while sleeping, where a breathing mask over your face keeps a continuoous pressure in your airway, preventing it from closing during an apnea incident.

However, the data shows that a lot of people prescribed CPAP machines have trouble using them regularly, or stop using them after a few months.  So I'm trying "Positional Therapy" first, arranging things where one spends sleep on their side, instead of on their back.  The basic methods are to either block oneself in, or to wear a snug t-shirt that has tennis balls or other obstructions sewn into pockets along the spine.  One keeps you on your side, the other wakes you up if you roll onto your back.

Since getting the results, I've been sleeping with Big Kitty, an extra-large stuffed animal which has doubled as a body pillow in the past, behind my back at night.  (I've also bought a "Sidesleeper" pillow, shaped with an extension along the back, but it just arrived yesterday and I haven't used it enough to say how well it works yet.) Staying on  my side doesn't solve everything, but there does seem to be some improvement, waking up feeling better rested and with a bit more energy during the day.

It would probably also help to lose those thirty excess pounds I've picked up over the last five or six years.  Getting back to exercising regularly would help with that, and it would really help if I stopped snacking and "grazing" so much.  (But it's hard to resist the siren call of the Doritos, or the "yip-yip-yip!" of the Cheez-It herds as they roll across the plains.)

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