"Aye, there's the rub"

When I was a child, I had an electric analog clock. It was white and boxy. It had a gold wire that you pulled out in the back to set the alarm.  The alarm sound was a buzzer mixed with a fire alarm mixed with an electric shock. When it woke me up, it jolted me out of bed with my heart racing and my mind filled with fear.  Waking suddenly, especially in the dark, leaves me disoriented. I startle easily.

I think it is for this reason that I stopped allow myself being woken up by alarms - never again would allow myself to be startled during the night.  Now I watch them throughout the night and anticipate them. I must have a clock with me in the room when I sleep. I need to watch it I need to always know where I am in the course of the night at all times. I wake in the night, check the time, and go back to sleep. I set the alarm at bedtime, to symbolically represent the end of my journey. But I only sleep lightly, especially the last two hours. I snooze myself for an hour anticipating the alarm time, and then shut it off a minute before.

I have always had poor sleep, as long as I can remember. I have always awoken without feeling refreshed.  I have double black bags under my eyes that never go away. I can remember my teacher in high school saying that I shouldn't be this tired.

When I was in high school, I slept in a room in the basement without any windows. Today, a room like this would have been considered against code. There was no way to synchronize my sleep with the natural world. I had to work extra hard to sleep and wake in a place like this.

My father snored very loudly. He knew it because he talked about the remedies of his day, such as sewing a small round object into the back of one's pajama top. I mentioned once before that my father remarried, to an impractical actress. Before the separation, the first sign of trouble in the marriage that I remember, other than dismissing the maid, was my father being banished to another bedroom for his loud snoring.

I have always snored very loudly.  My children used to put a towel under the bedroom door. When camping, others in the next tent referred to me as the Bear.

As long as I can remember, I have been quick to spring to action on rising, but lacking in that quality of feeling rested. I have always had that quality of sleeping with one eye open. This came in handy during the infancy of my three children - that I could arise to tend them in the night almost instantly.  I am on alert in the night.

I have adapted to the reality of being unrested by keeping myself stimulated - by being busy and anxious and nervous. I can't sit still for very long. I am restless. I must be up and about, engaged with busy work. Otherwise I fall asleep where I sit.

This behavior of falling asleep in inappropriate public places is called low sleep-onset latency. I can remember in high school and college of the early 80's having the squiggly scrawl crash line in my notes, where I had dozed off in the middle of writing.  After I started employment my managers were commenting on my visible sleep-crashes in meetings.

I can recall in 1990 when the president of our company came to our site to speak to the team. I was so excited to see him that I came to the room early to sit up front. However this proved my undoing as I feel asleep in front of him while he was speaking. I received a good talking-to after that.

At home, I cannot sit through an entire movie non-stop without standing up. I start to feel sleepy and sick and weak if I don't get up and move every fifteen minutes or so. I am always working around the house, if after 10p, to find some little chore to do like doing laundry or the dishes.

There's always more work to be done. I can't rest. Or else.

In addition to the falling-asleep incidents at work, and the snoring, my partner said that I gasped for air while sleeping. She said that I would stop breathing, then gasp suddenly, then fall back asleep.  This is a tragic thing to have to happen to someone over and over in their sleep and they don't even know it.  This is known as sleep apnea.

I started going to the sleep disorder center in the 1990's. It was there that I had my first overnight sleep study. A sleep study is like having an EKG, but with more electrodes. My first study was not wholly definitive, with the diagnosis of idiopathic hypersomnia.  This is an increased tendency toward sleepiness for an unspecific reason.

The number of gasping incidents is measured by the AHI. My number was nineteen, which is in the moderate range.  I was prescribed a CPAP machine which provides pressured airflow into my throat through a mask.

My sleep doctor said years later that if he had known of my bipolor disorder, he would have diagnosed my condition differently. Bipolor disorder can affect sleep, but also good sleep hygiene can manage the occurrence of manias.

http://bipolar.about.com/cs/sleep/a/0002_mood_sleep.htm

My first sleep study was in a cluster of rooms built into the below-ground parking garage of the hospital. Inside the lab there were control rooms with EKG machines for monitoring, hotel bedrooms for sleeping, and technicians awake all night for operating the study.  As I was being escorted down the halls, I remarked that this ought to be a magical, mysterious place: the place where dreams were made. The techs looked at me like I should try working the night-shift.

Sleep studies do not monitor dreams. They monitor the cycles of sleep, in which dreaming may occur.  Dreaming is associated with the REM phase, but dreaming does occur during other phases as well. The technicians do not see the dreams, nor can they control them. My dreams are mine. When I awake the operator asks me whether I dreamed.

There is something spooky about having someone watch you while you sleep.

Sleep studies remind me of the great novel by Ursula K. Leguin:

http://en.wikipedia.org/wiki/The_Lathe_of_Heaven

The PBS film adaption of the novel is also excellent.

One of the powerful images from the novel that has always stuck with me is the association of sleeping deeply and sinking deeply into the ocean.  We drop deeper and deeper into the depths.  It becomes darker and more mysterious. What is it like to float there? What is it that we see?

In the novel, we question what is the relation between dreaming and our reality?  Could this reality we experience be but the fevered dream of another tortured soul?  And can our dreaming or stopping dreaming really change the future?  Is it a different world after dreaming?

For me, one important lesson I have learned is the need for letting go and letting sleep. I tend to focus and hold thoughts and concerns in my mind, over and over in a loop. Sometimes I sleep a shallow sleep because I don't want to let these thoughts go.  I hold yesterday in my mind and prevent it from passing.

Suppose you were to pull an all-nighter. Would the next day be the next day, for you?  No, it would be hour 25 of yesterday. When you pulled that all-nighter, you held yesterday and retained yesterday's reality across the night. Now today is yesterday again.

Now suppose instead that you had gone to sleep. The day you did awake to would have been a new day, with an updated sense of priorities and perceptions.  You would perceive the new day for what it is. You would have forgotten the hot mental state of yesterday, and would be assembling a new today based only on what is salient.

Here is a proverb on sleep:

"The wise man doesn't go to sleep when he's tired, he goes to sleep when he's sleepy".




 

Panic and Anxiety

My first signs of panic were in my senior year of college. I remember losing the ability to squeeze the muscles in my armpits. There was so much tension in my upper arms that they went numb. I was very concerned about what this could mean. I didn't allow myself to go to the doctor at that time, so there was no way to have it checked. I remember walking across the Quad thinking: please hold me together until graduation. Please don't let me die now.

My first full-on panic attack came in the summer of 1985 before I left for graduate school in California.  During that summer, I worked as a summer intern for a computer company during the day, and then I worked at writing my own computer game at night. I stayed up until eleven each time typing furiously, fueled by caffeine. I was afraid I was not effective at my day job, and I was afraid that the game wasn't complete and fulfilling my high expectations for it. I came back to the house I was staying, one night in Aug and tried to get to sleep. I lay in bed and felt a kind of shock or shudder or jolt every few minutes. Just when I would start to doze I would be shocked awake. My heart was already racing from the caffeine and the concentration and racing thoughts. I thought I was going to have a heart attack. I was afraid to go to sleep because something would happen. I would sit up in bed and wait for the shakes to stop.  I was exhausted that next day. But I also became intolerant to caffeine: I couldn't drink any without feelings of fear and panic.

I'll go back to an earlier time to recall my feelings of anxiety. I think most of my anxiety is about not feeling safe. I have no family. I have no safety net.  I live on a thin line that could break at any time. I am exposed to danger. Anything could go wrong and I'd have no recourse. There is no one to help me. I can only depend on myself

I think my earliest feelings of insecurity date back to 1974, when my parents divorce was final. My mother was institutionalized and we moved to New Hampshire with my father. My father was an educated man and a good provider and he was there for the children when he could. My siblings and I became latch-key children and bear responsibility at an early age. At that time, my father the doctor was only available through an answering service. As the oldest I was responsible for holding things together at home. If my younger siblings were fighting, I had no recourse but to settle it until my father could come home. I was anxious that our home-life would be all right and safe.

I have mentioned in another post that I was present in 1979 where my father lay dying on the basement couch and that I rode with our neighbor the doctor to the hospital. I think it was during that time that I again feared for whom would take care of me.  My siblings and I were eventually taken in by father's sister, who we children did not know well at the time. But in that interval just after my father's death, I was unsure what was to become of us.

In the late summer of 1979 I was entering my junior year in high school. The setting was this: my father had passed away in August, my Aunt had three new kids to care for, her house was too small for her family and ours, the funds from our trust were not yet disbursed, we had only a month before school started, and our house needed to be made ready for sale. Being responsible, I made an audacious proposal: let me stay in the house on my own and take care of it. My sister, being the youngest, went back to my Aunt's home while my brother, the middle child, went to stay with a family nearby.

Looking back on that fall, it is what I don't remember that surprises me. I don't remember sleeping in that house. I don't remember eating there or shopping for food. I walked to school as always but I don't remember it. There was a neighbor who looked after me and fed me and washed my clothes. I don't know how I survived during that time. It was a lonely and deprived situation, but my physical needs were taken care of. I wasn't physically hurt. I recall that there was an estate sale for our belongings. I helped bag and tag the many items of my father's which we couldn't take.  I lived alone there for two and one-half months.

Returning the late summer of 1985, I was nervous about graduate school in California, especially since I had gotten it in my head to drive myself across the country. I had purchased a used car for myself at the last minute and I didn't know its reliability.  As I drove across the country on I-80, I remember lying awake in the hotel rooms wondering if I would survive the night. I would feel the same sort of jolting-awake shocks, and all I could do was to sit up, back to the wall, in the dark, and hope it would pass. I imagined dying in the hotel room, with no one to find me but the maid. I survived each day and made it to San Francisco without incident.

When I arrived at graduate school, I felt there was something terribly wrong with me. I was nervous and scared and had heart palpitations. I was truly afraid that I was going to need to be hospitalized. Although I never did go to the doctor's generally, I made an appointment at the campus clinic. The story I gave the doctor was a disorganized, guilt-ridden tale of how I must have had a bad lifestyle to hurt myself and I was afraid I was irreparably ill.  The doctor gave me an EKG. When he saw it was normal, he sent me on my way.