Tag Archives: sleep

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what I miss

what I miss after 8 years of divorce and 14 years of marriage is sleeping with a warm body not you but anyone after you fill the U-Haul and are surprised because you think that I am the packrat and all the stuff is mine but you have a piano and bicyles and a motorcycle and clothes and music and books and really you are one too, it’s just that I am worse and you drive away and I can’t sleep though really it did start before then we did over a year of couselling and I slept alone some and then kick you out and sleep alone more our daughter moves into the room across the hall up from the basement when you leave and in the middle of the night she comes up with me because you are gone to Colorado and now 6 years later she asks about it and I say you came in with me and she says she didn’t know that and would wonder why I would steal her in the middle of the night and I say I didn’t but as she is older and moves back two flights down to have that distance that one needs from a parent when one is in puberty and growing up and away and I wake at four am and now that same sex marriages are legal I wonder about buying an asian bride and then I would have a body a warm body to sleep with but it wouldn’t work and yes I miss sex too but not in the same way it’s the warm breath and heartbeat and movements and I am the monkey longing for a mother to cling to and I too make do with a pillow I could make a scarecrow for my bed a body not an inflatable too cold but something warm and I could put a watch in its chest an old one that ticked it doesn’t actually help to be in love because I am not sleeping with my love and that makes it all the worse I long for a warm body really no I long for my warm love this particular body and breath and heartbeat and I wake often longing for my warm love

the picture is my sister, who died in 2012 of breast cancer. I made her stuffed animals and puppets for years starting when we were little. I made the red eared puppet and bought her the puppet with legs that year….

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ZZZzzzzz

Z for ZZZzzzzz…. shhhh, everyone is asleep after the Blogging from A to Z Challenge and I am tiptoeing my last contribution in during May…..very quietly.

Yesterday morning Boa cat brought a mouse in the house. I heard it squeaking and protesting being played with before being eaten. Then Boa called me insistently, with her mouth full of squeaking mouse. I started down the stairs and she dropped it and it ran into a closet. She lost it.

I tried to find it, gingerly. I had to get the recycling out of that closet anyhow, because Tuesday is recycling day. I picked things up rather carefully. I found the mouse once but it skittered away in the closet again before Boa grabbed it and I was not about to grab it. Sharp teeth.

Last night Boa brought the mouse into my bedroom and tore around, chasing it. I think. I am not entirely sure whether Boa really did bring the mouse in or whether it was a dream. If it was a dream, it was very convincing and had five parts or more. And then I dreamed or heard crunching.

There is a pile of paper knocked over on the stairs. I have not checked my room for mouse feet or a tail. In the night I hoped Boa would keep the mouse on the floor and not bring it up on the bed. She didn’t.

The cat in the picture is not Boa. It’s Princess Mittens. She was about a year old and stood at the open back door growling at the terrible things in the back yard: a doe and two fauns, there to steal the apples. Princess Mittens was hit by a car last summer, at age ten. Boa misses her but would never ever admit it.

OLYMPUS DIGITAL CAMERA

And there: I am done with the A to Z Challenge! Sleep well, everyone!

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Under covers

U is for under covers in the Blogging from A to Z Challenge.

Under covers I had this dream:

I am in a large space, no walls. No grass or sky or sun either. There are boxes everywhere.

A male voice is telling me to get in a box.

“Which one?” I say.

“You may pick.” says the voice.

I look at the boxes. They are all next to each other, all different shapes. Square, octagonal, pentagon. They are made of wood and carved or inlaid. There are many beautiful designs, all different. I step from box to box.

“They are too small.” I say.

“If you sit down and tilt your head to the side, you fit.”

“That isn’t comfortable.” I say, after trying to sit. “It’s too small.”

“Pick a box.” the voice insists.

No, I think. I won’t. They are too small.

“Why do I need to be in a box?” I ask.

I wake up.

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Sleep

Our sleep doctor, a pulmonologist, gave us a wonderful update talk on sleep in early 2009.

He said, “First of all, I hate that blue butterfly.” For those who do not watch tv or read magazines in the United States, the blue butterfly was in advertisements for a sleep medicine.

“The blue butterfly lies,” he said. “Eight hours sleep is NOT normal and NOT average.”

He said the average amount of sleep for an adult is 7.5 hours. Some people need more, some people need less. I need 6 to 6.5 except on the first day of menses, when my body prefers 10-11 hours. Too much information?

“Catching up is a myth.” He said that we don’t catch up on sleep after the first night. I get people all the time in clinic who say that they haven’t slept for a month and “need to catch up.” The first night with a sleep medicine, people catch up some but that is it. After that, their body returns to their average.

Alcohol is bad for sleep. Yes, I know, it makes you fall asleep faster. However, it is not normal sleep and you will wake when it wears off, in 3-5 hours. And you may be a bit jittery and anxious, especially if you have more than 2 drinks a night routinely. Hello, I said that is the alcohol wearing off. Are you partly addicted? Tell me you can’t fall asleep at all without it? Want a pill instead?

Sleep pills are really alcohol in pill form. Really, really, really. We use benzodiazepines — that is, valium, ativan, librium, etc. for alcohol withdrawal because it has the same mechanism of action. In other words, we are substituting the benzo for the alcohol and then withdrawing you more slowly. Withdrawing from heroin or narcotics makes the pain receptors go completely gonzo, but it doesn’t kill you. It just makes you writhe with pain and wish you were dead. Withdrawing from alcohol can cause the blood pressure to go too high and can cause a stroke or seizures and kill you. So how enthusiastic am I about adding that lovely blue butterfly sleep pill to the 3-5 alcoholic drinks that someone has at night? NOT. Gosh, if we get the dose high enough, mix of alcohol and benzodiazepines the person could throw up and drown in their own vomit or just become sedated enough to stop breathing entirely and die, or just enough for brain damage. That’s fun.

And we don’t know if sleep pills are safe long term. Read the fine print. Ambien is tested and approved for use for two weeks. Right. Not 10 years. We don’t know what the hell they do to your brain if you use them for 10 years. One sleep pill has been tested for longer term use: that is, six whole weeks. Sonata. So I am stingy when it comes to sleep pills. I give people 8. Yes, 8, and tell them not to use them more often than once every three days because I am NOT going to give them 30 a month. I am going to give them 8 a month and that with reluctance. That is a conservative approach to long term use. And if they drink anything over 1-2 drinks a night, they have to cut that down first.

“But doctor, I wake up in the night!” And you are between 40 and 60 years old? That would be normal. Yes, I said normal. NORMAL NORMAL NORMAL. Ok, here’s the story. Little babies wake 4-5 times a night, right? Really. Ask any new mom or dad. Eventually they “sleep through the night”. No, actually they don’t really. They still wake 4-5 times a night but they fall back asleep really quickly and without howling. They keep doing this as children, teens, young adults, adults…..and then sometime in the 40-60 year old range the wake up periods get a little longer. And we remember them. It is normal. It is ok. Do not drug it.

“But I can’t go back to sleep.” Ok, here are the sleep hygiene rules. No violent tv or any screen time (yes, that includes computers, you addicts) for the last hour before bed. No caffeine after noon. Bed is for sleeping and sex only. If you want to read, get out of bed. A cushy armchair by the bed is fine, but get out of bed. Sorry, but you asked. Music is ok before bed and so is radio. The visual light in any screen activates weird parts of the brain, so that’s why no screen. Don’t listen to music or radio that sends your blood pressure through the roof. Exercise is best at least 4 hours before you are trying to drop off. A cool bedroom turns out to be better for sleep than a really warm one: turn down the heat and save money. Warm milk actually works.

“But doctor…” Ok, I know, you CAN’T do some part of the above. Do what you can.

“My teenager falls asleep in classes all the time.” Ah, teens are interesting. The brain essentially melts when puberty hits, at around 12, and is done with major hormonal rewiring by age 25. Teens need MORE sleep than kids or adults. 10-12 hours. They are working hard on puberty. Our sleep doctor said that the time the teen wakes up on the weekend indicates their real circadian rhythm. So, if a teen wakes at 1 pm on Saturday and Sunday, and is going to bed at two, that is where their circadian rhythm is set. Of course they are groggy as heck when they get up at 7 and trundle off to school and that history teacher is boring and drones in a monotone. How do we reset the rhythm? It takes time. The teen has to set an alarm on the weekend and get up progressively earlier. And they STILL need 10-11 hours so guess what? If the goal is 7 am, they should be going to bed by 9 pm. “HA, HA, HA, HA!” laughs the parent. Most teens are not getting enough sleep and are not catching up on the weekend. Parents can have influence. The sleep needs start to decrease as teens are entering their 20s.

Also, no screens in kids’ bedrooms. No tv, no computer, and the cell phone stays in another room. Start this with small children. Why? Kids are up texting at 2 am. Or surfing the net. Or watching whatever. It is a good sleep habit to get out of bed if you can’t sleep and go read something or listen to music. Out of bed, not in bed. Set a good example for your kids and get your television out of the bedroom….ok, now you hate our sleep doctor, not me.

What medicines do I use to help people sleep? I don’t like the benzodiazepine related drugs, which is most of the advertised New Fancy Expensive sleep medicines. I do use old medicines: antidepressants in low doses, very low. Trazodone, amitriptyline and nortriptyline. They are cheap and we are actually using the side effect; that is, they make people drowsy. I prescribe at doses way below the theraputic dose for depression.

Geriatrics. Well, it’s a difficult group. It’s not good to make someone drowsy who needs to get up at night twice to urinate and is a bit shaky on their pins and who won’t turn on the light for fear of disturbing someone. If I make them drowsy they trip and then we have a hip fracture. Mostly it is education: yes, they are waking up, maybe more than once and it’s normal. I have had people really cheer up once we’ve had this discussion. Oh, they say, I’m normal. They’ve been confused by that damn blue butterfly.

Sleep well.Moderate your alcohol, caffeine, television, computer, and cell phone; exercise, eat right, drink enough water and put your doctor right out of business. And the blue butterfly too.

revised. previously published on everything2 November 2009