Dear Diary: Of Course

Of course, I’m late again. Of course I’m still trying to get my crazy sleep schedule under control. Of course I’m eating too much chocolate. Of course I’m still experimenting with medical marijuana, which is the only thing that can get me to fall asleep. Last night, I put some alcohol tincture in a glass with V8 juice. It tastes like a Bloody Mary.

It still took at least an hour for me to fall asleep, so while I was lying there, I listened to one of my playlists on Spotify. It includes most of the songs I liked over the past 50 years. As I listened, I realized that I could put the songs in an order that reflected where I was in my life at the time each song was popular. I might try to do that at some point.

Listening to each song brought back very specific feelings, some of which I wish I could choose to forget. I have always tended to make choices based on what I wanted or needed. It’s not that I didn’t consider the wants and needs of others involved; but, ultimately I did what I wanted.

When I lie in bed at night, waiting for the THC to kick in, I let each song take me back, like the images in a photo album, to past places. When my mind reviews what my life was like each time, I feel regret. Regret about how little I understood myself and what little wisdom I had. Regret that I never learned how to “plan” — financially, physically, inter-personally. Regret that many of my choices negatively affected other people. Regret that I must have been very emotionally immature.

Throughout these 80 years I never set long-term goals, but rather I took advantage of opportunities (which worked out fine as far as my various careers, but not so fine in terms of my various relationships.)

It’s obvious to me, now, that the men with whom I chose to have a relationship were chosen because I knew they would not be around long. (The exception was my late ex-husband, but that’s a whole other story.) I knew, instinctively, how to get them to leave when I was ready to move on. In the meanwhile, each contributed, in his own way, to something I wanted or needed in my life. (Perhaps I also knew, instinctively, that there was no one man who could give me all I thought I needed; and now I see that I didn’t particularly care what they needed as well.)

From the perspective of decades, I am finally realizing several things: I am a bit of a narcissist; I am good at manipulating situations and people; I need people more than they need me; I like beginnings and endings and don’t do well keeping things going in the middle; I never knew who I really was. I’m not sure I even do now.

The Plague of Elders

I don’t mean that we Elders are the plague; I mean an awful lot of us Elders are afflicted with the same “plague.” It’s called There are lots of kinds of insomnia and there’s no cure for any of them.   There are a host of “remedies”, however, and I have tried all of them (see the end of this post), to no avail.  So had the author of a book I read several years ago, Insomniac, by Gayle Greene.  The book was published in 2008, and you would think there would have been some progress made since then with a treatment that works.  I contacted Greene last year to see if she ever found a way rid herself of insomnia  Basically, she said no; all she could do is schedule her life around it when she can, take sleep meds when she has no other choice, and keep looking for a solution.

Here’s a review from The Journal of Clinical Sleep Medicine Insomniac, by Gayle Greene, provides an interesting perspective and offers support to those with treatment resistant insomnia. It also offers a fresh perspective to readers who are also medical providers. The author defines insomnia in a way that sets the stage for the discussions that follow, as “Insomnia is when you can’t get the sleep you need to feel good, for no reason other than that you can’t.” By the end of the third chapter, the reader has a very clear understanding of the problems faced by insomniacs.

Greene’s book is both a memoir and a research paper. If you don’t read the book, read the whole review.  Here are some of the facts she shares in her book

A third of the American population suffers from insomnia enough to complain about it; in people over 65, estimates are as high as 60 percent.

⇒  Sleep has little part in medical curricula today, when doctors get an average of one or two hours’ instruction in sleep and sleep disorders.  The patient with a chronic complaint of insomnia will usually be referred to a psychiatrist.

  With all due respect, this is so ass-backwards, Greene states. The reason I want more sleep is so that I won’t feel depressed.  I need sleep not to avoid my life, but so that I can live it.

  This is what she learned from interviewing a range of sleep researchers and experts (all given citations in her book).  We do not know….the nature of the basic neural mechanisms underlying primary insomnia.  Nor do we know the identity of specific neurotransmitters that might be involved, or even whether specific neurotransmitter systems are involved.  The genetics of the disorder are also not known.

 The behavioral model (change your attitude, change your ways) has had, perhaps the unfortunate consequence of discouraging research into the neurobiology of the disorder.

 Insomnia is a subjective state..  There’s no blood test that it shows up on, no biopsy or x-ray that picks it up, and it doesn’t even show up on the EEG….. How much easier it is to tell us, as many clinics do, that we have “sleep disordered breathing,” or apnea.

  Exercise helps some people, but not all. “In order to make a difference, it has to intensive, enough to raise the core temperature (inside body temperature) to two degrees Fahrenheit for about twenty minutes, which happens with twenty to thirty minutes of aerobic exercise….. Since only people who are in shape can sustain vigorous exercise for twenty minutes or more, they’re the ones whose sleep is likely to be improved.

  Some billionaire who has a relative with terrible trouble sleeping…should endow a private foundation. There should be patient advocacy groups for insomnia, but they’ll need to stay independent of the pharmaceutical companies.

I wish every sleep doctor would read Greene’s book, which explores the various and complex reasons why folks have insomnia, including the gut-brain connections and the individual ways that insomnia manifests itself.  For example, I have the kind that prevents me from even falling asleep, from having my brain trigger what Greene calls the “sleep switch.”  I get relaxed and tired, but that last step evades me.

At the end of this month, I will have a sleep study.  I am going to give the doctors there a copy of this post.

Of all of the remedies I have tried for my insomnia,  I have to admit that I like the effect of medical marijuana (and I like the buzz I get before I fall asleep).  But trial and error has proven that I need sometimes 4 times the recommended dose to have any effect on my sleep.  That would cost me several hundred dollars a month, and I can’t afford that.  CBD helps with my daytime energy and mood, but has done nothing for my sleep issues.  And it’s not cheap, either.

I even bought some EMF fabric shield to cover my electronics at night. At my age (80), doctors will not give me prescription sleep meds.  Hell, I’m 80.  What’s it going to do, kill me?  Not sleeping is killing me and is depriving me of having any kind of satisfying life.

I no order of chronology or non-effectiveness, here is a list of what I have tried.
  Soto Bio-tuner; hypnosis; environmental changes; behavioral modification; yoga breathing; every pain and sleep-associated OTC on the market; a range of herbal, amino acids, and other supplements (sometimes combined); oxycodone (I’m running out of my old dental RX; I only take it when I can’t take the sleeplessness any more); binaural beats; relaxation, meditation, and music tapes; hot showers; massage (when I can afford it); decades of depression meds; tapping……..

Badly arthritic knees and a troublesome torn rotator cuff preclude me from doing the kinds of exercises that might tire me out enough to crash into sleep.

“Set your alarm and make sure you get up every morning even if you are tired,” they tell me.  Yeah, sure.  After finally falling asleep at 3 a.m. or so every night, I’m not about to get up at 9.  Maybe 11.  Sometimes noon or later.  When I finally sleep, I often sleep deeply and have great dreams.  But I miss half of the day.

There are still no advocacy groups for and by insomniacs to help spread the word and urge researcher and doctors to keep digging to discover the biological insomnia triggers and causes. There are plenty of support/forums for patients, but all those do is give us more places to complain.