A Week in Orlando: Sleep

 

    I've spent decades trying to develop a healthy sleep cycle.  It sounds deceptively easy to just go to bed and fall asleep.  In fact, it's something my husband does quite well.  It's happened multiple times that when I spoke to him just a few seconds after he laid down, I woke him up!  On the other side of things, I've spent so very many nights staring at the ceiling longing for rest either when I've gone to bed or when I've woken in the middle of the night.  Part of this is fueled by me being an incredibly light sleeper.  When my kids were younger, I could be in deep sleep but if they woke up and went into the kitchen, several rooms away from me, I would be fully awake and aware of what was happening in the house.  I also struggle with anxiety and when I'm home alone at night, or the only adult at home, it tends to be the worst. 

    These days I've found a much better rhythm for the most part, but a lot goes into that.  The first thing I needed to do was identify the factors that were keeping me from falling asleep or staying asleep.  Pain is definitely one of these.  I'm in pain all the time, but when I'm lying in bed at night in a quiet room my brain has nothing else to focus on and pain becomes all consuming.  This might come in the form of muscle aches, joint pain, or a migraine, but it could also manifest as digestive issues ranging from cramping to diarrhea or allergy symptoms like congestion, cough, or sinus pain.  In addition to pain, my brain can keep me awake.  I regularly struggled with to-do lists or what-ifs spiraling through my mind and preventing me from slipping into sleep.

    The first thing I successfully attacked was my thoughts.  While I was training to be and practicing as a yoga instructor, I spent a lot of time learning about Biblical Meditation. This is not a clearing of your mind but training yourself to be able to focus on listening to God or thinking on a particular piece of scripture.  Much of this training helped me learn to be in control of my random thoughts that would take over at night.  If you're interested in this concept, I would encourage you to read Into the Silent Land by Martin Laird. Another help in this area that I found a few years ago is a phone app called Calm. Not gonna lie, I was primarily influenced to try it because Matthew McConaughey was featured on it and I'm kind of a fan girl.  But after learning about the concepts behind it and the features in it I was hooked.  They have a wonderful section full of meditations that can help you learn the skill that are (mostly) free of eastern mysticism.  I do struggle with being able to relax into a meditation if I feel like I have to constantly be on my guard against teachings that go against my beliefs so I would often "preview" different mediations or stories before relaxing into them.  The biggest part of the app that I used though was the sleep stories.  For me, I found that the non-fiction stories worked best because if I used a story with a plot line a part of my brain would want to stay awake to see how it ended.  But about half of the stories on the app involve explanation or description that engaged my brain just enough to shut off the to-do lists but not enough to keep me awake to hear more.  For two or three years I started a sleep story nearly every time I laid down to go to bed, and sometimes when I woke up in the middle of the night as well.  There's lots of science that goes into the app and the stories are designed to help you go to sleep and stay asleep.  I'm not sure I can attest to their usefulness in staying asleep, but I could just be a special case because of my extenuating factors.  This last summer I found that I struggled to hear the story over the sound of the AC unit in our bedroom window and I stopped playing them.  Now when I go back to the app it doesn't work the same for me, so I think it has a lot to do with consistency and training.  If I remember correctly, it took about three months of listening initially for it to start helping me fall asleep in under ten minutes.  During the summer the white noise of the AC unit helped a lot and since then I've been using a brown noise through my bedroom speaker.  Something about the consistent, slightly distracting sound helps so much with rest.

    One of the key factors affording me consistent sleep came in the form of medication.  My doctor and I spent a long time finding the right combination for me.  We started with melatonin and then switched to an extended-release version that helped over the course of the night.  Next, we added in low-dose Naltrexone (LDN) to help with joint pain.  My doctor suggested that Hydroxyzine might help with allergies, anxiety, AND sleep so we added that on and it made a huge difference.  Interestingly, this was way before we identified EDS and its comorbidity, Mast Cell Activation Syndrome (MCAS), as being at work in me and Hydroxyzine is one of the primary tools doctors use to treat MCAS.  After we learned about the EDS at work in my body, my doctor wanted me to try using muscle relaxers to help with the pain.  I found that it made me too sleepy to use them during the day (except for big flares) but they were the final piece in the puzzle of getting me to sleep at night.  It's awfully hard to fall asleep when you're in pain, especially when you're as light a sleeper as me, and the Baclofen (muscle relaxer) helped so much with this, but unfortunately it wears off after about four hours and the pain often wakes me back up.

    There's so much more I've learned and tried in this process like eliminating blue light at night, warm baths or showers, consistent bedtime routines, etc.  These all make a difference and at different times in my life I've leaned into one or the other of these strategies.  I encourage you to learn more about the benefits of these tactics.  

    At home I do pretty well for the most part now, though I've spent more wakeful hours in the middle of the night lately than I'd like.  The challenge I face is when I travel.  I have so much less control of my environment in new places and my anxiety fueled light sleep alertness kicks into full gear.  Every noise seems to jolt me back to full awakeness, which is especially tricky with things like an air conditioner or heater that kicks on and off all night.  I've learned that I need to look at the room's thermostat and see if there is a way to turn it off or switch to constant fan mode during the night.  As much trouble as I have with sleep if the room is too warm, I have even more trouble with loud clanking noises!  This was especially troubling in the Disney resort because even though I switched the thermostat to fan it seemed to reset to AC after about an hour every time.  With a longer stay I would have called the desk to see if there was a way to override this, but with only being there two nights I didn't have the opportunity to sort it all out.  This was another valuable lesson I learned on my "scouting trip" so that I will come armed with information when we return for our anniversary in February.

Here's the thing: It's important to have lots of different tools in your toolbox when it comes to sleeping while you travel.  Knowing your triggers is so important and can help you determine the best remediation for different problems.  For me, having a good, loud brown noise is my first line of defense in addition to making sure I remember to take my medicine at bedtime.  It's also important, though, for me to be aware of what new things might be causing me to struggle with sleep so that I can find a work-around and get the rest I so desperately need while travelling.