It’s sleep awareness week. I’m not a good sleeper. I’ve never been a good sleeper, but I’m definitely bad at sleeping now.
I don’t sleep very much or have good quality sleep at night. I never wake up feeling rested. I have naps in the day and generally get better quality sleep during the day, but obviously I can’t sleep all day and not at night. In a ‘good’ 24 hours period of nighttime/naps, I sleep for about 7 hours. On a ‘bad’ night/naps I get between 3-4 hours. Sometimes, the opposite happens and I sleep for 21 hours out of 24 and only wake up to eat if shaken awake and to go to the toilet. But that’s not healthy either! It’s either I’m too tired to sleep, which sounds weird, or I’m essentially comatose. There doesn’t seem to be an in between. It’s quite common for people with adrenal insufficiency to have disrupted sleep, but there’s little in the way of studies to work out why. One of my theories is I sleep better during the day because my body has the cortisol it needs when I take my tablets, and I don’t sleep at night because my levels drop when I’m not taking my tablets so my body tries to keep itself awake to survive. But there might be other things going on too.
I can go to sleep fine, that’s not the problem. I wake up like I’ve been electrocuted at roughly the same time every night having sweated through my pyjamas, shaking, feeling sick. Sometimes it happens more than once and I need to get up to eat something. It quite often takes a while to settle down again and go back to sleep, if I manage to go back to sleep.
So I’m being referred to a sleep doctor. I have to say I’m relieved, I haven’t had a decent night’s sleep in about 3 years and that’s enough to drive anyone crazy! I’ve tried many, many different things myself and not got anywhere. It could be a number of things, but at the moment the working theories are:
– sleep apnea. This is where you temporarily stop breathing and start again. It sounds worse than it actually is. Apparently I have a wonky soft palette and chin or something which makes me more likely to have it.
– there are many hormones that can cause disrupted sleep if they’re missing, cortisol being one. You might be asleep at night but there’s still a lot going on in the background. So if there’s a hormone missing, that might be waking me up.
– nightmares causing a drop in cortisol. My body doesn’t go ‘oh it’s ok it was a nightmare’ when I wake up, it goes into panic mode because it’s not made any cortisol to counteract what’s going on. So it perceives the ‘threat’ of the nightmare as real long after I’ve woken up, floods my body with adrenaline which I can’t get rid of easily, which keeps me awake.
Nightmares is a tricky one because it’s hard to control what you dream about! I have a good sleep routine (like babies do!) and I do a lot of meditation. I started seeing a hypnotherapist to help with sleep which helps a lot- I tend to get more rested sleep after having been to a session. The aim is to try to reduce the nightmares and keep me asleep unless there’s a medical reason to wake up.
Hypnotherapy also helps rule out if there’s anything psychological waking me up. Most patients with AI who die out of hospital die in their sleep because cortisol replacements aren’t taken overnight and they’ve unknowingly not replaced enough during the day e.g. Stress dosing when sick so their cortisol level drops dangerously low. When I need to go to hospital, it tends to be in the evening/night after my last dose. I’ve woken up a couple of times in the middle of the night needing more hydrocortisone because I’ve been unwell and it’s a bit of a freaky feeling. Understandably, my subconscious might be worried that I might not wake up when I need to, even if logically I know I’ve always managed to wake up/my husband has woken me up to keep me safe in the past. That’s where hypnotherapy comes in- it’s hard to rationalise when you’re asleep! That wouldn’t explain why I can’t go back to sleep once I’ve woken up though.
Sleep is a complex thing. Our bodies are pretty amazing really- a lot goes on while we’re asleep. Cells repair, illnesses are attacked by our immune system, food gets digested, we know how to keep breathing and keep our hearts beating. It’s actually incredible if you think about it. Yet so many people have issues falling or staying asleep.
Photo: stock google image