Oh sleep, how I miss you.
I’m not talking about a medicine induced coma (I can eat Ambien like tic tac). Or exhaustion from being awake for three days (it’s amazing how many TV series you can get through on Netflix). Or won’t get out of bed from depression sleep (see the Anniversary post).
I mean normal, wholesome, lazy Sunday afternoon sleep.
All sleep is not created equal. Getting to normal sleep was the first thing I tackled managing and is a constant battle. My mind and body need it. Given the complexity of PTSD and the issues deeply tied to anxiety and safety, weaving through the dozens of variables that contribute to a good nights sleep can be tricky.
Homecoming Problems: Sleep was just the beginning
I was pretty much terrified to close my eyes when I got home from my second tour. Either I was worried about someone coming into my house, or the nightmares took me right back to a firefight. (Cue story about attacking my wife in my sleep…) What I quickly discovered was that I needed the meds, and because of the meds I needed a routine.
I put myself on as strict a routine as I could but, finding the data points was tricky. If you don’t keep a log, I would highly recommend it. I kept med dosages, time to bed, time up, and a few notes and lined up anniversaries and non-Army stressors. The better I kept the journal, the more trends I could find. (we are not talking statistical significance here, it just felt like I was identifying trends)
Probably the biggest significant data point I recognized from the early days was the impact alcohol had on me and my routine. In the beginning I was on trazodone, citalopram, quetiepam and prazosin. Everyday. I hate medicine. My temptation to suck things up gave me serious misgivings about all meds. When avoiding meds was not an option, my soul mission in life was to get the sleep under control so I could get under way with real work. I was also desperate to get away from all the drugs filling up my medicine cabinet and more importantly, my veins.
The labels on those bottles did not lie. Even with small bits of alcohol, I was completely out of whack with my sleep patterns. It was a heavy sleep and a long fog after I woke up. As a result, joblessness or working from home was my only option early on.
One day, I just made up my mind and stopped drinking entirely, and besides saving me a few bucks, I have never looked back (ok, maybe I look back occasionally, and I may have slammed a shot and a beer when they killed OBL… it tastes so good when it touches your lips)
Still, getting sleep to be manageable is in my opinion the best first step on the PTSD treatment road. Sleep makes me happy. Sleep helps me think rationally. Too much sleep and being unproductive gets me down. Finding that balance of sleep and medication helps.
Alternatives to Medicine
I am at a stage now where I need less medicine. Using the lessons from therapy as well as some visualization techniques, I rely on a relaxation exercise to help me when meds are to too much and I am too wound up to get to sleep quickly.
I am including a link to the Army Center for Enhanced Performance site. They have tools there for a variety of stuff, but I will point you to the relaxation MP3. Everyone has an MP3 player now right? Good. Go download it and give it a try. ACEP Resources
In summary: sleep is the gateway to getting to the real work. Understand the labels and the restrictions sleep meds put on you. Be disciplined in your approach to sleep. Try relaxtion techniques to assist with getting to sleep. I hope it helps you.