Thursday, July 2, 2009

Sleep Disordered, Part (yawn)

I hesitate to devote yet another post to my ongoing sleep woes, in large part because of all the wishful thinking incorporated into my previous posts on the subject, but I am trying a few new things. One, I'm currently taking Temazepam every other night, except that it will probably work out to three times a week, with my taking it on Sunday, Tuesday, and Thursday nights. On the other nights I've been taking a whole cocktail of over-the-counter supplements or meds: melatonin, L-Ornithine, Valerian root, and diphenhydramine hydrochloride (i.e., benadryl). This "OTC cocktail" produces some fairly profound drowsiness while at the same time not inducing sleep, at least immediately, which is a strange sensation to say the least.

Moreover, even when I finally fall asleep on my "OTC cocktail," I haven't been staying asleep for longer than three-plus hours, and then I lie awake the rest of the night. I can't blame that on swallowing air from the "VPAP Adapt SV" machine, because I reduced the "EEP" (End Expiratory Pressure) setting on it from 10.0 to 6.0, which immediately alleviated the air-swallowing problem. (I've since raised the "EEP" gradually to try to find the point at which I start swallowing air again, and that seems to be right at or near 8.0; last night I set it at 7.6, which seems to be the maximum I can tolerate before I start swallowing what feels like gallons of air; I guess I'll find out over time how much of a breathing aid the machine really is for me at that setting.)

I'm also trying some "cognitive behavior therapy" (CBT) techniques to see if I can develop better, balanced (and hence more positive) thought patterns respecting sleep. I'm working on becoming more-optimistic that my "OTC cocktail" can take the place of heavier meds like Temazepam, and that I can ultimately drop the antihistamine ingredient in it and rely wholly on its herbal constituents. I would certainly consider it an acceptable long-term result to be able to sleep 6-7 hours on most nights through (a) using the "VPAP Adapt SV" at a setting that causes me to swallow only a minimal amount of air, and (b) taking only melatonin, Valerian root, and L-Ornithine.

I'm wary, for several reasons, of taking prescription sleep meds on an indefinite basis. One, it's not a pleasant feeling to be dependent on them, especially when various people (e.g., pharmacists, insurance reps) seem to regard you as only one small step removed from being, say, a tweaker or a crack addict. Two, most of them are controlled substances, which makes it dicey to get prescriptions for them in the first place. And three, it's easy to develop a tolerance for them and to require larger doses of them to get the same effect. Herbal remedies don't pose any of these concerns -- if I can get to the point where they help me sleep more than they do currently. However, that will require that I get my mind working for me instead of against me, which is where CBT enters into the picture.

Now we'll see....