We all need it, and many of us aren't getting enough of it. I'm talking about sleep, of course.
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We've made tonight's orange croissants into turkey sandwiches. Eat up; the tryptophan will help you sleep, according to popular mythology (the myth being the quantity of tryptophan present in turkey meat relative to other poultry).
One of my favorite episodes of the 1970s/1980s TV series M*A*S*H was the eighth-season episode titled Dreams. It was directed and co-written by Alan Alda, who of course also starred as the lead character "Hawkeye" Pierce. Although laugh tracks were commonplace in sitcoms of the era, the M*A*S*H producers were able to convince CBS to lessen the dependency on a laugh track, and this particular episode aired with no laugh track at all. Overall, Dreams has a surreal feel to it, in no small part due to the dream sequences embedded in the show.
The premise of the episode is that this Mobile Army Surgical Hospital, in the midst of the Korean War, has been swamped with wounded soldiers. The surgeons and support staff have been working full out for more than 30 hours, with only a few minutes here and there for a nap. During those brief naps, the major characters have weird dreams appropriate to their individual stories, and as reminders of the war going on around them. And they are not all good dreams. For example:
Hawkeye Pierce dozes off in the mess hall, and undergoes the classic nightmare of being subject to a test he didn't study for (reattaching a limb). The professor instructs Pierce to remove both his arms (aided by Winchester, who was sitting next to him), which are promptly thrown away. The scene shifts to a lake full of mannequins' arms and legs, with an armless Pierce in a rowboat. He lands ashore, where a Korean child with a belly wound is waiting on an operating table. He is offered a scalpel, which he cannot take due to his lack of limbs, and hears the iconic sound of approaching helicopters, which causes him to scream in frustration. At that point, Pierce wakes up to the sound of real helicopters bringing more wounded.
The image of Hawkeye alone in the rowboat, and the sounds of the boat bumping into floating arms and legs, has been burned into my mind for many many years now. It's a disturbing but powerful scene, especially in the context of a sitcom.
The final scene has the major characters sitting in the mess hall, winding down after too many hours of surgery. As they begin to stand up to go to their quarters to sleep, Winchester utters a slight variation on the classic Shakespearean line: "Ahhh, sleep. Perchance to dream." The others sit back down, deciding instead to have more coffee.
And that concludes my review of a 35-year-old television episode.
In real life, I am one who rarely remembers dreams. Some people mistakenly say that such people don't dream. In fact, we all dream, and it seems to be an essential part of the brain's internal housekeeping during sleep. The degree to which we remember them varies from person to person, and sometimes by the circumstances under which we wake up. We don't dream during 100% of sleep time, and the chances of remembering depend somewhat on being awakened during a dream.
A few times a year, I wake up suddenly in total panic, scream out loud, and fling the bed covers away from me. In that instant, I am convinced that there is some kind of bug crawling on me. Yet with the lights fully on, and with close inspection, there is nothing there. It seems so real, and yet I slowly come around to the realization that I woke up in the middle of this particular dream. And it's always the same. The same bug, the same panic reaction, and the same ... nothing there.
Does that have some deeper meaning? I dunno. It's about the only thing I have, at least that I remember, that would be in the nightmare category. And though it is recurring, fortunately it's not frequent. And, knock on wood, it's only happened in my own home, when I am alone (partner travelling on business).
My more (much more) frequent problem has been insomnia. Not being able to get to sleep. And, after awakening in the middle of the night for whatever reason, not being able to get back to sleep.
At my age, and being male, I've also had the typical prostate problems that are not uncommon in my age group. Some of you men out there will know this one: getting out of bed to pee, urinating a small quantity, and then only minutes later having the urge to go all over again. Repeat, repeat, repeat, ... Fortunately there are medications for that, and they work for me.
But insomnia is the big one. I've had many many sleepless nights, tossing and turning, laying in bed not sleeping. I can be watching TV with my partner, and feel the urge to go to sleep. Get into bed, and then I'm wide awake. I describe it as not being able to find the brain's "off" switch.
Since Partner and I each got those fitness trackers you wear as a wristwatch, I've seen some real confirming numbers. On nights when I've felt that I did not sleep at all, I look at the tracker report the next morning, and it basically says to me: you forgot to go to bed last night. I didn't forget, and I did go to bed. I just didn't accomplish anything. Those are the mornings when Partner finds evidence that I've tried to sleep on just about every surface in the house: blankets and pillows on every couch, bed, and sometimes even floorspace. He will say "you had a rough night again?"
Michael Jackson died because he (and a now infamous doctor) were abusing anesthetics such as propofol. Jackson was a veteran insomniac, and was desperate for sleep, going to extreme lengths to get it. I certainly don't want to go down that road, but I understand it. Being so desperate to sleep, you will do anything. I get it.
The closest I've come to that was two different prescription sleep medications, from my family doctor. I took one of each of those, on separate occasions of course, and ended up dumping the rest. These drugs gave me nasty hallucinations. I described it at the time as being not just not sleeping, but standing beside myself watching me not sleep. It felt like an out of the body experience, and I didn't end up getting any useful sleep.
My sleeplessness has been going on (and occasionally off) for years. Quite a few years ago, when we lived in Atlanta, we both went on overnight sleep studies. That's when you check into a sleep clinic and get hooked up with all manner of wires and monitoring devices, and then you are watched over all night. I hated the experience, and didn't sleep much, as was confirmed in the morning by the monitoring attendant.
We were both diagnosed with sleep apnea, and advised to get a CPAP machine (Continuous Positive Air Pressure). Partner loves his, and over the years has gone through a few of the machines, each generation being a little smaller and quieter, and with more comfortable mask technology. He has two of them now, one for travel, that stays packed in the luggage he uses most frequently for business travel.
I hate it. What a horrid idea: if you have trouble sleeping, try getting to sleep with this ... thing ... covering your face in some sort of weird Vulcan death grip. It works well, as in Partner's case, when your main problem is apnea: waking up due to snoring and difficulty breathing. On the other hand, if your main problem is getting to sleep in the first place, a CPAP is helpful not so much.
Now as it happens, my sleep has actually been much better for about the last month or so. I go to bed, and most nights I fall asleep pretty quickly. I might wake up once in the middle of the night to go to the bathroom, but then I'm able to get back to sleep again, quickly. I wake up in the morning feeling much more refreshed than some nights where I've slept very little, or in fact not slept at all.
What changed?
As it happens, my family doctor has been telling me for a few years now that my blood sugar readings have been very slowly trending upward. I've been told that I am trending toward being diagnosed diabetic, but the line was only crossed on my most recent lab tests, about a month ago. Diet and exercise have not stopped the progression. My doctor immediately put me on a starter dosage of Metformin. Some articles describe this drug as the drug of first choice for type 2 diabetes. I'm scheduled to do the next lab tests about 2 weeks from now, and see the doctor again a few days later for the results.
But, in the meantime, I am suddenly sleeping much better. Naturally I started searching online for the combination of metformin and insomnia. Some articles claim that metformin is actually a cause of insomnia, and if this happens, you need to talk to your doctor right away. Other articles claim that there is a complex interaction between elevated blood sugar levels and sleep, and that one problem may aggravate the other. In other words, insomnia may help bring on diabetes, and reducing your blood sugar may help get your sleep back under control.
So, almost immediately after I started taking metformin, I started to sleep better. Much better.
Coincidence?
This, you can be sure, is going to be my number one topic of discussion with the doctor in a couple of weeks. Meanwhile I am liking the way this is trending.
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April 20, 2015
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April 20, 2015
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