Please help me sleep again!
July 3, 2014 8:33 AM Subscribe
I aggravated a lower back injury on June 3rd. This injury caused pretty bad nerve pain down my right leg that totally disrupted my sleep. Even though I am feeling much better now physically, my normal sleep has not returned. Note: I have read a bunch of AskMes about insomnia but I thought I would get some fresh responses here.
posted by Seymour Zamboni to Health & Fitness (7 answers total) 1 user marked this as a favorite
The nerve pain during that first week, when I was acute, was such that I could not sit or lie down. The only relief I had from the pain was when I was standing. And pain killers really didn't do much of anything to reduce the pain levels. As a result for about a week post injury I was on my feet 24/7, spending most days and nights leaning on the back of a high chair. On a few occasions I was able to find a sitting position that worked for a few hours-as long as I didn't move my leg. In those cases I was able to catch an hour or two of sleep. Also, I was on the 6-day prednisone pack to get the inflammation under control. That helped a lot but it made me jittery. Anyway, over the last few weeks my physical condition has markedly improved. I first regained the ability to sit comfortably, pain free. So I was able to catch more sleep sitting on a couch (in front of TV of course). Then I was able to lounge on the couch comfortably. And finally, I regained the ability to lie down horizontally. At that point, I returned to my bed and my ability to sleep vanished! I should emphasize that my pain levels now in bed are typically 0/10 or maybe 1/10. So I am totally comfortable. I've got the central AC running, I am wrapped in a comfortable blanket, etc. It feels great....but no sleep.
Things I have tried: Last week I tried taking unisom for a few days. Over time it seemed to have the opposite effect--making me feel a bit jittery and I was having frequent hypnic jerks. So I discontinued use. I also tried one 5 mg melotonin a few nights ago. Again, it didn't seem to make any difference but I felt even more groggy than usual the next day. So I discontinued use. Then I started to deal with sleep hygiene. I am doing all the recommended things, but I have only been doing it for 2 days. My routine (for the last 2 days) is to wind down after dinner--with very limited screen time. I take a short walk and sit by the pond for a bit. I then spend some time reading, or perhaps watching no more than 1 hour of TV. Then I go to bed. The last two nights I have gotten maybe a few hours of sleep--although it is remarkably hard to tell. I do recall a few dreams so I had to be sleeping some. Also, before this happened, my sleep hygiene wasn't great but I was always able to get maybe 5 hours of solid sleep, unless I fell asleep in the evening in front of the TV--in which case that night would often be sleepless until the very early morning hours. Also, there is no question that I have built up a lot of anxiety about sleep. So that isn't making things any easier. I have been taking a 30-45 minute walk each day. I know exercise helps and I was much more physically active before the injury. But I am still healing so I am cautious about trying to do more than a walk.
Anyway, here are my questions:
1) Should I try the melatonin again and maybe take it for a longer period of time to see if that helps? Is there a proper melatonin protocol (dosage, timing)?
2) I don't know much about OTC sleeping aids. But is there a type different from unisom that I could try? Or should I try Unisom for longer than just a few days/give it another chance?
3) Do I just need to be more patient and stick with the sleep hygiene routine and see what happens?
4) Regarding sleep hygiene, if I go to bed and can't fall asleep in say 30-60 minutes, should I get up? Is it OK to get up and read in a dimly lit room until the tired feeling comes back? Does this also apply if I do fall asleep for say 1 or 2 hours, then wake up and not feel tired? Or should I stay in bed and try to work through it?
5) yesterday at about 4 PM, I had an strong tired feeling wash over me. But given the time of day I resisted--it was torture. Should I just let myself go to sleep anytime given my sleep deprivation?
6) I am visiting my friends in NH on Monday. I visit them every few months and I have ALWAYS slept much better there--often through the night. They have no TV and go to bed much earlier than I usually do. Is this kind of change of venue typically helpful when dealing with insomnia? Would even going to a hotel for a few days be helpful as a way to get away from my bed?
7) Any other advice would be appreciated.