“I can’t sleep!”
A few years ago, that was me, wailing. I had full-blown insomnia.
It got so bad that about three nights a week, I was up all night. And for a year or so, it just got worse.
Articles that were supposed to be helpful freaked me out further.
Ever notice how sleep stories almost invariably start by listing all the terrible things that can happen to you if you don’t sleep? Heart attack, stroke, high blood pressure, obesity. Who can go to sleep after hearing all that?
Things have improved greatly – and I have since learned I was in good company.
The Centers for Disease Control and Prevention last fall declared insufficient sleep a public health problem. An estimated 50 million to 70 million adults in the United States have sleep or wakefulness disorder, the government determined.
Worse still, most sleep disorders are preventable or treatable, yet less than one-third of sufferers seek professional help, according the World Sleep Society in Rochester, Minn.
There’s no reason for that, not with the options and research now available.
Which is why I share the story of how I got my slumber back.
A FAMILIAR ROUTE
You feel terrible telling your doctor you can’t sleep, which is why I put it off. You feel like a basket case. But when I finally approached him, for better or worse, he did not appear to see it as much out of the ordinary. He shrugged. I pestered him for pills. He gave me Ambien.
The Ambien was a cool experience. You closed your eyes, and bingo, it was morning. But I worried I’d get hooked on it. Also, the pills made me groggy. I began getting migraines, a mean variety of migraine I hadn’t had before. Enough of that.
It was time to seek professional sleep help.
I got brave, and I got my doctor to refer me to Dr. Daniel Rifkin at the Sleep Medicine Centers of Western New York.
Just walking in, I felt better. Those other people in the elevator? They clearly had sleep problems, too. The next step up came as Rifkin quizzed me. I worried he would stare at me and then tell me, like all the magazine articles, that I was in danger of heart attack, stroke or more. Instead, he just smiled.
I was a textbook case, it turned out. Nothing unusual.
He gave me an amazing diagnosis: Psychophysiologic Insomnia with Negative Conditioning.
Rifkin prescribed not a pill, but Cognitive Behavioral Therapy (CBT).
This therapy is still very much in use and, he recently reassured me, had not changed since I was on it. The reasoning behind it was simple. I feared I would not sleep, and it had become a self-fulfilling prophecy. The goal of the treatment was to de-program me.
I had to go to bed every night at midnight, not before. And for the next five days, I was to get up promptly at 5 a.m. I could function on five hours’ sleep, I was told, although I was supposed to avoid driving.
No sleeping in. No napping. The idea is to make yourself tired enough so you are sure to sleep.
After five days, the 5 a.m. time moved to 5:15 – then, after five more days, to 5:30, and so forth, until I reached my optimal wake-up time.
Rifkin gave me a simple one-page sleep diary to fill in, and I went optimistically home with it. Did I sleep that night? No. Did I sleep the next night? You bet.
It wasn’t all roses, but things went pretty well. I decided I liked being up with the robins. One day, I used that early morning time to garden. Another morning, I made strawberry jam.
I stuck religiously with the therapy rules. If you are awake in the night, you can’t sip wine or go online. You are to go into another room, sit somewhere, read a magazine, drink herb tea. As the days passed, I began sleeping every night. My spirits soared. One day, even though I’d slept only four and a half hours, I felt great.
When my month or so was up, I went back for my follow-up. Rifkin studied my meticulous sleep diary.
“You’ve graduated,” he said, and tossed the paper into the trash.
“If you have more problems, you can always come back,” he shrugged. “And if you can’t sleep once in a while? No big deal.”
Now, I can say again that I’m a good sleeper. But having been there, I still feel a kind of kinship with people who suffer from sleep problems. The proliferation of sleep treatment centers bears out the national statistics. Sleep medicine centers have multiplied, with branches now in Amherst, Chautauqua, Kenmore, Lockport and the Southtowns. Kenmore Mercy Hospital is proud of its SleepCare Center, and Catholic Health also offers sleep testing at other locations, including Mercy Hospital. There is a sleep center at the DENT Neurologic Institute, and a chain called Sleep and Wellness Centers in Amherst and Batavia.
Sleep centers usually have test bedrooms, which resemble hotel rooms, that allow medical professionals to observe patients’ sleep. Sleep problems, unlike mine, could be physiological. Sleep apnea, restless leg syndrome and chronic pain can keep a person from sleeping well, and can be treated.
At the Buffalo Niagara Sleep Center’s downtown branch, in the Innovation Building at 640 Ellicott St., a half-dozen pretty bedrooms are ready for sleep studies. Patients arrive in the evening, get into pajamas and drift off beneath art prints such as Monet’s “Purple Poppies.” Electrodes monitor their sleep.
My therapy seemed low-tech by comparison. You could even do it at home, without supervision. It was fun to be comparing notes on my treatment with Rifkin, after all these years. I wondered why I had seen CBT described here and there as a treatment of last resort.
“I see it as a treatment of first resort,” he said.
But it doesn’t work overnight.
“It’s simpler for a physician to write a prescription,” he said. Patients, whose nerves are frayed by sleeplessness also often want an instant cure. And not everyone who opts for the therapy succeeds.
“One third do great. Another third do pretty well,” Rifkin said. “And one third don’t do well at all.”
CHANGE YOUR MIND
“If you’re not sleeping and you get angry, your subconscious brain associates your bed with a bad place,” Rifkin said. “The most important thing to overcome is getting over this concept that you can’t sleep. We are in a hyper-engaged society. People are going, going, going. You need time to let your body relax.”
He likens the mind to a symphony, with all kinds of components meshing correctly.
“If one oboe is out of tune, it destroys the whole thing.”
And he likened the therapy I went through to Pavlov’s research with dogs. That’s OK – I’ll take that, along with my sleep, thank you.
Looking back, I can see how the treatment worked. I had embraced it with a spirit of adventure, and I saw the humor in the situation.
Most importantly, I had taken that first step – toward a sleep pro. It was worth the chance. As Rifkin said, “People shouldn’t be afraid.”