Thursday, 11 March 2010

Insomnia almost beaten

    Since my current brush with insomnia seems to be drawing to a close it's worth noting down some of the various different strategies I've employed to combat it over the years.
    Lack of sleep has been a recurring feature of my life for well over twenty years now. An episode is usually triggered by a change in routine, an upsurge in my gender issues or something more traditional like the jetlag from a transatlantic flight. I will normally have no problems getting to sleep in the evening, the insomnia manifests itself as an early wake-up and an inability to return to sleep. This can last for anything from a few days to a few weeks, the exception being my most recent episode which has lasted nearly three months and led to my seeking medical help.
    There have been several strategies I've employed to overcome it. Over the counter pharmaceutical sleep aids, herbal sleep aids, guided meditations. What I've learned is that there is no magic bullet for every episode and that sometimes the pill that cures one will not work on the next. My option of last resort has been valerian tablets, herbal pills available from most pharmacists. They smell foul, but a couple of those have usually been enough to see me through to the morning. They have been particularly useful in jetlag induced episodes.
    One thing is worth mentioning because it doesn't work, a recurring suggestion from other people is that getting drunk would solve it. It doesn't. Waking up at 2 AM drunk, or worse still hung over, is worse than waking at the same time sober. A drunken stupor might help some people get to sleep, but it has no effect on when you wake up.
    In the last few months I've been using prescription drugs as sleep aids. My doctor may need a little education when it comes to gender variance issues but he seems on steadier ground with insomniacs. Zopiclone was brilliant for finally giving me some sleep but left me completely spaced out the next day so I came back and asked for something a bit milder. The resulting prescription, a low dose of amitriptyline, has been mostly successful in wrapping up this episode.
    Prescription drugs though are not a long-term solution. My doctor tells me amitryptiline is not addictive and I have to believe him, however I have observed it does seem to be cumulative. Take it for more than four days and thereafter you're half asleep all day. Not good if you have a job. So I found myself on a four-days-on, three-days-off routine which meant I could never have a full week of sleep. Fortunately after a few weeks of this my waking time on the nights with no pill has crept later as it would have naturally in time, indicating the episode is drawing to a close.
   So this one looks like it's nearly over. Not before time I have to say. It's been the worst so far, seriously affecting my work, derailing a couple of personal projects and forcing me out of the closet at last. I'd have to laugh or something, if I wasn't so knackered.

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