Useless Doctor

[snuginarug]

Wow, I am so frustrated I have to share this with someone. I was referred to an in-house psychologist to help me with my chronic insomnia. I've been going to bed at 2 am for 20 years. TWENTY YEARS. I am not going to change that. It is not aberrant, dysfunctional, pathological, naughty, non industrious, immoral, against the work ethic, or in any way shape or form BAD in itself. When i worked, I worked the 4 to midnight schedule. It suited me perfectly. End of story.

My sleep Dr, when I told him I had problems waking up early and not being able to get back to sleep, he said Go to bed earlier. So I did. I still slept four hours then woke up... I just did it earlier. So i reported back and he said Oh, OK, we'll let you talk to the psychologist. First the psychologist questioned my 2 am bedtime, like I was some sort of freak. He acted amazed that I could get work that fit such an obviously pathological life. Then the psychologist told me, Go to bed earlier, no naps. So i went to bed earlier and still woke up after 4 hours, and now was even more tired than before because I was getting no naps.

So SCREW THAT. The whole idea behind telling me to go to bed earlier is that it is the sun that is waking me up and that I am stubbornly defying nature. That if I acted in harmony with nature and went to bed earlier, I'd still wake up at 6am, having gotten more sleep. I WAKE UP AFTER FOUR HOURS NO MATTER MY BEDTIME. I told Dr Fertel this. I told the psychologist this. I have told everyone involved in this the same thing. No one listens except my psychiatrist. She seems more concerned with not tipping me back into my bipolar cycles and advocates that i sleep anyway I can get sleep, because it is so important for my mental health. And what do you know, following these suggestions from these idiots, I exhibited symptoms of bipolar for the first time in about 3 years. This really fucked with my life, did what might be irreparable damage to some really important things. The only way i am going to fix these things (if they can at all be saved) is to disclose my mental illness and beg pardon. I tell as few people as possible about my mental illness, because of the stigma and because of the ignorance of the general public. And it might not even help the situation. GRRR. Thanks a lot for screwing up my life. This stuff that was screwed up was really important to me.

SO THANKS A FUCKING LOT.

[SnoozyQ]

Damn Snug, I'm sorry to read this. I hate when docs don't really absorb what they are being told and act more upon what they assume. You told them you'd wake up in 4 hours, yet they just assume if you get yourself to bed before 2am, BOOM, you will sleep just fine.

I don't have any super advice to give, but wanted to offer my support in your struggle.

[BlackSpinner]

Follow your instincts. Feel good about being right. Let go of the energy sucking anger bonds.

[bap40]

Everyones sleep and wake cycle is different. It is what it is so why mess with it? If you aren't connecting with these medical people it is time to move on. I would never keep seeing someone whose opinion I thought was crap. Plain and simple, well in reality it isn't all that plain and simple I know but why go to a person you have no respect for. That will not help you at all as you have seem from your experience in dealing with them. Chalk it up to bad doctors and we know for sure they are out there.

[robysue]

Snug,

Sorry to hear you've run into several docs who seem to be incapable of hearing what you're saying.

There's nothing wrong with a 2:00 AM bedtime if that works for you. And from what you wrote, it does work for you as well as any other earlier bedtimes. Your goal seems to be to develop the ability to sleep longer than the four hours that you currently manage to get regardless of your bedtime. That's a reasonable goal. And since moving the bedtime back hasn't worked, it's reasonable to try to figure out what can be done to help encourage your body to sleep longer in the morning.

An obvious suggestion: If the sun coming through windows is a problem for you, get some black out shades: They look like normal shades, but are much better at blocking out the sun. If nothing else, this will provide you with a reasonable response when a doc says, "the sun is waking you up, just go to bed earlier." And if your bedroom gets substantial light coming in from street lights during the night, the black out shades will block that light as well and that might also help encourage you to sleep at least a bit longer.

And while you say "no naps" during the day is leaving you exhausted, in the long run combining "no naps" with your NORMAL bedtime of 2:00 AM, may help encourage you to sleep a bit longer in the morning.

And out of curiosity: What do you do after you wake up four hours after going to bed? Get up for the day? Or lie in bed trying unsuccessfully to get back to sleep for an hour or two? Or something in-between?

[Madalot]

Snug,

I am so sorry that trying to do what they suggested has caused you so many more problems. Frankly, if going to bed at 2am works for you, I don't see any reason to change it.

Over the years, I've had some doctors tell me some strange ass things. I had a doctor tell me one time that I just needed to relax and I WOULD get pregnant, which I know some doctors say because they're ignorant, but she HERSELF was suffering from infertility.

I don't have any personal experience with a situation like yours, but know that I am here for you.

[xenablue]

Wow - I'm a bit shocked, snuginarug! Flabbergasted, actually....

My DH who is NOT a morning person actually chooses to work 2nd shift because of this. His shift starts anywhere between 11am and 2pm, so his NORMAL bedtime is around 2.30-3.00am and he gets up around 9-10am.

This is NORMAL for him, hell - it's normal for me now, even though I like to get up early and go to bed early. We have blackout drapes so no matter when we go to bed, once the drapes are closed it's DARK - REALLY DARK. When he worked 3rd shift this was imperative and it's just stayed.

OK, so my DH is a little wacky - that's why I love him, but there's certainly nothing wrong with him due to sleeping "different" hours from MOST people - geez.

Cheers,
xena

[HoseCrusher]

I have a little different perspective on this.

First of all pay close attention to your diet. The brain works better when it has all the nutrients it needs in a proper balance.

Next pick up a notebook and and log how you feel after you sleep.

Enjoy your 4 hours of sleep and when you wake up, get up and get on with your day. Limit stimulants and pay attention to how you feel throughout the day. If you start to feel tired, log it in your notebook and take a nap.

Think of yourself as a child. You just wake up every 4 hours. The goal is to lump a couple of those 4 hour sessions together, but in the meantime a nap or two may be needed.

Finally, don't beat yourself up. I know of several people that thrive on 4 - 5 hours of sleep a night, and have been doing so for the 10 - 15 years that I have known them. Doctors are quick to point out that an average amount of sleep needed should be about 8 hours, but they never tell you how much scatter there is about that average.

Are you aware that an average height for a woman is 64 inches, but the range goes from 59 - 69 inches. The same goes for weight. The average weight for a women is 150 pounds, but the range goes from 90 - 230 pounds.

A study at the University of Chicago found that average sleep duration for women averaged from 5.9 - 6.7 hours, but they did not give any indication of the highs and lows.

Average numbers are informative, but they don't tell the whole story. Most people don't exactly fit an "average."

The most important thing to log in your sleep notebook is how well rested you feel when you wake up. Perhaps rather than agonizing over the amount of sleep you are getting, as you seem to be "wired" for 4 hours, you should concentrate on making that 4 hours of sleep the most restful sleep you have ever had.

[chunkyfrog]

Don't despair because someone is trying to make you feel like a square peg to make their job easier.
Some of us are different for a reason; and until doctors really understand ALL circadian rhythms,
we know nearly as much about it as they do--sometimes more.
They shouldn't be trying to force you into the round hole they learned about in school.
That may have been years ago. Continuing education/research nearly always lags behind our needs.
Tough to get stuck behind that rock. Feeling for you.

[LarryD]

Stress and anxiety can trigger symptoms in bipolar disorder. You have experienced both based on your post. Have you talked to your psychiatrist about the impact of your psychotropic medication on sleep/wake cycles?

Doctors are hard to teach but we have to keep trying.

[robysue]

Snug,

HoseCrusher brings up some really good points and many of these points raise important questions for you to ask yourself. Among them:

• How is your diet?
  
  How do you feel after you sleep?
  
  Do you feel rested enough to just get up and get on with your day? Or are you lying in bed for a couple more hours trying to get back to sleep before starting your day? Or something in-between?
  
  Are you capable of enjoying the four hours of sleep you do get each night?
  
  And how much sleep do you actually need to be fully functional in your opiniom? In other words, when you are at your best, how much sleep do you need?

It may well be significantly less than the well publicized "need to sleep 8 hours per night." For example, I know myself well enough to know that right now, with my sleep restricted schedule of no more than six hours in bed and averaging between 4 1/2 and 5 1/2 hours of sleep on most night, those nights where I get 5 1/2 hours of solid sleep are not much below what I really need to feel my best: Prior to starting CPAP, even with the untreated apnea I really functioned and felt best with around 6 1/2 to 7 hours of (highly fragmented) sleep. Less than that caused the obvious problems with lack of sleep, but more than that usually meant that I'd wake up groggy and less functional---unless I was fighting a cold, the flue, or a migraine.

Finally, HoseCrusher's suggestion:

The most important thing to log in your sleep notebook is how well rested you feel when you wake up. Perhaps rather than agonizing over the amount of sleep you are getting, as you seem to be "wired" for 4 hours, you should concentrate on making that 4 hours of sleep the most restful sleep you have ever had.

is spot on. Try keeping a sleep log for a couple of weeks, concentrating on how you feel when you wake up rather than what time it is when you wake up. If you can insure that the four hours of sleep you are getting nightly is high quality sleep, then it may well be that you'll find it's enough. On the other hand, if you are clearly feeling exhausted, tired, and still sleepy upon waking every morning once you are NOT worrying about when you get up for the day, then you know that you do need to do some work on addressing the "wake too early" variety of insomnia. What kind of work will depend upon your own preferences and that decision can wait until you know whether you have a problem.

[snuginarug]

SnoozyQ, thank you for your support.

Follow your instincts. Feel good about being right. Let go of the energy sucking anger bonds.

As usual you give me good advice that is hard to follow. I will practice letting go.

bap40 You're so right, I have no respect for this guy. I will be canceling my next appointment with him, and will inform my other doctor how useless the psychologist is.

Your goal seems to be to develop the ability to sleep longer than the four hours that you currently manage to get regardless of your bedtime. That's a reasonable goal. And since moving the bedtime back hasn't worked, it's reasonable to try to figure out what can be done to help encourage your body to sleep longer in the morning.

Nail on the head, this is exactly what I want. I have never had problems with sun waking me up, but I will look into the black out shades you and others suggest, as things might have changed. It all depends on the cost.

And while you say "no naps" during the day is leaving you exhausted, in the long run combining "no naps" with your NORMAL bedtime of 2:00 AM, may help encourage you to sleep a bit longer in the morning.

I think you're right... but fort the moment I am focusing on getting sleep, period, as I rebound from this shitty bipolar episode. But after I recover and feel stable, I will try that.

What do you do after you wake up four hours after going to bed? Get up for the day? Or lie in bed trying unsuccessfully to get back to sleep for an hour or two? Or something in-between?

I try to go sit in the dark living room and either just it there, or do something quiet and not stimulating, like listen to music softly or listen to an audio book. That's what i do when I am, feeling "good."-- following all the sleep hygiene rules. Sometimes I am just AWAKE and it is really obvious no matter how quiet and relaxed I try to be, I won't be getting sleepy any time soon. So then I go about my business normally. When I feel "bad" I break the sleep hygiene rules and do stimulating things although I know it is possible for me to get sleepy and go back to bed. I think one ting that might help is to practice relaxation techniques when I wake and feel sleepiness might return.

((( mad )))) thanks for being here for me.

xenablue, you make me laugh. I think most people would call me wacky too.

First of all pay close attention to your diet. The brain works better when it has all the nutrients it needs in a proper balance.

Oh you are so right! I overeat at some times, and undereat at others, and in general I am not getting the proper nutrients. That is something I have to work on. My goal right now is: more vegetables, especially dark green leafy ones. I know the best way to get all your vitamins and minerals is direct from the source, not through pills.

Next pick up a notebook and and log how you feel after you sleep.

Enjoy your 4 hours of sleep and when you wake up, get up and get on with your day. Limit stimulants and pay attention to how you feel throughout the day. If you start to feel tired, log it in your notebook and take a nap.

Think of yourself as a child. You just wake up every 4 hours. The goal is to lump a couple of those 4 hour sessions together, but in the meantime a nap or two may be needed

Very good idea! I will brush off the sleep journal and use the way you suggest.

Thanks, chunkyfrog... I'm a square peg and proud!

Stress and anxiety can trigger symptoms in bipolar disorder. You have experienced both based on your post. Have you talked to your psychiatrist about the impact of your psychotropic medication on sleep/wake cycles?

Well, perhaps this is something my psychiatrist and I might want to re-visit. My meds have not been a problem in the past as far as sleep goes, but we should probably go over that again when we meet next week.

Thanks to all of you for your validation, support and really good ideas.

[robysue]

What do you do after you wake up four hours after going to bed? Get up for the day? Or lie in bed trying unsuccessfully to get back to sleep for an hour or two? Or something in-between?

I try to go sit in the dark living room and either just it there, or do something quiet and not stimulating, like listen to music softly or listen to an audio book. That's what i do when I am, feeling "good."-- following all the sleep hygiene rules. Sometimes I am just AWAKE and it is really obvious no matter how quiet and relaxed I try to be, I won't be getting sleepy any time soon. So then I go about my business normally. When I feel "bad" I break the sleep hygiene rules and do stimulating things although I know it is possible for me to get sleepy and go back to bed. I think one ting that might help is to practice relaxation techniques when I wake and feel sleepiness might return.

If you're AWAKE and "it is really obvious" that you won't get sleepy anytime soon, that's most likely your body telling you it would just assume that you get up and start your day. And in that case, I think it's fine to do something stimulating when you're waking up too early and not feeling sleepy: Just start your day and try to keep going as long as possible.

It's lying in bed AWAKE that you want to avoid.

[Robespierre]

Snug,

I'm sorry to hear that the PITA shrink caused a return of your bipolar symptoms.

I hope some of the suggestions that you've been given will help.

Hang in there. (((hugs)))

[cpapcharge]

Snug,

I have to agree with what most people said, if you feel good then there is nothing wrong with it. Don't listen to someone, even if they are a doctor, if what they're telling you to do is hurting you. The whole nature comment is absurd, it's conditioning not nature.

I do have a question. If you've been getting 4 hours of sleep for 20 years what made you want to try and change it now?