Having a Nap is Good For You!

Circadian rhythm is a repeated 24-hour cycle of any biological process.  It is controlled by the hypothalmus in humans, where my largest brain lesion is. 

Just before lying in bed, I take 10mg of zolpidem tartrate (immediate release, not extended release) to fall asleep and 10mg melantonin to remain asleep.  I sleep almost exactly 8 hours, and then wake up naturally, without alarm, far more alert than when I slept without aid of meds.  Normally pain and/or spasms do not disturb my sleep, although they may greatly affect the time it takes me to be able to get out of bed.  I am more rested if my lower body is kept warm, even in hottest nights of summer, under blanket.  No matter what the temperature, I am soaked with sweat when I wake up--part of my disease, again problem based in hypothalamus.  With even low dose of prednisone, I cannot fall asleep--that was so when I was taking it for allergy alone.  Before paralysis, when I was able to wean off prednisone, then I could wean off sleep meds.  Now that I am steroid dependent for life, that means also sleep aid dependent.  When I take my meds, I sleep--time of day does not matter.  If I am up late, it is not because I cannot sleep, but because I stay up to work, waiting for bathroom issues, or to make sure that severe pain or heart arrhythmia is not going to necessitate trip to ER (A&E).  If I need to get up before 8 hours, I will take only 5mg zolpidem tartrate, and two 3mg melatonin--and be sure I am not driving for 2 hours after getting up. 

I wish I could just decide to go to bed without bathroom concerns so often--that is improving with time and new protocols.  But work is sporadic, and where I live the bandwidth is limited--so sometimes night is the only time I can handle large files, and I need to work when I have opportunity.  Return to old job duties under new arrangement still possible, but has been about a year off, so taking whatever assignments I can get.  Now I am nowhere near as healthy, and not sure I can handle additional hours required.  If they make an offer, I will have to decide!

Most people with my disease, especially the form I have, sleep in a few two-hour segments.  My PCP and I decided that sleep was more important than worrying about drug dependency, especially since the effectiveness of my dosing has not changed in 6+ years.  Sleep allows the body to heal itself when possible.  So she supports my using these meds, which has meant writing letters to get the government to allow it.  Our President wants to eradicate bad health by letting the sick and weak die off, unsupported by available measures--government and insurance companies control prescriptions now, not doctors unless they fight for you.  Even though I sleep well, fatigue is a crippling byproduct of my disease, because the body is constantly fighting to destroy itself, and the immune suppressing meds are potent and somewhat toxic.