I have had trouble sleeping for about 25 years. I am among legions of people who share the same trouble.
Some have difficulty falling asleep. They toss and turn as thoughts race through the brain while infusing the body with neurotransmitters and stress hormones that further rev up our engines. Some awake after several hours to have the same experience as their insomniac counterparts, only later in the night. Still others make it until early in the morning when their mind overpowers the tired body and robs it of more needed rest. Some poor souls have all three, but that is uncommon.
There are many causes for these forms of nocturnal misery. If trouble sleeping plagues you or someone you care about then talk to a doctor, because a sleep disturbance may be the tip of a medical iceberg. Loss of physiologically-restorative sleep also impairs concentration, performance and judgment. Many simple and good remedies exist.
I want to report on one remedy I tried that transported me to quite a remarkable experience, namely sleepwalking.
I fall asleep immediately (thank goodness) but soon awake, again and again, with my mind suffused with dreams and experiences from the most mundane to the otherworldly. When my sleep problems worsened in recent years, I sought medical and alternative medicine consultations and cures. My three sleep studies (done by an EEG, an electroencephalogram, and an innovative home device under development) all had remarkably consistent findings: I drop into slumber but then awake as often as dozens of times a night -- though not significantly attributable to apnea (breathing problems), neurological illness (restless legs syndrome or early Parkinson's disease) or other known causes. The conclusion was that my sleep is disrupted (I knew that) for reasons not understood (at least not signaling worrisome diseases).
What could I do? There are the general measures of avoiding caffeine late in day, getting exercise, limiting alcohol to modest consumption, not getting all riled up before bedtime and the like: This is called sleep hygiene. I had been trying these but with limited effect. As a doctor, I am not against medications but tend to be conservative and hoped to avoid sleeping pills.
But my fatigue was wearing me down. After a year or more of waking in the morning needing a nap I decided to try various sleeping agents. I tried melatonin, homeopathic remedies and other non-prescription aids without benefit.
I had taken AmbienŽ (zolpidem) on overnight plane flights and it had worked. I began on a trial of this medication, in its short and longer-acting forms. It was helping, a little, in that I awoke less often and my overactive dreaming was muted. I was concerned about getting dependent on a sleeping pill but zolpidem's pharmacology suggests it does not produce withdrawal or a need for higher doses. I began taking it a few nights a week to see if I might change my sleep pattern.
Then one night the strangest thing happened. After a few hours of sleep, I got up, went to the bathroom and ran water for a bath. My wife was sound asleep, as is her great fortune. It had been a while since I took a bath in this country and never in the middle of the night. The water was pleasantly warm when I immersed myself. I realized that the t-shirt I had left on was getting drenched so I took it off and draped it over the tub's edge. I wondered what I was doing in the bath but it was pleasant and I continued to soak luxuriously, not bothering to lather with any soap. I carefully replaced the towel on the rack but left the bath mat on the floor and wet garments scattered about. When I awoke in the morning the proof of my twilight behavior was indisputable: a wet shirt and towels in the bathroom, a closet cabinet open where I had fetched fresh and dry underwear that I was now wearing, and a dim recollection of having taken a relaxing bath. My wife did not awake so could not confirm my meanderings but could see the detritus I had left.
When I told my doctor about my sleepwalking experience he said we better find another medication. I know he was not trying to deprive me of tub pleasures but rather prevent some unwelcome accident during the night, whatever that might be.
Sleepwalking, I thus attest, is for real. I don't know the full measure of what is possible during this altered state. I don't want to find out. I would rather toss and turn, or maybe just get up and take a bath.
The opinions expressed here are solely my own as a psychiatrist and public health advocate. I receive no support from any pharmaceutical or device company.
Originally published in The Huffington Post on December 14, 2011.
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