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"To sleep, perchance to dream"

soccerfreaks's picture

(William Shakespeare reference)

It is nearly 5:30 in the morning here on the east coast as I begin writing this. I have been up all night without the benefit of stimulants. No, I am merely in one of my all too frequent weird sleep cycles. I still get my required seven, eight hours of sleep, largely uninterrupted, but at this moment it is as if I am working the graveyard shift, getting home just in time to doze off at about 8AM.

I thought at one time I knew the reason for this. It began to happen, after all, only after I came home from my original surgery and began my subsequent chemotherapy and radiation treatments. I KNEW, for example, that the steroid included with my chemo cocktail was keeping me awake for at least 24 hours, or so it seemed. I KNEW that my wife could wake up expecting to find a house that was virtually sterile in its cleanliness (ok, let's not go that far). I KNEW that while I was in the hospital for those two weeks of glee I was awakened at least every four hours so that my lovely nurses could verify that I was alive, that I had blood, that I had blood pressure, that I had a heart beat, that I had sufficient insulin but not too much, and, most importantly I came to believe, that I was awake.

KInd of like sleeping in bunk beds with your little brother who, from the bottom bunk, asks you time and time again if you are asleep yet, such that you eventually find ways to torture him including clever uses of rubber bands and pillows, until such time as the ruckus brings in the big guns, afterwhich you are somehow in trouble while the little hamster is sound asleep.

Kind of like that, except that these people are paid to do it.

So it was no wonder that my sleep cycle was off right after coming home, especially when you add the occasional pain, the preordained doses of various opiates designed not just to reduce and/or eliminate pain but also to put you to sleep.

Then, too, in my case, there was the waking every couple of hours for a month or more to get to the bathroom to eject the phlegm that was blocking proper breathing.

There was that.

And all of that was understandable. Hell yeah, I was on odd hours.

What is rather inexplicable is why it continues, even long after my second major surgery (and this time an entire month in the joint).

Me, I speculate that it has something to do with our biorhythms. By now I am a believer in the notion that we (and other animals and almost certainly even plants when you come to think of it) have biorhythms, that we are conditioned or, more likely, biologically predisposed, to live within certain sleep/waking cycles, some of us even happy/sad cycles, some of us even manic/depressive cycles. But I am limiting this to sleep/waking, that aspect of what is often referred to as our biorhythm.

(As an aside, when I worked at the Air Force Geophysics Laboratory, surrounded in the main by mainly idle civil servants but also by some fairly sharp engineers and scientists, I met a bearded old fellow at a picnic we had who confessed to me ... and I think that is the right word whether he does or not ... that, scientist that he was, and working on space-related activities, he was secretly turning off the bedroom light a bit earlier each evening to evaluate this action's impact on his wife's menstrual cycle. Seriously. He was trying to simulate the waxing and the waning of the moon, and its relationship to this cycle in women. I suppose it was a hobby of his, one he kept diligent records of but which would probably not hold up to the exacting criteria of real scientific research.)

Where were we?


And how cancer and its related treatments might have to do with a long term impact on them.

You see, while I was not thinking of any of this at all, despite many instances where I have lost control of my 'cycle' and had to reclaim it so that I woke up more or less when my wife did and went to sleep more or less when she did, someone entered the room, a west coaster, who was up way past her bed time too, and following a very pleasant chat about many other things, it came up, in her words, not mine, that there are many CSN'ers who were awake at this very early time of morning, such an early time of morning that many of us refer to it as 'night', perhaps even 'late into the night'.

This motivated my brain cells, of course, something not easily done by anything other than sports, sex, and food porn. What would make this such a common thing among cancer survivors?

As mentioned above, I began with some of the obvious suspects: getting used to being awakened at all hours of the night for an extended period of time; the effects of medication, the effects of treatment, the effects of the diseases themselves; perhaps long-term impact of chemotherapy and/or radiation; the result of anxiety, depression, post traumatic stress syndrome or post traumatic stress disorder.

Any or all of the above. What triggers it? And how is it that we are able to 'recycle' back into normal sleeping patterns for extended periods of time before it returns. And why does it then return.

A cynic might say, as my wife suggested: Get a job. A forced schedule surely compels us into patterns of behavior that include going to sleep at a time reasonably early enough that we can expect to be at our job the next day on a timely basis, if we are responsible folks, as most of us are.

But this discounts the many of us who do work, whether at home or in someone's cubicle world or wherever, who have the same problem and find ways to borrow sleep, as it were, not healthy but necessary, a catnap here, an after-work slumber there, while the news drones on about one catastrophe after another.

I am not discounting the computer as an addiction that keeps us in touch with friends and with digital friends, free to share our opinions, our news, our photos, whatever, something that allows us to feel connected to others especially when we really are not.

But I also am not discounting anxiety and/or depression, nor even the impact of treatments, surgeries, chemo, rads, meds, whatever other methods of cure or longevity are insinuated into our lives, upon our bodies, upon our minds.

It is true that a lot of people go into the hospital, even for extended stays, then leave and go right back to their old routines. It is true that many cancer survivors, even, leave the hospital and go right back to their jobs and their more or less normal lives.

Still, there are quite a number of folks wandering the night.

It's 8:21AM. I am going to bed.


tufi000's picture

It was interesting to me that my onc was never surprised about my insomnia. In addition to this, I have held onto a theory that, unless given a work schedule or other outside responsibility to adhere to, your time of birth is a major factor. I was born at 10:30 PM and spent many nights of my childhood reading with no discomfort till 5AM.
Using meditation to overcome the afternoon fall when working and being up with a baby at night to occasionally restore myself to efficiency to get through the rest of the work day, I still maintain my body thinks that night is when my day begins. I become more energized at night and would accomplish much except for the fear of waking those on a more normal routine.
This is supported by my observations of the rest of my family. The ones born in the morning are morning people, and the ones born at night, when given the flexibility, seem to drift into an active nighttime routine. Perhaps the biorhythms are more of a determining factor than we give them credit for.
I will say though that since treatments in 2003-2007, the sleeping issues have become acute and less responsive to solutions. Sooooo Joe, I say, let's reactivate the insomniac club and not sweat the small stuff. As a musician I was comfortable with the underground through-the-night culture and people who inhabited it.
There HAS to be some benefit to this. I refuse to stress it, but still long to find a way to prevail in my current isolation.

RE's picture

After our chat I had a feeling I would be reading a blog from you this morning on just this subject! :-D Now after my stellar 4 hours of sleep and my 2 hours of wishing I was asleep I decided to see if my hunch was right! So all you sleepless CSNER's out there chime in and tell me if you have resolved this or if you have any tricks to falling asleep, I know~I know....log off! :-) Good topic Soccer glad you posted it.


tufi000's picture

Since those alone night hours have been the biggest hurdle to trying to stop smoking, I tried a piece of advice I had gotten in the rad waiting room years ago.
I take my sleeper as usual, then after an hour of not sleeping, I pop 1/2 or whole (depending on wakefulness) of a benadryl. The doc was floored at how ingenious a solution it was and said after 4 months to stop and see if there was a permanent improvement. He was also concerned about the mornings. Well, ya the mornings are very sluggish, but hey, I slept at night!!!!
Please don't ask about the smoking. I think that would require a major life shift.

Marcia527's picture

I sleep a full eight hours and have a nap of about an hour during the day. Sometimes all it takes to put me to sleep is to sit down. I think my son took a picture of me sleeping at the computer. When I ask him he just grins. This is because I'm on meds that cause it. It's not intended for sleeping but is a side effect. Before I was on this medication if I couldn't sleep I'd drink a glass of milk. It always worked for me.

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