A good night’s sleep

I am a champion sleeper. I fall asleep fast. I can fall asleep just about anywhere and  power naps works wonders. I am a huge fan of the ‘pants off, under the covers’ weekend nap. I find hotels with super fridged A/C settings and black out curtains to be a delicious night of sleep. Add a high end king-sized bed and foam earplugs and the distant, muffled thudding and pounding of the hotel and that room becomes womb-like. Most nights it seems I don’t move a centimeter. I wake in the same left-lying position with adjacent pillows as I arranged before laying my head down. I fall asleep in seconds. My problems are simply going to bed or being awakened from sleep in the night. The ‘going to bed’ part is easy to fix. With nothing worthy of sleep deprivation on TV, especially now with DVR, I put myself to bed. While an engrossing novel can keep me awake , it’s why I limit my leisure reading to weekends. I know I fore go sleep for Edward & Jacob or Lestat  or Richard the woodsguide.

Fractured sleep is a different matter.

I could easily blame  medical school and internship year where I carried a code pager every 3th night. Or residency where I had to get up, drive in and admit from the emergency room. I could blame it on ultrasensitive baby monitors that all neurotic mothers purchase to combat the fear of our babies choking to death in their sleep. The mere sigh of my first born could wake me from sleep. The same is true of the now rare middle-of-the-night page from a patient. I wake; I am fully alert and cognitive. I sign on to the office remotely and write on-call notes. Sometimes I even call and speak to the 24hour pharmacist or the ER staff. And then I go right back to sleep.

But lately, I am waking for no discernible reason and I am only partially waking. Usually the residue of a lucid dream remains  like the condensation on the bathroom mirror after a steamy shower. If I ‘decide’ to linger in that middle space between sleep and wake, the dream is a high def plasma screen on pause.My lucid, vivid and complex dreams are common, life long and (thankfully) rarely nightmarish. But I usually sleep all the way though unless a true external event wakes me. Recently, I am waking unprovoked for some internal reason at about the 3.5 hour mark. The pattern is very reminiscent of my youngest son, who is a true sleep walker. From toddler-hood, he walked in his sleep. As soon as he could crawl out of bed (or climb out of a his crib) he walked in his sleep. Once we got him to sleep, 90 minutes later he walked out. He went easily back to sleep only to come out again in 90 minutes. This pattern repeated three times and then he’d sleep through to morning or I’d wake with him in my bed. The pattern was so unbelievable, the pediatrician ordered a sleep study in a sleep lab. I sit here and realize, my oldest child also often woke a bit too early and I would wake with him in my bed. He’d replace my side sleeping king sized pillow. [The sleeping-in of my children (even as infants) violated all kinds of American Academy of Pediatrics and Family Physician guidelines. I remember clearly defending the practice in Grand Rounds one morning. Families all over the planet sleep in family beds and parents don’t suffocate their babies unless they are drunk or high.] Cameron, as a small child, stopped coming into my bed when displaced by his younger brother. Honestly, and sweetly, both boys although old enough to sleep through in their own beds will sometimes still come into my bed. It is a blessing to see their faces while they are deeply asleep because the sweet vestiges of their baby faces can still be seen.

But I was a sleep walker. In my childhood home, there was a walk-in hall closet just inside the foyer. Even model of my home in our large Lennar neighborhood build in the early 1960’s had this walk-in closet. Ours stores Christmas ornaments, jigsaw puzzles, board games, and on the back of the door hung the ironing board. It hung on one of those over the door hooks like we use to hang front door wreaths. When you opened that hall closet door, the ironing board made this banging sound. If either of my sisters or mother are reading this, their mind just replayed that sound, an indelible audio memory. The other thing inside that closet was a meal laundry hamper covered in some kind of vinyl contact paper. It had a hinged padded lid and those metal hinges squeaked. There was no sneaking dirty clothes in or out of that hamper. Several times in my sleep walking childhood, my mother would hear that hall closet open and that hamper lid go up but it was hours past when we all went to bed. My momma would find me perched on the hamper as if it were the toilet. I recall none of this. It is one of those reconstructed memories you have because you were told it so many times (or heard it told to others). This remote history of sleep walking is the NUMBER ONE reason I would never trust taking zolpidem or any other sleep aid. I know I do crazy stuff in my sleep. I don’t need a drug that is known to activate sleep activities.

P.S. I have some GREAT stories recounted to me by patietns as to the things they have done or been told they did while on zolpidem.