Q: Sleep Problem & What Could be Causing It ?
I have been diagnosed with bipolar I since 1997. I am currently on Dekakote, Seroquel, Zonegran, Ativan(as needed), and Klonopin. I have extreme
trouble falling asleep and then once I am finally asleep...morning rolls around
and I just can not seem to have the will or desire or energy or motivation to do
anything. I have even fallen asleep in my cereal bowl. (lol) My doctor and I
have tried to take my off of different meds to see if it helped and have tried
many different others and I have even gone off everything for a period of three
months, with his supervision. Is it possible that something else could be
causing this problem? I have to be awake during the day. I have other people in
my family that depend on me.
Dear Michelle --
Not that this carries a guarantee or anything, but there is something pretty
simple you can try that doesn't require any medication change. You might have
tried this already but I doubt it, so here's the deal.
Our bodies have to reset their clocks every day, sort
of like the end of daylight savings time every single day; without that reset we
tend to run later every day -- staying up later and getting up later. The main
reference point for that reset is the time at which we see light in the
morning. In our modern world, often we don't see the sunlight gradually appear
in the morning. Whether you do or don't, there's a second reference point for
setting our body timing: when the light starts to go away in the evening.
Almost everyone in our modern world uses electric light to delay that process,
Well, some people appear to be extra-sensitive to these
light shifts. The one that really messes some people up is the night-time light
exposure. You can see it coming, right? What you can try is to limit your
night-time light exposure. I'll give you a link to really extreme example of
this in a minute, a case in which this trick worked dramatically well.
There are two night-time light sources that are
probably the worst part of this problem: the TV, and the computer. If you
decide to go for a few weeks trying this idea, those are the two main culprits
you need to limit. I tell my patients they can't use those devices after 9 pm,
and that's actually being pretty liberal compared to the case I'll link you to.
Dave Avery, the light specialist researcher at University of Washington, says to
put dimmers on all the main lights you use after 9 pm and start turning them
down at that time (for example, don't use the shaving lights over the sink when
you brush your teeth before bed!)
There could be some other basis for your sleep problem
and I'm not in a position to help your doctors figure that out, but this
kind of "loose clock" problem is extremely common in people with bipolar
disorder (to the extent that I think it's kind of part of the illness, at least
in one particular variant (which also commonly includes a big seasonal shift in
mood and/or energy)). Since there's little risk in trying this kind of
approach, if there really was some other basis for the problem, this isn't
likely to hurt you even if it's wrong. If you want to see an example, quite
extreme, try this link to two patients' stories that show
how the biological
clock is important in bipolar disorder.
Published February, 2005