The time right now is 03.53. Apart from about 30 minutes of deep sleep between 23.45 and 00.15, to all intents and purposes, I haven’t slept since. When I awoke suddenly at 00.15, it wasn’t to the convulsive leg movements of PLMD (which normally occur in deep REM sleep after 60 to 90 minutes of initial sleep): I simply woke up. I then lay awake with thoughts and tune fragments drifting through my mind, as is pretty much standard process with my sleeplessness. The thoughts are not anxiety-driven; they’re generally clear and sequential, alternating between what strategies I might best use to get back to sleep and memory fragments from the preceding days.
After what I assumed to be at the most 30 – 40 minutes of tired but consistent wakefulness, I checked the time. It was 01.35. Somehow 1 hour 20 minutes had passed. It seemed inconceivable that I’d been lying in the same sleep-promotion position, awake and mentally active for so very long. Presumably I must have dozed off, but I had no sense of having passed from clear consciousness through light sleep and then back into the sequential thinking and the earworm tune as a murmurous soundtrack behind it all.
Since 01.35 I’ve been completely conscious – tired (so tired after nearly two months of disrupted sleep), but alert. I’m calm and philosophical about another night during which sleep – sore nature’s balm – has eluded me. But I am concerned about these strange holes in nocturnal time, periods during which I was either effectively asleep, albeit so lightly as to have been completely unaware of any transition between states, or, more alarmingly, awake but made subject to some unaccountable looping of time bringing about a greatly accelerated sense of its passing.
Tonight’s sleep-deprivation experience has been a sort of augmented insomnia, unconnected to my sleep disorder, which enables sleep but interrupts it. The standard process for me – inasmuch as there is any kind of pattern to it thus far – is an hour or so of sleep at a time alternated with leg convulsions that wake me up and will only abate after physical exercise and/or a period of full wakefulness in bed. A good night is one in which I fall asleep quickly after the necessary therapy. Straightforward insomnia is much less common; tonight’s experience of ‘time-slip’ insomnia is, I believe, a first.
I’m ringing the surgery tomorrow morning (more accurately, in about 3 hours) to get a referral for a consultation with a sleep specialist at a local private hospital. Hopefully, in essence the disorder will prove to be relatively straightforward. Having experienced Restless Leg Syndrome in youth and early middle age, I’m assuming that my PLMD is what is termed ‘primary’, as opposed to ‘secondary’, which would indicate some underlying disorder. (My health anxiety issues are very much tied in with fears of conditions relating to extreme morbidity or mortality). Until some programme is in process I shall continue to record my experiences here on the blog, elective access to which is available via Facebook.
It’s now 04.54. I’ll go back to bed, but it’s very unlikely that I’ll fall asleep now. The day ahead will be difficult: the general disorientation and dislocation caused by the effective merging of one day into another without sleep in between is something of a struggle. I don’t have the option of napping during the day because, as during the night, when I hit REM sleep the PLMs begin. So tonight I have to hope for, at worst, a resumption of the hour-long alternations of sleep and leg convulsions with a swift dropping off after each enforced full awakening. And at unlikely best a resumption of the full night’s sleep free of PLMD that the clonazepam gave me up to the tolerance that so suddenly came about early in August.
And so to bed…
Everything you describe is so familiar to me – presumably because my own insomnia was also caused by an unrelated, benign but persistent and severe disorder that woke me every hour or two (menopausal hot flushes in my case). I think the whole syndrome may be exacerbated if you’re a physically and emotionally sensitive/reactive kind of person who is quite quickly so deeply affected that the pattern of wakefulness occurs irrespective of the other symptoms. This is entirely my own uninformed speculation…
I believe that your uninformed speculation is on the money, Jean! There’s no clear connection between PLMD and insomnia, other than that being woken up constantly by a profoundly disagreeable set of sensations might have one staying awake, consciously or unconsciously, in order to avoid that eventuality. However, after a while that exacerbation comes into being and one’s lumbered with free-standing (or recumbent) insomnia. I hope to be seeing a guy about it in a week or two so if he’s one of those physicians who actually recognises that there’s a person pulsing away inside that histology, I might get some relief!