Ah, to Retire… for the Night

I’m an insomniac, and have been for years. Perhaps it’s hereditary. My father was the same way. I remember the many times I’d hear him pacing our apartment in the wee hours of the night when I was a kid. More likely, my insomnia is acquired, possibly a result of pulling those all-nighters as an undergraduate, and then the frequent overnight shifts as a senior veterinary student in the medicine wards and the horse barn, and of course, the subsequent expected emergency coverage I got saddled with when I was a newbie veterinarian. Regardless, I’m a terrible sleeper, and on the rare occasions when I do catch a few winks, it is terrible quality, just one notch above lying there awake with your eyes closed. If I do fall asleep, if someone in North America happens to cough, I’m awake again. Like much of America, I found myself having to resort to medical assistance to help me to tackle this problem. My drug of choice has been Ambien, or as I call it, Satan’s aspirin.
Like many fellow insomniacs, my problem isn’t with falling asleep. It’s staying asleep. Most nights, I’d take an Ambien, and then readily konk out. However, if I got up to go to the bathroom, the brain would invariably start kicking it into high gear, and that was that. Game over. No matter how tired my body was, the brain rebelled. My subsequent approach was to not take Ambien at bedtime, but rather, pop a half tablet when I woke up in the middle of the night. The problem with this approach is that the alarm clock was set to blare at 5:30 a.m. If I fell asleep at 11:00 p.m. but woke up at 1:00 a.m., the half-Ambien approach worked perfectly. However, if I fell asleep at 11:00 a.m. and then woke up at 3:30 a.m., I couldn’t take a half-Ambien knowing the alarm clock was set to ring in two hours. I’d be a zombie the entire next day.
Naturally, I tried many other potential remedies, including all the other common sleeping pills. None worked as well as Ambien. Melatonin did nothing. Warm milk, hot tea, exercising before bed, reading before bed, not reading before bed… nothing helped. Then I discovered Ambien CR, the controlled release version of Ambien. This worked brilliantly. The outer part of the tablet dissolves immediately, and then a few hours later, the inner core of the tablet, containing more Ambien, dissolves later on, keeping you asleep all night. If Ambien is Satan’s aspirin, then Ambien CR is Satan’s Nyquil. Ambien can be costly, but a generic formulation (zolpidem) has made it much more affordable for those in need. Ambien CR has no generic form, so cost remains a concern for a lot of people. Ironically, the brand name versions (both Ambien and Ambien CR) don’t cost me a cent, because I’m on my spouse’s health care plan, and he happens to work for the pharmaceutical company that just happens to manufacture Ambien! If your doctor prescribes a drug that their company makes, it’s free! How conveeeenient!
The thing is, I already wasn’t too enamored with the idea of taking Ambien every night, and I was even more concerned about taking a long-acting formulation. Although I’ve never suffered the cognitive side effects that have been famously reported for Ambien: sleepwalking, sleep-eating, dizziness, hallucinations, suicidal thoughts, etc., I didn’t really want to tempt fate.
It is with great relief that I now report the miraculous cure for my insomnia: retirement. Not having to worry about being mentally sharp and rested the next day turned out to be the most effective remedy. It’s clear to me now that a large portion of my insomnia was due to anxiety, and that there were two major components to this anxiety: the first was the fear that being sleep-depreived would affect my performance during veterinary appointments and surgery. The second component was the anxiety from worrying about falling back to sleep once I woke up in the middle of the night. This latter component is worse in that it is self-perpetuating. I’d lie there telling myself not to look at the clock because it’ll just enhance mycurrent freaked-out state, and then I’d succumb, glancing at the clock and seeing that it’s 4:25 and knowing that I’ll be up in an hour anyway so why even bother trying to get a few desperate winks? These were the factors that made sleep impossible. Now that the need for mental acuity for my job (where not being sharp could result in missing a critical diagnosis) is gone, and not caring if I wake up at 4:25 a.m. because I know I can just take a nap later in the day (ideally, on the bench that I like in Tompkins Square Park) has resolved my insomnia. I rarely take Ambien now, and if I do awaken in the wee hours, I have no trouble falling back asleep if I want to. It’s a miracle.
I’ve been fighting with my body for years. Social convention has dictated that I sleep from around 11:00 p.m. to 5:30 a.m. Most people with 9 to 5 jobs are in this same boat as me, and they learn to adapt to this routine at an early age. Somehow, I never fully adapted. I just want to obey my body, and eat when I’m hungry and sleep when I’m tired, the clock be damned. I only need 6 hours of sleep, but on many occasions, my body wants some shuteye from 11 p.m. to 3:00 a.m., and then a little more from 4:00 p.m. to 6:00 p.m. Lately, I’ve been getting all six hours in one shot, overnight. But on those occasions when I wake up at 3:00 a.m. and am rarin’ to go, I give into it, and I find myself much more productive. And I get to sleep in the park later in the day. For me, this may be the greatest perk of retirement.
