I saw a sleep doctor yesterday for a consult. I described my situation, reproduced here in brief:
- I used to have a great deal of difficulty getting to sleep. That's mostly been resolved with medication and therapy addressing the thought patterns and emotions that were keeping me up.
- I toss and turn in bed (thrashing we call it).
- A relatively recent development: I wake up frequently to go to the bathroom but fall back to sleep quickly. This change coincides with taking Cymbalta but that contradicts it's indication as a drug with success in treating incontinence.
- If I sleep on my back it's reliable that I snore, sometimes such that I wake myself up. Consequently I try to never sleep on my back. I also never sleep on my stomach.
- When I wake up I feel like a bag of smashed assholes. The earlier I wake up, the worse it is. This is lethargy in the best case and great nausea in the worst case.
- It's about 3-4 times a year that I wake up feeling rested and refreshed.
- No record of waking up unable to breathe, short of breath, headache, etc.
- While in college, when I had a variable schedule and no job, my sleep cycle would consistently drift forward around the clock.
- I often have difficulty focusing at work, especially at the beginning of the day, highly dependent on the quality of my sleep.
- I drink caffeine but on weekdays rarely have any after 2:00pm.
The doctor's opinion was that my circadian rhythm is later than most and that I should get up later than what I normally try (6:45, with mixed results), maybe 8:00.
I'm a little disappointed because if I'm leaving the house by 8:00 I generally contend with very little traffic. 8:30 or later and my 4.5 mile drive to work is on the order of 20-30 minutes. I also like the idea of getting to the office early and finishing my day early.
Of course, if I find that my workday focus and energy level are improved I'll be getting more done and feel better about the day. I also think it will help with my mood and may make it reasonable to bring my Cymbalta down from 90mg back to 60mg. That will be a decision to look at in a few months.
This morning was my first day intentionally getting up at 8:00 and I have to say that I do feel a little more attentive and focus. Not a huge difference, but I understand that it can take a few weeks of getting up at the same time for my body's schedule to settle.
Today I have to pick up an at-home sleep study device to use this evening and return tomorrow. I'll provide an update when I get the results back.