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Hey, is anyone else awake?

It all started around three weeks before my wedding. Not a night went by in which I either didn’t sleep at all (worst-case scenario), fell asleep only as the rest of the family was getting up, or awakened around 5:30 a.m. and was unable to fall back asleep (best-case scenario). I was a happy kallah throughout my engagement and wasn’t aware of any unusual tension or anxieties as my wedding approached. Nevertheless, when my family and friends diagnosed my troubles as typical pre-wedding jitters I accepted their verdict, thinking that perhaps subconsciously I was harboring some understandable apprehension. I was further reassured that the problem would resolve itself when I read the leaflet that came along with some medications I was taking during the weeks leading up the wedding. Eureka! Possible side effects included “difficulty sleeping (insomnia).” Satisfied that my sudden difficulties had such a plausible and easily cured cause, I reassured my mother that no, nothing was bothering me—except for the fear that my appearance at the wedding would bear testimony to the severe sleep deprivation that had preceded it. My wedding came and went in a blissful whirl. Before I knew it, we were at our first sheva brachos—and I still hadn’t closed my eyes since the morning of my wedding. You’re overexcited; still too wound up, I reasoned. Tonight you’ll definitely crash. Unfortunately, it was only wishful thinking. Over the course of the entire week I slept less than ten hours in total, going through the motions in a haze of extreme exhaustion. My new husband was convinced he’d married a high-powered superwoman who was remarkably able to function on ridiculously small amounts of sleep. I was, shall we say, somewhat less enthralled by the notion. I never thought I’d look forward to returning to work after my wedding.

Yet I found myself awaiting the day eagerly, if not desperately, hoping that implementing a routine would restore my regular sleeping patterns. I was soon back at my desk, but sadly my sleeplessness had trailed along after me. It takes time for the effects of the medication to wear off, I told myself, gritting my teeth. “Just give it a few weeks,” counseled my wise married workmates. “It takes a while to settle down in the beginning.” I wondered miserably how long “the beginning” was and struggled to concentrate on my work. Several weeks later I was still suffering through the long, lonely nights, ruminating dismally over how I would get through the day while waiting for my husband’s alarm clock to go off. Although my husband will never admit it, I know that starting married life with a chronically sleep-deprived wife was frustrating and difficult. I felt guilty about “being complicated,” however irrational that was. The first thing he’d say to me every morning was, “How did your night go?” and I felt awful telling him the unvarnished truth. Occasionally I’d fake a smile and add a couple of hours of sleep onto the number I mentioned. My mother received the same daily report, and I’m sure she lost her share of sleep as well, worrying that I was secretly grappling with something monstrous. I had never suffered from headaches, but now my sleeping difficulties were causing severe migraines sporadically throughout the day, particularly in the evenings. The pain would start out as an ache at the top of my skull and inch its way downward to pound at my jaws and teeth.

Sleep was impossible, and the nights became unbearably long. I didn’t bother getting a “white noise” machine because my sleep environment was fine; there were no street sounds filtering in from outside and, thankfully, I hadn’t married a snorer. I began taking painkillers just so I could get through the day and fulfill my duties at work and at home.Around two weeks later, I finally visited my doctor. He listened to my story and was not surprised that I had developed migraines as a result of my sleeplessness. After a blood test to rule out something more ominous as the cause, he diagnosed me with “chronic insomnia.” I was relieved to have a diagnosis, believing it meant there was an effective treatment plan. The doctor explained to me that there were three possibilities: Chronic insomnia could be a passing phase (if I was lucky); it could come and go intermittently; or, if I was really unlucky, I could be stuck with it for the rest of my life. That was quite sobering. A thorough interrogation regarding the state of my emotional health, daily stresses and relationships ruled out the possibility of anxiety as a cause. I really wasn’t anxious, just tired, and when a person is chronically fatigued it’s much more difficult for the brain to settle into sleeping mode, which only feeds into the cycle. Although reluctant to do so, the doctor prescribed a very short course of sleeping pills. While they are known to be very habit-forming, he hoped they would break the cycle of insomnia and help me regain a regular sleeping pattern, which would then be maintained naturally. He admitted that he’d never prescribed these pills to anyone less than four decades older than me, but I held on to that little bottle secure in the conviction that I would be “cured.” Two sleepless nights later I was back in the doctor’s office. He was shocked to hear that the pills hadn’t had any effect.

By then my life was unraveling; I was struggling to keep up at work, battling constant headaches, popping painkillers like candy, and trying to suppress my moodiness and frustration. After again probing for an emotional cause (there was none), he prescribed a mild antihistamine that had a side effect of drowsiness. This was a far safer option,particularly as he knew there was a possibility that I might be pregnant. I downed a pill in the early evening as instructed, and settled in for the night. To my amazement, the next sounds I heard were my alarm clock and my neighbors hurrying their kids out to school. The next three days were blissful; I slept through the night and felt like a new person. We instituted an early bedtime and I felt myself emerging from the fog and coming back to a vibrant, joyful life. I began preaching about the benefits of an early bedtime to anybody who was willing to listen—and probably some who weren’t. Unfortunately, the miracle was short-lived. Night number four was a disaster. I stopped taking the pills for a couple of nights and then resumed in case I had developed an immunity, but the insomnia was back. The headaches followed faithfully, and with increasing intensity. Whenever I had an attack I didn’t want to sit, stand, lie down, walk or talk. All I wanted was to remove my head from my body for a few minutes of relief. I debated the most effective way of coping with the seemingly endless nocturnal hours.

On the one hand, just lying in bed was enough to drive me mad. But would turning on a light and reading or working on the laptop stimulate my brain and further discourage sleep? My husband would sometimes stay awake for a while to keep me company, until I convinced him that although I truly appreciated the gesture, all it did was make both of us feel weary the next day. It was also ironic how people reacted when they heard about my condition. “Wow!” they’d exclaim. “You get by on so little sleep? You must accomplish so much!” Did they think I was mastering Mandarin Chinese in my spare time? In truth, I’d have been happy to be accomplishing just the basics competently. A short time later we traveled abroad to visit my in-laws for a week. Strangely, when we arrived I slept right through the night, something I hadn’t done in weeks. I reported this ecstatically to my mother back home, teasing her that I was already looking for an apartment as I was considering moving there. The second night wasn’t as marvelous as the first, but the change of scenery did seem to help. My mother-in-law also got to see a live demonstration of what her son was living through. We arrived home to the exciting news that a baby was on the way. I fretted about being able to manage being pregnant and then caring for a baby with my condition, especially as I had to abruptly stop taking the strong painkillers I’d become dependent on and switch to a far milder alternative. To my surprise, my sleep situation improved dramatically during the early weeks of pregnancy, despite my having read that insomnia is relatively common in the first trimester. With only the odd night of sleeplessness, I felt really good and was cautiously hopeful that my insomnia had been a passing, if somewhat prolonged, blip on my radar. It wasn’t.

Following a pattern that had become all too predictable, the brief period of blessed relief came to an end much too soon. I began to feel as if my insomnia would be a lifelong battle to recapture my energy, work performance and quality of life. And I was on the losing side. I knew I had reached a turning point when I found myself sitting at my dining room table one morning as the sun came up, weeping and desperate for sleep. My insomnia-induced headache was so excruciating that I started to worry that the tests had been wrong, and there really was something sinister lurking in my brain. I could not endure even a single night more of this. I booked an emergency appointment at the doctor and almost broke down as I begged him to help me, casting aside my dignity. My options were even more limited now by my pregnancy. After expressing his sympathies, the doctor jotted down a list of four possible causes of my headaches: 1) they could be “painkiller headaches,” which can occur as a result of the prolonged use of painkillers; 2) anemia (iron deficiency); 3) vision problems; and 4) tension. He then mapped out a plan to tackle them one by one: I was to immediately stop taking the low-strength painkillers I was using, take a blood test to measure my level of iron, and book an eye exam. Tension headaches were taken off the list after I again ascertained that although my job was stressful, it had been equally stressful before the insomnia invaded my life.

And no, I had no significant worries about finances or relationships. Armed with a plan of action, I immediately set out to implement it. Stopping the painkillers was easy; they hadn’t offered relief anyway. I think I was only taking them to make myself feel that I was doing something. The blood test came back normal as well. That left the eye examination. I had never worn glasses or contact lenses so I was skeptical that it was necessary. I was surprised when the optician strongly recommended eyeglasses; I was slightly nearsighted in one eye and a little farsighted in the other. He believed that the discrepancy was contributing significantly to my headaches. “Let’s say a woman wears heels of two different heights,” he explained. “I wouldn’t say that she can’t walk, but she’s definitely uncomfortable, and the imbalance is placing a strain on her spine and muscles.” Similarly, the imbalance in my vision didn’t mean that I wasn’t seeing clearly, but it was straining my eyes and brain, especially since I spent long hours every day in front of a computer screen. Doubtful but desperate, I picked out a pair of inconspicuous frames and went to collect my glasses a week later. Slipping them onto my face I awaited a miracle—and got the mother of all headaches instead. I had never experienced a headache of this magnitude and it persisted for almost two days. Thankfully, after that the headaches slowly dissipated, and wonder of wonders, I started sleeping a lot better as well. Over a month has gone by since then, and I now get headaches only once or twice a week on average and they aren’t as painful. I’m not sure if the fact that my sleeping patterns are so erratic is helpful or harmful; I tend to sleep in on weekends because I find that my most restful sleep occurs between the hours of nine a.m. and noon. My insomnia is also unpredictable: An absolutely terrible night can be followed by several nights of almost uninterrupted slumber in five- or six-hour blocks.

Right now I’m blaming many of my difficulties on pregnancy-related aches and pains. I’m hoping that motherhood will knock me out! So while my insomnia has greatly improved (although it would be difficult to pinpoint a reason why) the problem remains far from resolved. The fear of it returning full-force is never far off, and I dread the toll it takes whenever it does rear its ugly head. My husband is ever-attentive and considerate, and I do try to muster enthusiasm and a smile, but he senses my despair. Sometimes I think the situation is as challenging for him as it is for me. I hail from a family of firm believers in modern medicine, but should my insomnia spiral out of control again (G-d forbid), I will seriously consider alternative remedies recommended by acquaintances. My boss has repeatedly mentioned something called “One Brain” (kinesiology). A cousin insists that a couple of visits to the chiropractor would cure me. My neighbor is advocating homeopathic remedies. And I keep reading about the benefits of cognitive behavioral therapy. I am writing this in the hope that readers will be able to offer tried-and-true advice and solutions. In the meantime, to anyone who is awake and lonely, or desperate to share some breaking news while the rest of the world is asleep, you know where to find me.                  

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