Desperate for sleep, wants sedation

Q:  After 4 straight days of little to no sleep, I got desperate and went to the emergency room.  I was so tired but did not feel sleepy.  I was shaky and desperate and felt like fainting, but sleep would not come.  I wanted to be sedated, but the doctor prescribed a high potency anti-anxiety drug, which finally made me pass out.  Now I am worried this is my life.  I  cannot function like this and don’t know what to do.

A:  Your story may reflect what happens when a part of the brain called the amygdala gets caught up with our ability to rationally manage sleep.  The amygdala is the part of the brain that largely generates the fear response. When fear kicks in, the common worry and concern many insomniacs feel about the idea of sleep gets intensified greatly. The body’s stress system goes into overtime, pumping adrenalin, cortisol, and other stress hormones into the body, putting us into a hyperaroused state, and thus making it very difficult to feel drowsy, let alone sleep.

On the other hand, our inherent requirement for sleep, our physiologic requirement for sleep, is much like breathing.  At some level we know we can’t not sleep any more than we can’t not breathe.  And indeed, we inevitably reach the point where our sleep response becomes autonomic, overpowering even our worst fears and anxieties.  When that happens, we crash.  And sleep.  Every time.  Without fail.  Sounds like this is what happened to you.

The key of course is managing this inevitable sleep process intelligently, rationally, and for the best results.

A good first step would be to see your primary care physician for a full work up.  Describe this issue in detail.  Your goal should be to either treat or eliminate the possibility of any underlying medical problem.

Your true underlying problem however, may not be medical.  It may be some combination of bad sleep habits (alcohol near bed time, inconsistent sleep schedule, and so on) and excessive worry, even fear, about the idea of sleep.  The worry and negative thoughts are a very potent fuel for insomnia.

If that’s the case, look first at non-drug solutions that are behavioral.  You can in fact change your behaviors and your thinking to support better sleep.  The best way to do this is through cognitive behavioral therapy, specifically designed for better sleep.  CBT is the standard of care as recommended by the American Association of Sleep Medicine, the society of doctors specializing in sleep medicine.  CBT-based sleep training is very effective for most people, is drug-free, permanent, and has no side effects.

Also be aware that sedation is not the same as sleep.  Anesthesia produces more of a “switched off” physiologic state, whereas natural sleep is a much more dynamic metabolic process.

Your description suggests the possibility you may have a legitimate psychiatric condition that is beyond normal levels of worry and anxiety.  If that’s the case you may need to work with a psychotherapist, but be assured all this is treatable.  You can make this better.

Explore posts in the same categories: Fear, Health, Insomnia, sleep

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