Brought to you by Ambien

Lately, I can't sleep. I do my work. I come home. I'm exhausted some days. I eat dinner. I watch TV. I play around on the internets. I go to bed. And I lie in bed for 2 hours. It is utterly frustrating.

I know all about sleep hygiene. I have given this talk a ridiculous number of times. It is advice so trite that most of my patients thumb through a magazine while I give the talk. You've undoubtedly heard it before: set a fixed bedtime and waking time, don't nap, avoid caffeine and alcohol, exercise regularly...

Most of the time I am giving advice to patients, I am being hypocritical, but except for the caffeine part, I actually follow this sleep hygiene stuff, and still! Insomnia! It is utterly frustrating and agonizing. It seems like there should be some way to sleep better, some way that I can relax and get a good night of sleep every time. I wish I knew how.


Fizzy said...

I found this awesome relaxation yoga video on youtube that always puts me to sleep. Unfortunately, at the end of the video, the relaxing voice says, "OK, WAKE UP NOW." Need to learn how to edit videos.

By the way, I really like your blog. All the medical bloggers out there are so in love with medicine and themselves and each other, but you sound a little more jaded, like a lot of real doctors (like me).

Anonymous said...

You've probably thought of these things too -but they help me for sure. Just in case:

1. have a bedtime ritual. like dim the lights for the last half hour before bed, and do exactly the same things in the same order for the last 15 or so minutes. the trick with this is you have to keep doing it for it to work.

2. do nothing mentally stimulating for the last hour you plan to be awake - no reading literature or news, no working.

3. get sunlight on your face when you wake up for a few minutes. this also helps set your circadian rhythm.

and really, no caffeine for the last six to eight hours your plan to be awake.

Hope this helps!

Anonymous said...

THANK YOU. The only thing that sucks more than insomnia is the advice about coping with insomnia. Shame on me for having read a book in bed once in 1987.

The upside? If you don't sleep tonight then you know you'll probably sleep tomorrow night. All you have to do is keep your mind distracted 'til dawn.

Am glad you're still posting.

Metapodiac said...

I've got the same problem as you, i've tried to force myself to sleep early, but for some reason, i always "wake up" (since i wasn't actually really asleep yet) in the middle of night with a full bladder. But once you get into the pattern, its a downhill ride.

I was wondering if you heard of the phrase "ars longa, vita brevis"? Its meaning has been much debated over, but it relates to medicine - being coined by the great Hippocrates himself - so I was hoping you could make some sense of it with your experience?

Personally I thought along the lines of "is medicine really worth it?" linking it with your "Don't become a doctor" series. Since the art of medicine takes so long to master, and life is so short, and even after you master the art, "experimentum (est) periculosum", "iudicium difficile" - there are still uncertainties and hard times - you end up asking yourself, "is it really worth it?"

(well, of course it is worth it, if you love medicine, you finally doing the thing you love, helping people, hypertension, whatever it is about med that excites you. But its your interpretation of the old phrase that is my interest)


incidental findings said...

It should be said that Hippocrates wrote the line in Greek, so my Latin skills are not necessarily appropriate. The quote in Latin is rendered:
Ars longa, vita brevis, occasio praeceps, experimentum periculosum, iudicium difficile.

My very liberal translation of this would be:
The art [of medicine] is vast, but one's life is so short, the opportunities fleeting, the experiences dangerous, and the decisions difficult.

An even more generous interpretation of the phrase would be: There's so much to learn in medicine, but the lessons are tough, and you spend a lifetime learning them.

Hippocrates was talking about lifelong learning back before CME credit.

Anonymous said...

Hippocrates would've been more sanguine if Pfizer had invited him to Jamaica?

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incidental findings said...

Dear Dr. Rutledge, you should be aware that there is actually no medical advice whatsoever on my blog.

As well, I currently do not desire more readership. Thank you for the offer though.

Anonymous said...

tylenol PM only before work's great. I also keep a very routine sleep pattern and no caffiene after 1pm usually...

incidental findings said...

People keep leaving comments about advice/issues with ambien. This is a blog about being a doctor, but contains no actual medical advice.

Any further comments regarding ambien or insomnia treatment will be deleted.