Question:
I had my gallbladder removed on 12/22/2006.
That's almost three weeks ago. Since the surgery, I just can not seem
to get a full night sleep. I wake up ever hour all night long. I've
tried Lunesta and Ambien and I fall asleep faster, but I still wake up
thru out the night. Last night I only woke up three times and that's a
blessing compared to other nights.
I've even tried over the counter stuff and herbal supplements and still
no sleep.
Has this happened to anyone else? I feel like I'm losing my mind and I
feel like an idiot each time I call my doctor. I'm at my wits end and
I just want to sleep.
Answer:
If you have physical problems remaining from the surgery you should
wait till they resolve.
But if you are OK from the surgery, something else to consider is that
sometimes a stressful event causes sleep problems, which then causes us
to start worrying about sleep and the sleep problems remain after the
event. You might consider a program based on cognitive behavioral
therapy (CBT) to help with the remaining anxiety about sleep.
Look for Gregg Jacobs book "Say good night to insomnia" at your local
library. He does a decent job explaining insomnia and has CBT based
program to help deal with it.
The main thing you have to do is to realize that you can continue to
function even if you sleep poorly. This takes away the power of the
insomnia and helps you control your anxiety and to sleep better.
That book is good for describing his techniques, but it is
unnecessarily harsh on other explanations of insomnia which
are valid for certain patients, and misleading in the
matter of certain other successful therapies. It is a
great place to start to learn about taking control
of insomnia, but people should not be discouraged
by it's "vendetta" against other medical and
non-pharmacologic therapies. I guess he has
a product to sell and needs to discredit any
"competitors".
I guess I am pretty naive at this. Jacobs clearly has an
anti-medication bias/approach. I guess that fits my experience. I have
tried halcion, ativan, ambien, klonopin, and ambien CR and have not had
good results. I probably felt about as bad after using them as if I
had not slept.
I'm afraid that might require writing another book. I was
deliberately non-specific about it because most of the
other therapies I am referring to are quite specific to
the myriad diagnoses which also result in insomnia,
and are not really something that people should just
try for their own undiagnosed problem. My main point
was that he skims completely past the idea that there
*are* many causes of insomnia, and it is *not* "all in
your head" in such a fashion that all it takes is presence
of mind to control the problem. I didn't want to say it
quite that way initially because I do not want to give
the impression that "all in your head" usually gives
to people. His meaning is quite deliberately helpful
in that, *when all other causes are ruled out*, and
when stress is a definite factor in someone's insomnia,
then there are very productive techniques for taking
mental control over the problem and banishing it
forever. I agree with that idea completely, I just
don't think it is then necessary to give it credibility
through discrediting any other causes or treatments
which are important and, in some cases, manageable.
The interplay between "organic" and "non-organic"
causes of insomnia is important and they definitely
have an effect on each other. Someone with
Obstructive Sleep Apnea, for example, can give
you an excellent description of organic insomnia
due to hypoxia which, when totally successfully
treated with CPAP, can still have a profound
insomnia problem related to:
1) finding it difficult to mentally get out of the
"habit" of being an insomniac
2) finding it difficult to banish the distracting
and awakening factors related to the machinery
involved in treatment
3) coping with garden-variety stress that encumbers
all our lives and manifests in these patients preferentially
as insomnia, since that is now their typical response to
stress.
A patient like this might get significant helpful suggestions
from his book regarding mental state, visualization techniques,
relaxation techniques, and ordinary sleep hygiene practices.
BUT he won't get squat from the book if it tells him that
medicine has failed utterly to help insomniacs and that
he should abandon all hope of medical treatment. If he
did that, he would be taking one step forwards, and
three steps back. It would have been much better for
him to promote his material as supplementary or as
an adjunct to full medical investigation and treatment
if necessary. And, I might add, as a professional clinical
psychologist, he should have known better. His
colleagues in various healthcare fields would have
respected him better for it, I think. 8^P
