Tuesday, March 6, 2012

Perchance To Dream

One of the most common effects of stroke is that you sleep more. At least that's the received wisdom. And for a while after I first had the stroke, I certainly did, as some of the wonderful visitors I had can attest: At least one person shlepped up to Mt. Sinai to find me slumbering beatifically (I assume), and went away again without me waking for an hour or more. Kudos to them.

However, as I progressed through rehab, my sleep was disturbed. Part of the problem is that my left eye (still) won't rest closed. If I jam my face into the pillow just right then it closes properly, but while in the pleasantly dark in-patient rehab facility, I was considered at risk of falling, which apparently included falling out of bed, so someone would poke their head around the door softly to check that I wasn't flailing about on the floor. No matter how quiet they were (which was variable), they admitted light to the room, and my brain, receiving the light from the open eye, would wake me up. Usually after the offending dutiful carers were gone, making shouted remonstrations impractical as well as ill-mannered.

This contributed to what I now think of as "my bad week" when I was tired, irascible, depressed, reluctant to do exercises and generally unpleasant. Or even more unpleasant than usual depending on how well you know me, and your perspective. 

As time has progressed, however, I haven't had any external factors to blame for interrupted sleep, and I realise that unlike every other stroke sufferer I've met or read about, I sleep less than I did before. Or at least I think I sleep less, but maybe the reality is that I sleep about the same, but became hyper-aware of being awake for the brief moments I was awake.

Over a few weeks it became clear that, although I was aware of being awake for short periods, this seemed to have no bearing on how tired I actually felt,how much I could do in the gym, or anything else except my mood. The very idea that I had slept poorly made me grouchy. I decided to relax a bit about being awake whenever I was awake, and remember that I was getting several chunks of good sleep anyway, and made the 'problem' just go away by thinking about it differently.

Now, I don't stress out when I'm awake in the middle of the night, I just turn on the light and read for an hour or two, then go back to sleep. The timely article about historical second sleeps helped me not care about being awake, too.

Recently I found a way to be a bit more empirical about how long I'm actually sleeping, using the Sleep Cycle alarm clock app. Its daily graph of when I was awake or asleep (using the iPhone's accelerometer and how much I move about) is not enormously accurate, or particularly scientific, but it works well enough for me. It's confirmed that I'm sleeping less than I used to, but also that I'm getting more sleep than my awareness of being awake would lead me to believe. 

TL;DR: My brain (and brain injury) are weird, I sleep less than before my stroke, but more than I think.