Wide Awake at 3 AM: What Now?

Posted by Michael Collins in Life After Paralysis on June 02, 2017 # Health

Lying in bed may sound peaceful to most but, for me, there are too many nights when being in that position does not involve adequate restful slumber. Staring at the red numerals from my alarm clock projected on my bedroom ceiling leads to the realization that there are still several hours remaining before my caregiver will arrive to assist with the morning routine.

The position I find myself in during the beginning and middle of the night is where I will remain until morning. If something cannot be accomplished from this position it isn't going to happen, as I require assistance to get out of bed and into my wheelchair and there is no one else at home to provide that help. The options of going to another room to enjoy a snack or check the computer are thus beyond my capabilities.

Many people experience insomnia, so it may not seem that unusual. Unfortunately, my insomnia has become more frequent as I get older, and many of my peers report similar problems. For those of us who are paralyzed, for whatever reason, some of the normal solutions to the condition may not be practical.

My quest for a restful night's sleep has led me to seek out expert advice regarding what might help me slumber throughout the night. My resources include an acquaintance who spent 11 years as the director of a hospital sleep lab, my personal physician and a respected physiatrist who has worked in the field of rehabilitation of people with all types of disabilities for several decades.

In the sleep lab, it is common to detect the presence of sleep apnea as people are being monitored in that controlled environment. Obstructive sleep apnea can be dangerous and in more severe cases apnea can even contribute to heart attacks, so it is wise to seek professional advice if the condition persists.

The advice they gave me makes a lot of sense and I have tried to follow it. However, being paralyzed brings with it some restrictions so not everything is possible for those of us who need assistance with many of the activities of daily living.

Here are some of the main pieces of advice I received:

1. Avoid caffeine-containing drinks after noon. That cup of coffee or cola might seem like a good pick-me-up for that 2 PM slump, but can have a delayed stimulatory effect. I do not drink caffeine after noon, but so far that doesn't seem to help.

2. A glass of wine before bed may cause you to wake up sweaty and agitated at 3 am. It's because the pyruvate in the wine is metabolized to cause a glucose/energy spike that hits in the middle of the night. I also avoid alcoholic beverages so I have that one covered.

3. Even though over-the-counter anticholinergic antihistamines may be pretty good at keeping you asleep in a non-addicting way, there is some evidence that these medications may be linked to a higher incidence of dementia so it's probably good to avoid using these medications regularly for sleep. There are a number of prescription sleep medications that one can take for severe insomnia, but they can be habit forming and have some serious side effects. While I do take a very small dose of melatonin periodically, I avoid using what many people consider to be more powerful "sleeping potions."

4. The ever-attractive glowing screen is a sleep-killer. In particular, blue light is very stimulating. As I lie awake I see a number of colored lights scattered throughout my bedroom: the remote sensor for the cable box; the digital clock; indicators that my cell phone, bluetooth earpiece, ceiling lift and power wheelchair are charging and glowing buttons on the television's remote control. I may try covering each of them with a small piece of dark cloth to see if that might help, but am not sure what else might work to eliminate that nighttime lighting.

5. It may seem obvious, but positioning is important. People who tend to have nasal congestion or a bit of heartburn often do better with their head elevated a bit. Using a mattress that is both supportive and forgiving is important. Fortunately I have an adjustable bed so I'm able to sleep with my head slightly elevated to avoid acid reflux and minimize snoring. I also retired the tattered mattress I have used for the past 25 years.

With the completion of the above steps, I still have hopes that full nights of restful sleep will eventually arrive; for that to happen, I probably need to stop listening to the evening news.

© 2017 Michael Collins

The National Paralysis Resource Center website is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $8,700,000 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.