Circadian Sleep Disorders Network - Advocating for people with misaligned body clocks
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B's Story Managing DSPD

by B. (name withheld by request)

The following are B's words. We have not verified the information, and do not judge their applicability to others. What works for some may not work for others.

As I have gotten older (I passed 80 last March) my DSPD, as mild as it is, has become more and more difficult to manage.

My management techniques since was I was 40 were, in addition to sheer will power forcing my system into the "normal" daily awake/sleep cycle:

Before Ambien - Age 40 to around 50

  1. Smoke a filter cigarette after 11 PM and hope that would get me to sleep by 12. If not, another cigarette.
  2. Keep my sales job (refuse promotions) so I could secure appointments after 11 AM. Luckily the company was results oriented and didn't much care what hours I kept as long as I produced.
  3. Get up around 10 -10:30 (will power) and have a large glass of orange juice (sugar high) since I was immune to the effects of caffeine.

After Ambien - After age 50, Ambien (Zolpidem) was introduced in the market as a sleep aid and for me it was a miracle drug.

  1. Quit smoking - took 1/4 of a 10 mg Ambien after 11PM. No effect if I took it before 11 PM and often, as with the cigarette, an hour later I'd take another 1/4 of the 10 mg Ambien. I've been doing that for the past 30 years with good results and no side effects. Note: In 2007 the Ambien generic Zolpidem was introduced and I've been taken that ever since. Same results.
  2. Took early retirement, so getting up in the morning was not as critical, although I've pretty much (90%) maintained the same schedule as before in order to keep in synch with the rest of the normal awake day.
  3. In the past two years I found that taking a cold glass of orange juice was upsetting my stomach so I've switched to an old English morning drink, strong hot sweet tea. I highly recommend it.
  4. The other adjustment I've had to make as I got older and found myself waking up 2-3 times a night to go to the bathroom, is to take that 1/4 of the 10 mg Ambien each time I get up in order to get back asleep. Of note, that 1/4 Ambien doesn't keep me asleep, it only puts me to sleep.

Now I'm experiencing another symptom that I have never had to deal with. Starting around 4 PM I start to feel generally poorly. It's not nausea, but centers around an upset stomach, affects my appetite and often begins to make me feel depressed (cause & effect?). Then at about 8 PM it starts to subside and by 9 PM I feel great, probably better than any other time during the day. Unfortunately I don't get to enjoy it for very long, since I feel it's important to try to maintain a more common sleep/awake schedule, so I begin the nightly struggle, around 11 PM, to get to sleep. Incidentally that struggle has become more difficult with the 4PM - 8PM feeling bad and then the 8 till whenever feeling good.

Below is a graph of circadian rhythms that illustrate what the medical profession believes to be a good approximation of the awake/asleep cycles. As noted, normal is in green and the average DSPD in blue. Based on my some 70 years experience dealing with the effects and management of DSPD (I recognized I had a "go to sleep" problems since I was 8 years old) I've added what I think best represents my particular cycle, in red. The delay is about 1 hour greater although, as I have mentioned, its effect is somewhat mild as compared to others that I have read about.

graph of normal, DSPD, and B's sleep-wake cycle

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Last modified Dec 22, 2018
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