A Closer Look at Situational Insomnia

I met Deb at the gym a couple of years ago and the gym, being a very friendly and social place, brought us together at different times. Deb’s husband recently died from cancer. With all the other big emotions happening, insomnia has become part of her grief package. I asked Deb more about her situational insomnia.

How would you describe your usual sleep patterns?

D: Before I had kids it was very settled and I don’t remember having any problems. I had no issues as a child. I never slept walked or talked and always felt safe and secure. I didn’t really wake up during the night and would get a really good 7 hours. I woke up feeling good, raring to go and could make good decisions with no brain fog.

When did you first notice a change?

D: The very first change came with children and it set up unhealthy sleep patterns. Or no patterns at all really. We have 3 children and 1 of them had night terrors. I didn’t get a full week’s sleep until the eldest was 8 years old.

Lack of sleep and hormones really affected my sleep patterns and I had post-natal depression. I would dream feed the youngest then pop him into bed. It would take me hours to get to sleep while I tossed and turned. My ears were on strings with the kids so really bad habits were established but I assumed this was part of life and just got on with it.

When they were little I’d think, “Oh God, I’m awake!” when it was 2 or 3 or 4 in the morning but I turned the narrative around and went, “Yoo hoo! I’ve had 2 hours sleep!” If I could get to sleep from 4 AM to 6 AM then I could function for the rest of the day.

Did these patterns ever reset?

D: As the kids got older they got jobs and started going out, so I was aware and awake while they were out and working. But once the youngest was 15 things got more settled.

When did things change recently?

D: My husband got seriously sick 3 years ago, on and off. He was diagnosed with SCC – a squamous cell carcinoma which aggressively metastasised to his head and neck. He went through copious amounts of surgery, skin grafts, muscle grafts, radiation therapy which failed, and then immunotherapy. With immunotherapy, he became very compromised and picked up a lot of infections.

When he was in the hospital I didn’t sleep well because I was worried and when he was home he didn’t sleep well because he was in pain and again my ears would be on strings just listening to him breathe. I could have gone into another room but that would be just as bad because I’d be concerned about not being able to hear him.

When he was away in the hospital, I got into some terrible habits. I’d have a 20 to 30 minute nap on the lounge after dinner then I’d go to bed. I had a routine – brush my teeth, go to the toilet, have a shower then get into bed – and be wide awake. I couldn’t turn the brain off. It was like a constant radio switching from station to station. I find it really hard to turn that knob down to the point I can sleep.

Over those 3 years, I always stayed in bed hoping to fall asleep. I tossed and turned and had very light sleep. I trained myself to stay in bed from 10 PM until 6 AM. All in all, I gave up trying to figure out how many hours of broken sleep I had. It would make me angry to know.

That went on for 3 years, until the week before he died. I spent that last week in the hospital with him in palliative care. We set the bed up and I lay in it but I didn’t even bother sleeping there. The first night I got some sleep was 2 nights before he died. My daughter was with me and she stayed up with him. I fell straight to sleep for 2 solid hours then I was wide awake again because his breathing changed.

That was 4 weeks ago. Since then, I’ve been organising the funeral and having a house full of people so I’ve slipped into bad habits again. I haven’t been totally unconscious or woken refreshed and fully functional since then.

I’ve established a new routine though. I make sure I go to bed before 10. I close the house down, don’t fall asleep in front of the TV, and never have screens or phones in my room. Although lately, I put the iPad on a timer beside me in bed and watch Friends or Gilmore Girls or something that I’ve watched so many times that it’s like chatter. Chewing gum for the brain I call it. I also take over-the-counter medication so I fall asleep within 30 minutes and sleep a couple of hours. Then I wake up because the brain won’t turn off.

How has this change impacted your everyday life?

D: The brain fog. I have suffered from depression and I’ve been fully well so I can feel the difference now. When making decisions I have to be very calculated. I have to stop, really analyse from every direction and take time. My energy levels are either hyper-high or lowly low.

My period of good sleep lasted about 7 years – between the last of kid worries and the beginning of worrying about my husband. I’ve never actually asked myself these questions before. I just thought it was part of your life. You’re busy. You just get on with life, but I guess my insomnia seems to be emotional.