Tolerance and Dependence

I take a sleeping tablet every night. It has changed my life. I went from being awake almost 24/7 – short 20-minute naps here and there – to sleeping a solid 4 to 7 hours each night.

Perhaps 4 hours doesn’t sound like a lot to some people, but those of you suffering chronic insomnia will know just how precious 4 uninterrupted hours of sleep can be. It’s the holy grail of sleeping sanity.

Finding myself on a downward trajectory

Unfortunately, like many sleeping medications, mine can cause tolerance and dependence. And after a year, I have become both tolerant and dependent. My magical 4 hours are slipping further and further back. I now get perhaps 2 uninterrupted hours followed by a few hours of dozing. While I am acutely aware that this is way more sleep than I used to get, I’m also aware I’m on a downward trajectory.

I am on the lowest dose of my medication, so the first option I was presented with was to double the dose. It is not a path I am keen to tread as eventually I’ll need to keep doubling the dose and that seems like a very slippery slope. Nonetheless, I did trial the occasional extra dose, but alas, it did not increase my sleep.

My ability to cope with less sleep has decreased

For a while, I thought I could just put up with it. I mean, 2 to 3 hours with some bonus dozing and the occasional daytime nap would have been an absolute miracle 18 months ago. So surely I can manage it now? But no.

My aging body has become used to a regular dose of sleep and mental time out. My ability to cope with less and less sleep is decreasing. Where once I would slip into a slightly hyper manic state and get loads of stuff done, now I can barely function and I do nothing.

So, something needed to be done.

Resetting my tolerance and dependence

I spoke to my healthcare professionals and I have decided to stop my sleeping tablet altogether for a month, which should be enough time (please cross your fingers for me!) to reset the tolerance and dependence, and I will once again be able to sleep.

In the meantime, I am taking a benzodiazepine as a replacement. It doesn’t work very effectively for me. I think the dose is too low, but I’m hesitant to have too much going on in my system for now. So, I sometimes get my solid 2 to 3 hours sleep and sometimes not even that. I can then doze for quite a few hours, feeling restless and exhausted but at least I’m not up and wearing my body out even more.

Effects on my body and mind

The thing I have really noticed, though, is my inability to manage the fatigue in the way I used to. Having learned how to sleep over the last 18 months, it is very hard to go back.

My body is weary and my eyes are heavy. My brain is foggy and my movements slow. I do the bare minimum to get by each day but any more up and go is a bit beyond me right now. My days of working non-stop on zero sleep are far behind me.

Protecting whatever sleep I can get

I have lived with insomnia for so very, very long and it became so critical my mental health was shattered and I had a complete nervous breakdown. I’m now very protective of whatever sleep I can get. I don’t push through exhaustion. I rest and engage in self-care. And I will do whatever it takes to get my sleeping tablet working once again. Even if that means a month of sleepless nights and dreary days.