helen-louise (baratron) wrote,

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why Delayed Sleep Phase Disorder sucks, part n in a very long-running series

Dear gods, I am an idiot. I have spent at least the past month fighting with a combination of my chronic fatigue and sleep disorder, almost completely ineffectively. I've been trying to reset my body clock the "normal" way - or at least, the socially acceptable way. Getting up earlier and going to sleep earlier. That's what's supposed to work, if you have willpower and really want to get better - right? Yeah - just the same as how depression goes away by itself if you really want to get better...

The thing is, I - and everyone who's ever done research into it, know that this approach simply doesn't work for people with Delayed Sleep Phase Syndrome. If I could fall asleep earlier by sheer willpower alone, I'd have done it by now. It's not like I'm particularly happy about having been a raging insomniac for decades. If I could get out of bed when improperly rested, I would do it. Sometimes, I even manage it - for example, on Saturday, I got up at 9.25 am because I had a really good reason to. But getting up early doesn't make me fall asleep any earlier. I was physically and mentally shattered for pretty much the entirety of Saturday, but couldn't get to sleep before about 2 am, because that's how my brain works. And then the chronic fatigue set in, and I promptly slept until 6 pm on Sunday, and could not physically wake up or be woken up before that.

Other people's expectations get in the way. Delayed Sleep Phase Disorder is possibly one of the truest arguments for the Social Model of Disability. The more we learn about human biochemistry, the more obvious it is that DSPS is not actually a disorder in the medical sense. Individual people have so-called "chronotypes", which determine the time of day when their brains are most active. This makes sense from an evolutionary perspective: different members of a tribe had different jobs, and were required to be active at different times of day. For example, it would be useful to have some members who were able to sit up and watch out for predators or threats while everyone else was asleep. I've presumably inherited or acquired that particular set of genes. (Chronotypes may be soft-coded or epigenetic rather than hard-coded - this seems more likely because changes to preferred sleep-wake cycles are very common during puberty). Similarly, some members of the tribe would fall asleep earlier and wake up earlier than everyone else, to take over the watch in the early morning or start gathering fresh food for the day. Those are the extreme morning people. It is all perfectly normal biology. But the assumption that a 9-5 day suits everyone means that people who don't naturally wake up before noon are, at worst considered lazy, at best disabled by society.

Lately, though, my sleep pattern has got to a state where it's actively inconvenient. I am quite happy with waking up about noon and falling asleep about 3 or 4 am. That works very well for me, and I can maintain it basically until I get sick. (When I then sleep for 15 hours, and get messed up again). I am not happy with waking up at 5 pm and not getting to sleep until 9 am. Also, I need to be awake about 9 am this Saturday, and stay awake all day, as we're going to the Sonisphere festival. And I'd quite like to be in a vaguely getting-up-near the morning routine for BiCon at the end of August (which I finally booked and paid for). Blargh.

So what I'm doing now is the joyous, joyous thing known as chronotherapy, which is rotating one's sleep pattern by staying up later and getting up later. Like I said, it's the only thing that works. I've wasted a month trying to drag my sleep cycle backwards with willpower, tablets, and multiple alarm clocks, and have got nowhere. So why have I been resisting chronotherapy so hard?

Simple. It's extremely antisocial. I got up at 9 pm on Tuesday. I'll let myself go to bed at 1pm today. Then I'll get up again at midnight (oh gods), go to bed at 4 pm on Thursday, get up at 3 am on Friday, go to bed at, like, 7 pm on Friday, and hope I can get up by 9 am on Saturday. All of this being somewhat subject to change depending on how much extra crashing-out time I need. Really, I shouldn't be doing it this fast, but I don't have a lot of choice. Oddly, and somewhat usefully, with shifting your body clock forward, it doesn't matter if you're extra-tired and need to sleep for longer - as long as you can force yourself to stay awake for long enough. So I'll see Richard for all of 2 hours tonight (unless he happens to wake up early so I see him before he goes to work), not at all on Thursday (each of us will be asleep while the other one's awake), and probably not at all on Friday either unless he wakes up early. JOY JOY JOY. I think I'll go insane with that little human contact.
Tags: chronic fatigue, not a morning person, sleep disorders

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