Sleep.

I would venture to say that at least 4/7 nights a week I get fewer than 3 hours of sleep. I would also venture to say that I, on average, score roughly 30 hours of sleep per week. How do I function? I truly have no idea, as this is just how it's always (well, at least for the last 11 years) been. This lack of sleep is due boils down to two factors: 

1. The nightmares. Actually, I think they can be classified as night terrors. A few excerpts from the Wikipedia page for night terrors for reference: 

·      A night terror, sleep terror or pavor nocturnus is a parasomnia or sleep disorder, causing feelings of terror or dread, and typically occurs during the first hours of stage 3-4 non-rapid eye movement (NREM) sleep.

·      Sleep terrors begin between ages 3 and 12 years and then usually dissipate during adolescence. In adults, they most commonly occur between the ages of 20 to 30.

·      Though the frequency and severity vary between individuals, the episodes can occur in intervals of days or weeks, but can also occur over consecutive nights or multiple times in one night.

·      The universal feature of night terrors is inconsolability. During night terror bouts, patients are usually described as "bolting upright" with their eyes wide open and a look of fear and panic on their face. They will often scream. Furthermore, they will usually sweat, exhibit rapid respiration, and have a rapid heart rate (autonomic signs).

·      In some cases, individuals are likely to have even more elaborate motor activity, such as a thrashing of limbs—which may include punching, swinging, or fleeing motions. There is a sense that the individual is trying to protect himself and/or escape from a possible threat which threatens bodily injury.

·      The DSM-IV-TR diagnostic criteria for sleep terror disorder requires:

o   Recurrent periods where the individual abruptly wakes from sleeping with a scream

o   The individual experiences intense fear and symptoms of autonomic arousal such as increased heart rate, heavy breathing, and increased perspiration

o   The individual cannot be soothed or comforted during the episode

o   The individual is unable to remember details of the dream or details of the episode

o   The occurrence of the sleep terror episode causes clinically significant distress or impairment in the individual's functioning

I experience all but one of the details listed above. The only 'symptom' I 'lack' is "the individual is unable to remember details of the dream or details of the episode". I remember everything, every time. I can always feel his knee on my throat and his hand on my wrists, even after I wake up. This is also unfortunate for Andrew, as he is the recipient of any "thrashing of limbs...punching, swinging, or fleeing motions" that result from these experiences. Also, sudden and random screaming, which I can imagine are a bit unsettling to wake up to so abruptly. Though, he reports the screaming is fairly infrequent. More often than not, these 'terrors' happen more than once over the course of one night. Once one occurs, it becomes infinitely more difficult to calm down enough to even begin convincing myself that it's okay to try and fall back asleep again. I do, however, count the time that I am experiencing these as time I am "sleeping".

2. I simply can't convince myself to fall asleep. I know what's more than likely going to happen when I do fall asleep, so I begin to panic before I've even fallen asleep. I think this goes along with the typical symptoms of PTSD, all of which I experience on a weekly (if not daily) basis: 

·      Exposure to a stressful event or situation (either short or long lasting) of exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almost anyone.

·      Persistent remembering or "reliving" the stressor by intrusive flash backs, vivid memories, recurring dreams, or by experiencing distress when exposed to circumstances resembling or associated with the stressor.

·      Actual or preferred avoidance of circumstances resembling or associated with the stressor (not present before exposure to the stressor).

·      Inability to recall, either partially or completely, some important aspects of the period of exposure to the stressor.

·      Persistent symptoms of increased psychological sensitivity (not present before exposure to the stressor) shown by any two of the following:

o   Difficulty in falling or staying asleep

o   Irritability

o   Outbursts of anger

o   Difficulty in concentrating

o   Hyper-vigilance

o   Exaggerated startle response.  

At this point I'm just too overwhelmed to figure out where to start fixing everything. The various avenues I've gone down in an attempt to fix things have all failed. Numerous people have suggested another round of therapy might do the trick (third time's the charm? really?), but I have my doubts and my truckloads of inhibitions. Additionally, things like yoga, general exercise, meditation, hot tea, music, a book, writing, video games, a shower/bath, etc. have also not helped. I'm always open to more suggestions...not that anyone regularly reads this thing. Yeah, considering that last bit, I should probably just go lay in bed and try to sleep. I guess I'll end with two of my favorite (since they're relevant) quotes from the ever-apt House of Leaves: 

“This much I'm certain of: it doesn't happen immediately. You'll finish [the book] and that will be that, until a moment will come, maybe in a month, maybe a year, maybe even several years. You'll be sick or feeling troubled or deeply in love or quietly uncertain or even content for the first time in your life. It won't matter. Out of the blue, beyond any cause you can trace, you'll suddenly realize things are not how you perceived them to be at all. For some reason, you will no longer be the person you believed you once were. You'll detect slow and subtle shifts going on all around you, more importantly shifts in you. Worse, you'll realize it's always been shifting, like a shimmer of sorts, a vast shimmer, only dark like a room. But you won't understand why or how. You'll have forgotten what granted you this awareness in the first place

...

You might try then, as I did, to find a sky so full of stars it will blind you again. Only no sky can blind you now. Even with all that iridescent magic up there, your eye will no longer linger on the light, it will no longer trace constellations. You'll care only about the darkness and you'll watch it for hours, for days, maybe even for years, trying in vain to believe you're some kind of indispensable, universe-appointed sentinel, as if just by looking you could actually keep it all at bay. It will get so bad you'll be afraid to look away, you'll be afraid to sleep.

Then no matter where you are, in a crowded restaurant or on some desolate street or even in the comforts of your own home, you'll watch yourself dismantle every assurance you ever lived by. You'll stand aside as a great complexity intrudes, tearing apart, piece by piece, all of your carefully conceived denials, whether deliberate or unconscious. And then for better or worse you'll turn, unable to resist, though try to resist you still will, fighting with everything you've got not to face the thing you most dread, what is now, what will be, what has always come before, the creature you truly are, the creature we all are, buried in the nameless black of a name.

And then the nightmares will begin.”

"I still get nightmares. In fact I get them so often I should be used to them by now. I'm not. No one ever really gets used to nightmares. For a while there I tried every pill imaginable. Anything to curb the fear. Excedrin PMs, Melatonin, L-tryptophan, Valium, Vicodin, quite a few member of the barbatal family. A pretty extensive list, frequently mixed, often matched, with shots of bourbon, a few lung rasping bong hits, sometimes even the vaporous confidence-trip of cocaine. None of it helped. I think it's pretty safe to assume there's no lab sophisticated enough yet to synthesize the kind of chemicals I need. A Nobel Prize to the one who invents that puppy. I'm so tired. Sleep's been stalking me for too long to remember. Inevitable I suppose. Sadly though, I'm not looking forward to the prospect. I say "sadly" because there was a time when I actually enjoyed sleeping. In fact I slept all the time."

-Johnny Truant, House of Leaves