The Ambien Diaries

I have long believed that pharmaceuticals tend in most cases to create as many problems as they solve, that for every symptom cleared up another is produced. I suspect this belief of creating a perverse sort of placebo effect for me, whereby because I expect limited benefit or unpleasant side effects, that is precisely what I get.

I suppose I should be more amenable to medicine, especially when I ask for it. I've had a lot of trouble sleeping lately—well, ever since I arrived, although to be honest I haven't slept really well, night after night, in years, and sometimes wonder if I ever will again. I used to. I used to be able to fall asleep within minutes of deciding to do so, too. Then again there are lots of things I used to be able to do and there's no profit in dwelling on the past.

I'm not certain of the root cause of my sleeplessness here and in truth there is unlikely to be a single cause. It's said that mefloquin, the anti-malarial prophylaxis I'm taking, can give you difficulty sleeping the first couple weeks, but I started taking it the first week in July and my body should be used to it by now.

(That said, the drug information sheet that comes with mefloquin points out that there are other anti-malarials available, and if you A) have trouble remembering to take a weekly pill (yes!); B) have been depressed within the past year (hello!); or C) have a generalized anxiety disorder (oh, waiter!), you should seek out one of the alternatives. Nice of the docs back home to inquire into my medical history before writing the prescription.)

There's the matter of my daily schedule, which is a bit unusual, since I work 1400 til 2200, go to the gym at 2230-ish, eat a meal at midnight, and go to bed around two. Nothing inherently wrong with that but it's not what I do at home. And of course there are plenty of other stressors in my life that could be affecting my sleep, though those have been around for a while.

Regardless of why I can't sleep, I can't sleep. So I went to the doctor. I first went to the doctor a week ago and asked for some help, and they told me to come back in another week because I was probably just getting used to the mefloquin. I resisted the urge to point out that if I went another week without sleeping it wouldn't matter what the cause was because I'd be completely batshit crazy. I waited four days, and went back this past Monday.

As I expected, I got a prescription for a week's worth of Ambien. This is what I wanted. Valium gives me a hangover, and though I could cut the pills in half I have a really large knife and it would be like using a 2x4 to swat flies—it would do the job but there'd be a lot of collateral damage. So I took a pill Monday around two-thirty.

And woke up bolt upright in the bed and wide awake at seven thirty. Five hours, that's pretty good. I got up, went to the latrine, came back, and collapsed into bed again and slept until at least nine. And I was still tired, so I stayed in bed until ten-thirty reading. Then I got up to take in my laundry and have some lunch.

Tuesday night I took a pill around two. I was asleep within twenty minutes, but once again I was very suddenly jerked awake, at around six-thirty or so. I didn't have to pee, either, which is weird because you always have to pee when you get up in the morning here. I say you because I mean everybody, not just me. But I got up and went to the latrine anyway because the act of walking there in the morning is usually enough to get things working. I decided, since I was up, I'd have breakfast, which I never do (lunch is my breakfast), and had a nice meal and went to the exchange to buy… something, I don't recall. And then I came back to my little hooch and promptly fell asleep again. I woke up around eleven and read for a while, then got some lunch and went to work.

Wednesday night I felt tired, although I'd slept plenty the previous two days, so I didn't go to the gym and took the pill around midnight. And I slept until ten, and then stayed in bed and read until one.

So in the last three days (it's 0100 Friday morning—which is to say Thursday night by my schedule) I've slept 25+ hours and spent most of the rest of my non-working awake time lying in bed. This is hardly normal and certainly not a pattern I wish to continue. Consequently I'm debating whether to take the pill tonight or not—or whether to simply take the pill an hour later and not worry about it. And there's the matter of do I really need the pill? How long should I lie in bed not sleeping before I decide to take it? And how the hell will I know? It's dark in the tent, literally so dark you cannot see your hand in front of your face if everyone has their lights off.

Sleep isn't supposed to cause stress.