mr sandman, bring me a dream

At the moment I am dreaming in that special way I do when I am pregnant. My night life seems to be as involved and comprehensive as my waking life, filled with vivid images and complex stories that haunt my days. I love this part of being pregnant.

But I'm not so crazy on the pull to sleep that is gradually taking over my days. No amount of sleep it seems can leave me refreshed and energised, and no matter how long the nights are I still find myself locked in a futile battle each afternoon to keep my eyes open and my head upright. In an open plan corporate office this is a daily humiliation for me and my chiropractor is growing rich as he battles my daily whiplash from nodding off.

Slowly, stealthily I feel the obsession with sleep creeping in. Like a junkie with a craving I can never satisfy. How much can I get? When and where can I get my next hit? What will I have to sacrifice to get what I need? How can I be so powerless in the face of this all-consuming need?

And I keep thinking about the fact that this is only the beginning, it only gets harder from here and frankly I am scared. I am scared of revisiting those days, well years, when Amy was young and never slept. When it seemed all I could do was complain about tiredness and its many companion ailments.

There was a flurry in the news recently about the release of a study conducted at the Children's Hospital here in Melbourne on PND and sleep. The main finding of the report was that while the rate of PND for the general population of new mothers is 15%, for mothers of children with sleep issues it sky rockets to 45%. More amazingly, that treating their children's sleep problems and providing night time respite resolved PND for the majority of these mothers.

I find the results of this study comforting and alarming at the same time. I am greatly comforted that it seems at last we have clearly and scientifically established what is so obvious to mothers whose babies don’t sleep. Chronic and repeated sleep deprivation sends you mad, and when sleep returns sanity usually follows. The military understand sleep deprivation as a form of torture, and hopefully now the general population is beginning to believe it too.

Why is lack of sleep so wearing? Why don’t new mums sleep when their babies do, as is so often touted as the solution to night waking? If you haven’t been intimate with this scenario let me describe for you the descent into hell.

Not getting enough sleep, and getting broken sleep makes you tired. This is the part we all know. But over time that starts to change the nature of the sleep you do get, with far reaching consequences. You lose out on deep sleep, the really relaxing and refreshing bit, so often you wake up feeling much the same as you did before you went to sleep. You also aren’t getting all the physical things that deep sleep gives you, the healing and repair work that keeps you healthy. Soon you find it harder to get to sleep, and harder to stay asleep. Noise wakes you more easily because you aren’t deeply asleep and other external factors (like temperature and bed comfort) also intrude.

For me this manifested in a constant stiffness and pain in my neck and shoulders. The neck bit gave me headaches, the feeling that I was in a perpetual fog and then escalated into migraines. I became increasingly vulnerable to every germ and virus, and each bout of illness lasted longer and hit harder than it should have. I started suffering from a chronic low level asthma I just couldn’t shake. It seemed like every other week Amy and or I was on a course of antibiotics. I was full of aches and pains and overwhelming exhaustion but bizarrely was increasingly insomniac. I would lie in bed just waiting to hear Amy cry, lie in bed cursing that I wasn’t asleep, lie in bed watching the minutes of precious time tick by on the clock. And when I did eventually fall asleep I would be wrenched awake by those cries I had known were coming. I did try to nap when Amy did but the frustration of spending so much time trying to fall asleep only to be woken in a matter of minutes only depressed me more.

And what was going on in my mind all this time? As you can imagine I was irritable as all hell. I was tired and in pain and seemingly helpless to get myself or my baby to sleep more, or better. Even when others would step in for an afternoon or evening, I couldn’t get the sleep I needed, the situation was so deeply embedded in my body that a few nights off didn’t make a dent in the problem. I was frustrated and angry and totally defeated. I couldn’t foresee a time when things would be different or anything that could happen or be done to change the underlying problem.

And I resented that the pursuit of sleep, alongside the care of a child and the seeking of cures to my various ailments, was all my life had become. Everyday I had to decide whether to spend the precious time when Amy was asleep chasing a nap, or doing something that made me feel I had some shreds of life as person who did more than mothering. Even the domestic chores like washing and cooking gave me some satisfaction, even though they contributed to my tiredness. There certainly wasn’t space for much more. I knew I was going mad from it, but I had no idea what to do.

As it turned out much of Amy’s sleep problems had underlying medical causes. The difficulty in getting these diagnosed, being believed by doctors who were convinced she had ‘behavioural issues’, and being provided with practical assistance in managing them still leave me pained beyond belief. When we finally found a sleep specialist who asked me questions about Amy and then leaned across the table and said your child does not have a behavioural problem and something needs to be done, I almost cried with relief. But knowing about causes didn’t much change the reality of living with the problem that laying down caused her pain and when she was in pain she couldn’t sleep.

She was two and a half before she started to sleep through the night and it was only then that I realised how deeply depressed and unwell I had been.

So the thing I find alarming about the study results is that we know all this stuff, we know what should be obvious, and yet it still happens to a very large number of women. They still front up to GPs and Maternal Health nurses and hospital clinics and get told to pat their child to sleep or take away their dummies or let them cry it out. They get told there is a solution and once correctly implemented everything will be all right. For many babies this may well be true. For many babies it is not. Some babies sleep less than others, some babies have problems with their guts and their ears and their respiratory systems that make it harder for them to go to or stay sleep.

And in all this mothers (and father sometimes too) lose a lot of sleep. They lose confidence in themselves and they lose the capacity to deal with problems effectively because they are tired and stressed and unwell. And our solution is to say take a nap here and there, try a new technique, and basically just handle it better.

I look back on my experience and what scares me the most is not knowing how I might have changed things for the better. What I needed seemed so very far away from what was possible. A night off seemed life an offer of a band aid for my spurting jugular. Despite a supportive partner and a helpful network of family and friends I just couldn’t get on top of it. There is only so much of the burden that others can take from you, only so much that can realistically be expected from doctors and health professionals.

So what will I do if I have another baby who won’t sleep? I’d like to believe that I will ask for more help, that I will be clearer about the importance of not letting myself slide down that slope. But I say that more with hope than conviction because I also know that the asking and the giving of help carries other kinds of burdens and sometimes it seems like it isn’t worth it.

I will most certainly be checking in to a weeklong residential program that treats both mother and child for sleep problems. I will take nights off as soon as I am able to and go and stay somewhere else so I can sleep soundly (I did this only twice when Amy was young and D and I now wonder why we waited so long and why we didn’t do it more). I’ll take drugs if I need to in order to re-establish sleep patterns or lift depression. I hope I will remain clear that from lack of sleep all else flows and stemming the tide is the first line of defence.