This might be a new regular or occasional feature. How’s that for a commitment? There are a lot of little things that come up during the week that I’d like to share but they’re too small to make a proper post about. Instead, I’m going to roll them all up into one hot mess of a post on Mondays.
News from the Melatonin Front
I accidentally bought 3 mg melatonin tablets rather than my usual 5 mg tablets. Cue three nights of bizarre dreams before I realized my mistake (followed by a frantic midweek trip to Target). Yikes. Now I see why some people can’t take melatonin. I didn’t have nightmares but I did have some freaky dreams and woke up feeling like the night had been about a week long.
Research on Using the Internet as a Communication Medium
Amy Woodham, a masters student in psychology in the UK is doing a study on how women with Aspergers and High Functioning (ack!) Autism use the internet for communication. It’s a short, mostly multiple choice survey that took me about 15 minutes to complete. To participate, you need to be a female over the age of 18 with an official diagnosis of AS or HFA (I know that rules a bunch of you out, sorry). If you’re interested, you can find details here.
**Updated to add that you’re welcome to participate in the study if you are self-diagnosed/suspected AS/HFA. See the comments for the source of this additional information.
A-dar is an Actual Thing
I live next to an elementary school now. It has a giant playground with a forest of colorful plastic playground equipment, as playgrounds do these days. Last Tuesday when I took the dog out for our midday constitutional, I saw just one girl on the playground. She was walking around the paved play area, making loud vocalizations while looking at the numbers and shapes painted on the ground (for playing hopscotch and such). There were four adults nearby, chatting and paying no mind to girl’s unusual behavior.
“Wow,” I thought, “best recess ever.”
As I rounded the corner of the playground and headed out into the nearby field, I noticed another girl, hunched over at the end of a slide, scraping up and sifting through the bark mulch. Then a boy, kneeling under another slide, doing something in the dirt I couldn’t make out. Oh, and a second boy, sitting in the middle of yet another slide, flapping his hands, which were hidden in his shirt sleeves.
This seriously looked like the best recess ever to me. As I walked by the fence, feeling happy for these kids who were getting to whatever they damn well pleased on the playground, the flappy boy slid down the slide and ran over to the chain link fence to watch me. I waved. He licked the fence.
This would be even more fun if you all had things to share too. What’s going on with your week? Find anything new or exciting or interesting you want to tell everyone about? Could be ASD-related or not. I have no idea how this might work, except that we should do what makes us happy.
Last November I wrote about my insomnia and nightmares. Since then, I’ve been conducting some experiments. Here’s an update on what I’ve learned:
In early December I started taking melatonin and I immediately felt like I was sleeping better. To be certain I wasn’t just imagining that my sleep had improved, I conducted a 2-week sleep study on myself.
The Scientist hooked me up with an armband that monitors sleep quality. I wore it while I slept for two weeks, one week on the melatonin and one week off. Thanks to the software that came with the armband, here’s a graphic representation of how well I slept during each of the weeks:
I was surprised by how frequently my sleep is interrupted on any given night. There is one night out of each week that I got a long uninterrupted period of sleep. On most nights the longest period of continuous sleep is a couple of hours or ninety minutes. I knew that my sleep patterns were disrupted, but I didn’t know the problem was this bad.
I also found it interesting that I have to spend 9-10 hours in bed to get 8 hours of sleep.
So does the melatonin work? I averaged 25 minutes more sleep per night when I was taking it, which added up to an additional 3 hours of sleep for the week.
Since doing the sleep study two months ago, I’ve continued taking melatonin and it feels like my sleep has continued to improve. There are still nights where I only get 5 hours of sleep (last night, in fact) or I’m wide awake at 3:30 AM, but they’re less frequent. In general, I fall asleep more quickly. The melatonin creates a pleasant drowsiness that makes it easier to fall back asleep when I wake up during the night. Some days I feel a little sleepy in the morning, but that fades after I exercise, which I do first thing after getting out of bed.
If you’re considering taking melatonin as a sleep enhancer, there are some things you should know:
Melatonin makes you sleepy. Take it only at bedtime. I take 5 mg about 30 minutes before bed.
High doses of melatonin have been associated with increased depression and psychosis in people already suffering from these conditions. Also, women who are pregnant or trying to become pregnant, nursing mothers, and individuals with cancer, leukemia, lymphoma, multiple myeloma or Hodgkin’s disease should not take melatonin. It’s a good idea to consult with your doctor before starting the use of a melatonin supplement, especially if you are being treated for any other condition or taking any type of medication.
In the US, you can buy melatonin over-the-counter at stores that sell vitamins and supplements. It comes in 0.75 to 5 mg doses. Taking the smallest effective dose is safer.
Melatonin makes you feel drowsy and relaxed but not drugged, so you should still be able to easily wake if necessary, for example to respond to an emergency call from a family member.
It’s often recommended that you take melatonin every other day so you don’t inhibit natural production. (Personally, I think my natural production is already screwed beyond all hope and always has been, so I take it every day.)
Some people take melatonin for a few weeks then take a week off on the belief that it loses it’s effectiveness if taken continuously. I’ve been taking it for 5 months with only two weeks off (one due to illness and one for the sleep study). I haven’t seen a drop in effectiveness.
If you feel groggy in the morning, try reducing the dosage.
Some people experience nightmares when taking melatonin. (I’ve found that my nightmares have lessened–more on that in the next part).
Other side effects can include: mild headache, upset stomach, lower sex drive and depression. Again, reducing dosage can alleviate side effects. Most people don’t experience any side effects at a dosage of 1 mg.
Some people experience rebound insomnia when they stop taking melatonin. I stopped twice for about a week each time and didn’t feel like my insomnia was any worse than it had been before beginning the melatonin. One way to avoid potential rebound insomnia is to taper off, using lower dosages over 1-2 weeks if you decide you no longer need to take it.
My Nightmare Journal
When I wrote about nightmares, I suspected that they were connected to unprocessed bouts of anxiety. To identify trigger events, I started a log of my nightmares along with some details like possible triggers and whether I’d felt like I processed the triggering event. My goal was to become more aware of triggers and spend time working through them during my waking hours rather than letting my sleeping brain get creative with them.
According to my log, here is # of nights that I had nightmares each month:
Nov 15th-30th: 4 nights
December: 10 nights
January: 3 nights
February: 1 night
March: 0 nights
April : 0 nights
I know what you’re thinking: You did it! You learned to identify your triggers and process your anxiety!
Well, no. I tried that all through December and failed miserably. Then in January, I said “fuck you, anxiety” and I wrote this. And hey, the nightmares disappeared!
Two things seem to be at work here. First, melatonin helps me sleep more deeply, which makes my dreams harder to remember and less vivid. Of the 14 nightmares I had after starting on the melatonin, I rated 6 mild and 2 moderate. That alone is a relief.
The other thing that’s happening? I’ve become autistic in my sleep! On January 23rd, I got my flap back in a dream. After that, I had only 2 nightmares and 1 of them didn’t fit my typical nightmare profile at all. I’ve started dreaming in an entirely different way.
In my dreams now, I often tell people that I’m autistic or consciously think of myself of as autistic. That’s completely new. Twice, when it seemed like someone was going to attack me, setting off a typical nightmare scenario in which I had to physically defend myself, the police showed up and took the threatening person away! That’s never happened before. Another time, I was lost and couldn’t find my new (in the dream) apartment. I told some people who worked in the building that I was autistic and couldn’t remember where I lived and they all offered to help me. That never happens in my dreams either.
This is really exciting. I feel like the way I’m thinking about myself and my relationship with the world around me is changing in a profound way. The changes to my dream life are concrete evidence of this.
That’s not to say I don’t have any disturbing dreams. I have plenty. I dream that I’m late for important events. That I need to call 911 but no one answers or the phone doesn’t work. That I need to run but my legs don’t work. That I’m blind. That I’m in school but don’t know my class schedule. That I have a baby but keep forgetting to care for it.
I also still have weird, inexplicable dreams. That I’m playing golf, but in the opposite direction of everyone else on the course. That I’ve accidentally rubbed the ink from my tattoo off and when I check it in the mirror I notice that I’m also pregnant.
All of those dreams are unsettling, but they aren’t nightmares. I don’t wake up sweating with my heart pounding out of my chest. I don’t cry myself awake. I don’t startle awake because the dream has become so intensely physically painful that I can’t stand it anymore. I don’t spend most of the next day trying to forget frightening images. I’m not reluctant to go to sleep the next night.
I’m okay with having occasionally unpleasant dreams, as long as the really bad nightmares stay away. Will they? Who knows. I’m in a fairly stressful period right now, one that would have typically triggered a nightmare cycle in the past. So far, nothing.
Warning: This contains some nongraphic descriptions of violent/disturbing nightmares.
I have a lot of nightmares. If the statistics at WebMD are correct, I fall into the 2-8% of the adult population that has nightmares more than once a month. I’d love to know the percentage of people who have nightmares more than once a week. I bet that would make me feel really special.
Lately, though, I’m getting fed up with the nightmares. I’m ready to get myself into the 90+ percent of people who don’t regularly dream about being chased and assaulted.
Locating the Source of the Problem
Recently I began to suspect that my nightmares were related to my Asperger’s. Since finding out that I’m an aspie, this has been my default explanation for anything out of the ordinary.
Some digging through the PubMed database failed to turn up any research strongly linking nightmares and autism. Autistic kids are known to have a very high incidence of sleep disorders (look for a separate post on this next week). Some studies reported that as many as 80% of children with ASD have some form of insomnia. But nightmares haven’t been strongly linked to autism in children and, not surprisingly, there were no studies on sleep disorders in autistic adults.
My next stop was Google. If Asperger’s wasn’t to blame, I needed to find a likely suspect, and where better to hunt for clues than the internet, right?
Visits to WebMD and the International Association for the Study of Dreams turned up good background information about adult nightmares. I scanned through the common causes: medication or withdrawal from medication/alcohol, late-night snacking (because it increases metabolism), a traumatic event, PTSD, anxiety, stress, depression.
Aha! There it was. Anxiety. Asperger’s was to blame after all.
Connecting the Dots
Since I’ve been paying closer attention, I’ve noticed that my nightmares fall into two categories: violent or rage-filled.
The violent nightmares are closer to what most people think of when they think nightmare: being chased, being attacked, being seriously injured. The threatening person (or people) is always a stranger. The dreams used to end in me being seriously injured or nearly dying. A few years ago they shifted. Now the violent dreams almost always end with me seriously injuring or killing the attacker(s). If this sounds like an improvement, trust me, it’s not.
The rage-filled nightmares are characterized by me getting extremely angry with someone I know and blowing up at them. I’m not the kind of person who screams and rages at people in my waking life, so doing it in a dream is strange and disturbing. The rage feels uncontrollable and far more extreme than anything I’ve ever experienced in a sustained way while awake. It feels like I’ve snapped.
Over time, I’ve noticed a pattern in when I have nightmares. I can go weeks without a bad dream and then I’ll have a string of nights filled with long vivid nightmares.
The trigger for each of the types is specific, too. The violent nightmares usually follow a day where I’ve had a frustrating social encounter with a stranger or acquaintance–something that’s left me feeling tongue-tied, inadequate or embarrassed. The rage-filled nightmares usually follow an unpleasant interaction with someone I know. Often that person will be the target of the rage in the dream.
Armed with this analysis, I went off in search of remedies.
A Possible Solution
One of the most common suggestions I found for reducing nightmares was journaling. I’ve tried journaling in the past, unsuccessfully, because part of my brain spends the whole time going “why are we writing this if no one is going to read it?” But the underlying principle of using journaling to process my anxiety makes sense.
My hypothesis about my nightmares: When a trigger event occurs, I’m not processing the feelings associated with it. The lack of processing in my conscious mind is forcing my subconscious to process the feelings, resulting in the unpleasant dreams.
So here is my Aspergarian solution: a spreadsheet. I’m going to track suspected trigger events and nightmares–along with a couple of other variables, like hormonal fluctuations–to see if there’s any relationship between the two.
Ideally, I’d also like to recognize triggering events and try to conscious process the feelings associated with them, no matter how unpleasant that might be. Avoiding them obviously isn’t working. Maybe making a deliberate attempt to look at the triggering situation, acknowledge what I’m feeling and then tell myself that it’s okay to feel that way will diffuse the power of the triggering events and lessen the frequency of the nightmares.
I’ll be back in a few months with a post about how this works.