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Autistic Inertia & Sleep

Posted Oct 13 2009 10:04pm
As you probably know, I've been having some severe problems at school and, as usual, my sleep schedule is at the root of it. From what I can tell, it's some kind of circadian-rhythm issue--as in, my body doesn't like a regular cycle, doesn't really know when to sleep. I hear of it happening a lot in blind people (I'm not blind) who can't see light and so their bodies don't pick up on when it's daytime. But a lack of light is not my problem. I have four large windows in my apartment and I keep the blinds up during the day. It could just be that I have such trouble with transitions that I don't want to stop what I'm doing... six hours past when I should have stopped it. Which can mean, six a.m. before I get to bed; and then the naturally wonky sleep cycle kicks in and before I know it my brain says, "Hey, it's five in the afternoon, time to wake up!" or, "hey, it's three p.m., time to go to bed!" what seems to be totally out of the blue.

What I am currently trying:
--Melatonin, which helps to some degree to straighten out a severely messed up circadian rhythm
--OTC sleep aid, which also helps to some degree (but not on the same nights with the melatonin, I haven't asked whether it's dangerous to double up so I won't do it). Problem with this is that I can easily just stay up despite the slight tiredness this causes. If I'm having enough trouble getting myself to bed, I can literally stay up until I'm incapable of thinking coherently, and at that point may stay up two hours longer.
--A computerized alarm clock that gives me an hour's warning, then a fifteen minute warning, then another warning at bedtime (I have it set to wake me up, too, plus an alarm clock across the room from my bed).
--I don't do anything but sleep near my bed (studio apartment--it's all the same room) so as to preserve the sleep/bed connection and not end up with insomnia. For clarification, I only end up with insomnia if I'm actually not tired when I'm going to bed; the problem is getting to bed in the first place.

What I've tried that didn't work:
--Prescription sleep medicine. I only ended up too tired in the morning. Tried both an allergy medicine (for the drowsiness side effect) and amitryptiline.
--Forcing myself to get up in the morning whether I had enough sleep or not, and hoping I'd be tired enough to sleep on time. It only ruined the day, and I'd still stay up too late the next night because I'd have the same trouble getting myself to bed.
--Rewarding myself for getting to bed on time. Wasn't enough of a motivator, no matter how good the reward, which is generally true in cases where the person being rewarded can't do what's being asked. Which suggests some gap still in my skills or my strategy.

So what I have here, as far as I can analyze the problem, is a pretty run-of-the-mill transition thing; inertia, I guess. I have the same problems with other things--getting to class, getting to work, taking a shower, switching from one activity to another. I have the same trouble with eating--I'll forget about it and put it off until I'm starting to get weak from hunger. Embarrassing as it is to talk about, I also wait until the last minute to use the toilet... so that I often find myself running the few steps to my bathroom.

I live on my own, and don't have anybody to force me into bed. This is a global problem, really, but I wish I could solve at least this one aspect of it. I feel like, if only I could force order on this one part of my life, I might be able to organize the rest of it. Organization, and routines, are the only way things get done in my life, other than coming up against extremely strong reminders like the threat of wetting one's pants or passing out from exhaustion; and those aren't a pleasant way to get anything done.

Some advice would be welcome.
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