Sleepless

February 25, 2008 | 25 comments
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A medical bleg from a bloggernacle regular in need: My oldest daughter is expecting her third child. She has not slept (except for three hours) in twelve days.

She has had her thyroid tested and the tests have been in the normal range, though she shows all symptoms of someone with serious thyroid problems. She is not depressed. This is pregnancy-related, but the health care professionals jump immediately to the depression idea.

I need to send out a huge call for help to anyone who might have had this kind of situation. Is there a way T&S can do this? We are trying everything and are feeling desperate. When her ward learned about this problem, they started bringing meals in, which has been wonderful. But what I really need is someone who has any idea of what’s going on. I’m hoping someone on the bloggernacle might be able to help us.

Does this sound familiar to anyone? If anyone has had experience with something like this, please let me know, in comments, or via e-mail.

Meanwhile, let’s keep M’s daughter, and her child, in our thoughts and prayers.

25 Responses to Sleepless

  1. Margaret Young on February 25, 2008 at 4:28 pm

    Thank you, Kaimi. I don’t have to be anonymous. FYI, we have tried the “okay” sleep inducers–unisom and ambien. Nothing has worked. We’ve done every test we can think of;, we’ve talked to midwives and ob-gyns. If you have ideas, you can either post them or e-mail me at Margaret_Young@byu.edu .

    I think the bloggernacle is at its best when we come together and help each other. Thank you!

  2. cmp on February 25, 2008 at 5:48 pm

    I had a very serious case of Restless Leg Syndrome the last six weeks of my pregnancy. I couldn\’t sleep more than an hour or two per day. It went away the day my son was born. This was about 8 years ago, and the doctor had no idea what was going on. I thought I was going crazy. I think it\’s also related to iron-deficiency.

  3. Julie M. Smith on February 25, 2008 at 8:06 pm

    I read the post, was going to say Restless Leg Syndrome, but didn’t want anyone to think I was crazy. Then I saw cmp’s comment . . .

    RLS has made me absolutely batty during my pregnancies. The legs don’t hurt, you just feel this overwhelming need to move them and of course you can’t sleep when your legs are moving. I thought I was loosing my mind until I read about it and realized that it is a “real” problem.

  4. Sarah on February 25, 2008 at 9:23 pm

    I think my stepmother had problems sleeping when she was pregnant with my youngest half-siblings (I was a kid, so I’m not 100% sure) — but I’m pretty confident it was because of the enforced bed rest (something like three weeks with my brother, but almost two months with my baby sister.) Not so much the lack of exercise as the stress of being allowed to get out of bed for the bathroom and one walk around the block per day and that’s it (also, her hair started coming out, from the stress, per the doctors.) Honestly, I have no good advice (I trick myself into going to sleep through meditation and toe-wiggling, and I don’t know why it works.) I hope someone else is more helpful than me!

  5. Margaret Young on February 25, 2008 at 10:48 pm

    7:41 p.m. Monday
    My daughter had acupuncture ($120.) today. We’ll see how it does. I sent her home with aromatic massage oil and instructions for her husband to give her a massage. (She also has a neighbor who is a massage therapist.)
    I also sent _Groundhog Day_ with her. It is so delightfully repetitive that it lulls me to sleep (after my sleeping pill, of course). I’m not at all sure any of these will work, because it seems to be chemical. But we’re trying everything.

    My daughter is touched by the concern so many have shown. So am I.

  6. E on February 26, 2008 at 12:05 am

    I think you are too quick to discount the idea of a mental health problem. That would be, by far, the commonest cause of severe sleep disturbance, including in a pregnant woman.

  7. m&m on February 26, 2008 at 12:40 am

    I just had someone suggest calcium, magnesium, and zinc at night for my insomnia. I don’t know how that works or if is ok in pregnancy…I have asked and am waiting for a response.

    Also, I have heard that sometimes typical thyroid tests don’t always show the subtleties that specialists can find. It might be worth a followup.

    Good luck. Insomnia is so very difficult. My heart goes out to her.

  8. queuno on February 26, 2008 at 12:42 am

    I’ve had a friend send me a reference to a movie:

    “The Cure for Insomnia (1987) is the longest movie ever made at a total running time of 85 hours (5,220 min) . It premiered in its entirety at The School Of The Art Institute in Chicago, Illinois from January 31 to February 3, 1987, in one continuous showing.”

  9. JA Benson on February 26, 2008 at 8:16 am

    I have a mild form of Lupus. I am often anemic. I do not have restless leg syndrome. Like # 2 cmp iron poor blood causes me to not to sleep. There is a gentle iron in tablet and liquid form that you can find at a health food store. It is easy on the stomach and should not cause upset. Good Luck

  10. Chad S. on February 26, 2008 at 9:49 am

    Margaret,

    I have emailed you a couple evidence-based articles on insomnia. I hope they are helpful, and I wish you and your daughter the best.

  11. bookslinger on February 26, 2008 at 11:59 am

    1. Melatonin is an over-the-counter drug that can help regulate sleep. Check to see if it is counter-indicated during pregnancy.

    2. When looking for specific causes of specific problems the “general” stuff necessary for good health can often be over-looked, such as diet, hydration, electrolytes, etc. Sometimes dietary goals, such as low fat, can be taken too far, and we don’t get enough fats (vegetable or animal) in our diet. Also low salt: at times I’ve exercised so much that I sweat off too much electrolytes, and don’t replace them enough because I’m on low salt, and need to take a potassium supplement. The calcium/magnesium/zinc tablets also help in that regard. For a while, I also got away from getting sufficient plain water. I was drinking sport drinks, soda, and lots of liquids, but not enough just plain water. Sometimes doctors want to find “medical reasons” for things, when the solution actually lies in common sense stuff that we are overlooking or getting out of balance. Books on general wellness and diet might help, or someone like a nutritional consultant, naturopath, or osteopathic physician might shed light.

  12. Kari on February 26, 2008 at 12:49 pm

    Margaret,

    I would suggest that your daughter ask for a referral to a sleep specialist, and if that’s not available then to a general neurologist.

    As a neurologist I see many people with sleep disturbances, including insomnia. Without a full description of her insomnia I think that we are all doing your daughter a disservice by guessing at her diagnosis, or making suggestions for therapy. The list of possibilities is certainly longer than most would imagine. The most common explanation would simply be the fact that she is pregnant, and by some counts up to 75% of women experience sleep difficulties during pregnancy ( I don’t agree with E that depression is the most common explanation). But certainly there are other possibilities. I would encourage her to be as descriptive as possible with her physicians, and not to hold anything back because she thinks it doesn’t apply; she should let her doctor decide what is relevant. I can’t tell you how many times I ask a patient a question of a patient and after they answer they say “I didn’t think that was important” or something similar.

    I wish her well. Please keep us updated.

  13. Margaret Young on February 26, 2008 at 12:59 pm

    Thanks all for these ideas. We just went through another night without sleep. The acupuncture was relaxing, but she still couldn’t transition into sleep. Bookslinger, I take calcium/magnesium/potassium, which helps with sleep. My daughter is so careful to not take anything which could harm the baby that she won’t take anything without checking first to be sure it’s all right. She has decided to quit the midwife she was seeing, whose advice was “Take the non-generic ambien and see me in a week.” She’ll be with an ob/gyn now, but honestly, we haven’t gotten much help from ob/gyns (and we have called on them). Today I’m taking her to the person I go to, who does alternative medicine. That’s where I get my supplements and vitamin B shots. It could be that her seratonin isn’t getting where it needs to, but I still think there’s a thyroid issue. The big thing is that she needs someone who has TIME to look at the possibilities and really listen. Big disappointment that the acupuncture didn’t work.

  14. Jonovitch on February 26, 2008 at 1:25 pm

    Margaret (12), a psychologist once told me that some people need to take pills for physical problems and others have to take pills for mental problems. His point was, I shouldn’t be pre-occupied with the social stigma of needing medicine to “fix” my brain. (Full disclosure: he never did issue me a prescription, but his comment helped me develop a more well-rounded opinion of “crazy pills” as someone I know, who does need them, calls them.)

    It might be worth it to mention to your daughter that the insomnia (and subsequent stress and anxiety) might not be good for the baby either, and that taking some of these vitamins might help alleviate the problem. In other words, sometimes taking medicine really is a good option.

    I just wanted to offer that perspective. Also, I would never underestimate the benefits of a solid, well-rounded, healthy diet for the human body, especially during pregnancy. Fruits, veggies, whole grain breads, water, etc. Nothing pre-made, pre-cooked, pre-treated, pre-processed — real food does not come in a box! But you probably knew that already. :)

    We’re all pulling for her!

    Jon

  15. Jonovitch on February 26, 2008 at 1:29 pm

    Oops, my reference to Margaret should have been (13).

    P.S. Do you happen to still have a favorite blanket from when she was a young girl, hidden away somewhere? Or a favorite teddy-bear or doll that she liked to snuggle with? Just a thought I had — you never know what might help.

    Jon

  16. Margaret Young on February 26, 2008 at 1:40 pm

    I’m in process of listing symptoms.
    Kari, thank you for your counsel. Have you ever seen insomnia which persisted for 2 weeks? To be really honest, we’ve found that the medical offices are so busy that my daughter is given a rather quick evaluation (including “see a psychiatrist”), or a quick prescription, but is then left on her own with an appoinement scheduled according to the doctor’s availability–like in a week. “On her own,” nothing has worked. We have called a sleep disorder clinic. Obviously, I see one option of taking my grandkids for awhile and having her spend a night or two in a sleep disorder place.

    Jon, the blanket idea is interesting.

    Thanks everyone.

  17. HeidiAnn on February 26, 2008 at 3:20 pm

    I think pregnancy insomnia can become something of a self-fulfilling prophecy too. You don’t sleep one night, you worry about not sleeping the next night, you spend that night worrying if you’ll fall asleep or not and when, then, lather, rinse, repeat. I have Restless Legs Syndrome, but during pregnancy it is nearly unbearable (some people only have it during pregnancy). Whether she has RLS or not, she needs to create a bedtime routine which is repeated the same way, at the same time every single night. She also needs to be given lots of opportunity to sleep. If someone comes and takes the kids for 2 hours, she’ll probably feel a lot of pressure to sleep during that time, which will make sleeping all the more difficult. If she is given lots of opportunities, it will lessen that pressure. Journaling helps too, especially if thoughts keep her awake. She will be able to “surrender” those thoughts, knowing she won’t forget about them if they’re written down. Also, is there something you did to help her sleep as a child? My mother used to gently caress my arm with her fingertips. To this day, that sensation helps me fall asleep. My mom later told me that technique is also recommended to help women relax during labor. I think there is some fancy Frenchy-French term for it. Good Luck! Next time I’m in the temple I’ll put “Margaret Y.’s daughter” on the prayer roll. Oh, and she is not alone, this happened to me during all 4 of my pregnancies (my 4th child is 3 mo. old now).

  18. Lisa on February 26, 2008 at 4:08 pm

    I talked to my husband about this. He teaches about sleep disorders at Stanford and manages a sleep lab. He said he agrees that there are a lot of potential causes and it\’s important to see a sleep specialist. Her regular doctor can recommend one.

    He wouldn\’t recommend that she take melatonin during pregnancy because it\’s unregulated and melatonin can affect sexual development and the effect during pregnancy isn\’t known.

    For his insomnia patients, he recommends cognitive behavioral therapy. It has been found to be as helpful as sleeping pills. I don\’t know where your daughter lives, but I\’m guessing Utah? If so, here\’s the name of a behavioral sleep medicine specialist in Salt Lake:

    Laura Anne Czajkowfki (He doesn\’t know this person; he\’s just in the professional organization for behavioral sleep medicine and looked at their member list.)

    He also says insomnia in pregnancy is common. He wanted to know too whether she snores when she does sleep. If so, she may have sleep apnea. Sleep apnea can be common in pregnancy and it resolves after the baby is delivered.

    He also says she may be sleeping more than she thinks she is. This is often seen in insomniac patients. THey think they\’re not sleeping at all, but when hooked up for a sleep study, it shows they are sleeping.

    Relaxation, meditation, bedtime rituals really do help. And she could look at two books that may help: No More Sleepless Nights (this is the Mayo Clinic program for insomnia) and Insomnia by Charles Morin (make sure you get the one that\’s for patients, not for professionals). You might find information on the National Sleep Foundation website (sleepfoundation.org).

    Insomnia is tough. I often have it myself and it\’s very frustrating. Good luck.

  19. Margaret Young on February 26, 2008 at 6:33 pm

    I wish my daughter’s insomnia were one night on, one night off, but it has been consistent for two weeks. However, I believe we have just had a miracle.
    First of all, thank you to those who sent me private messages, websites, and to one very helpful blogger who had a long and extremely useful phone conversation with me. While I was talking to him, my daughter called to tell me that something wonderful had happened. Through a friend, she had found a doctor who specialized in hormonal problems in pregnancies. It happened that someone had canceled their appointment today, so she was able to see him immediately. He LISTENED to her for over an hour and started her on a program of hormonal assistance which we feel will be the answer to our prayers. I don’t anticipate a full night’s rest tonight, but I think she will get several hours. I really do believe this is an answer to prayer, and am very aware that for a moment, many bloggers left important conversations to remember my daughter in her need. Thank you.

  20. Mark IV on February 26, 2008 at 7:22 pm

    Terrific news, sister Young.

  21. Kari on February 26, 2008 at 10:11 pm

    Thanks good news, Margaret. I hope it works for your daughter.

    To answer your previous questions, yes I have seen a number of patients with persistent insomnia. It can be a vexing problem, and requires a physician who will listen carefully, and who has the knowledge to ask the right questions.

    I agree with the previous posters, your daughter shouldn’t take anything without talking to her physician about how it may affect her pregnancy.

    Good Luck.

  22. Erika on February 27, 2008 at 4:34 am

    That\’s great that she was able to see that doctor. Hopefully it will help. Something else that could help is called Cranio Sacral Therapy. I don\’t think it would solve anything, but it knocks you out while you are having the session. In massage school we were ALL snoring as we received it. She could get some well-needed rest while she is waiting for the medications to work. A trained massage therapist could do this. It\’s very non invasive and is done while you are fully clothed.

  23. Margaret Young on February 27, 2008 at 8:04 pm

    Latest report (which I’m hoping might help someone in the future):
    I always suspected a thyroid problem because of other symptoms my daughter showed (extremely dry and matted hair, for example). The new doctor has put her on iodine, which encourages the body to regulate thyroid production. She took her first iodine supplement this morning. This afternoon, she took a nap–two hours. That is more sleep than she has had in two weeks, except for one night when she slept for three hours.
    What I’ve learned:
    1) Just because thyroid tests come back within the normal does not mean the RECEPTORS are working. (The blogger who called me explained this, and the doctor my daughter saw already understood it.)
    2) Our remarkable bodies are intended to work in great harmony–the endocrine system, digestive system, etc. If something is off, everything is affected.
    3) Pregnancy is a huge stress on the body, and there are pregnancy-induced tumors (something I learned from another blogger); pregnancy-induced skin conditions; pregnancy-induced endocrine anomalies, etc.
    4) Mother’s intuition is real. I had a sense of what was wrong. I know that insomnia is common among pregnant women. (I’ve been visiting websites for a couple of weeks now.) I know that depression is the most logical diagnosis. Nonetheless, I had a gut sense that my daughter’s thyroid was messed up and that I shouldn’t accept the first answers.
    5) All pregnant women need someone to listen to them. With so many pregnant women in Utah, most get a couple of minutes of a doctor’s time–and even midwives are often booked and easily give a prescription and then leave the room. Somehow, we need to have a place where pregnant women can go to be heard.
    6) Prayer works!

  24. Proud Daughter of Eve on February 28, 2008 at 10:12 pm

    Oh good! I’m so glad that things have worked out as they have! Good luck and God bless to all!

  25. Kaimi Wenger on February 28, 2008 at 11:53 pm

    So glad to hear that things are doing better, Margaret. I hope things continue well.

    Margaret writes: “Somehow, we need to have a place where pregnant women can go to be heard.”

    I agree. Also, why does that line sound like something out of Refuge, or maybe Red?

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