Irregular sleep patterns no longer a problem for Columbia, Maryland resident, thanks to the University of Maryland Sleep Disorders Center
What types of sleep problems were you experiencing and when did they start?
I had a very irregular sleep pattern. I didn't sleep at the same time every day. I could just as easily stay up all night. Since I didn't have a job it didn't bother me, but when I got a job outside the house I needed to regulate my sleep pattern.
There was no consistency. I've had this problem all my life, in high school and college. As I got older it got worse.
Sometimes I wouldn't go to bed until 8 a.m. and sleep until noon and then I might go to bed one night at 2 a.m. and the next night at 5 a.m. Dr. Steven M. Scharf (the medical director of the UM Sleep Disorders Center), said it was an irregular sleep phase.
How did you find out about the University of Maryland Sleep Disorders Center?
I live in Columbia, Maryland. I did an Internet search on sleep hospitals and Dr. Scharf's sleep center study came up.
It took two years before I decided I wanted to talk to a doctor in person. I went to Dr. Scharf three or four months ago. I was skeptical at first but I told him that I would be the most compliant patient he ever had.
What happened when you went to the Sleep Disorders Center? What type of treatment did you undergo?
Dr. Scharf had sent me an information packet beforehand, including a sleep schedule that I had to fill out for one week. From that he got a sense of what was wrong. He recommended a regimen for me.
I was told either to use a light box in the morning for 20 minutes or go outside to get the morning light to wake me up. He purposely made me sleep deprived so the first week, I slept through the night.
We decided together when I wanted to get up -- at 8 a.m. That meant I couldn't go to bed before 1:30 a.m. He purposely wanted to make me sleep deprived so that when I slept, it was a deeper sleep. But part of my problem was that when I was supposed to go to bed, I wasn't tired. So he wanted me to feel tired when I went to bed. I was only allowed to nap 30 minutes a day, and only between 3 p.m. and 5 p.m.
There were several things I couldn't have after 6 p.m. -- no alcohol, no caffeine, and no stimulants. I had to do that for a week. Then after one week of this I could go to bed at 1 a.m. and wake up at 8 a.m. After another week I moved it to a 12:30 a.m. bedtime. After two weeks of this routine I was supposed to make an appointment to see Patricia Smale, the nurse practitioner. By the time I saw her she said to move it to 12 a.m. bedtime.
A big part of the problem was that I wanted sleep but I wouldn't sleep for eight hours -- I would only sleep four hours. They considered that a form of insomnia so if going to bed at 12 a.m. made it so I'd wake up in middle of night then I would have to go to bed later again.
If I woke up before 8 a.m. I couldn't do anything "fun" like watch television or go on the computer. Instead I had to read, meditate or do relaxation exercises. And I had to be really strict with bedtimes so that my body got used to doing certain things. I had to limit activities to lessen the motivation to wake up in middle of the night.
Another part of the routine was that I had to take melatonin at 10 p.m. every night. (I don't take it anymore.) I think it was a combination of being regimented with the schedule and the light box. Whatever receptors in my body were registering night and day were a little faulty.
I used the light box during day, and at night my room had to be completely dark. From a biological standpoint my body needed light and dark exaggerated, and psychologically I needed all rituals.
I saw Pat three weeks after I started the treatment. By that time I didn't have to move up my bedtime. I was able to sleep from 12 a.m. to 8 a.m.
I was doing great. I took to it like a fish to water. I had a new attitude. To begin with, I thought it wouldn't work -- it was too easy, too simple. After three weeks it was working and I graduated from the program. Pat said that I was doing so well I didn't have to come back.
What did you think of Dr. Scharf and the University of Maryland Sleep Disorders Center?
I was really impressed. Dr. Scharf really knows what he's doing. He definitely hit the nail on the head with me. He gave me an accurate diagnosis and knew what to do to fix me up and I appreciate that.
The biggest benefit I got from the Sleep Disorders Center is that I got a correct diagnosis. Previously I tried myself to fix the problem but it didn't work. Dr. Scharf is a really sweet, nice, professional, caring guy. He is very relaxed, mellow and patient. He has a very good bedside manner and rapport with his patients and I felt he heard me and that he really cared. Other doctors weren't listening to me.
I would definitely recommend the University of Maryland Sleep Disorders Center.
How has your life changed?
The biggest change is that now I can plan my day. Before, it was so hard to make appointments; now I can. My husband and I have a lot more time together. I have a regular schedule. I still get up every day at 8 a.m.
-- by Michelle Murray
Message from Dr. Steven M. Scharf, the medical director of the University of Maryland Sleep Disorders Center
Many physicians and patients believe that the Sleep Disorders Center deals exclusively with sleep-related breathing problems such as sleep apnea. However, as illustrated in the above case, many of the disorders we deal with are in fact related to problems with sleep habits, changes in sleep biorhythm and sleep scheduling. This can lead to severe, distressing and life-altering insomnia as we have just seen. In many instances, health care providers prescribe sleeping pills as first line treatment for these chronic problems. While sleeping pills or hypnotics certainly have their role, other forms of treatment may in fact be more effective. Alteration of sleep scheduling and addressing the natural sleep-related biorhythm are part of cognitive behavioral treatment of chronic insomnia and can be life altering.
As a full service center, the University of Maryland Sleep Disorders Center is equipped to provide these comprehensive services to patients with severe and distressing chronic insomnia.