Diphenhydramine combined with bourbon probably not effective

OK, my next pseudoscientific experiment didn't have great results. I tried bourbon in combination with diphenhydramine, and hypnopompia was significant. A problem, though, with these experiments is that I probably develop tolerance to the diphenhydramine, and one day is affected by the previous ones. In any case, my impression is that alcohol + diphenhydramine isn't a magical potion. These experiments continued directly after the last blog entry:

• Night1. 10:45 pm, two diphenhydramine tablets and began 4 ounces (measured) of bourbon. At about 11:15, couldn't resist another two ounces. Asleep about 12:30 am. No hypnopompic episodes, but had depressing dreams. Felt a bit worse than recently in the morning, but went away fairly quickly. Ran 4.6 miles during the day and felt strong at the end. Less appetite suppression than previously.
• Night 2. Two pints of beer at happy hour. diphenhydramine at 9:30 pm, about 6 ounces of bourbon from 10:45 to midnight. Asleep about 12:30 till 7 am. Hangover and felt tired throughout day. No hypnopompic episodes, regular dreams. Appetite suppression was missing after the diphenhydramine. Felt like the hangover probably from bourbon and beer.
• Night 3. Two glasses red wine 8:30 to 10:30 pm. About 4 ounces bourbon 11:30 pm. Asleep about 1 am, very strong and recurring hypnompia. At one point woke up realizing that hundreds of plastic wind up toys had been piled on me and around the room. I realized this was "all of the wind up toys," and that made sense to me. Tired and sleepy during the day (as in I could have fallen asleep for a nap).
• Night 4. Diphenhydramine about 10:00 pm, asleep about 1:00 am. Also a lot of greasy and high calorie food in the early evening (definitely over-ate). Also, doing very intellectually stimulating work while drinking bourbon (learning and writing about a detailed scientific subject). Very strong and recurring hypnopompia, even worse than previous night. I think episodes recurred from maybe 2 am to 5 am, which is much longer than normal. One of them, I woke up to a voice (probably my wife's, but a hallucination, of course) saying, "...but do you see a yellow light?" The smoke alarm which has an LED that is commonly part of my hallucinations seemed to have two lights, and the room appeared to be lit by a yellow light. This had an element of "aha" to me, as if things finally made sense. This is a common theme of my hypnopompic hallucinations...it's as if I know that I have had them in the past, but this time it's finally real, and I'm finally going to prove that all this time somebody really has been messing with me. But as I wake up and the illusions fade, I always, of course, know that it's a hallucination. Another one I had this night was I woke up just as "someone" was finishing painting the entire room a slightly darker shade. Somehow I could tell this was true. I quickly turned on the lamp to try to catch something, but didn't see anyone / thing and then woke up. I don't exactly remember the other episodes, but they involved real objects being slightly different, and I think each time it "proved" to me that something actually was going on. I found this all very annoying, and I don't think I slept much (for real) in the middle of the night. After that, I had vivid and memorable dreams, and in my dreams there was a lot of dialogue and me explaining past events to other characters, some real and some not real. Overall, I felt very tired and not rested in the morning (up about 8 am).

OK, so looking at this set of trials, it seems that a reasonable amount of bourbon isn't a magic bullet for getting rid of hypnopompia. It's possible that a lot (6 ounces plus) is effective, but that is probably too much to be healthy (although I do enjoy it). This is bad science unavoidably. There are so many other factors, such as time of bourbon dose, and diet, exercise, etc. the prior day(s). I also feel like the diphenhydramine isn't working any more either. Perhaps I will try some no-alcohol again and also try not eating in the evening (if possible).

Diphenhydramine (Benadryl) has some positive effects

So about four days ago, I decided to finally try diphenhydramine, which is the drug in Benadryl and over-the-counter sleep aids such as Tylenol PM. I knew that it had made me drowsy a few years ago when I took it for an allergic skin reaction. My motivation was that I was spending a lot of money on bourbon, and probably drinking more than the recommended 2 drinks per day. Alcohol seems to make me sleep better, despite the media reports and commonly held beliefs that it disrupts sleep. But probably the amount I need to drink is much higher than what is accepted to be the amount that is healthy. It's also tough to dose and because I enjoy being buzzed, it makes me happy to be awake...OK, back on topic:

For my diphenhydramine experiment, I first tried without any alcohol at all (although as far as my research has shown, there aren't reported dangers when combining with alcohol). Here are the results:

• Night 1: no alcohol, two pills (50 mg total of generic brand) at about 11 pm. Easily fell asleep at about 1 am, slept till about 7:30. No nightmares or hallucinations. In short, a good nights sleep! Felt like crap, though when waking...very dry mouth and sore throat. Thought I was sick, but turns out was just a side-effect. Did not bother me after being awake an hour or so.
• Night 2: two beers in evening, two pills around 11 pm, asleep by 1 am. Can't remember details, but was positive. Dehydrated feeling in morning.
  
• Night 3: four beers during the day (for bowl games), two pills around 10:30 pm, alseep around midnight, woke at 7. Hypnopompic hallucinations during the night, fairly strong. Happened repeatedly, with me quickly turning on the light to try to "catch" whoever was messing with objects in my room. Epic stress dream about school later in night. Still, though, felt like a decent night sleep, for some reason. Why?
  
• Night 4 (last night): no alcohol, two pills (50 mg total) around 10:00 pm. Fell asleep at midnight, woke at 1 am with strong hypnopompic hallucinations. I rarely have auditory hallucinations during these episodes (and if so, it's a fleeting voice that terrifies me). Last night, though, I woke up, and the LCD clock on an audio receiver was doing something strange, and I could hear a childrens song playing. So, I deduced that someone had come into my room and played this song on the machine...I think the auditory hallucination (which was vivid) lasted for 10 seconds or so, and the visual part (screwed up LED) a little longer. For some reason it alarmed me. Then I fully woke up and was still alarmed, but then amazed at the auditory hallucination. I don't remember ever having an auditory hypnompic hallucination that was musical (it always previously was a fleeting voice). Subsequently, I had one or more "regular" visual hypnopompic episodes, and then slept until 7:30 without nightmares, I think.

OK, so that is the current status of my diphenhydramine experiment. After writing it down, I realize that if anything, the outcome is worse hypnopompia. For example, a new form of auditory hallucination. However, for some reason, I remain excited about this drug, maybe because I have found it easy to fall asleep 4 nights in a row. Because this is an experiment on myself, and interpreted by my own brain, it's pseudoscience at best. But here are some other positives I am feeling:

• Decreased appetite. I typically find it very hard to resist eating when at home. For the past four days, I have found it very easy to resist eating. Especially late at night, I don't have any of the usual cravings (which are usually insatiable too). This would be a very welcome effect, if it persists, because even though I'm reasonably fit, I'm definitely a fatty at heart and would get very fat if I didn't have a conscious desire to not get fat and various strategies for limiting eating.
• Decreased appetite for alcohol. I have in mind to try the pills combined with a small amount of alcohol, but for some reason, don't "feel like it." I actually really enjoy a beer or bourbon, typically, but the past four nights, haven't felt like it at all. That is strange. Instead, I'm just like, "I'll take the two pills and see what happens."
• I generally just feel better. This could simply be due to more sleep than normal (despite the hallucinations), or because of the pills, or because of a desire for the pills to be magical. It's a funny contrast to the clonazepam, though, which ostensibly had the same effect on hypnopompia, but which I did not view positively at all.

OK, that's the up to date news. I plan on continuing the diphenhydramine for the next few days, and possibly trying in combination with a few ounces of bourbon at night (with hopes that it diphenhydramine will eliminate insomnia and bourbon will reduce chance of hypnopompia). Another thing I should mention is that I've been more motivated for running the past few days, finding it easy and enjoyable to run 6 miles after night 1, 0 miles after night 2, and 4.5 miles after night 3. Remains to be seen what I'll do today, but I am stoked about going running if I have time (man I've blown the whole morning on this blog, but hopefully will have a positive effect on someone).

Clonazepam did not help, possibly hurt

As I mentioned in previous entry, I finally went to see a sleep doctor because the hypnopompic episodes were very frequent and disruptive. I was thinking he'd prescribe a pill they advertise on TV, but surprisingly he prescribed Clonazepam, which apparently is very effective at treating non-REM (and also REM-type I think) sleep disorders (although more severe and dangerous than the ones I have). It's similar to valium, but more potent.

I have more details from a journal I kept, but for now, here is the brief recollection of the experiment:

• I tried the pills for two days first. No alcohol at all. First time, I actually got very sleepy within 1/2 hour of taking pill (0.5 mg pill), fell asleep right away, but had nightmares. Second night, I think I had insomnia (felt a little drowsy but couldn't sleep) and then had strong hypnopompic episodes. Both days I felt hungover (like from alcohol) and tired throughout the whole day. I was really busy at work, and couldn't afford to experiment anymore, so I quit the pill and just went into "not sleeping much" mode. Probably a couple days later I switched backed to alcohol (wine, bourbon) which definitely works better than clonazepam in my case (yeah, I do know alcohol is supposed to make you sleep worse, blah blah blah)
• I tried another experiment later for three days, again, without any alcohol at all. I don't remember the details, but I was convinced that the pill either didn't help or exasperated the hypnopompic episodes, and also seemed to trigger regular nightmares. Also, the whole-day hangover didn't seem to be getting better, which was worse than being just tired anyway. Combined with possible side-effects, decided to quit the pill.

So, overall clonazepam didn't help at all, which was disappointing, given the reported success with much worse problems.

Eye mask

Several years ago, when the hypnopompic hallucinations seemed to ramp up, I began trying a darkening eye mask. The thinking was that the hallucinations seem to build upon visible objects (often LED lights) in the room. At first I thought this helped. Now, I am not sure, because it seems like I will take the mask off because I "know" there are differences in the room that I need to look at. I use the mask, though, because I often sleep in daylight hours.

I should also mention that I am a very light sleeper. I use a white noise machine (an actual motorized fan) and put a pillow over my ear to try to deaden external sounds (such as dogs barking).

Other health history

In case it is relevant to find common factors, here is other health history:

• 6 general anesthetic surgeries from age 2 to maybe 14. First for "tubes" (myringotomy plus tube) for chronic ear infections. The final procedures were for a complete reconstruction of left eardrum and subsequently a patching of a hole in that replacement (tympanoplasty).
• Asthma and allergies (from young age), requiring a preventative inhaler (some crazy device that punctured a capsule and then made a powder mist when inhaling quickly) and allergy shots (shots around teenage years, I think). Parents also smoked in home. Got much better after adolescence. Asthma seems better in very dry air and / or high altitude.
• Some kind of allergic reaction to seawater and lake water...if swimming in ocean (or sometimes just being near ocean, specifically Atlantic, and actually also on Great Lakes once), severe asthma develops, worsening over course of days to point of consciously needed effort to breathe. Improved via oral steroid. Don't think it happens at Pacific ocean, but don't have theory as to why.
  
• Slightly high blood pressure. Around 130 systolic at 15 years old. Peaking at 150 around 28 years old, diagnosed as "white coat hypertension" i.e., no other negative effects were seen (via echocardiogram). Currently usually in the 130's.
• High cholesterol. Not severely. "Good" cholesterol is high enough, "Bad" is too high.
  
• Chronic heartburn, diagnosed at 15 years old as an ineffective cardiac sphincter (now called esophageal sphincter, I think) via upper-GI. Seems to be allergy-related. Worst heartburn caused by shrimp. Also guacamole, nuts (especially peanuts), most fresh fruits and veggies (especially carrots and bananas).
  
• Bladder stones (calcium phosphate I believe).
• Persistently cold feet and hands, i.e., colder than everyone else, and show up black on an infrared camera :). Also dry skin, especially on hands (surprisingly, seems better in dry climate, although also it is warmer).
• Allergic reaction to bactrim (sulfa drug)
  
• Back / neck pain
• Don't know if this is relevant, but vicodin seems to have little effect on me. First for painkilling, and then out of curiosity, took 3-4 times recommended dose when heathly and couldn't notice any effect. Also, nicotine has a strong effect on me (a buzz), but I notice not tendency for nicotine addiction.
• Don't use drugs (besides prescription), and drink a fair amount. Enjoy drinking.
  

OK, that's all I can think of now...not trying to sound like a hypochondriac, although I realize I do. Actually, I wonder sometimes whether I am, which is a very ironic worry.

Introduction and purpose

My goal with this blog is to post my own experiences with parasomnias (such as hypnopompia) and insomnia and various medications or strategies I have tried. I am hoping for two positive outcomes: first, any mild successes I have had may help others who land here via google searching, and second, readers' comments may give me and others better ideas.

I could go on and on with my history of sleep "disorders", which are all pretty benign compared with the really bad stuff you can get such as night terrors and REM sleep disorders. Mostly they just affect my amount of sleep achieved and don't endanger me or others. Here is a list of sleep things:

• Insomnia starting at about 8 years old. Often awake until 3 or 4 am and having to wake up around 7 for school, making me quite crabby. Parents had me see doctor and allergist, with no help really. This evolved into a sort of skill, where in late high school and college and grad school I could easily pull all nighters studying. Basically, I adapted to be productive instead of just laying in bed. More recently, bad insomnia has seemingly been less common for me, but I also don't try to go to bed at normal times unless trying a sleep med or something.
• Sleep walking as a child. Don't remember how common. Remember peeing in a few places I wasn't supposed to. Usually didn't get to far before really waking up.
• Vivid dreams. I have had vivid memorable dreams for as long as I can remember. I may have made this worse by writing my dreams down when I was about 15 or so. Sometimes I have what I call "epic" dreams, which seem to go on and on and when I actually wrote them down it took over half an hour even when forgetting many of the details. As a young child I had a recurring nightmare about a bald-headed alien with an anesthesia gas mask that wanted to put me under. I can remember having this dream maybe half a dozen times over maybe several years, until finally having a different dream where the voice of the alien apologized to me from inside a tree and said he didn't mean to hurt me and then I haven't ever had that dream again. (Yes, I know this sounds hard to believe.)
• Lucid dreams. Despite efforts I made as a child, I can't intentionally have lucid dreams. I do have them maybe a few times per year, but usually or perhaps always cannot control them. Maybe 50% of these are nightmares where I am being attacked and I can't scream and am trying to scream "wake up" but can't. These usually end with me grunting out loud and waking myself up. Over the past few years I will become semi-lucid in dreams that my father is in (he has passed away), because I realize that he is not alive...but I don't wake up and these dreams go on and are sometimes pleasant, often depressing.
  
• Waking hallucinations, starting probably in teenage years. As far as I can tell this phenomena is called hypnopompia (found on wikipedia: http://en.wikipedia.org/wiki/Hypnopompic). What I remember as a teenager is that I would commonly wake up and see someone skirt off into the other room, and then be terrified. I also remember waking up and seeing a ray of light coming through the window across the room (like a red laser beam). I would see it for a while and then it would fade, this was maybe alarming but not scary. In both of these cases, I very rarely got out of bed to go investigate the intruder or light source. It's as if I'm too lazy/tired to do something even though I know I should...and then within a minute, I usually realize I was hallucinating. I also view this as "lazy sleep walking." These hallucinations mix in with the actual real objects in the room (superimposed).
  
• Waking hallucinations, later years and currently. Interestingly, I don't really remember hypnopompic problems during my undergraduate years. At the same time, I started exercising a lot and also drinking a lot (regular college binge drinking)...don't know if either of those tempered the problem. I also don't know if I'm just forgetting the symptoms. I probably pulled about two all-nighters per week, though, so I was usually really tired. I don't remember any sleep walking. I do remember vivid "epic" dreams. More recently (grad school and later), the hypnopompic hallucinations became more vivid, and probably longer lasting. I think also they became more frequently non-alarming but just absurd or bothersome. For example, a whole bunch of books stacked all over the room. I would usually blame these on my wife (as opposed to an intruder) and get a little irritated that she had done all this while I was sleeping. Then within a minute or so, the images fade and I realize it was just a hallucination. Usually after fully waking I'll go ahead and go to the bathroom since I'm awake anyway. I think these hallucinations usually occur between an hour and 3 hours after going to sleep.
  The absolutely most vivid hallucinations occurred after a multi-day rafting/camping trip through scenery that was absolutely amazing and completely new to me. These hallucinations were in a class of their own due to: (a) vividness and (b) long-duration, well past the point where I realized I was hallucinating. I could literally look around the room and examine features of landscape that I knew was an illusion. These were amazing and not at all unpleasant. I chalked this up to the fact that some parts of my brain were over-stimulated by so many new kinds of images reinforced over a few days. This ability faded over the course of several days, and hasn't returned.
  Within the last couple years, the hypnopompic hallucinations seemed to increase in frequency to the point where many days would go by where I felt like I had these every night and multiple times per night. Finally I went to see a sleep doctor who recommended clonazepam, which I will talk about later (and didn't work). Commonly, these hallucinations are extensions of dim lights in the room (such as light on smoke alarm, and LED displays on electronics, such as clocks). I believe I have these more in rooms I am accustomed to, versus hotel rooms, for example.
• Hypnogic hallucinations. As I understand it, these are very common--hallucinations while drifting off to sleep. I have mine with my eyes closed, and I know they are not real. Commonly they are faces, though I don't think recognizable. The only perhaps remarkable feature of mine are sometimes they are incredibly vivid, and sometimes I am able to control them slightly. Also remarkable are auditory hallucinations I have either at a similar time, or maybe slightly earlier than a visual hallucination would occur. These auditory hallucinations are always voices talking, usually in short phrases or single words (such as my name). They voices are not controllable, but seem "almost controllable," as if I think a phrase I may hear a voice say it, but can't pick the voice (I think often the voices are recognizable to me). These too I know are not real.
  
• Insomnia recently. I feel like my insomnia isn't as bad as it used to be, and I think I am better about (a) not trying to go to sleep too early and (b) not letting my mind race while falling asleep. I do still have trouble, and I dread when I know I have to wake up extra early the next day. This is what makes me really want a good sleeping aid, combined with the sense that now that I'm in my 30's I can't handle all-nighters nearly as well as I used to.
• Other relevant info: I actually seem to have little trouble staying asleep once I've passed the hypnopompic stage. So, if allowed, I could sleep 8 hours easily. Without any other constraints, I think my optimum sleep cycle would be to sleep 6 am to 12 pm, which I actually did successfully for a while in graduate school. I don't think I every have insomnia at 6 am.
  

OK, I think that is a good introduction, and in the following posts, I'm going to put a bit about treatments I've tried.