Sometimes I feel like my days are nothing more than elaborate rituals to prepare me for bed time. Extreme sleep deprivation was one of the most intolerable consequences of my sciatica. It takes some work to quiet the nerve, but I’ve also become zealous about making sure nothing else prevents a good night’s sleep. I get royally pissed off if my nerve is behaving but some other factor keeps me awake.
I start my day with peppermint tea rather than coffee, because caffeine irritates my nerve. I stand to eat to eat my breakfast, and then either walk, stand, or lie down to work.
In the evenings I will either go for a walk or do some gentle weightlifting exercises to warm up my muscles. I have a stretch routine that I do before bed. I also drink at least 32 ounces of water at night to be sure I’m not dehydrated.
There is exactly one position I can sleep in. My husband calls it vampire mode; I lay on my back with my spine straight and my hands at my side. My legs are shoulder-width apart. For my pre-sciatica life I slept almost exclusively on my left side so it took some retraining to be comfortable in this pose.
Since I’m limited to one position I make that position as comfortable as possible. I sleep on a couch rather than a bed since I can wedge myself up against the side if I need a slight change in how my weight is distributed. I place a small pillow under my ankles, otherwise my heels dig into the cushions and drive me crazy.
I wear a sleep mask so light doesn’t wake me. I wear earplugs so noise doesn’t wake me. If it’s particularly noisy (for example, if I’m staying in a hotel with thin walls or the neighbors are having a party) I also put on noise-canceling headphones (yes, over my earplugs) and listen to my Relax Melodies app.
I’m not above pharmacological intervention, though these days I stick with OTC meds. I take Benadryl shortly before bed, which has the dual effect of knocking out my allergies (which have always been particularly atrocious) and zonking me out.
At the end of a sunless winter day or after I’ve been texting too close to bedtime I take melatonin. In other situations I don’t find it particularly useful.
When I was still visiting doctors and exploring standard medical treatments I was prescribed a few pills that could push me over the edge into sleep. I don’t regularly take these now, since lifestyle changes work better and don’t come packaged with annoying side effects.
Lyrica and gabapentin were both prescribed to help with the nerve pain and both cause drowsiness. Gabapentin worked better for me, and I hated the side effects less, so I did use it for a time. I was also prescribed cyclobenzaprine as a muscle relaxant. Now I save cyclobenzaprine for exceptional circumstances (such as after a flight) when it can push me over the edge into sleep.
Valium is hands-down the most effective med I’ve tried, both for managing cramps and knocking me out. It’s not an appealing long-term solution, though, and I’ve only taken low doses a handful of times.
One thing I haven’t tried, but would be open to, are sleeping pills. Again, I see this as an emergency option, to be reserved for situations like international flights. So far, my doctors have not been willing to prescribe them since I was taking other meds, but I haven’t exactly exhausted all opportunities there.