I refer to “The Nightmare” throughout my discussions on PTSD. The whole insomnia, pain and depression triangle of evil are fueled by each other, a synergistic effect where 1+1+1 = 5, not 3. The symptoms of one being the result or cause of the other. Like nightmares, or night sweats, or flashbacks.
Insomnia has plagued me for a long time, but in the last 5 years has taken on a whole life of its own. My physical pain has joined forces with the mental anguish. The old cure for lack of sleep is a simple night of drinking heavily. But everyone knows a good night’s sleep from being drunk isn’t a good night’s sleep at all.
Now without alcohol to ease the insomnia, my self-medicating, the doctors are relying on various concoctions of drugs to do the trick. There seems to be a subconscious thought that fights my going to sleep.
Deep sleep, also known as Stage 5 or REM sleep is where dreams occur. This is when your mind fully processes the day’s events into bytes and memories. I’ve learned about the 5 stages of sleep from working with my neurologist, Dr. L. His role in managing my health has expanded beyond the need to help with sleep apnea. He’s a whole body doctor, and realizes the pain and depression need to be better managed before he can work on the apnea.
This past year I came close to dying because of the apnea, alongside a dose of morphine and a high on a ketamine infusion. Close, but there’s another story behind that, ketamine for PTSD.
I am stuck in Stage 4, and there is no physical cause of being stuck. I’m in a twilight zone actually, drifting between the two stages. Oh there’s plenty of physical pain that hampers my getting to sleep, or that may wake me. Plus a bad case of sleep apnea mixed in.
I firmly believe that the part of me that is terrified to sleep, is deeply rooted from the trauma of my childhood, yet another symptom of PTSD. The shame and guilt that I tried to bear as a result of wrongful thinking. The very real belief that somehow that I, even as a seven year old, was the cause of what befell me. That guilt carried into the dreams, and one dream in particular seemed to recur more than others. It probably didn’t happen that often but it left the biggest mark.
The Nightmare (I feel it needs its own proper name) is always the same. The last in a string of other dreams during a night, but the only part I remember. The dream starts when I awake in the hospital ward in 1964 and I can easily picture the scene as I write this. It’s burned into my memory from the Nightmare and EMDR.
In the dream I am waking alone and afraid, and need badly to go pee. But I am in the hospital ward, and the same man in the blue bathrobe goes through the exact same routine in this Nightmare of mine. He leads me down the dimly lit hall in the middle of the night. The hospital corridor, totally vacant of activity and lights dimly lit. I take all the same steps, leading me to the door of the restroom.
I go up to the urinal, where I stand on tiptoes, needing to pee desperately but can’t. But in the Nightmare, as the shaking begins, I believe I can stop what’s going to happen. If I can only pee then what follows will not take place. If I could be good. Be a good boy.
But the shaking only intensifies as the man’s frustration grows. But I can’t pee from pain, the exploratory test with the ureteroscope had done some damage. Remember the year, 1964.
In the warped belief that this will be the only way to stop the rape from happening, simply going to the bathroom, I pee. In the Nightmare. And in real life, while sleeping. Wetting the bed in a deep Stage 5 REM sleep.
I am awoken once again by the feeling of warm water soaking my pajamas. Some nights during the Nightmare I wake up just in time, but many I don’t. In a drunken state I wouldn’t wake at all.
As a child growing up both my mom and aunt dealt with it quietly. The Nightmare and bedwetting starting shortly after the rape. I used to cry, feeling more shame and guilt, but the crying ceased as it became a part of life. Neither woman raised their voice, lectured or punished. It became a chore.
How often? Maybe once a month, if that. Hiding the wet clothes and bedding until dad left. His knowledge of wetting the bed would have meant punishment, probably the belt, and disgrace.
I’ve never fully escaped the Nightmare and without alcohol to knock me out I use the next best method. I quit sleeping. With the added pain, restless legs and fear of going to sleep many nights are 3-4 hours spread out in one hour increments.
Has the bedwetting stopped? The last time was 6 months ago, and of course it was the same dream, the Nightmare. This time it was just the pajama bottoms, as I awoke when it started. Cleanup, change sweatpants and crawl back on the couch to try to sleep.
I’ll tell my wife in the morning, and she goes about quietly cleaning up the mess, doing the laundry. Never raising her voice, another chore.
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