• Hypnic jerk (and a plantar fasciitis update)

    This is one of those N=1, my health story posts. If that’s not your thing, skip it. I like to document this stuff, as it’s how I “enjoy” my health problems. For those more interested in my plantar fasciitis story, see the very end for an update I’ve been meaning to provide for a while now.

    It seems to be my lot in life to experience all the major sleep disorders. I’ve already had and cured/addressed insomnia and obstructive sleep apnea. Now I get to “enjoy” persistent hypnic jerks (a.k.a., says Wikipedia, sleep starts, hypnagogic jerks, and predormital myoclonus). That’s the wonderful condition in which some of your muscles involuntarily and rapidly contract (jerk) just as you’re drifting off to sleep.

    No big deal if it only happens now and then and/or you sleep through it. I suspect hypnic jerks are pretty common, though I haven’t found a prevalence estimate I trust yet.

    What’s undoubtedly less common is to experience them every night, all night, causing the loss of many hours of sleep. Lucky me, that’s what I’ve been experiencing for over a week.

    Unless I’ve got some deeper disorder (doc visits pending, which may land me in the sleep lab again), my guess is it started from anxiety and stress, which are documented risk factors, among others that don’t seem to fit for me. It’s been a challenging few weeks.

    Another risk factor is fatigue. Well, if you are awakened by hypnic jerks every night for long enough, you’re going to be fatigued! I think I’m now in that vicious cycle.

    Magnesium is supposed to help, and some nuts (e.g., almonds and cashews) are full of it, so I’ve upped my intake. Doesn’t seem to have done much of good. There may be medications that could help (my docs will advise me on that). I do know from experience that Ambien will knock me out, and if I’m having them while on a full dose of it, I sure don’t notice! But that’s not a long term solution.

    None of this is good for a fragile sleeper like me, prone to insomnia. Wake me up enough in the night and I will definitely stay awake. Do it to me night after night and I’m re-digging that sleep maintenance insomnia groove I worked so hard to pave over.

    Concurrent with this, I’m probably experiencing the sleep-related signs of aging. And as one ages, melatonin levels fall, making sleep maintenance more difficult (or so I’ve read somewhere or other*). Another consequence of low melatonin is raised body temperature in the middle of the night (again, or so I’ve read somewhere*). I’ve been noticing both issues for much of this year, apart from allergy season during which I am blissfully drowsy enough all night to sleep 9-10 hours without a problem. I never thought I’d say it, but bring on allergy season!

    So, maybe melatonin supplementation is in order? I’ve started experimenting, but don’t have enough data to support results. I can say that years ago I tried it at bedtime and hated it. Made me feel like crap. Maybe the dose was too high. I don’t remember. Doesn’t matter, what I needed was CBT for insomnia and that’s what I eventually did. This time I’m trying something new: taking a dose if I wake before 2:30AM, as it only stays in one’s system for about 4 hours (or so I’ve read somewhere*). Last night, at 1:30AM, I took a very tiny dose, 75mcg (yeah, I split a 300mcg pill in quarters). I still didn’t sleep much between 1:30-5AM (because, you know, hypnik jerks), but I didn’t get hot, so that’s something. I think tonight I’ll double my dose.

    It’s a blessing I take few things personally, because “hypnic jerk” sure sounds pejorative. But it fits me to a tee.

    Other notes:

    • * Clearly my research is far from thorough. I’m just too busy. A little N=1 experimentation won’t do any harm and if something seems to work, I’ll dig into the research. In the meantime, I’ll be clear when I am not going on much and don’t trust any statements so annotated.
    • On that note, here’s a hypnic jerk review article I’ve yet to read.
    • On plantar fasciitis: As some of my posts earlier this year suggested, I don’t have it. I probably never did. The symptoms never matched. What I had/have is undiagnosed. Let’s call it an allergy to highly structured footwear. Basically, my feet hate closed-healed shoes and significant arch support, particularly support further toward the heal. Xero Terraflex shoes are the best I’ve found, perhaps because the footbed is so flat and wide in the heal. Oddly, Merrell barefoot shoes bother me, maybe because they’re just too tight in the heal. Most sandals are fine. Of those I’ve tried, Echos are the best. The contours of Birkenstocks don’t bother me. Keans are borderline. With waterproof socks, I have even worn sandals in the snow. It’s no problem at all! No, it’s not my fashion choice, but happy feet are worth it. Plus, I really don’t care what other people think.

    @afrakt

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