This week has been a busy and tiring one with journeys, meetings and a conference. It is not surprising that I have been falling asleep at every opportunity; on the train, in the car and in public. One particularly tiring afternoon, I woke up just in time to avoid falling off my chair at a conference. I was not alone, and others were sleeping fitfully. I drifted off on several train journeys waking up with a start wondering if I had missed my station or whether the whole carriage had heard me snore. My Pilates class on Tuesday had some moments on concentrated activity when we stretched out our rigid muscles, but the moment we lay on our backs, I dozed off rudely missing the instructions.
Nodding off, snoozing or having forty winks (referred to medically as daytime somnolence or sudden sleep attacks) are habits I had planned to resist in middle age, until I got Parkinson’s Disease (PD). If there was an Olympic medal for nodding off, I would get Gold. It has very little to do with boredom; I have even nodded off while in the middle of this paragraph but just for 10 seconds. Like all of my Parkinson’s symptoms, sudden sleep attacks are a nuisance and often embarrassing,
Somnolence is a well-recognised feature of PD and thought to be related to neurodegeneration and PD medication. Unlike the nodding off that hits many people after lunch, the attacks are sudden and can occur anytime and anywhere. For me, the most likely time is when my medication is working well. I have nodded off in many locations, but it usually happens when I am sitting comfortably in a warm room or a car with a dry atmosphere which causes my eyelids to drop.
I recollect first being affected by this not long after my diagnosis. It involved an irresistible urge to fall asleep, with very little warning. I would drift in and out of my dream world for a while and the distinction between being awake and being asleep became blurred. In my case, it was not real sleep, but a mental shut down for just a few seconds during which time I could continue talking, eating or writing. I have fallen asleep mid-sentence while using voice recognition and when I started ‘sleep-marking’ I realised it was time to give up teaching.
My husband is used to driving with a comatose passenger, but on several occasions I have been awakened by the unexpected. Once it was alarming to wake up in the middle of a ford that had turned into a raging torrent. It was quite surreal; a magical marital moment when I was lost for words as the car spluttered to a halt.
But nodding off in the car can have serious consequences for a driver as I discovered five years ago. On this occasion, I woke up in a hedge having fallen asleep for just a few seconds, but enough to smash in the side of the car and knock down a large sign and push it thirty meters along the road. Fortunately, I had no injuries, neither did I experience any shock, presumably because I missed the whole event. Some paramedics checked me over and the police breathalysed me, much to my youngest son’s amusement when he arrived on the scene to help. I was none the worse for this accident.
The rest of that day, I felt fine, but that night I began to realise that falling asleep at the wheel was nothing new and many times I had yawned my way home through the rush-hour struggling to stay awake. This had been an accident waiting to happen, and next time I would not be so lucky. I discussed the risks of driving with my GP and we concluded that it was too risky for me to continue. I surrendered my driving licence in May 2007 and have not missed driving thanks to my friends and a fantastic local bus service.
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