[mikelevins]

One of the other weird things I referred to is best described as discovering that I could be awake and asleep at the same time. I think it might be another case of our naive ideas about cognitive processes being a little oversimplified.

It sounds like nonsense, of course, but that's because we naively assume that sleep and wakefulness are opposites--that they are mutually exclusive. What if we're wrong about that? What if instead each of them is a set of processes that normally work together, but that can be disrupted, and what if disrupting them makes the boundary between them more porous?

I have CFS, which boils down to having something screwed up in my recovery from fatigue. Nowadays it's not a big deal, as long as I follow some rules, but it took the better part of a decade to reach that point. For several years I used prescription modafinil and armodafinil to control when I was awake (because otherwise I slept eighteen to twenty hours a day).

With the modafinil I managed to reach a stable state where I could usually be awake for a fairly normal part of the day, but a couple of times a month I'd get so tired that I'd fall asleep even with a full dose of the stimulant in me.

Those naps were weird, though, in that I remained conscious through them. I mean I'd lie down, relax like normal falling asleep, and start breathing in that distinctive arrythmic way that tells you someone's asleep. I would just be awake the whole time, watching myself sleep. I experimented with trying to move when I was "asleep". Sometimes I could; sometimes I couldn't.

You can imagine that I really was asleep, and maybe the stimulant just caused me to dream that I was awake, watching myself sleep. The main problem I have with that explanation is that I have never in any other circumstance experienced dreams that were so much the same over and over, and without the usual fantastic elements.

Of course, you could argue that was the modafinil affecting my dreams, and that could be true.

But my hypothesis is similar to the migraine and scotoma blindsight thing: what if awake and asleep are not opposites, after all? What if they aren't actually mutually exclusive? What if, instead, they're just two complexes of cognitive and physiological states that don't normally happen at the same time because they interfere with each other? It's not useful for them to happen together, so our bodies and brains don't normally do that. But mix a strong CNS stimulant with extreme fatigue, and things get messed up.

If it was actually happening, and not some weird drug-induced dream or hallucination, then it strikes me as another case where our cognitive processes are a little more complicated and messy than we normally assume.

[claylimo]

Being aware while asleep is something that can happen to advanced meditators. The more aware you are the more you are there is no difference between being awake or asleep. I haven’t heard it brought up in any other contexts except maybe for lucid dream practitioners. I’ve also read accounts from those who have done dark room retreats where perception of being awake and asleep blur and the perception of what you are experiencing has a lot of mind generated in experiences that can seem very real, dream-like, or using Buddhist language, empty.

[mikelevins]

I went to school at Naropa University, where a lot of meditation was part of the required curriculum (at least, when I was there; I have no idea what it's like now). I never experience the awake/asleep thing in connection with meditation, either at Naropa or in meditation practice outside the school, but I doubt that I could be in any way considered an advanced meditator.

[claylimo]

Should be clear: not every advanced meditator experiences this and is not a prerequisite to be “advanced”. It would just not be unusual if it did happen.

[derangedHorse]

You should try and play an audiobook before you lay down to rest and see if you can hear and remember what's being played. Echoing another comment describing this as similar to sleep paralysis, playing things while I'm "asleep" and recalling them once awake has led to successful results

[stavros]

I've been awake while asleep too, that's what sleep paralysis is. Sounds like it was a bit different for you, in that you didn't wake up to it, but it sounds like the same experience otherwise.

[mikelevins]

Right; in my case I would instead be awake but very tired, and I'd lie down and go to sleep without losing consciousness. The first time it happened I assumed it was a unique one-time experience, but it happened again several times.

It never happened, as far as I can remember, before I developed CFS. It never happened when I was not taking modafinil or armodafinil.

[barry-cotter]

Sounds like multiple PhD theses/journal articles could be mined from CFS + modafinil.

[mikelevins]

I know what you mean, but I don't know how the heck you could arrange for just the right combination of large doses of modafinil and profound exhaustion at just the right times.

To give you some idea of how profound my fatigue was, let's start with the fact that I've been extremely sensitive to stimulants of any kind since I can remember. A can of coke past 8PM would keep me awake half the night. It's a trait that I apparently inherited from my mother and passed on to my daughter.

After I developed CFS, I could take a full dose of an amphetamine and sleep like a baby. I know because amphetamines were one of the alternatives my physician tried for controlling my sleepiness and attention problems.

Modafinil and armodafinil are the drugs that worked for me. By the way, please don't anyone assume that they'll do the same thing for you that they did for me. Everybody's different. Talk to your doctor, not some random internet storyteller.

[sjg007]

Is it the caffeine or the sugar when you drink the can of coke or both?

I've found sugar to be way worse for my insomnia than anything else. Caffeine does play a role but excess sugar really revs me up ironically.

[mikelevins]

It was definitely the caffeine. For example, a can of Diet Coke was just as bad. I also know from experience with other stimulants that I was just extremely sensitive to stimulants in general (and so is my mother, and so is my daughter).

Not anymore, though; not since I developed CFS.

[aaaaaaaaata]

Are you actively seeking replacement ideas for underlying causes of the CFS, or are you good with what's established?

[mikelevins]

I guess I would say that I'm interested in a desultory way, but without urgency.

I've achieved a good adaptation to it, and my life proceeds mostly as if I didn't have it now, as long as I observe some rules: regular schedule, good nutrition, regular low-impact exercise. (If my exercise gets too high-impact then I cross into the kind of fatigue I cannot easily recover from.)

I do follow science and medical news related to it. The present state of affairs as I currently understand it is that it's still a syndrome rather than a disease, which basically means it's a big bag of symptoms without an agreed-upon underlying cause or mechanism. There's some evidence that ties it somehow to the Epstein-Barr virus (and, perhaps coincidentally, one of my kids had mononucleosis in the months before I developed the syndrome). There's also some evidence that suggests that susceptibility to it is heritable. Some researchers have hypothesized that it's an epigenetic disorder--that is, a genetic disease that is activated by an environmental trigger (such as a viral infection--a large fraction of CFS cases start with a viral infection).

Someone published some work that claims that folks with CFS have distinctively abnormal calcium metabolism, which might account for the difficulty recovering from fatigue.

There are still some people who think it's psychosomatic, or mostly psychosomatic, too.

That's about as much as I remember off the top of my head. As I say, I'm interested, but not urgently so. I seem to have found my accommodation.

[r6203]

I could be wrong but the experience you're describing sounds like lucid dreaming.

[mikelevins]

No, it's different. I'm an experienced lucid dreamer. I'm also an experienced practitioner of shamanic drumming and the associated waking dream states. It's not the same as that, either.

[joveian]

I have several serious sleep issues including insomnia (not usually due to racing thoughts, just inability to sleep) and circadian issues. What you are describing sounds like what I call "half sleeping", although I can always move if I try (I'll also usually unintentionally wake myself up rather quickly when lucid dreaming and can then move almost immediately; I definitely do not have sleep paralysis, although possibly it is similar but not being able to move). This happens to me quite a lot, maybe even almost daily (sometimes multiple times). I think at least some cases of "day dreaming" are a similar state as well.

Both going to sleep and waking up I often notice this state; when going to sleep, I'll either stay that way long enough to actually get to sleep (usually only a few minutes I think, possibly 15-30 minutes at most on rare occasions) or unfortunately I often unintentionally wake myself up from that state (on those occasions it feels a bit like I have a fear of sleep). After I have slept for a while I am more commonly in that state for 15-30 minutes at a time and maybe sometimes longer, it is hard to remember (total time a day can be longer but I will fully wake up or sleep for a while in between). My memory for sleep related stuff is likely much better than most people due to the decades of insomnia, however it still isn't that good (nor is my memory in general after so much sleep trouble). I think my sense of time is fairly accurate in that state and it is often how I decide to consider it half sleeping or sleeping for my sleep log (I'll often look at a clock before it happens and if the next time I look at the clock it is a fair amount later than I expect then I was likely sleeping, although sometimes when near sleep I've looked at the clock and clearly seen a different time than it actually is so that might be the issue at times as well; the clock thing is not just lucid dreaming since it often happens when I'm standing up on the way to the bathroom). My understanding is the way sleep is defined it is possible at times to maintain awareness between being awake and in light non-REM sleep so I am also not 100% sure that "half sleeping" isn't technically sleep.

My understanding based partly on looking at some research (although I'm hazy in my memory at the moment so definitely look into any particular point if interested with the idea that I might be remembering incorrectly) is that there are a number of independent processes that are usually orchestrated fairly well into what we call sleep. There are a few parts of the brain that coordinate sleep and circadian rhythm, including a part of the hypothalamus. IIRC what we consider to be falling asleep may be closely connected to a state of the thalamus that is exclusive with being awake, but other parts of the brain can indepenently be more like being awake or more like the various non-REM sleep stages. This can happen the opposite way as well with "microsleep". When particularly sleep deprived I'll often involuntarily nod my head down a bit and microsleep in what feels like much of my brain while generally still aware of my surroundings. I think microsleeps may also cause the loss of working memory at times when sleep deprived and various other short term oddities. REM sleep is a different thing entirely with movement inhibition based in the brain stem and where the brain is otherwise mostly in its awake state. While dreaming is more common in REM sleep it is yet another independent mechanism that seems related to dopamine. The memory changes with sleep might be yet another usually connected but distinct mechanism. Sleep also isn't just neurally activated but there are a variety of endogenous sleep promoting and wake promoting substances. So definitely more complicated and messy than we usually think of it with a collection of sometimes mutually exclusive states none of which fully correspond with what we consider to be sleeping.

[mikelevins]

This all sounds pretty much consistent with my guesses about what was happening. In particular, I'm predisposed to agree with your idea that sleep is a bunch of different processes that are normally well-coordinated. I hypothesize that the combination of my Chronic Fatigue Syndrome and the doses of modafinil disrupted that coordination, resulting in my experience of being awake and asleep at the same time.

Of course, just because we both came up with similar hypotheses doesn't mean we're right, but I'll take it as a tentative working theory for now.