Getting cranky about the things that keep us awake
By Sarah Fay
March 1, 2008
Insomniac, by Gayle Greene, University of California Press, $29.95
According to Gayle Greene’s new book, Insomniac, the ancient Egyptians believed that one of the three living hells was “to be in bed and sleep not.” Even the Pharaohs’ tombs were replete with soporific herbs. Human beings, it seems, have always feared sleeplessness and have adopted myriad remedies to overcome it. At one time people actually brushed their teeth “with the earwax of a dog” to coax sleep. In addition to accounting for such historical remedies and those available now (we no longer drink hemlock, but valerian root is still around), Insomniac is a compendium of the social, physiological, and psychological factors that contribute to sleeplessness. The book thoroughly investigates the current medical research on the disorder. But what makes Greene’s method different is how she weaves together two seemingly disparate genres—the science essay and the memoir—to convince readers that insomnia needs to be taken more seriously and indeed should be treated as a physical disease akin to diabetes.
In her book, Greene, professor of literature and women’s studies at Scripps College, reports on her experiences of scouring libraries; attending conferences in Chicago, Prague, Minneapolis, and Denver; talking to researchers and doctors at the forefront of what’s known as sleep science; spending a night in the Stanford Sleep Research Center; and trolling insomnia Web sites and blogs. She examines the benefits and risks of insomnia drugs, herbal supplements, and behavior therapies (such as sleep hygiene). Each of these treatments seems promising but can be compounded by such troubling side effects as an irregular heartbeat, depression, sleep-eating (one Ambien patient reportedly ate an entire tub of margarine), and the kind of rigidity that can destroy one’s social life.
Greene presents a surfeit of information—who knew that each of us is born with a specific sleep propensity or that people can die of insomnia? She delves into the history of sleep culture—at one time people had two phases of sleep separated by a “meditative period” or a social hour during which many visited neighbors or had sex—but she abandons the topic after five pages. At times the book reads like a Google search gone mad, and this busyness muddles her arguments. For example, Greene writes, “Americans work harder than anyone, even the Japanese. Since 1969, we’ve added 150 hours to the work year.” It may be true that Americans work more hours, but Greene makes a leap when she concludes that this, combined with the fact that we carry laptops and cell phones (the Europeans and Japanese don’t?), proves that we work “harder” and therefore suffer from insomnia. According to an oft-cited BBC News report from 1999, Americans worked more hours but lagged behind Europeans in productivity. Greene does not cite a study that tracked how the number of hours worked affects sleep. In addition, Greene’s working premise—that sleep deprivation among Americans is at a crisis point—is not shared by everyone. Although 10 to 15 percent of all Americans suffer from some chronic sleep disorder, A. Roger Ekirch, a historian from Virginia Tech, wrote in a New York Times op-ed piece in 2006: “In all likelihood, we have never slept so soundly. Yes, the length of a single night’s sleep has decreased over the years (upward of 30 percent of adults average six or fewer hours), but the quality of our sleep has improved significantly. And quality, not quantity, sleep researchers tell us, is more important to feeling well rested.”
In her research Greene discovers that nobody really knows the causes of and effective treatments for insomnia. No specific neurotransmitter or genetic cause has ever been found. Researchers do not even conduct postmortem studies because they do not know what to look for. Greene writes that our brains have “no single ‘sleep center’: sleep is diffuse all throughout, a process or an array of processes and interactions among various areas of the brain, an elaborate dance of neurotransmitters, some of which take center stage at some points, others at other points.” As she discovers at the sleep lab at the University of California at Davis, there are simply “too many missing pieces” to pinpoint the “multifactorial” nature of sleeplessness. Greene is at her best when she seeks out the mysterious ways sleep eludes us rather than when she seeks a cure-all.
Greene has a full agenda. She wants doctors to stop viewing sleeplessness as a bad habit for which the sleeper is to blame and wants researchers to admit that sleep disorders are different for women, especially just before ovulation when the hypocretin system, which controls appetite as well as “the wake up neurotransmitter,” is stimulated. She also wants researchers to find the weak or defective mechanism in the sleep system that is responsible for insomnia and calls for development of a drug that will “precisely target [insomniacs’] specific problems.” Greene makes her case in part by relaying her own experiences as an insomniac. Like any protagonist, she wants something, and we want her to get what she wants. But employing this personal narrative undermines her objective. Greene describes how at the first conference she attended she had to “haul” herself out of bed to make various breakfast meetings. She grumbles about the Stanford sleep clinic asking her to sleep outside of her usual sleep pattern, which is 3:00 A.M. to 10:00 A.M. As a university professor, she reluctantly acknowledges, she has an unusually flexible schedule but has difficulty attending the 9:00 A.M. faculty meeting once a week. When she claims that researchers must make the case for insomniacs so that employers will permit them to “do the work on [their] own time” and likens such accommodations to “wheelchair ramps or larger bathroom stalls” for the disabled, she resembles the “mere neurotic” with “less incentive to change” described by an unnamed Berkeley psychiatrist. Ultimately, Greene’s personal story trivializes the larger points she wants to make.
To her credit, Greene admits that this is a “cranky” book and that she is perhaps not the best test subject. Despite the positive side effects of behavior therapy (“improvement of mood and daytime functioning”), she dismisses it as depriving her of “the only latitude in her life.” Though she hyperbolically declares that she would have “sold her soul for sleep,” she refuses to give up wine or leave parties early so that she can have a regular sleep schedule. Confusingly, she concludes, “I love sleep too much to voluntarily restrict it for the rest of my life.”
Though Insomniac sets out to remind us that sleep is precious and that not getting enough of it can be akin to the most debilitating physical disorder, it ultimately shows us something else. Often, we are comforted by a “victim status” that relies on the medicalization of the body, emotions, and experiences. Despite all of the steps Greene takes and the vast amount she learns, she is not soothed. One cliché in American culture is that we should always get all of the information, but this book shows how that can sometimes do more harm than good.
Sarah Fay is an essayist whose work has appeared in The New York Times Book Review, The Paris Review, and BOMB.
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