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Sunday, March 23, 2008

The Wretched Life of the Insomniac

Last year, I spotted an interesting report about ways to treat insomnia without drugs. I wrote about it and quickly learned how devastating an illness insomnia really is. Hundreds of readers shared their stories of wretched nights awake and a medical community that offered no real answers. Writer Gayle Greene’s new book, “Insomniac,” from the University of California Press, is both memoir and investigation into the world of insomnia. Here is an excerpt. — Tara Parker-Pope

By Gayle Greene

The first thing to go is your sense of humor. Then goes the desire to do the things you used to do, then the desire to do anything at all. Parts of your body ache that you don’t even know the names of, and your eyes forget how to focus. Words you once knew aren’t there anymore, and there’s less and less to say. People you once cared about fall by the way and you let them go, too.

INSERT DESCRIPTIONGayle Greene, dozing off. (Hannah Graves)

Insomnia is a problem most insomniacs don’t want to talk about. In fact, it’s a problem many of us don’t know how to talk about. “Oh, you know, a bad night,’’ I say to a colleague’s “What’s wrong?” on one of my walking-into-walls day. “Why, Gayle, what do you have to lose sleep about? You’ve got no problems,” says my colleague, eyebrows raised. If I’d been up with a bad tooth or a sick child, that’s something he would understand. If I just plain can’t sleep, that’s weird. Anyhow, chronic insomnia is not just ”a bad night.” Chronic insomnia is a bad night that goes on and on.

Look on the Web, read what insomniacs say on Sleepnet.com and Talkaboutsleep.com, and you’ll find stories of lives wrecked by this affliction, marriages ruined, educations abandoned, jobs lost, careers destroyed. We reach for metaphors, analogies, figures of speech to say what it’s like. “It’s like someone opened a tap at the bottom of your body and just tapped out all the blood, and it’s just gone, there’s nothing left.” “It’s like I’m wasting away, slipping away, losin’ it.’’

Insomnia has been with us as long as we’ve had language. Ancient Egyptian hieroglyphs record a lament for “three living hells,’’ one of which is “to be in bed and sleep not.’’ Insomnia may come with the territory of being human, but it has, for a variety of reasons, become the plague of modern times. Surveys indicate that about a third of the American population suffers with it enough to complain about it, and that as many as 10 to 15 percent have it chronically. Among the poor, the female and the elderly, the incidence is much higher — in people over 65, estimates are as high as 60 percent. Since there are no outward and apparent signs for what we have, no wounds, scars, crutches, casts, wheelchairs, this is an invisible epidemic.

Insomnia is not seen, and it’s certainly not heard, since insomniacs are not speaking out. “Insomniacs are seen as neurotics who should have more willpower,’’ says Stanford researcher Richard Coleman. “Knowing that they’ll be granted little sympathy if they mention some of their miserable daytime symptoms…or ask for sick leave, insomniacs tend to keep their sleep complaints to themselves.’’

Friends and family weigh in with advice. “A little warm milk — puts you right out.’’ Or, “A shot of whiskey does the trick.’’ “A hot bath…” “A big plate of pasta…” “Have you tried melatonin?”

“If there’s any illness for which people offer many remedies,’’ says a character in Anton Chekhov’s “The Cherry Orchard,” “you may be sure that particular illness is incurable.’’…

In one of his stand-up routines, British comedian David Baddiel asks why, when people hear he’s an insomniac, they say, “Really? ‘Cos I fall asleep the second my head hits the pillow.” He adds, “When I see someone in a wheelchair, I don’t say, “Really? ‘Cos I can do this…” and he hops around the stage on one leg. …

Sleep is personal, sleep is intimate, sleep is interwoven into the fabric of our deepest beings. It’s not surprising, then, that we have relations to sleep that are as individual and distinctive as we ourselves are.

You must find your own way with insomnia, make your own terms with it, learn what works for you and what does not. Become a close observer of your sleep, which does not mean obsessing about your sleep, but learning your body, how it reacts to foods, drugs, light, time of day. Cobble together from what you learn a way of life that works. There is no “program” that is right for everybody. There is only what you can find that works.

I don’t use the word manage with insomnia, though people like this word. I don’t manage this beast. I live with it. I live around it. I bed down with it every night, gingerly, cautiously, careful not to provoke it. I do my best to placate it, domesticate it, dull its claws, avoid its fangs, knowing that at any moment it can pounce on me and tear me to bits. But manage it? I wouldn’t say so.

Gayle Greene is professor of literature and women’s studies at Scripps College in Claremont, Calif., and a patient representative on the board of the American Insomnia Association. See www.sleepstarved.org for an ongoing discussion of insomnia issues. Tara Parker-Pope is on vacation.

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