Le problème de l'esprit sans sommeilnovembre 20, 2019
I can tell you the exact night I stopped sleeping. Thursday, August 11, 2016. Before that, I slept like a monarch in my Cal king bed. I never thought much about the subject at all. Insomnia runs in my family, my mother’s side, like bad apples on the ancestral tree. But by some great stroke of fortune, the gene had skipped me.
Source: Francisco Goya (1746–1828)/Caprichos image #43, El sueño de la razón produce monstruos. (The sleep of reason brings forth monsters.)
For 59 years, sleep was that invisible, soft redemption separating today from tomorrow. Right through August 10th it was that way and then abruptly I stopped sleeping completely.
One night awake is nothing to worry about. It happens. Trans-oceanic travel. Or the eve of a big event. I couldn’t fall asleep the night before my wedding due to how appalling my soon-to-be-mother-in-law had behaved at the rehearsal dinner.
Yet sometimes the source of disquiet isn’t so straightforward. It’s what’s lumped into the catchall of modern life. Work, love, family, loss—the pot of soup that forever simmers. Night isn’t what it used to be, not since the advent of Edison’s light bulb. With cable television, the internet, all-night call-in sports shows, we have a myriad of reasons keeping us awake.
But my one night of no sleep became two, then three, and on the fifth day I confessed to my wife my circumstance. Janet gazed at me.
“Why didn’t you tell me sooner?” she said. It was more of a rhetorical question. Janet was aware by then that I preferred to stubbornly power through setbacks rather than suffer the indignity of discussing them. “Everybody sleeps even when you don’t think you are,” she assured me. Janet held up the screen of her laptop for proof. “Well, if it’s online,” I said, “it must be true.”
She wasn’t wrong, either. I had brief, intermittent periods of the night that couldn’t be accounted for. Sleep wasn’t the precise word for what was happening, more a gray gauze that passed over me, and then I’d jolt back to the living world, heart racing.
Insomnia is an attack of such a private nature that my initial reaction was embarrassment. Sleep is the ultimate version of personal time. You don the barest of clothing and have the license to drool.
Nightly, in slumber, the strange movie house of dreams opens in your brain. The stories are by turns mundane, scary, thrilling, sad, cruel, happy—and, occasionally, all of the above. You don’t control the plot but that’s okay since you won’t remember much of the experience anyway. The whole enterprise of sleep is a nifty magic trick. You lie down at night and when you open your eyes it’s morning and, usually, you’re somewhat better by whatever transpired in between.
In the beginning, my insomnia made me feel as if I’d turned against nature, that all of a sudden I was fundamentally different from other people, marching to a tune other than the circadian rhythm everyone else was moving to. Publicly, I acted like nothing was wrong. I didn’t wish to court local pity. I chose instead to treat my budding sleeplessness like a transient cough or outbreak of poison ivy. I tried to ignore it and hoped it would go away on its own.
What I didn’t know then was that I wasn’t alone in the dark. Insomnia is a universal condition that probably dates all the way back to that original cave-person peering up at the roof of the grotto while the rest of his clan caught some shut-eye.
For such a universal condition, it certainly hides in shame’s closet. Insomnia seems to suggest a deeper psychological underpinning at work, an outer sign of an unwell soul within. “There is a history of regarding insomniacs as guilty or morally suspect,” writes Eluned Summers-Bremmer.
Statistics indicate there’s currently a vast army of us out there. Some 30 percent of the population suffers from chronic sleeplessness. It gets worse as you age, when the numbers rise upwards of 50 percent for 60-year-olds. One in three individuals slog through some form of insomnia over the course of a lifetime. Women nearly twice as much as men. In pure population data, some 60 million Americans have a sleep disorder. A majority of that number don’t even realize they’re in the tribe of the walking dead.
Most of those who do, wind up trying to power through it. Why see a doctor? The symptoms didn’t seem to add up to a medical problem. In my case, I was anxious and moody, both of which stemmed from not sleeping. The problem appeared to be more psychologically based. That is to say, slippery and elusive, requiring the offices of a different kind of professional, and I didn’t have a hankering to initiate that kind of relationship at the time.
Instead, I began to inventory what might be keeping me up at night. My starting point was that I was happy. For the gift of Janet and our three dogs, two border collies and a Parson Russell terrier named Little Daddy. For the house we designed and built overlooking the Alexander Valley in northern Sonoma County. For the blessing of returning to the writing desk again. Years ago, I’d embarked on an extended period of not writing, which lasted so long that the editor of my first book retired and the one for my second died.
So life at that moment couldn’t have been better—or so I believed. It was entirely possible that old fish named doubt might have been swimming at the bottom of the lake inside me, about my novel and its eventual prospects, a faint ripple, not enough to classify as a disturbance at the time, and certainly not enough to keep me up night after night.
Crescents of shadows had cropped up under my eyes by then. If I smiled broadly, they weren’t as evident. My eyes themselves burned, the lids hot, swollen. My anxiety regularly spiked into a region I hadn’t ventured before: Panic attacks. Acute bouts of fear about events that hadn’t happened yet. Not only the final disposition of the novel but my own final disposition. In the throes of a panic attack, my heart pounded and my hands grew clammy and cold and I’d ponder whether I was experiencing a coronary incident or stroke.
I wouldn’t classify myself as a hypochondriac. Then again how many hypochondriacs would? A better description of the problem would be that I hadn’t slept for almost 30 days and my body was letting me know it.
I didn’t intend to become a connoisseur of sleep. I had a novel to write and my insomnia eventually grew burdensome. I only dove into the subject out of desperation, when my healthcare facility had reached dead end after dead end about how to treat me. I began doing research on my own to discover what I could find out, learning that sleep disorders can be as misleading as the meaning of dreams. Things aren’t what they appear to be. There’s often something hiding behind the original complaint.
In my case, it turned there was an underlying physical reason for my sleeplessness, but because the study of sleep is rather recent and continues to occupy that no-man’s land between medicine and psychology, my problem went undiagnosed for 339 days.
It needn’t have taken so long for a doctor to diagnose sleep apnea. In his seminal work The Promise of Sleep, William Dement soberly writes, “For nearly half a century, a huge reservoir of knowledge about sleep, sleep deprivation, and sleep disorders has been building up behind a dam of pervasive lack of awareness and unresponsive bureaucracies. We don’t know how many preventable tragedies are occurring right now, today, this very instant.”
The additional tragedy is that Dement wrote these words almost 20 years ago and his advice hasn’t since been more widely heeded. I count myself among the lucky ones: I finally found a doctor who knew a thing or two about sleep.