Insomnia: Eyes Wide Open

by Elizabeth Keenan

It is 3:48am on a weeknight and I’ve surrendered to the fact that I may never get a full night’s sleep again. I know too well the exceeding frustration of wanting sleep, yet despite my best attempts—bottomless mugs of chamomile tea and mind numbing infomercials—my body refuses to relinquish itself to rest. Sleep just isn’t that into me.

I am not one of those people who functions well on little sleep, and I don’t trust people who claim that they can subsist on two hours of sleep no problem. Next to eating and reading, I’ll take uninterrupted slumber over just about anything. But to love something that just doesn’t want to love you back is the grand “fuck you” of life, and for an insomniac—the reality of a night’s sleep being unattainable—it is the ultimate heartbreak.

On a survival level, sleep is more important than food. Twenty days or less of sleep deprivation can result in death, while people have lived for months without eating. Reports vary on how many hours of sleep people actually need to be fully functional the following day (some say four, while others claim eight), but for insomniacs, a single hour of shut-eye hour can be a triumph.

I’m feeling the effects of my third night of sleeplessness. My boyfriend has been happily dreaming for hours and even the nocturnally inclined cats have settled down for the night. I’ve got sleep envy, and pacing around the apartment in the dark without bumping into the furniture has lost its novelty. There’s a Pink Floyd laser show going on out of my left periphery but I’m far from comfortably numb. I could cry at any moment. Or laugh. It’s hard to say for sure.

Sleep deprivation is not pretty. From the BBC, “After two nights without sleep, the hallucinations start, and after three nights, people are having dreams while fairly awake, which is a form of psychosis.” The most spur-of-the-moment suicides occur after midnight. How many of those moments of desperation were precipitated by acute insomnia? Common symptoms of sleep deprivation include hallucinations, short-term memory loss, paranoia, and delusions. Uncommon symptoms include believing you are Paul Lowe winning the Rose Bowl and that a street sign is a person, as experienced by Randy Gardner, who currently holds the Guinness world record for the longest period of time any human has gone without sleep without the aid of stimulants. In 1964, Gardner stayed awake for 264 hours (11 days) “to prove that bad things didn't happen if you went without sleep.”

Clearly, Gardner never fell victim to sleep-deprivation torture as favored by the KGB and the Japanese in POW camps in WWII and, scarily, our modern-day military. An online search of “sleep-deprived” yields innumerable articles about the horrors of sleep-deprivation interrogation, torture, and the resulting insanity. These methods date back to the ancient Romans who used “tormentum vigilae” (waking torture) to extract information from their enemies. After a week of five or six hours of sleep total, I’ll tell you anything you want to know.

While I have always been one to lament “if I only had a few more hours in the day, I’d get so much more accomplished,” the extra hours spent trying to achieve slumber are far from useful or productive. The sheer quality of time changes, the periods that should be spent unconscious, becomes one drawn out Dali-esque moment, and your brain can’t stop running long enough to relax or focus on any given ask. A tired body and an active brain are a maddening combination. Where the extra hours may seem ideal to knock off a couple of loads of laundry, make a stew, or learn Italian, staring at a blinking cursor or exploring the medicine cabinet for unexpired Nyquil is more like it.

After resolving that sleep is not in the cards tonight, I take solace in Googling my frustration out. The Internet is a wondrous thing for an insomniac. Mindlessly searching for any word or phrase that comes to mind is the extent of what I’m able to muster after staring at the clock for an hour, convinced that the time-space continuum ceases to exist in my apartment. I become well acquainted with famous insomniacs, of whom there are many, and I hope to find a panacea cure in their experiences. Kafka kept a diary of his sleeplessness:

“Sleepless night. The third in a row. I fall asleep soundly, but after an hour I wake up, as though I had laid my head in the wrong hole.”

I take a stab at my own journaling, but even sleep deprived, I am no Kafka.

“3:59am. Still can’t sleep. Drank an entire bottle of red wine and attempted my ‘evening yoga’ DVD. Wine and ‘Salutation to the Sun’ don’t mix. Seem to have pulled at least three muscles at once. Also managed to face plant into the hardwood floor, but failed to even accidentally knock myself out. Wine + Yoga = bad idea.”

I go deeper into the annals of famous insomniacs. The roster is long and colorful; including Napoleon, Catherine the Great, Churchill, Dickens, Edison, Proust, and Van Gogh. Apparently the smart and the crazy couldn’t sleep. I guess I’m in good company, though I won’t be inventing the next light bulb or creating a masterpiece at 4:00am (although I have rediscovered the art of collage-making and the lost joy of glue sticks.)

I spend time pondering what is keeping me up, but am unable to organize my thoughts. I look to WebMD for a cyber diagnosis. Causes of insomnia are most commonly identified as acute anxiety and depression. It is a self-perpetuating condition, where the less one sleeps the more anxious and stressed they become, creating the vicious cycle of chronic sleeplessness. Sixty million Americans are unable to sleep on a regular basis. What’s keeping us all awake? For me, it could be the war, global warming, violent crimes in New York and the eleventh person I know this week that’s sworn that The Secret will change my life. But these things aren’t really troubling me when I’m zombified in the wee hours. Mostly I think about wanting to sleep and not being able to have it. Obsess is a better word. I obsess about shut-eye over and over with fragments of “Enter Sandman” by Metallica playing in my head.

Remedies for insomnia range from drinking hot milk before bedtime (with high levels of tryptophan) to yoga, herbology, acupuncture, meditation, and psychotherapy. W.C. Fields, another famous insomniac, bypassed the evening yoga and resorted to rather unusual methods of his own to usher in sleep. A big fan of haircuts, he would stretch out in a barber’s chair with towels wrapped around him, until he felt drowsy. When the chair didn’t do the trick, he tried stretching out on his pool table or falling asleep under a beach umbrella being sprinkled by a garden hose. His explanation: “somehow a moratorium is declared on all my troubles when it is raining.” (The Book Of Lists, Wallace & Wallechinsky).

My own remedy attempts have been less imaginative. I’ve tried reading Stephen King’s Insomnia while listening to Radiohead’s Amnesiac and Feng Shui-ing my apartment to create flow to aid in sleeping. I’ve color coded my books, alphabetized my CD collection, and attempted to potty train my cats. None of these things have worked, nor have they strengthened my boyfriend’s faith in my sanity. Most often, I sit in the dark, staring at the ceiling, counting sheep. Sometimes they are cloned sheep that just sit around and refuse to jump, other times they sleep and snore, taunting me.

I start navigating the online world of sleeping pills. With blurry eyes and a pounding headache, I learn that for the low price of $59.95, I too can have the gift of slumber straight from Mexico and Canada. Or I can visit my doctor and get my very own prescription, legally. These days the pharmaceutical giants are in big business with the sandman. The New York Times reported that 25 million Ambien prescriptions were written last year (the same article cites that including other “sleep aids,” prescriptions handed out in 2006 topped 50 million). Prescription “sleep-aids” include highly-addictive benzodiazepines like Xanax and Klonopan, and non-benzodiazepine drugs, including Ambien and Lunesta, which are allegedly less addicting and apparently prescribed to one out of three people in my office alone. Nearly everybody with insomnia appears to be taking matters into their own hands. A recent blog entry in The Huffington Post alleges that even the commander-in-chief uses sleep aids to get his shut eye. Which answers my long-standing question, “How can he sleep at night?”

The lure of a miracle cure is strong, especially at 4:30am. At this point, I resolve that it is better to stay up for the duration instead of getting an hour or two of restless sleep before work. My stomach starts to churn with the dread and frustration of an inevitably exhausting day to come. Why not just get a prescription and be done with it? I’ve long avoided sleeping pills because of the implied addiction for someone who loves to sleep as much as I do and has a lot of lost time to make up for. And I’ve read Valley of the Dolls too many times. The avid Ambien supporters I’ve polled report that sleep has never been so easy and the side effects are minimal. After I pointedly asked, “isn’t that stuff habit forming?” two people uttered the words: “I’m addicted, but not in the bad way.”

A deeper investigation into the miracle pill reveals a darker side. The side effects of the drug include; “Hallucinations, through all physical senses, of varying intensity; Delusions; poor motor coordination, difficulty maintaining balance; euphoria and/or dysphoria; increased appetite; increased libido; impaired judgment and reasoning; uninhibited extroversion in social or interpersonal settings; increased impulsivity”; too name a few). Taken out of context, this could as easily be the side effects of too many martinis at dinner. “There’s no hangover with Ambien,” an online user posting claims.

I scan the recent news stories about Ambien, of which there are many. There is the case of Brent Walden, a school board president in Bennet, CO who attacked his estranged wife and claims he doesn’t remember it because he hopped up on the snooze aid. And even more disturbingly sleep-driving, as in the case of Rhode Island Rep. and son of Ted, Patrick Kennedy, crashing his car after taking Ambien a year ago, with dozens of cases of sleep-driving reported since. And the sketch-comedy-worthy cases of Ambien users who’ve mysteriously gained thirty pounds in a two-month period in spite of their daytime dieting, who realize they’ve gone and polished off a gallon of ice-cream in an attack of “sleep-eating.” (Although, I have to admit, the prospect of being able to eat and sleep at the same time sounds divine to me. Now if they could only figure out a pill that would allow me to sleep-read, I’d be in heaven).

I’m slap happy by 5:00am, and muse about how far this Ambien-induced sleep functioning can be taken. Can I sleep work? Sleep clean? Sleep bitch-slap that squinty girl with the staring problem at my morning coffee place? Visions (or hallucinations) of the myriad of boneheaded sleep hijinks is only entertaining momentarily, and the profound and familiar wave of utter exhaustion overtakes me. For the time being, I think I’ll stick with the chamomile.

The sun is coming up and I pause from my Googling to enjoy the one and only benefit of these sleepless nights; the beautiful early light of a new day cracking through a long and agonizing night of frustration. The sunrise, so hopeful in its beauty, calms me enough to catch an hour or so of sleep before the alarm clock I set so optimistically goes off. I’ll take what I can get.

Comments

[j]

Wow, who knew insomnia could be so beautiful? Sorry Liz, but if your sleeplessness means that we'll get to read articles like this, well...maybe it's not so bad.

[bcl]

You took the words right out of my mouth, j. This is an exceedingly beautiful article.

[JJ]

Sleeping well is underapprciated. It only takes reading about one wine + yoga experince to want to avoid that ever happening. Hail lunesta.

[sarah]

when I had my last period at menopause, my insomnia started. After 8 years of trying every natural remedy I could think of, I now take Lunesta. I know a ton of women who also can't sleep. It is amazing that doctors and the public in general don't realize the scale of this problem.

[Kate]

Elizabeth:

Two things come to mind. Have you ever bit the bullet and done a sleep test, to examine your pattern? I've been there, gone four nights at a time without sleep, and still have trouble sleeping. But being in an altered state, that never occurred to me. My Dad is insomniac -- I didn't think there was anything that could be done for it. Now, I'm thinking sleep study.

Second thing -- find a Lyme-literate doctor and have a clinical evaluation for an undetected case of Lyme disease. The three most common symptoms of Lyme are arthritis, migraine headaches, and -- wait for it -- insomnia.

Good luck -- and productive time awake, if that's all you can pull out of it!

[mezmer]

One time I was driving. Hadn't slept for days. Somehow my vision got snagged by a raindrop on the windshield and suddenly I was looking out from inside of it's tiny convex surface. Like a miniscule goldfish stuck to the windshield of the moving car.

I took Ambien for a while. It's really good stuff. No daytime drowsiness. And glorious sleep. The one downside was that I would sometimes be looking right at something and walk smack into it. I could see it and I didn't percieve any kind of impairment. I just sometimes couldn't act accordingly. That was strange.

[Jean]

6:40 am, no sleep - the just awakened birds heard my laughs - the restlessness of your prose, its mixture of wit and melancholy: exquisite

[Insomniac]

I was convinced I was going mad for a few months, thanks to sleep deprivation and resultant auditory and visual hallucinations. Not a pleasant experience. If you can't break out of insomnia naturally (I eventually did), medicate. The alternative can be terrifying.

[stephen]

This sounds frivilous, but I'm deadly serious: Henry James's _The Wings of A Dove_ is the most incredibly sleep-inducing tract. (Apparently something about how it was written - as a rambling dictation - is the reason for its strange power in this regard.) Good luck!

[kim]

Try trazadone. Formerly an antidepressant many years ago, now a sleep aid that is totally nonaddictive. And cheap - generic is about $8 for a month's supply. I use it (sparingly) and it works great. Requires a prescription.

[Tim]

I'm a psychologist who treats chronic pain patients, and they often have substantial sleep problems. This can get better. You have a complicated problem that has become more complex over time. Your sleep/activity pattern, fundamental attitudes generating autonomic arousal, behaviors such as drinking wine and exercising at night, and possibly acclimating to medications by depending on them too much has muddled up the picture. Don't look for a single solution; it will likely be multifactorial and this will take some time to slowly straighten out. This assumes there is not a substantial neurobiological process creating the problem.

If you find the right health care provider, possibly a psychologist specializing in sleep (please, no psychoanalysts or people who use crystals)or a sleep medicine specialist easy on the drugs and who doesn't want to sell you a CPAP machine (a big money-maker) you could get better. Or try a book like "Power Sleep" and actually use the common-sense suggestions and stick with them for a while. Also, a good sleep-induction CD can be a good addition to those measures. Most of us have one we provide patients.

Good Luck

[b. lynch black]

always a complainer about sleep being a waste of time, i had a lot to do: writing, painting, working a full time job and partying with my friends. i'd often skip a full night or so, staying up late, or staying out, and could manage for a couple of days without full sleep. i tried an experiment of *gradually* cutting back on sleep. so i went from my normal 7 hours a night, down to 6 for a few weeks. everything went fine, i was busy, i was happy. a few weeks of 6 hours, i cut down to 5. i was still functioning, maybe a bit dozy in the late afternoons, but i always got a second wind, and i was working on my novel well into the wee hours. then i cut down to 4 hours a night. after the first week, i was weepy and emotional, but still going to work, and staying late, trying to do creative stuff. well, on night after about 2 weeks of 4 hours a night, i started hearing people in the office hallway, so i went out to investigate. no one there. i went back to work, and after a few minutes started hearing people again, whispering in an alarming manner. then i started seeing things flitting out of the corner of my eye, disappearing into the doorways and corridors. i shut off the computer, hailed a cab, went home, took the next day off and slept the sleep of the truly exhausted. i still try to get away with only 6 hours a night, but as i say to my nieces and nephews now: I may not need *more* sleep than i always did, but i sure as hell need it a lot more regularly!

[dissent]

I have a 'sleep disorder' and an 'anxiety disorder' and what works for me is daily meditation. At least 15 minutes before bed. Mindfulness. If I can't sleep, no matter what time it is, I sit up (in bed) on my meditation cushion and meditate. Tapes (with earphones, so I don't disturb my partner) are helpful. Serious meditation tapes, not new age mantra stuff. I prefer Eugene Cash intro meditation, a half hour meditation tape that introduces Buddhism/mindfulness. If you're resistant to the Buddhist angle, consider: they've been practicing meditation for over 2000 years, they know the subject.

What sometimes happens in my before bed meditation is that a source of anxiety will surface. I will get clarity on an anxiety. I just pray or write about it, then I have my sleep.

I prefer this approach to relying on any substances. It takes patience, but it also increases my overall wellbeing and my self understanding.

[sleeping well]

Have you tried melatonin? It's easily available from almost any grocery store, no prescription is needed, it doesn't drug you like benzodiazapines etc, and for me at least has worked remarkably well when I have insomnia occasionally.

[on and off the sleep wagon]

I am having my first sleepless night in several months and found this -- I'm late in on the discussion here, but, hey, I'm not going to sleep any time soon, and this might just help someone:

I (barely) lived through many torturous years of major insomnia before, miracle of miracles, I found an ND who diagnosed my adrenal issues. Most MDs won't even consider looking at hormones when faced with insomnia. Most won't recognize subtle chronic diseases (as mentioned - Lyme disease and chronic pain, but also food allergies, parasites from travelling) that might play a role. They are way too quick to push the prescription sleep aids and antidepressants, often skipping over the "science" part of their job that would require running the simple saliva tests for cortisol levels that should be standard. If you think adrenal issues wouldn't pertain to you, just think about all the stress factors we have in modern life. Never mind how even minor chronic health conditions can wear down adrenals, just working a normal 9-5 job with a poor diet and little exercise will give just about anyone whacky hormones.

Today, I know that I am having a sleepless night because I mismanaged my progesterone cream dosage leading up to my period. End of story. Most of the time, my sleeplessness is managed beautifully by good diet, having a sensible schedule, watching my intake of stimulants (sugar and caffeine), getting enough exercise, and having good mental/emotional hygiene (ie. meditation/journaling/counseling). I take a few supplements for adrenal regulation, and progesterone cream (the cyclical female hormones are tied into the other adrenal hormones such as cortisol). And for those nights when I haven't been so vigilant, L-Tryptophan (natural food supplement, as in the substance that makes you sleepy after eating turkey and potatoes) is an incredibly effective backup -- and it safely boosts your serotonin levels, too.

I am down to only one or two sleepless nights every two months or less. Most nights I get a solid 7-8 hours of sleep. A year into it, sleeping regularly has totally changed my life. I literally am a different person now, compared to when I was getting no more than 5 hours max most nights, and having twice monthly boughts of 3+ days in a row of complete sleeplessness (no naps). Hallucinations? You bet I had them! I wrote some of my best (and a few of my worst) essays during those fits. I used to worry that if I fixed my sleeping problem, I would lose my writing talent. There probably is something to that. I don't give myself over to the muse quite so dramatically now. But the trade of is I have a mental clarity and consistency that just wasn't there before. Now I can have a conversation with the muse, instead of sacrificing myself to her (that is what it used to feel like).

For the record, I tried all kinds of meditation. I'm not knocking it. Meditation is everything it is cracked up to be. That said, no amount of meditating, or psychotherapy, was going to fix my very physical problem. I can see mindfulness techniques alleviating high stress, therefore preventing adrenal fatigue... but once the damage is done, the damage is done. Good mental health definitely helps speed along healing, but it is not substite for proper attention to physical health.

As a side note, people should beware of taking melatonin if there is a possibility of adrenal burnout as it supresses cortisol, so far as I understand. I had a really bad experience with melatonin, before I was diagnosed. It totally wiped me out, but I still couldn't sleep. It was an absolute nightmare.

Insomniacs everywhere, I feel your pain. But... trust me... there is hope: just keep thinking critically about it and don't let any doctors bully you into settling for a prescription sleep aid when there are other factors at work. Find a better doctor, and address any underlying physical conditions that might be messing you up. It's worth it. Life without sleep just isn't living.

[Sherry Stevens]

A few comments:
1. Klonopin, an anxiolytic benzodizapine is habit forming, but it's NOT addictive. I took it for over a year, tapered off over 3 months and never used it again.

2.Rozerem is a prescription sleep aid that is not related to Ambien or Lunesta.

3. Sleep restriction therapy, done under the supervision of a psychologist, can be very helpful. Some studies rate it better than medication.

[Manic or Bipolar?]

Get thee to the psychiatrist. You may be manic! Color-coding and hyperproductivity along with insomnia--haha! Emily Dickinson's poetry and Van Gogh's painting and your writing, all brilliant,all possibly manic behavior.

[Kathy]

Wow, you may not be able to sleep but you can sure write!! Wonderful writing with no sleep!Alot of talent being hidden apparently will not rest till released!!!
Thanks for sharing!!

[P. Verdoux]

An amazing article; beautifully written. I've found cognitive-behavioral therapy to help quite a lot. Hope your sleep improves.

[Shox NZ]

Great news! In regards to the difficulties, I haven't believed about them additional.thank you particularly a whole lot best sharing i'm coming everday.

[kerry harrison]

Did anyone know, that worst of scars are in the mind? we live in a "BIG BROTHER" Society with cctv everywhere and covert operations going on all the time - however if used over prolonged periods of time such methods of interrogation "go beyound the scope of "little brother" and non physical methods are wide-spread and include SLEEP DEPRIVATION. Such methods can become coercive.
"For me a haze forms, my spirit wearied, one desire only I have, to sleep, to sleep a little, not to be woken up and to forget" When someone goes through RIPA and intercepts your home, this is what happens. "Anyone who has experienced this desire, knows what im talking about - the longing for uninterrupted sleep!
Beware, not everything people allege is "all in the mind"

[kerry harrison]

BIG BROTHER Society does exist- The use of sleep deprivation is a favoured method of interrogation, as I have found out. The England(UK) BBC Programe "Who's watching you, who's watching who" discovered the BIG BROTHER Society - they know what im talking.
"Who's talking to you when you're asleep?" might not be far from the truth.

[BiPAP]

Is insomia can be harmful diseases? Is it only treated in medicines or machines or there are alternative treatments for that?

[CPAP]

i am now experiencing insomnia and I really hate having this...anyone who could help me? What triggers insomnia?

[Custom Finance Essays]

This is a nice things to read