Robert Burton, whose 1621 book Anatomy of Melancholy,was probably the first full-length treatment of depression, encyclopedic in its scope, described the reciprocal interconnection among insomnia, depression, and the kind of anxious, hypochondriacal fantasy that feeds on itself in the middle of the night. "Waking overmuch, is both a symptom, and an ordinary cause [of melancholy]. It causeth dryness of the brain, frenzy, dotage, and makes the body dry, lean, hard, and ugly to behold . . . . The temperature of the brain is corrupted by it, the humours adust [burn or scorch], the eyes made to sink into the head, choler increased, and the whole body inflamed. . . . Waking, by reason of their continual cares, fears, sorrows, dry brains, is a symptom that much crucifies melancholy men, and must therefore be speedily helped, and sleep by all means procured, which sometimes is a sufficient remedy of itself without any other physic." During bouts of insomnia, we all know only too well, don't we, what that hot, dry, corrupted, shriveled brain feels like, mummifying inside our heads?
The Literary View
Writers, past and present, have been no strangers to insomnia. An incomplete, ad hoc list of confessed insomniacs includes Charles Dickens, the Bront' sisters, Franz Kafka, Marcel Proust, Lewis Carroll, Ernest Hemingway, Mark Twain, Gertrude Stein, and Philip Larkin. Other possible sufferers were Sappho, Dante, Shakespeare, Cervantes, and Dostoevsky—all of whom wrote about insomnia as if they knew it all too personally. As you'd expect, insomnia is often paired with guilt, fear, and despair. In the Divine Comedy, adulterous lovers in the second circle of hell are kept perpetually awake by a "hellish hurricane, which never rests, drives on the spirits with its violence: wheeling and pounding, it harasses them. . . . Now here, now there, now down, now up, it drives them. There is no hope that ever comforts them, no hope for rest and none for lesser pain." (Lying awake at 4:00 a.m. listening to the winter wind howling and rattling the windows provides a reasonable facsimile.)
Probably Shakespeare was the master of characterizing insomnia as the wages of sin and guilt. Think of Macbeth's cry to himself after he's murdered Duncan: "Methought I heard a voice cry 'Sleep no more! Macbeth hath murdered sleep'—the innocent sleep. Sleep that knits up the raveled sleave of care." Or Iago, about Othello, whom he deceives into becoming jealous of the innocent Desdemona and murdering her: "Not poppy nor mandragora, Nor all the drowsy syrups of the world, Shall ever medicine thee to that sweet sleep Which thou own'dst yesterday." Or Queen Margaret, who curses serial killer Richard III: "No sleep close up that deadly eye of thine, Unless it be while some tormenting dream Affrights thee with a hell of ugly devils."
But in more modern times, a tradition has emerged linking insomnia, like madness and melancholy, not so much with guilt as with Faustian powers of creativity and imagination, and perhaps even the promise of immortality, not granted to dull slugabeds catching their nightly eight and a half hours. "There is a nocturnal personality, a nocturnal spirit, distinct from that of daylight and available only in solitude: hence the secret pride of the insomniac who, for all his anguish, for all his very real discomfort, knows himself set apart from others," writes Joyce Carol Oates in her preface to Nightwalks: A Bedside Companion. "Unable to sleep, one suddenly grasps the profound meaning of being awake: a revelation that shades subtly into horror, or into instruction," continues Oates, who's herself both an insomniac and a master of literary horror fiction.
Franz Kafka seems to have taken both "instruction" and "horror" from insomnia: his sleeplessness, waking dreams, and the turbulence of his imagination all erupted together in the creation of his surreal and nightmarish fictions. "I believe this sleeplessness comes only because I write," he explained in his diary. "[I feel] especially toward evening and even more in the morning, the approaching, the imminent possibility of great moments which would tear me open, which could make me capable of anything, and in the general uproar that is within me [I] find no rest. . . . My being does not have sufficient strength or the capacity to hold the present mixture, during the day the visible world helps me, during the night it cuts me to pieces unhindered." Insomnia for him, too, was a no-man's-land, both enchanted and damned, the source of visions that, in their power, nearly destroyed him.
In some literary works, the insomniac sets him- or herself proudly above the natural laws mandating sleep, but pays for this arrogance in a horror of madness, damnation, or death. At the end of Isak Dinesen's short story Night Walk, a guilt-ridden insomniac encounters an ugly redheaded man, who sits at a table and counts a pile of silver coins over and over. Repeating "with extreme arrogance" and "deep scorn, "I never sleep. Only dolts and drudges sleep,'" the coin-counter reveals himself to be none other than Judas Iscariot, who hasn't slept since the night he betrayed Jesus. Now, he's doomed to spend eternity alone with his demonic pride, his 30 pieces of silver, and his insomnia.
Vladimir Nabokov once called sleep the "most moronic fraternity in the world, . . . [a] nightly betrayal of reason, humanity, genius." He really did have it in for Hypnos, the ancient Greek god of sleep. In his memoir, Speak, Memory, he writes, "People in trains, who lay their newspaper aside, fold their silly arms, and immediately, with an offensive familiarity of demeanor, start snoring, amaze me as much as the uninhabited chap who cozily defecates in the presence of a chatty tubber [bather]. . . . I simply cannot get used to the nightly betrayal of reason, humanity, genius. No matter how great my weariness, the wrench of parting with consciousness is unspeakably repulsive."
Nonetheless, in Nabokov's novel The Defense, a chess master is so obsessed with his "chess life" in which "everything obeyed his will and bowed to his schemes" that he doesn't go to sleep at all, but devotes himself night and day to perfecting every conceivable chess strategy. In the end, he's horribly punished for his monomaniacal determination to win at all costs by an insomnia that drives him mad and kills him. Exhausted and reeling during a heated match, he falls into a delirious phantasmagoria of "twilight murk, thick, cotton-wool air," in which strange voices, lights, chess figures, ghosts, and shadows, snatches of landscape and architecture appear and disappear before "a wave of oppressive blackness wash[es] over him," whereupon he collapses and dies. In "Sleep," a surrealist story (surrealism, fantasy, magic realism, all lend themselves to insomnia, and vice versa) by Haruki Murakami, a woman, suddenly liberated from the need to sleep at all, finds herself becoming a tireless, perfectly functioning humanoid machine—entirely free of ordinary biological constraints, more energized, intelligent, self-confident, her consciousness expanding, expanding until . . . until her life explodes, literally, in terror and death. "I had imagined death as an extension of sleep. . . . Eternal rest. A total blackout," she thinks, on the way to her demise. "But now I wondered if I had been wrong. Perhaps death was a state entirely unlike sleep, something that belonged to a different category altogether—like the deep, endless wakeful darkness I was seeing now."
In our own culture, there's an eerie echo of this insatiable striving to rise above our stupid, beastlike, physiological need for sleep and become unflagging, bionic powerhouses. For some years now, a drug called Provigil has been marketed as an alternative to amphetamines for keeping people awake and alert without the screaming meemies that are often a side effect of Dexadrine and other forms of speed. Provigil was originally intended to treat people with narcolepsy, but 90 percent of all prescriptions now are written "off label" ($575 million worth in 2005) for travelers who want to avoid jet lag, night-shift workers and long-distance truckers, military personnel, people in high-stress jobs (those 15-hour-a-day junior lawyers bucking to make partner), and students pulling all-nighters (or just partying all night). "There is a multibillion-dollar demand from civilians who wish to sleep only when they want to sleep," Jonathan Moreno wrote in the November 2006 issue of Scientific American.
Provigil is only one of several such wake-up drugs in the research pipeline. The Pentagon's Defense Advanced Projects Research Agency (DARPA), which pioneered Internet technology in the '60s, is investing at least $100 million for research into even better wake-up-and-stay-up contrivances, including more powerful, side-effect-free drugs, focused magnetic waves, and light stimulus. "The more we understand about the body's 24-hour, clock the more we'll be able to override it," says Russell Foster, a circadian biologist at Imperial College London quoted by Graham Lawton in the February 18, 2006, issue of New Scientist. "In 10 to 20 years we'll be able to pharmacologically turn sleep off."
To anyone not enchanted with this forecast of perpetual, goggle-eyed wakefulness, who still values sleep and rues insomnia (which is most people, barring self-defined masters of the universe and Dr. Strangelove types), for anyone who still has some retrograde attachment to the idea of natural body rhythms, this kind of scientifically generated defeat of so integral a part of human biology as sleep is inherently abhorrent. But, it turns out, we've long been insulting our natural wake-sleep cycle—for well over a century anyway—simply by expecting ourselves to fall asleep precisely at 10:00 or 11:00 p.m., sleep solidly the entire night, and wake promptly at 6:00 or 7:00 a.m. There's now accumulating scientific and historical evidence that human beings, like many of our mammalian cousins, weren't meant to follow what we consider a "normal" wake-sleep pattern of two strictly segregated blocks of time—16 uninterrupted hours awake, 8 uninterrupted hours asleep.
In studies conducted at the National Institute of Mental Health during the '90s, psychiatrist Thomas Wehr and colleagues found that when research subjects were deprived of artificial light and restricted to a dark room for 14 hours a day (closely approximating the natural light-dark conditions of winter) for several weeks, their entire sleep pattern shifted dramatically. They didn't sleep solidly for 8 or 10 or 14 hours, but first lay quietly in bed for two hours, then slept in two sessions of about four to five hours each, separated by one to three hours of calm, reflective, wakefulness. Instead of having the stress hormone cortisol streaming through their bodies—like insomniacs have when they can't sleep—these subjects exhibited heightened levels of prolactin, the pituitary hormone that stimulates lactation in mothers and permits chickens to brood contentedly on their eggs, during their periods of nighttime wakefulness. Their brain-wave measurements at these times resembled a state of meditation.
This bimodal sleep pattern now appears to have been the normal way human beings slept throughout preindustrial history, before the invention of electrical light put an end to it. It's still the norm among some premodern tribes in Africa and Pakistan. In At Day's Close: Night in Times Past, historian A. Roger Ekirch demonstrates, through a wealth of written evidence (diaries, philosophical treatises, religious tracts, plays, legal depositions, medical books, and the like), that before the 19th century, people in Western Europe frequently wrote of sleep intervals "as if the prospect of awakening in the middle of the night was common knowledge that required no elaboration." During this time awake, people might get up and do chores, smoke a pipe, engage in prayer or reading, converse, visit neighbors, make love, or simply lie there in contemplation and fantasy. It was, by many accounts, an uncommonly peaceful, even pleasurable, time of night. Ekirch quotes 17th-century poet and moralist Francis Quarles, "Let the end of thy first sleep raise thee from repose: then hath thy body the best temper; then hath thy soule the least incumbrance; then no noyse shall disturbe thine ear; no object shall divert thine eye."
Some researchers, including Ekirch, are apparently drawing the conclusion from this material that midnight or early-morning insomnia is possibly more "natural" than the pattern of eight hours straight sleep that we've come to expect, but often fail to achieve. Perhaps, the implication is, we ought to accept the reality of those hours awake and cultivate a better attitude toward the inevitable—we should accept and make friends with those wakeful hours in the middle of the night. According to sleep researchers, lying quietly and peacefully awake can be as restful and restorative as sleep. And it's undoubtedly true that expending much anxiety on insomnia just makes the problem worse.
But those gentle, midnight ramblings and tranquil musings of the bimodalists clearly have nothing in common with what we experience as insomnia, in all its tense, anxiety-haunted misery.
Anyway, we don't have the time for playing around with first and second sleeps and late-night contemplation and conversation—we've only got what we've got, which is usually a pitifully few hours after work, after dinner, after the kids are settled, after we've answered our e-mail, after we've made some calls, after we've paid some bills, after we've done some laundry, to get whatever sleep we can steal from what's left of the night. In obvious ways, we've long since abandoned the ancient habits and rhythms of our primordial ancestors, not only in our patterns of waking and sleeping, but of working and playing, mating and child-rearing, thinking and believing. We aren't likely ever to return to those old patterns—barring a worldwide catastrophe that sends those of us who survive back into paleolithic times. And we might not want to: the staggering scientific and social progress of the modern era probably owes a good deal to all those extra, artificially lit hours of wakefulness devoted to thought, study, research, invention, and production.
Even so, the very fact that sleep disorders have garnered so much attention is itself proof that we not only still desperately want our sleep, but remain stubbornly in love with the idea, the idealization even, of sleep as something desirable in itself. No matter how inconvenient sleep is, how "moronic" (as Nabokov put it), how much effort is expended on keeping us comfortably, interminably awake, or how celebrated the fashionable ability to "get by" on four hours of rest a night, most of us still long for that nightly return to the entirely unwilled, unconscious, unproductive, unknowing state of sleep. Perhaps sleep is a rehearsal for death, as some have said. So what? Eternal life—in this world, anyway—would be intolerable, and a night without sleep can feel like an eternity—the hours of unceasing consciousness an intolerable abyss of tedium and wakeful emptiness, when all we want is the paradoxical fullness, the rich plenitude, of sleep. We not only are biologically programmed to hunger for rest, for our daily dose of oblivion, but we positively delight in this "experience" that we aren't even aware of experiencing—we're asleep, after all! It isn't called "blissful sleep" for nothing.
Mary Sykes Wylie, Ph.D., is senior editor of the Psychotherapy Networker.
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