My Battle With Sleeplessness

Can a cadre of experts help this writer overcome her chronic insomnia? A nighttime drama in three acts.

Photo by Elinor Carucci

I couldn’t sleep like a baby even when I was a baby. My mother says that when she rocked me, I would jerk myself awake. As an adult, I never looked forward to bedtime the way that other people did, and when I got stressed, sleeping was the first thing to go. Then, one night, I forgot how to do it entirely.

It happened when I moved from New York City to the bucolic New England countryside, just past a squash farm. How was I ever supposed to sleep in all that deafening quiet? It was a massive life upheaval, and sleep turned from challenging to impossible. The sun would come up and there I would be, wide awake under my charming homemade quilt. I tried to surrender to unconsciousness. I really did—but it felt like trying to drown myself in a bucket.

After doctors ruled out medical causes for my wakefulness (an overactive thyroid, for example), I experimented with acupuncture, yoga, herbs, Gregorian chants, earplugs, and a sleeping mask. What worked? Ambien. The hypnotic drug put me to sleep and more or less kept me asleep, and it felt like the best thing that had ever happened to me.

Ambien promotes the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that reduces electrical impulses in the brain, and I’ve been taking it since my insomnia took hold, six years ago. From time to time, I’ve tried to get to the Land of Nod without those little pharmaceutical passports, but to no avail.

“Sleep can be a delicate process, and when insomnia sets in, it can easily become long-term,” says Gregg D. Jacobs, Ph.D., an insomnia specialist at the Sleep Disorders Center at the University of Massachusetts Medical School, in Worcester. “We develop thought patterns and behaviors surrounding the insomnia, and those patterns and behaviors help perpetuate it.” That is, sleeplessness creates anxiety, which causes us to think of our once cozy beds as torture racks, which makes us more anxious and sleepless. Then we try to manage the next-day exhaustion with caffeine (I’m guilty) or naps (I couldn’t nap at gunpoint), which ensures that it’s harder to sleep the next night and so on.

I hated the thought of being dependent on medication, and though I was sleeping, I often didn’t feel rested. Sometimes, after a really bad night, I would go to the ladies’ room for a second just so I could rest my head on the toilet-paper roll. I read a profile of Hillary Clinton that extolled her great talent for sleeping on command. I wondered what life would be like if I could sleep soundly. Maybe I could be the secretary of state.

The Sleep Clinic

In this, Year Six of my insomnia, I decide that I need a real intervention, so I book an appointment at the Sleep Disorders Institute, in New York City. I hope to spend a night hooked up to some wires, like the Six Million Dollar Woman, but no such luck. “A sleep study isn’t always the first line of treatment for someone with insomnia,” says Maha Ahmad, M.D., an associate director at the clinic. “First we want to look at your sleeping habits, then start you on a behavioral program.” I begin by keeping a diary (yawn) for two weeks, noting sleep and wake times and medication. For now I can keep taking the Ambien.