Dark Neural Corners

I developed insomnia in my late thirties. After four sleepless nights, I placed a crazed call to my doctor's office.

"Are you feeling suicidal?" The nurse asked.

"Yes."

I meant it. Hours later I was given a prescription for Temazepam, a sort of Valium lite, and sent home. The pills helped for awhile. Then I developed a tolerance and they didn't. I became an official insomniac.

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I have a friend who had a benign brain tumor on her pituitary gland. For years she lived with it. But then it began leaching calcium from her bones, and doctors removed the tumor. She survived, but her ability to sleep did not.

She described the horrors of not sleeping to me, the passing hours, the growing inability to think clearly. I did not understand. I equated not sleeping with being awake. "Can't you write?" I asked (she was working on her doctoral thesis at the time). "Or read until you're sleepy?"

No, and no. She tried to explain the awful state of muddled wakefulness that is insomnia. Like all champion sleepers, I didn't understand.

"I'm taking Halcion," She told me.

"Doesn't that stuff make people psychotic?" I asked, remembering a Presidential episode of erratic behavior ascribed to the drug.

"Not sleeping makes people psychotic." She said.

A few months later she called me with wonderful news. A new drug called Ambien had come to market. She could finally sleep again.

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My insomnia comes and goes: I can sleep well for weeks, then suddenly begin waking with a jolt at three a.m. Always three a.m., precisely, as if my body possessed some demonically programmed alarm clock. I jerk awake. I am hot. My hands, encased in their carpal tunnel braces, are aflame with pain. If I was sleeping on my right side, my shoulder, also affected by CT, will join the chorus. Restlessly I try to find a more comfortable position: my back? the left side? Nothing doing.

Now my mind begins speeding along in its private version of night terrors. Work, health worries, excruciating examinations of situations where I might have acted differently, said the right words.

Four a.m. In an hour, my alarm clock will go off.

Sometimes I doze, dreaming nonsense dreams. Sometimes I can calm myself by thinking about whatever I'm reading, or mulling over things I might like to write. This can lull me back to sleep, only by now it's four-thirty on a Thursday morning, so what's the point? Might as well get up and start the coffee.

The very act of standing upright sends the night terrors scuttling back to their dark neural corners. I make the coffee. I feel awful, as if I were coming down with the flu. My head aches. I must carefully attend to the task at hand: fitting the filter into the coffeemaker, measuring the coffee, counting each scoop lest I lose track, pouring the right amount of water into the machine.

The day unspools before me: getting our breakfasts, packing a lunch, driving the car to work. Then work itself, demanding accuracy and even more unthinkable, civility. Any plans for postwork errands are scuttled; anything beyond the bare bones of surviving the day must wait. No working on the blog, or the promised book review, or the essay so happily begun a few weeks back. I can't string a coherent thought together. I am depressed enough to understand why people commit suicide. Only by now I am also familiar enough with insomnia to recognize my mood is mercifully transient, and will lift after a good night's sleep. What I don't know is when that sleep will come.

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Like Joan Didion searching out the causes of Quintana's illness, I studied the literature. That's what bookish types do. We read. We work it up. I learned all sorts of useless things. Keep your bedroom quiet, use your bed only for sex, reading, and sleeping. Don't engage in heavy exercise just before sleeping. No heavy meals before bed. Cut down on alcohol, which might make you sleepy in the short term, but wake you in the middle of the night. Eat properly. Exercise regularly. Avoid naps, which will only throw off your body further. Reduce stress.

Yeah, right. I wasn't doing any of the dont's already. I cut my Excedrin intake, which was alarming anyway. No effect. I returned to the doctor, who gave me a few Ambien to try. I hallucinated, then fell asleep with the lights burning, a book in my lap, my hair still pinned back in metal barrettes that should have been uncomfortable enough to wake me. I don't remember how I felt in the morning.

I went back and got a prescription for Lunesta, which isn't any better than Temazepam. Taking it is a hollow gesture, a comforting ritual. I could just as easily burn sage, drink valerian tea, throw the I ching. I might sleep. I might not.

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In my previous life as a sleeper, I did not understand the difference between being awake and wakefulness. My copy of the The Concise Oxford Dictionary defines awake as "cease to sleep; become active; become conscious of; rouse from sleep."

Wakefulness is defined as "unable to sleep; night passed with little or no sleep; vigilant."

Now, in the land of the sleepless, I am often fogged. I am not vigilant; I am too tired. But being tired is no promise of sleep.

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There are two solutions, both difficult. The first would be ameliorating stress. For various reasons--my economic well-being, a passing effort to remain acquainted with reality--this is unlikely to occur. The second is to take stronger sleeping pills. Certainly taking Ambien or an equivalent would at least get me some rest. But I fear that sincere efforts to curb my intake would collapse after a couple sleepless nights. Or that the threat of insomnia after an especially difficult day might send me into the medicine cabinet whether I'd been having a bout or not.

Normally I am not an addictive personality. But my friend is right: not sleeping makes you psychotic.

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Yesterday my office was quiet: many had begun their long weekends. At noon one of the faculty appeared at my desk. "Go home," he ordered, smiling. "Get out of here."

I thanked him. I drove home. It was a beautiful day, sunny and cool. "Try and get some rest," My husband urged when I called him. But the laundry had piled up. The apartment was dusty. And if I spent the afternoon asleep, what would happen come night-time?

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There is a certain quality of mind that accompanies sleeplessness. The aforementioned depression, the inability to think, linked to a kind of feverishness. Sunlight looks thinner, yet yellower; distances appear curved, bent, further than I know them to be. This makes driving especially dangerous; I once almost hit a pedestrian while underslept. When he saw how upset I was, he, poor man, apologized to me.

Time warps. Long periods of wakefulness make seven p.m. feel like midnight, while outside it is the cusp of summer, daylight barely fading.

I cry more easily, like a child who has missed her nap. Last night we watched a PBS presentation about China. This third episode of the four-part series was about pollution. We gasped at the footage of filthy waterways. But it was the dead frogs, choked by poisoned water, that brought me nearly to tears. I sniffled discreetly, embarassed by my uncontrollable emotions.

As for thought, that running narrative we all carry within, well, it takes on a distance. I am not thinking, as I most often do, about reading or writing or whatever daily task is at hand. Instead I am off to the side, removed. At best I am coasting, the way one might feel while driving a familiar route and listening to music. Suddenly you return to yourself: five miles have passed, and with them, a small bit of your life. Where did it go? It doesn't matter: it's irretrievable.

And that's the worst part of insomnia. Ironically, all those waking hours, and the many hours required to recover from them, are time lost.

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In the end I did the housework. I prepared a nice dinner. I watched the special on China. By then it was nine-forty-five. I brushed my teeth, taped my hands into their braces, and lay down. I slept. Not perfectly: from two onward I woke several times, but was able to sink back down. I slept--lightly--until seven. And today I am tired. But not as tired. I am able to think. I can write. Tonight, or in three days, or in a week, I will begin sleeping normally again. I will recover my mental stamina. Until the next bout. There is nothing I can do but abide it.