Insomniac

by Gayle Greene

"I can't work, I can't think, I can't connect with anyone anymore. . . . I mope through a day's work and haven't had a promotion in years. . . . It's like I'm being sucked dry, eaten away, swallowed up, coming unglued. . . . "These are voices of a few of the tens of millions who suffer from chronic insomnia. In this revelatory book, Gayle Greene offers a uniquely comprehensive account of this devastating and little-understood condition. She has traveled the world in a quest for answers, interviewing neurologists, sleep researchers, doctors, psychotherapists, and insomniacs of all sorts. What comes of her extraordinary journey is an up-to-date account of what is known about insomnia, providing the information every insomniac needs to know to make intelligent choices among medications and therapies. "Insomniac "is at once a field guide through the hidden terrain inhabited by insomniacs and a book of consolations for anyone who has struggled with this affliction that has long been trivialized and neglected.

Genres: Nonfiction, Psychology, Science, Mental Health, Health, Memoir, Medical

775 pages, Kindle Edition

First published February 9, 2008

Reviews

[mark · Rating 5 out of 5]

"Insomnia" sometimes haunts me. Last night it did, after finishing this book, which is, fascinating and well written. So what is Gayle Greene's problem? She has trouble sleeping, so what? Most people do, don't they, sometimes? She takes pills and that helps her get "enough" sleep. She's happily married and successful in her career. Love and work, what else is there? I think this book is mostly about psychology; but Greene makes the case that insomnia is mostly about biology--hormones and genes. She gets about 2-4 "natural" hours of sleep a night, and a drug gets her another 3 to 4, if she chooses to take it, which she doesn't sometimes, and then she ruminates all the rest of the night, worrying about sleeping. She says she is not neurotic, that she has a hormone imbalance and has always had it. And the medical profession is wedded to profit (it is); which is a barrier to funding for proper research regarding sleep, and sleep disorders--which consume one third of our time on earth; and we ought to know more about it. I agree; but what I want to know more of is dreams. If she's not neurotic, what's her problem?

This year, I have watched two people, Barack Obama and Hillary Clinton, campaign for the presidency of the United States for the past eighteen months. They each get about four hours of sleep a night. I have never, ever, known of two more highly functioning individuals--persons "on their game." Are they on drugs? Adrenaline. Ill effects? I don't see any.

Greene denies she gets any "secondary" benefit from her insomnia. Really? How-a-bout a great book? She is witty, smart, articulate, loved and successful ... and neurotic and obsessive. I think she's fortunate. I hope she reads this. I'm glad she wrote the book. The book details a lot that is wrong, and right, with the practice of medicine. The story she tells does an excellent job of describing how people are different, and that what "works" for one, might not work for another. And also, that what "works" most reliably is belief, or the "placebo effect" (a sugar pill.) The placebo effect IS the most reliable (it explains the success of alternative medicine's sometimes efficacy); and that people often report getting better to please the professional (even when they're not.) But that doesn't work for her ... seems she is stubborn. So I think ... hmmmm.... Her father is a physician. I have/had a friend, an old one, who is mad at me for calling her out, who's father is this great doctor ... and she suffers from chronic pain--nothing works--NOTHING--to the point she contemplates suicide from time to time. Now, that is anecdotal evidence (if evidence at all) of the possibility of unconscious motivation; and I can't help but think that both my friend's, and Greene's, incidents of incurable malaise are related to daddy. And, moreover, that belief in being cared for is a powerful treatment for what ails a person. Nice work, Gayle. Get some rest, now.

[Ashley A-F · Rating 4 out of 5]

Gayle Greene has written a wonderfully witty and harrowing memoir of her life with insomnia. Insomniacs will find a lot to empathize with here, as she recounts each failed treatment and wacky solution prescribed by professionals and non-professionals (most of whom are 'normal sleepers') who just don't get it. Greene and I have different problems (her issue is idiopathic sleep maintenance, while I'm a late chronotype with a circadian rhythm sleep onset disorder) but our paths through treatment have been remarkably similar, as I suspect has been the case with many of us with sleep problems - despite the wide range of sleep disorders that have been identified. She really hits the nail on the head regarding several issues: 1) the medical community's steadfast cheerleading for CBTI (cognitive behavioral therapy for insomnia) despite the shoddy evidence that CBTI is effective for all types of insomnia; 2) the seemingly inexplicable foray of pulmonologists into the field of sleep medicine (spoiler alert: apnea is easy to diagnose and treat, and it's a big moneymaker); and 3) the complex architecture that makes up our sleep, which medical professionals are still only beginning to understand. She highlights relevant research, subjects herself to attending a bunch of boring and expensive medical conferences in the name of research (and is treated as a suspicious outsider at each one), and above all, gives people like us a voice, which we desperately need. People who suffer from sleep disorders are viewed as lazy, neurotic, sleep-obsessed pill junkies - Greene pointedly remarks that most people would seem neurotic and sleep-obsessed if they weren't getting enough sleep, and she recounts the benefits and pitfalls of hypnotics, from trazodone to benzos to z-drugs. Curiously, the one medication that has finally worked for me is not one she has listed as trying, but that just shows that there really is no "one size fits all" approach to sleep medicine.

Unfortunately, the population that desperately needs to read this book is the population of medical professionals who treat people with sleep disorders, and it's unlikely that any of them will go near it. The fact is, a humanities scholar writing about medicine has no place among the Physician's Desk Reference and the latest edition of the DSM, which is a complete shame. Psychiatrists and medical professionals, in my experience, put on blinders and focus only on the research that favors the cheap treatment (CBTI) or the fancy new drugs, and don't listen to their patients - only when we get lucky and find a professional who believes us do we have any chance of getting to a place where we can get a decent night's sleep.

[Judith · Rating 2 out of 5]

This is a study of insomnia. The author's suffering from the condition is all too apparent. She has the tone just right----somewhere between sleepy crankiness and sleep-deprived hysteria. It's hard to like this book, but it is enlightening. I thought I suffered from insomnia till I read this book and then realized I just have occasional sleep problems. The insomniacs described here are like characters from "The Night of the Living Dead". I feel so sorry for them that it's hard to criticize, but she is pretty whiny. The author's picture on the inside book jacket shows her seated with her head resting on her hand, eyes shut, face mostly obscured by a plastic water bottle. I couldn't help wondering what message was being sent: "I am so tired I can't even open my eyes for this picture that will accompany my book." ? Or perhaps product placement of Arrowhead sparkling water? The picture was more than just a little detail. It made me wonder if the book wasn't also exaggerated.

[Erika · Rating 3 out of 5]

Greene is a literature professor (Shakespearean) with a lifelong intractable sleep-maintenance insomnia issue. She has over the years immersed herself in the medical research in this space as well as, it seems, all literature and thinking on insomnia. And so the book is a fascinating catalog of her more than 60 years of experience and research -- with chapters on pharmacology, on alternative medicine, on sleep clinics, and the like.

As a resource on the state of science (albeit a few years old), the book seems solid and well documented (the endnotes are astonishing). I think her right to call for more research, to suggest that there are many different types of insomnia, and to suggest more focus on biological (especially neurological) causes. Her criticism of the pharmaceutical industry was not well researched, though, and she relied excessively on Marcia Angell, who is anything but objective herself. That chapter nearly prompted me to toss the book aside in annoyance. At the same time, her suggestion that sleep clinics mainly turn beds (like a hotel) and diagnose apnea was intriguing.

As a memoir, the book was frustrating, because she herself admits that she cannot stick with anything. It's hard to know how to react, when she tries a pill for one night only, or discards expensive devices soon after acquisition and perhaps one test-run. On the one hand, I empathized (violently) with her misery over sleep maintenance insomnia, and I agree completely with her frustration over stakeholders (physicians, mainly) who assume that depression and anxiety (and other psychological issues) cause insomnia (rather than vice versa). On the other hand, and in complete contradiction to that, I wondered whether she has missed opportunities to solve her problem and why that might be. And I can't really tell if she has "solved" her issue to her satisfaction. "Bedding Down with the Beast" -- the chapter in which she describes what she does -- suggests to the reader that she has found the "as good as it gets" state, which seems to be somewhat limited by what she is and is not willing to do.

The bottom line: this is well worth reading, if you have insomnia (especially sleep maintenance insomnia) or live with someone who does. I admire her greatly for researching and writing this book, which is thorough and fascinating.

[bea · Rating 5 out of 5]

I often imagine a book promises more than it actually delivers (a friend once asked kindly, somewhat perplexed: "what were you *expecting* from 'A History of Dust'?") However, this book delivers. Gayle Greene answers all the questions that I, as a sometime-insomniac, have asked myself as I lay awake in the wee hours. She writes well and critically, as one might expect from a feminist Shakespearian scholar; she writes intelligently about the science of sleep; and she writes with welcome humor, which can be a rare commodity after a bad night's sleep. I loved the irony of her enjoying lavish corporate-sponsored dinners at the Sleep Conference, after all the money she's spent on sleeping meds over the years (much better food, she notes, than at the MLA conferences she usually attends). She was interviewed by Michael Krasney on NPR the other morning if you're interested in learning what she's about--the podcast is available online.

[Staci · Rating 5 out of 5]

All that I have read on the subject of insomnia has said the same thing, over and over, until now. This book is written from the point of view of a sufferer of chronic insomnia, who has explored the subject from every perspective possible and finally says what no other medical article on insomnia dares to say: science doesn't know why we sleep and so why some of us don't sleep is equally a mystery. It has given me much-needed insight into my insomnia patient's struggles and seeming "overuse" of prescription sleep medications.

I believe all pharmacists need to read this book to prevent categorizing an entire group of suffering people as simple "drug seekers."

[Topmar · Rating 3 out of 5]

What better reading for an insomniac (at 11:30pm) than this book? Reassuring to know I'm in such abundant good company. Exhaustive research on the subject that doctors ignore and restful sleepers minimize. Identifies sleep deprivation as a factor in emotional distress, joblessness, suicide, divorce and overall humorlessness. Identifies all drugs, alternative therapies, sleep lab operations...Author is scathing, cynical, and TIRED.

[Millie · Rating 2 out of 5]

I was going back and forth between 2 and 3 stars for this book, and if GR had half stars, it probably would've gotten a 2.5.

There was some interesting information in the book, but it was drowned out by the sound of the author's whining. I know she's tired. She's an insonmiac. And I feel for her. But her surly tone went more than a little overboard. And, ultimately, the entire 400 pages were a lot of "gripe gripe gripe nothing works gripe maybe the future will see more research."

[Julie · Rating 4 out of 5]

As someone who suffers frequent trouble with sleep I found this a very informative book. My only reservation is that the writer focuses solely on what works for her so that chapters on methods she didn't like are scant and poorly researched. This is more a "state of the research and lack thereof" than a self-help type book.

[Kari Matadobra · Rating 4 out of 5]

I read this book when my sister was going through intense insomnia in her pregnancy. She has often had insomnia since college. I really appreciated the authors due diligence in studying and shedding light on how sleep centers blame sleep apnea on insomnia the majority of the time, and are not equipped to look into other issues. I was saddened by the story of the Mom who helplessly watched her daughter suffer the same issues. One year after reading this book, I was shocked into the world of parasites and their documented increase in activity around the full moon and at different times at night depending on which fungi, bacteria, amoeba or worm has taken residence. Only when I had completely unexplained insomnia myself for months (I would wake up alarmed and be unable to sleep for hours- every night, with no apparent cause), did I do research and an investigation with a microscope despite two "negative"lab tests (which are automated and only detect heavy loads).// Parasites can be passed between family members in what may only appear as hereditary insomnia. It is definitely worth looking into. Dr David Young N.D. Ps.d. says in his book 'Parasites and Worms in Humans,' "In recent medical studies it has been estimated that 85% of the North American adult population has at least one form of parasite living inside their bodies. Some professionals believe this is actually closer to 95%." Dr Hulda Clark recommends ornithine to help sufferers sleep, since it helps offset the ammonia given off by parasites. One quote that is important to note: "Make no mistake about it; worms are the most toxic agents in the human body. They are one of the primary underlying causes of disease and are the most basic cause if a compromised immune system." -Hazel Parcells, D.C., N.D., Ph.D" This book is very much worth reading, but does not address parasites! Especially in our globalized society where people from all over the world live together.

[Jeff · Rating 3 out of 5]

There are some gems in this one and I found the author's personal experiences with insomnia to be fascinating and insightful. Yet, this is by no means a concise volume on the science of insomnia and it's becoming a bit dated. Many chapters read like Greene was trying to cram in as many references as possible. It was both redundant and unnecessarily long. At times I got the impression that by the time Greene got around to writing the later chapters she had forgotten was she had already written in earlier ones. I definitely wouldn't recommend trying to read cover to cover.

[Lasse Laitinen · Rating 4 out of 5]

Good if you want to understand insomnia. Lousy if you want to cure your insomnia with tricks. Great if you want to understand insomniacs, I think. And a great read. Greene discusses insomnia from a fairly wide personal and objective medical-neurobiological-socio-cultural-anthropological-historical-gender perspective, to get started with.

[Kathya Gonzalez · Rating 5 out of 5]

The best book to learn and to raise awareness about Insomnia. Very easy to read.

[Marianne · Rating 4 out of 5]

The forward had me worried, but it turned out to be better than I expected.

[Chris · Rating 5 out of 5]

Excellent book. Informative, entertaining, and well written.

[Greg Heath · Rating 5 out of 5]

Gayle Greene's exhaustively researched "Insomniac" was certainly eye-opening for me. Equal parts memoir and collected research & analysis, it reads as both harrowing personal tale and desperate call to action. A chronic lifelong insomniac herself, Greene approaches the subject with an appropriate mix of scorn and whimsy, keeping things deadly serious but injecting some humor and optimism in as well. The book covers an extraordinarily wide range of information on the oft-overlooked condition, running the gamut from insomnia's impact on a person's life, what goes on behind the scenes at sleep conferences, what's known about sleep architecture, what one can expect from a sleep clinic, and the myriad treatment options available to sufferers. The latter, in particular, chilled my blood. As the reader will come to discover, none of the treatments come without a price, and none have worked for Greene herself.

I devoured most of this book in one sitting, dog-earing pages left and right. I wish I had no interest in this subject, but unfortunately I've recently become a chronic insomniac, myself. For sufferers like me, this book will serve to both calm and infuriate you. Greene gives voice to the insomniacs of the world, quoting them directly throughout the entirety of the book, and as such, sufferers will feel much less alone and likely very calmed with Greene's underlying warm tone and empathy toward her fellow insomniacs. The horrifying outrage, though, is that the medical community gives little to no attention to insomnia, and that insomniacs themselves continue to go unnoticed, unappreciated, and oftentimes even seen as a nuisance. As shown through Greene's conversations with psychiatrists, doctors and drug reps, there's a common "blame the patient" attitude among professionals in the medical community, particularly when it comes to issues of medication and dependence.

The chapter on medication options and the author's own experiences with them is particularly sobering, as it quickly becomes clear that many, if not most, of the drugs prescribed for insomnia have the potential for addiction and long-term cognitive damage. What's even more terrifying is that very little is known about how sleep works or why we need it, and as such, these drugs are barely understood and their long-term effects have not been studied thoroughly. Of the studies that have been done, though, a few things are indicated: the cognitive impairment caused by benzos and similar meds can take a very long time to subside, and may not diminish completely. It is also indicated that sleep meds do not induce natural sleep, thus leaving potential for damaging sleep architecture and suppressing deep & REM sleep (necessary for replenishing the body and mind for waking hours). This chapter is a must-read for any insomniac considering medical treatment, and is easily worth the price of admission alone.

The real meat of the book, however - beyond the overwhelming amount of information and research data - is Gayle Greene, herself. An English professor by trade, she inspires hope in sufferers and stands as something of a poster child for insomnia, calling for action and giving voice to insomniacs the world over whilst drawing attention to the neglect and stagnation in progress on behalf of the medical community. She is honest to the core, and her book is very well-written, despite her having a condition that essentially bludgeons the mind. She even admits, at one point, to her rough drafts having been chock-full of spelling and grammatical errors, to the point where editors and spellcheckers had to ask her what she meant. Despite this, though, she's written perhaps the best book to date on the subject - a realistic look at the condition and what's being done to treat it by someone who actually suffers from it. Any insomniac who's pored through the many carbon-copy, outside-approach books on fixing sleep can tell you that this, alone, sets it in a field all its own.

As a writer, I've actually learned a lot from this book. Not necessarily having to do with technique or structure - though this would certainly serve as fantastic reference in outlining a memoir or research book - but regarding doggedness and force of will. I've only had insomnia for a few months, and my writing and cognitive processes are already starting to suffer. Gayle Greene, though, has had it for her entire life, and has had it worse than I have - and she's written a powerful, passionate, highly-acclaimed book in spite of it. So, in closing: this book will not offer you any definitive answers or perfect treatment options, because there aren't any. It will, however, serve to comfort, entertain, and hopefully inspire any suffering insomniac who reads it. Highly, highly recommended.

[Sally · Rating 4 out of 5]

This is a great book for anyone who struggles with insomnia. It doesn't promise any miracle cures for this condition, but it does provide a very thorough review (from the perspective of an insomniac) of the current state of understanding of the causes and treatments for insomnia.

Gayle Greene is a literature professor who spent years researching this book, in an effort to understand her own struggle with insomnia. Her stories in the chapter about what she learned by attending sleep conferences and interviewing sleep researchers are enlightening and often humorous.

Greene has little patience for the medical establishment that has for so long "blamed the victim" by focusing on the psychological contributors to insomnia rather than on the physiological and genetic aspects of this condition. This will no doubt strike a chord with many insomniacs who read the book, but I felt that she overemphasized this point a little bit too much throughout the course of the book.

As an insomniac myself, I found the early chapters of the book a bit depressing, as I realized how much worse my insomnia could get, how little doctors know about the causes and how ineffective most of the treatments are. I think these chapters are designed to wake up medical practitioners and researchers to reality of living with insomnia. If you are insomniac, however, I suggest that you start with the next-to-last chapter: Bedding Down with the Beast. In this chapter Greene gives some tips about what sometimes works for her or for other insomniacs she has interviewed. Although there are no reliable treatments that work all the time for everyone (or anyone?), there some things that do work sometimes for some people, and reading about these gave me hope. Once armed with this hope, I found the other chapters much more enjoyable.

She really has done an incredible amount of research for a layperson and outsider to this field, and she presents it in an engaging, easy-to-understand, story-telling manner. I haven't finished the book yet, and I can't wait to get back to it tonight.

[Quiver · Rating 3 out of 5]

If you suffer from insomnia or know anyone who does, this may be the book that helps you. And I don't mean help you overcome insomnia -- although some of the ideas in there might -- I mean help you know that you are not alone, not crazy, or help you understand a suffer's seemingly erratic behaviour. It's a subjective account, but this is not hidden. The author is an English professor, not a researcher in the field of Insomnia, but she has suffered this affliction for her entire life and has tried (almost) everything to get help. This includes researching for herself the causes and effects of insomnia, and trying the various remedies, both traditional medication and alternative therapies. She has gone to conferences on sleep and talked to the professionals there, but to no avail.

More resources and research is needed, but in the mean time, the anecdotes and stories in here are a good reflection of the state of the field when the book is written. The insights about what it is like to live with insomnia will help anyone who's never felt it on their own skin understand how horrible it is and how it wrecks havoc with people's lives.

[Meg]

I found this text a fascinating addition to my drug/knee surgery/pain induced insomnia. Not that I've ever experienced anything so awful as 'real' insomnia, normally I'm one of those annoying people who fall asleep "as soon as my head hits the pillow" aside from being an annoying light sleeper who wakes up at any damn thing, but this was my companion every morning I was up at midnight or 1 or 3 or 4am icing my knee, taking a bath or popping more pain killers in the hopes of eking out a couple more hours or sleep.

Greene is an insomniac and english professor who had gathered together all the history, research, and real experiences of insomniacs in the english speaking world to show how difficult it is to treat a problem that people are not really sure the origins of and the frustrations of its sufferers. She includes fascinating (and disturbing) chapters on sleep deprivation, sleep conferences, and the varied drugs and tactics sufferers have used over the years to try and deal with their affliction.

[Carolyn · Rating 4 out of 5]

Once i got about half way through, I was having some trouble continuing to read this book. The first few chapters and the last 2 or 3 are fascinating, the middle drags and is a bit repetitive.

However, an English professor who suffers from insomnia but with no scientific background thoroughly researching and writing about this personal disorder is extraordinary. She really has done her research: attending sleep conferences, speaking to doctors of all sorts, researching treatment with drugs, behavioral therapy, alternative medicine, etc.

The overwhelming amount of information is in part why the middle chapters drag. But as a counterbalance, the early and later chapters have a very personal, even revolutionary undercurrent that I can't ignore.

[Lauren · Rating 4 out of 5]

My senior year of high school, I stopped sleeping at night. It wasn't uncommon for me to get maybe an hour or so between 5 and 6AM, before having to slog off to school and be a walking zombie. No one else had this problem, so I jumped to the conclusion that it was my fault. I never got any treatment, it was just something that happened. I've wanted to read a book about insomnia ever since, and i was thrilled to find this last month.

As a memoir, this was frustrating. It was hard to watch the author repeatedly give up on treatments so quickly. But as a history of a seldom explored disability, this was spectacular. Sleep is something we all take for granted, right up until the moment we can't get any.

[Darshan Elena · Rating 2 out of 5]

Snore, snooze, and slumber when it comes to the science, this book is best when describing the author's own struggles with insomnia. I reckon that Greene would be pleased that I fell asleep (!) twenty pages into her book. It's a keeper for that simple reason. When I began this book, I startled, thinking that I was not that bad, as bad, so bad as those folks Greene introduces. But no. I'd just had several excellent nights. Alas! I remain insomniac... and somewhat proud of it. As a coping mechanism, I have come to romanticize my long nights abed. I read more than anyone I have ever met. I love that, though I loved last night's seven hours of sleep almost as much!

[Jean-claude · Rating 5 out of 5]

This is a candid review of Greene's relationship with sleep and insomnia. Anyone who has had that problem will relate with her frustrations and quest to find relief.

She brings up several interesting obervations from her research. The one I liked best was the theory that humans are not adapted to sleep in a continuous 6-8 hour stretch. Before electric illumination, apparently people used to refer to the "first sleep" followed by a period of awakeness then a "morning sleep" characterized by much more dreaming. That seems to resonate with a lot of people today as well, who try to fight the mid-sleep awakeness period because of time constraints.

[Michele · Rating 2 out of 5]

I haven't presently finished this book; going through it is arduous, and perhaps as frustrating as experiencing the subject firsthand is. It sets the context wonderfully, I suppose one could say. I've got a handful of sleep problems myself (to the point where I stopped driving altogether for some time because I kept falling asleep for microseconds at the wheel) but I don't think it necessarily warrants this much moaning. Ah, well, that's what I get for selecting an autobiographical account over a journal -- but it is worth at least a glance, I think, in that it introduces some fairly under-investigated angles on insomnia.

[Holly · Rating 3 out of 5]

This book was pretty interesting...all about people who suffer insomnia and how little is known about the disorder. The author has struggled with it her whole life and is desperately trying to determine what causes it. The book consists mainly of her research of the disorder in the different aspects of it - medically, psychologically, physically, etc.

[Carrie Cooper · Rating 4 out of 5]

anyone who is suffering from chronic insomnia, or loves someone who suffers from it, needs to read this book! good argument for the possibility that it is a physiological problem, as opposed to a psychological one...

[J]

Alright, I haven't read this book. I'm just an insomniac. It's been a terrible 3 days without sleep and I can't take it!

[Jenn · Rating 5 out of 5]

Thank you, Gayle Greene, for writing the best book ever written on insomnia. It's rarely taken seriously and this book is remarkable.

[Matt · Rating 5 out of 5]

I felt like I was reading my autobiography

[Aimee · Rating 3 out of 5]

Interesting and entertaining read however If you don't have insomnia you may live in terror of it after this. There is actually a fatal insomnia disease!