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Can't Sleep? Neither Can 60 Million Other Americans

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Can't Sleep? Neither Can 60 Million Other Americans

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Can't Sleep? Neither Can 60 Million Other Americans

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NEAL CONAN, host:

This is Talk of the Nation. I'm Neal Conan in Washington. Somebody once remarked the best cure for insomnia is a Monday morning. Well, not for everybody. Chronic insomnia is a sleep disorder that prevents people from falling asleep or staying asleep. Roughly 60 million Americans suffer from it every year, and it disproportionately affects women and people over 65. Insomnia can paralyze daily routines, ruin marriages and careers, and it also comes with a host of stigmas. Science knows relatively little about how it works or why it afflicts some people and not others, and there's a debate over treatments.

Today we'll hear from one insomniac about her personal journey through a lifetime of sleeplessness, and a bit later from two professionals who tell us about the latest findings and field your questions. So, insomniacs, what do you do to deal with it? Tell us your story. Our phone number is 800-989-8255. Email us, talk@npr.org, and you can weigh in on our blog at npr.org/blogofthenation.

Later in the program, what's an honorary doctorate good for anyway? But first, insomnia, and we begin with Gayle Greene, professor of English at Scripps College and author of the book "Insomniac." She joins us from the studios of the Graduate School of Journalism at UC Berkeley. Nice to have you on the program today.

Dr. GAYLE GREENE (English, Scripps College; Author, "Insomniac") Thanks, nice to be here.

CONAN: And I guess there are a couple of questions about how you deal with your insomnia. For one thing, what do you do to try to get to sleep?

Dr. GREENE: First let me say this book is not just about me. I'm actually a pretty lucky person because I'm a professor, which means that I get to structure my own work hours and that's, I think, really the most important thing about sleep. Is like if you have, feel like you have some kind of control over your hours, it's a huge advantage because it means you can sort of sleep when you can, take sleep, you know, when it comes along. Find your own body rhythms, when - which of the hours when you can sleep best. Some people just have a very late sleep phase syndrome.

If you can sleep between five and noon, try to sort of make a schedule around that. I'm an academic, and also I'm not adverse to chemical help. A lot of people are adverse to sleeping pills, and I was for years, and years, and years. And I just found I really couldn't function on the kind of sleep that my body seemed to want to give me.

It seems to want to give me two, three, four, five hours of sleep, and I'm not Maggie Thatcher and I'm not Napoleon Bonaparte and these amazing short sleepers who can do on that. I'm a person with normal sleep needs, that is, six to seven hours. So, you have to cobble together a way of life that works for you. The hardest, the hardest thing I've found that stories that really broke my heart, I interviewed dozens of people for this book

I just talked to lots and lots, because insomnia's not really, insomniacs had not been talked to. That's why I had named the book "Insomniac," because it really centers on our experience. The hardest are people who are really caught, mangled, you know, in this kind of nine to five, or eight to five, or seven to five, these horrible early schedules. People who have children, they have to get them up and take them, you know, to school and so forth. These, this is the hardest kind.

I mean, my book is really not a kind of woe-is-me story. My book is very kind of lucky story of someone who actually did manage to find a work situation where I could be productive and at the same time get the kind of sleep I need. But it's miserable, I mean, you know what it's like to have two, three hours of sleep. I mean, you're good for nothing. You're just like the glass is half empty. Or the glass is totally empty.

CONAN: Yeah. You've written, in fact, that the first thing to go is the sense of humor.

Dr. GREENE: Yeah, exactly. I mean you're just good for nothing to anybody. To yourself, you know, I mean creativity goes out the window. I cannot, you know, string two words together in a sentence on those kinds of days. And I'm happiest when I'm productive, and when I'm functional, and when I'm out there in the world kind of doing stuff.

And this makes you sort of just want to stay at home, crawl under the sheets and hide. So it's a very debilitating, it really cuts you off at the knees. I mean obviously there are many worse afflictions than insomnia, but sleep is the fuel of life. I mean, it's nourishing, it's restorative, and when you're deprived of it, you are really deprived of a basic kind of sustenance. Sleep that knits the raveled sleeve of care, said Shakespeare.

CONAN: You are also, and I guess I wasn't aware of this, but that insomniacs are not taken very seriously by doctors, by science. And indeed that they're not taken seriously, by oh, you can't sleep, big deal.

Dr. GREENE: Yeah. Exactly. I mean sleep is very invisible in this society. Sleep itself is not taken seriously. I mean, you think about the people you know who sort of boast about how little sleep they need. It's very, very aggravating, those people. But, we kind of admire, it's kind of a sleep machismo we admire. You know, my students tell me I'll sleep when I'm dead, or you snooze you lose. I mean, there are these kinds of sayings that go around college campuses and doctors are caught up in this. I mean, think about their training, which is a kind of hazing in sleep deprivation.

Doctors actually get very little training in sleep itself. So, when you're dealing with a doctor, you're dealing often with somebody who really doesn't know how to deal with the problem. And when you don't know how to deal with a problem, you tend to shove it back on the patient. You know, I don't know what's wrong with you. I don't know how to fix it. It must be something you're doing wrong. And so it gets kind of shoved over. Blame the victim, you know, kicked into our court.

If you could only change your attitude, change your habits, have a better frame of mind, have a more regular schedule, you could get a hold of it. And so, it's something you're doing wrong. And also there's this sort of waste basket diagnosis, which is depression anxiety. You must be depressed, you must be anxious. Here, have an anti-depressant. Well, of course we get depressed and anxious when we can't sleep.

CONAN: When we can't sleep, I see.

Dr. GREENE: Anybody does.

CONAN: And it used to be thought that this was a symptom of something else, as opposed to being just what it is, itself.

Dr. GREENE: Yeah, exactly. Insomnia was seen as secondary to something else. Secondary to depression, anxiety, to some kind of psychoneurosis, some kind of psychopathology. Again, sort of kick it back into the court of the person who has it. And if it's so defined as a secondary rather than a primary disorder, then why research it? You know, why spend the research money to find the neurobiology of insomnia?

It's only very recently, really since about 2005, the NIH conference in 2005, that it was acknowledged to be a primary disorder, truly a primary disorder. I mean, it's been in the DSM as primary since 1994, but it was, you know, really kind of discussed as something we have to look at in a neurobiological way at that conference. Very exciting conference.

CONAN: We're asking Gayle Greene's fellow insomniacs in the audience to call and tell us how they cope with their condition, 800-989-8255. Email us, talk@npr.org. Let's begin with Emily, Emily is calling from Ledyard in Connecticut.

EMILY (Caller): Yeah, Hi. I have suffered from insomnia for years. And you know, I tried meditation. I tried reading books, you know, everything, and nothing ever helps. And it was really a problem for me until when my daughter was born, it actually became an asset, because I was used to being up all night. I had no problems, well, less problems functioning the next day than my husband, who always has had like a good night's sleep, you know. So I just wanted to say that you know, definitely having a history of insomnia helped me through those sleepless nights with my newborn.

CONAN: So, there wasn't the usual resentment that one partner has to get up and deal with a crying baby?

EMILY: Yeah, no. I just did it voluntarily because I was used to being up all night anyway. So.

CONAN: All right, well, I guess that's the silver lining, though I suspect your daughter's now old enough that this is no longer helping.

EMILY: She is eight months old...

CONAN: Ah.

EMILY: So, she's sleeping through the night, and I'm not. So, the first time when my husband was sleeping, the baby was sleeping, the dog was sleeping, and I wasn't, then I knew that she was passed being a newborn, and she's now, you know, on to bigger things, so...

CONAN: Emily, you must be exhausted.

EMILY: It's - there are some long days. It - no lie, it can be a long day especially because I have an hour commute, and I have called in tired once.

CONAN: Called in tired?

EMILY: Yeah. If I was up all night with the baby or whatever and you have an hour commute, what can you do? If you need to watch out for the safety of yourself and others on the road, you know?

CONAN: Mm hm. Well, thanks very much for the call. Good luck with it.

EMILY: Thank you.

CONAN: OK. Bye-bye.

EMILY: Bye-bye.

CONAN: And let's see if we can go now to Jim, and Jim's with us from California.

JIM (Caller): Yeah, hi. Yeah, I have a little trick I use, I have a small cassette, and I have earphones that I put in my ears so I don't disturb my wife, and I listen to a not too exciting narrative, usually, history or something that's not, you know, a little bit...

CONAN: Maybe somebody reading the Manhattan phone book?

JIM: Well, no, no, it can't be that boring because then it won't - the point is, it's got to interrupt my train of thought...

CONAN: I see.

JIM: Because that's what is the sort of the obsessive nature that prevents me from falling asleep.

CONAN: Gayle Greene, have you tried that?

Dr. GREENE: Oh, have I tried it? That is one of my time-honored devices. I'm so glad you mentioned that. I actually, I love memoirs and certain kinds of novels that aren't...

JIM: Yeah, you can pick them up any place.

Dr. GREENE: Yeah, exactly. It doesn't matter if you fall asleep. You can't be lying there waiting to see what comes out next, you know, page turners, cliff hangers. They don't work. There are many, some books by Alice Hoffman that have kept me awake until dawn. But something where, you know, and it's got to be read in a kind of soothing way, and it's wonderful to get your mind onto another story. I think it evokes the inner child in us, you know, tell me a story.

I love these things. I'm completely addicted to them. I need, you know, tapes. I can't use the newer technologies, because you wake up, and you're at the end of the novel. I mean, I have to - tapes are shorter. You wake up, and you can just wind back the next night, but they're very, very comforting and very interesting. It's a way of keeping up with what's going on, you know, for me, in contemporary fiction and non-fiction writing. So, I'm glad you mentioned that.

CONAN: Jim, maybe you and Gayle should get together...

Dr. GREENE: And compare.

CONAN: And make an insomniacs' all-time hit parade.

JIM: I thought you were going to say sleep together.

(Soundbite of laughter)

CONAN: It's a family show, Jim.

JIM: We could share earphones.

Dr. GREENE: I think there are a lot of people who have found their way to this technique since - from my interviews, I've heard quite a few, some people actually like to watch things. Some people swear by the golf channel. That's wonderful. I watch DVDs before I go to sleep. You're not supposed to watch anything, but I like visuals as well. That's before I go to sleep, but when I wake up in the middle of the night, it's the books on tape.

CONAN: Jim, thanks very much for the call and good reading!

JIM: OK, thank you.

CONAN: Bye-bye. If you've been tossing and turning at night, fighting off insomnia, what have you tried? We'll come back and talk about two kinds of solutions, medical and behavioral. And we'll take more of your calls. 800-989-8255. Email talk@npr.org, and you can also check out what other listeners are saying on our blog at npr.org/blogofthenation. I'm Neal Conan. Stay with us. It's the Talk of the Nation from NPR News.

(Soundbite of music)

CONAN: This is Talk of the Nation. I'm Neal Conan in Washington. We're talking about insomnia this hour. Our phone number, if you'd like to join the conversation and tell us what you do to deal with the problem, is 800-989-8255. Email is talk@npr.org. Our guest is Gayle Greene, author of the book, "Insomniac."

We got this email from Virginia. Little money and no drugs and it's worked for 20 years for me. Buy two electric timers. Plug one in an electric blanket. Plug in bedside lamp in the other. One old newspaper folded in fourths to a rather boring article one can read and fall asleep on one's side with the warmth of the blanket and never have to turn it or the lamp off. If that should fail, BBC or some such overnight, no music on the radio, turned almost too low to understand what is said. Have you tried the two timers technique at all, Gayle, do you think?

Dr. GREENE: It's just so amazing to me because everybody's story is so different and everybody's solution is so different. Warmth of a blanket, no. I need it cold. I need - temperature actually needs to decline in sleep, and it's kind of the trigger for sleep is this decline of - falling temperature. And so, warmth of the blanket, counter-intuitive, but, hey, if it works, go with it.

I was also really interested in one of the earlier callers who talked about motherhood as helping her insomnia because many women, of course, are, you know, it precipitates insomnia, so that story was very different, as well. I mean, we all have to - there is no one-size-fits-all solutions to insomnia.

There's no one-size-fits-all explanation for insomnia. We have to find our own way with this. Find whatever works. So, these stories that come in, I love them. They're ingenious. They're inventive. People have really worked out things that work for them. That's what we all have to do.

CONAN: Joining us now are Dr. Ronald Chervin and Todd Arnedt. They work in tandem at the Sleep Disorder Center at the University of Michigan to address the medical and psychological issues that surround insomnia. They're with us now from member station WUOM in Ann Arbor. Nice to have you with us on the program, today.

Dr. TODD ARNEDT (Fellowship Director, Sleep Disorder Center, University of Michigan): Thanks for having us.

CONAN: And who's who? First of all, Dr. Chervin, so we can hear your voice?

Dr. RONALD CHERVIN (Director, Sleep Disorder Center, University of Michigan): Yes, pleasure to be here.

CONAN: And then Todd Arnedt?

Dr. ARNEDT: I'm Todd. Right here.

CONAN: OK. We can tell your voice is a little bit different. To begin with, what do you make of Gayle Greene's criticism that medicine and science often don't take sleep, or insomnia, for that matter, very seriously?

Dr. CHERVIN: I find that really resonates very accurately. We see a lot of sleep patients at our sleep disorder center, and the large majority have had their problems for many, many years. Many have complained to various people including, sometimes, their physicians about it, and not gotten a satisfying answer.

CONAN: She writes in her book, and, oh, I'm sorry, go ahead. I didn't mean to...

Dr. ARNEDT: I was just going to say it's truly something that's under recognized as I think our guest alluded to. Doctors don't learn about sleep as they go through college, and so, they're often reluctant to ask their patients about sleep. And so, it often gets missed in the context of a primary care setting. And so, it's only after years of struggling that patients finally end up in our specialty clinics, looking for answers, searching for solutions.

CONAN: She also pointed out that doctors don't get a lot of sleep in college, and even less when they're interns.

Dr. ARNEDT: Yes, that's very true, and we actually have some research evidence that suggests that, after a month of heavy call, they may be as impaired as a low dose of alcohol in certain performance tests. So, we know that it's quite impairing.

CONAN: Are there psychological issues that are linked to insomnia?

Dr. ARNEDT: Well, as you both alluded to, there's definitely this cyclical nature that goes on where you don't get a lot of sleep and that triggers a low mood. And then when you have a low mood, it makes your sleep worse, and the two sort of feed off each other. And that's probably, in the studies that we've looked at, that's probably the most robust effect of sleep deprivation is its effect directly on mood, whether it increases anxiety or whether it increases depression, the mood effects are quite robust.

CONAN: There are also a lot of sleep clinics around. I understand that those are largely to treat a condition called sleep apnea where a sort of mechanical problem keeps waking you up at night. You deprive yourself of oxygen, but do sleep clinics address insomnia, per se?

Dr. CHERVIN: They do, they do very much. In fact, the main complaints that bring people to sleep clinics are either that they're too sleepy during the day or that they have some trouble sleeping at night. And one of the first things we do with either of those complaints is try to diagnose the hypersomnia, in the first case, or the insomnia, in the second case.

And there can be a lot of different reasons for insomnia, specifically. And they range from medical causes to psychological causes to primary insomnia or psycho-physiological insomnia, which a great number of people have, which I think Gayle Greene was talking about when she said that insomnia is not necessarily secondary to something else.

CONAN: Gayle Greene, I know, part of the research for your book, you went to a sleep clinic, and well, it was a strange experience.

Dr. GREENE: It wasn't very satisfying. It, first of all, I was supposed to sleep between ten p.m. and six a.m., and my usual sleep hours are more like three a.m. to ten a.m., and so - and I was supposed to sleep on my back so they could check for breathing, and I never sleep on my back. So, all in all, I think they looked at - they actually saw about three hours of my sleep.

And also, with an insomniac, our sleep patterns are so erratic, so various from, you know, night to night, that one night doesn't really tell much. And everybody, you know, acknowledges this, but of course, no HMO is going to, you know, foot the bill for more than one night because the clinics are extremely expensive.

So, the paperwork took a year, about a calendar year, from the time my physician had put in the request to the time that I actually saw, you know, consulted with somebody at the clinic. And I kept thinking, gee, it's really - nobody really much cares in this health care system whether I'm sleeping or not. In fact, I wasn't sleeping very much at that point. And it just seemed so non-urgent and so perfunctory.

And then, at the end of it, I got advice on sleep hygiene, which I could have read on anyone of many, many web pages. Even, you know, it's - this is in the air. I didn't need to go to a clinic to hear this. So, it was not satisfactory. I'm sorry to say, and I - a lot of insomniacs I've talked to have been disillusioned with the clinics in terms of insomnia. For apnea, for movement disorders, this is very, very important to, you know, screen this out. But for insomnia, I did not feel a lot of enthusiasm from insomniacs.

Dr. ARNEDT: Yeah, that's - let me just jump in here and say that not all sleep clinics are created equal. I think it's...

Dr. GREENE: I agree.

Dr. ARNEDT: Important to go to an accredited clinic, and there are resources out there available to do some research and look in to see how good your clinic is. A good website for information is www.sleepeducation.com. And there you can find a list of accredited centers that you can expect would treat insomnia in probably a more appropriate way that Gayle's perhaps was dealt with.

Certainly with insomnia, our first line of defense is not usually a sleep study, unless we feel strongly that something like sleep apnea might be causing the insomnia. It's often to go in alternative routes and not all sleep centers have clinics devoted to insomnia specifically. Our's is one that does, but they're certainly in short supply across the country.

CONAN: Let's get another caller on the line. This is Kevin, Kevin with us from Fresno in California.

KEVIN (Caller): Yeah, hey, how're you doing?

CONAN: OK.

KEVIN: This topic is so - the inability to sleep has all but destroyed my life, and I'll try not to get too emotional here, but over the years, I have gone - my body seems to work not on a 24-hour clock, but on a 30- to 36-hour clock. If I wake up at six a.m. one morning and get to work and work during the day and, instead of being tired and ready for bed at 10 or 11 o'clock that night, I'm not tired until three or four the next morning, and I've got to get back up at six.

And sometimes, I can't sleep for a couple - the longest I've ever gone was four straight days without sleep, and then I'll sleep like the dead, and it's not uncommon for me to oversleep my alarm by not a few minutes, but by four or five or six hours. I have lost countless jobs due to not being able to sleep or get up in time to get to work and after not sleeping a couple of days, or going in on my second or third day without sleep and not being able to perform. I've lost relationships. I've lost my relationships with my parents because I can't hold a job, and I can't think straight and I can't see straight.

And I've lost my relationship with a good woman, my son's mother and my son, I don't see him. And it all comes down to sleep, the inability to sleep, and then when I do, I sleep like I'm dead. And I don't know where to go, what to do, who to talk to. I can't get anybody, for the last 10 years, I've been trying to get someone to, kind of, take this seriously, and I can't find that. And this is - I'm getting - well, I've been up for, God, almost 30 hours now.

CONAN: Oh, I'm so sorry.

KEVIN: But it's a constant thing, Neal. It's constant, and it's been this way as far back as I can remember. I'm in my mid-30s, and it's been this way as far back as I can remember, being a little kid, getting in trouble for still being awake at 11 or 12 o'clock at night. And I just can't sleep.

CONAN: Gayle...

Dr. GREENE: You are why I wrote the book. I mean, I'm hearing you and, you know, my heart is breaking for you. And you're speaking for so many people. You are not alone, there are so many people whose lives have been destroyed by this, who end up, you know, on disability, who can't hold jobs, who can't hold relationships. And it's just not their fault.

And nobody is hearing them, nobody's taking this seriously. You obviously have a sleep pattern that's unusual and employers, hear this. I mean, lighten up. I mean, let us do flex time. let us do the work on our own time. Don't insist that everybody, you know, be there nine to five. Some employers are getting this message, and allowing sort of napping, and allowing people to work from home.

You get more out of workers doing this. And friends listen, you know, friends and family and relationships, this is not something we're bringing on ourselves or something we could get hold of if we'd only observe better sleep habits. This is something that has got us, you know, in its grip and really can just - you know, what you said is so eloquent, and thank you for saying it.

CONAN: Dr. Chervin, Todd Arnedt, any advice for Kevin?

Dr. CHERVIN: Well, I have a slightly different take on it. I think that the problems that Kevin is describing are certainly serious, and I certainly hear him. But what I wanted - the messages I want to give him is that most of our patients who come in, even with a life-long history of insomnia like that, can be helped, and can be helped effectively.

In fact, you know, with all respect, Gayle Greene's experience aside, one of the reasons that people like me come into the sleep field is because it's one of the most rewarding areas of medicine. Our patients by and large are very happy patients when we're done treating them. And I don't think that Kevin's - the chronicity or the long-term nature of it or even the amount that it's impacted his life means that he couldn't do something about it.

And in particular, for example, people have a lot of trouble going to sleep at night, and a lot of trouble getting up in the morning, if that was some of the pattern that he was describing, may have a condition called delayed sleep phase syndrome. And it's believed to relate to the clock inside our brains and it becomes...

KEVIN: Yeah, that's exactly how it feels. And that's how I've tried to describe it to people. Like I said at the beginning of the call, I don't work on a 24-hour clock. My body seems to work on a 30 to 36-hour clock.

CONAN: And can that clock be reset?

Dr. CHERVIN: What we have all kinds of strategies to effectively help with that. Short of asking society to change their tolerance, and I'm not arguing against that, I do think employers need to be sensitive to people with medical disorders, including sleep disorders. But there are all kinds of things, ranging - including regular scheduling, sometimes modifying your schedule for a short period, to get back on a regular schedule, sometimes using bright light in the morning effectively. We have a lot of good approaches that can be effective for this.

KEVIN: Bright lights tend to make me angry.

(Soundbite of laughter)

CONAN: Kevin, I can't tell you how much we all wish you the best of luck and a good night's sleep.

KEVIN: Well, thank you very much, and I hope there will be links and information on the website I can check out.

CONAN: I hope so. And one of the links we will provide is obviously the one that we just heard about from the University of Michigan there, but also some links that Gayle Greene has brought up in her writings, for people with these conditions to talk to each other and find out that they are not alone. But thank you very much for the call, Kevin.

KEVIN: Thank you, Neal.

CONAN: Bye-bye.

KEVIN: Bye-bye.

CONAN: We're talking about insomnia with Gayle Greene, the author of "Insomniac." Also with Dr. Ronald Chervin and Todd Arnedt who are with us from the University of Michigan. You're listening to Talk of the Nation from NPR News. And let's get Bill on the line, Bill from Portland, Oregon.

BILL (Caller): I have a question about how this might be passed on through heredity and so forth. I've had - I've noticed it more and more the older I got, but my father I think had it, didn't acknowledge it, it was just a part of his lifestyle, he used to call it, only sleeping about five hours a night. I do about three to four. And now I have a daughter that's in her 30s, and she's starting to suffer from it also.

CONAN: Any information on the hereditary nature of insomnia?

Dr. ARNEDT: Well, that's an emerging field, actually, of research, and there's some preliminary studies, at least in the insomnia field, to suggest that a good portion of it is hereditary. And the way I sort of think about it is, I think there are people out there who do inherit, if you like, a sensitive sleep system, that really can be perturbed quite easily and can cause problems for them chronically, in terms of their sleep. And we're starting to understand that that is the case for at least a significant portion of people. But it's a young field, and it's growing and we only have a few research articles out on it currently.

BILL: Well, thanks. And the only other think I wanted to say about the condition that my daughter and I both have is that one peculiar thing is we absolutely cannot take sleep during the daytime hours, during, you know, any time the sun is out. And it's almost like we have an internal clock that knows that sunrise during the summer months is even earlier that it is during the winter months, and that affects our sleep pattern. It's really bizarre. I can be just walking dead in the middle of the day, and I cannot sleep, until...

Dr. ARNEDT: Well, sun is certainly the strongest time-giver to that brain, that internal brain clock everybody's got that sort of governs when our body feels sleepy and when it feels alert. So you just may have a particularly sensitive system.

BILL: Yeah, blackout curtains do not work.

(Soundbite of laughter)

CONAN: Well, Bill, again, good luck to you.

BILL: Thank you.

CONAN: And Gayle Greene, before we let you got, what's been the reaction to your book? I know that you've - one of the great things that this is done is to get people to realize they are not alone.

Dr. GREENE: Yeah, I've gotten some wonderful letters from people that have said, you know, this book is an enormous comfort, and it's helped me through many sleepless nights, and it's given me ideas of how to, you know, ways to work with my problem. I was really shocked when I started it to realize there was no insomnia advocacy group. I mean, there's advocacy groups for everything, for narcolepsy and restless leg syndrome, certainly they affect far fewer people.

This affects millions and millions of people and causes enormous misery to millions. And we haven't organized on our own behalf. And it was one of the things I hoped to do with this book was to get people talking to them - talking to each other and to share their experiences. And you know, funding goes to patients who make noise, I mean, bottom line is this condition is very little funded.

There were 20 million dollars spent by the NIH in 2005 on insomnia research. There was 123 million spent by Sanofi Aventis to advertise Ambien that same year. So 20 million to research insomnia versus 123 million to advertise one drug. This is a condition that needs a whole lot more research.

And maybe if insomniacs can talk to each other - I have a web page blog that I'm trying to get going, and it's called sleepstarved.org. And I would really appreciate people to come to this and, you know, share the kinds of things you know about your own condition, ways you found of dealing with it, and maybe we can even find out, you know, what's gone wrong.

CONAN: Gayle Greene, a professor of English at Scripps College. Her book, again, "Insomniac." And there's a link to the Sleep Starved blog on our blog at npr.org/blogofthenation. We'd like to thank her, and also we'd like to thank Todd Arnedt and Dr. Ronald Chervin of the Sleep Disorder Center at the University of Michigan. I'm Neal Conan. It's the Talk of the Nation from NPR News.

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