'Wide Awake' And Desperate To Beat Insomnia
REBECCA ROBERTS, host:
This is TALK OF THE NATION. Im Rebecca Roberts in Washington. Neal Conan is away.
Writer Patricia Morrisroe has been an insomniac for most of her life. She falls asleep pretty easily but inevitably, wakes up after a couple of hours. She's tried everything: pills, soft pillows, expensive sheets. She scoured New York City, the city that quite famously never sleeps, for a quiet apartment, but nothing seemed to work.
Why, Morrisroe wondered, night after night, was it so hard to sleep? A few years ago, she went on a quest for a cure. Morrisroe traveled the world, meeting with sleep specialists. She tried new treatments, sleep studies, hypnosis, new medications.
In a new book called "Wide Awake: A Memoir of Insomnia," Morrisroe chronicles her search for a good night's sleep, and she'll join us in just a moment.
How do you handle your insomnia? Tell us your story. Our number here in Washington is 800-989-8255. Our email address is firstname.lastname@example.org. And you can join the conversation at our website. Go to npr.org, and click on TALK OF THE NATION.
Later this hour, the deadly flooding in Tennessee. If you're in Nashville or affected by the floods, you can send us an email now, email@example.com.
But first, "Wide Awake." Patricia Morrisroe joins us from our bureau in New York City. It's good to have you with us.
Ms. PATRICIA MORRISROE (Author, "Wide Awake: A Memoir of Insomnia"): Thank you very much.
ROBERTS: When did you realize you were a bad sleeper?
Ms. MORRISROE: I think I was always a very light sleeper. You know, as a child, you know, anything could keep me up. I mean, if Santa Claus was coming, that would keep me up; the Tooth Fairy, the Easter Bunny, you know, and those were good things.
I often couldn't sleep before tests. I had to come home from sleep-away camp because I couldn't sleep away. So I think very early on, I recognized that, you know, I had sleep issues.
ROBERTS: Which also, certainly, wouldn't have put you in the minority of your family.
Ms. MORRISROE: Exactly, on my mother's side. My father's side, they sleep very well.
ROBERTS: So give us a sense of what you tried - or did you just kind of resign yourself to being chronically sleepless?
Ms. MORRISROE: No. I mean, I think the real turning point for me was a couple of years ago. I was so tired; I had only gotten three hours of sleep. And I went out to cross the street on a red light and nearly got hit by a cab, and the cab driver shouted: Lady, what's your problem?
And I really began to think, hmm, what is my problem, and what can I do to fix it? And I spoke to my internist and she said, look, you'd better go see a sleep doctor. So I started from that point on, and then went through the sleep study and all that entailed.
ROBERTS: Well, you know, it's interesting because it seems like the stakes are sort of ever raised. I mean, we just heard a report just moments ago about a new study that says that teenage boys not getting enough sleep are likely to be obese.
You know, the health effects of sleeplessness - in addition to the possibility of getting hit by a cab - seem to stack up on each other with every new study. So it's not just sort of feeling exhausted. It's actually dangerous.
Ms. MORRISROE: Yes, I mean, I think that point can be overstated a little. I think the fact that people may be overweight in this country has probably more to do with overeating at this point than it does real sleep deprivation.
But certainly, you know, it's important to get not so much the seven to nine hours of sleep that seem to be recommended. I mean, it's important to get, to figure out what - how many hours you need and do that.
I mean, the one thing that I found in doing all the research is sleep is very, very personal. There's really no one size that fits all. People are very individual sleepers, and what some people may need 10 hours. Some people may need six hours. You know, the key is finding out what's right for you.
ROBERTS: Well, it also gets at this idea that it's very hard to tease out cause and effect, that, you know, if sleeplessness is causing other health issues or maybe other health issues - is affecting your sleep, and maybe you're having a hard time sleeping because you're anxious, or maybe you're anxious because you're not sleeping - that sort of what is the root cause is kind of hard to pin down.
Ms. MORRISROE: It's always been very difficult. You know, insomnia is a very, very vague complaint. Is it linked to depression? Is it linked to anxiety? Are you not sleeping because you have sleep apnea or restless leg syndrome?
You know, you could be sleeping for sleepless for a variety of different reasons, which is why it's really important to check it out. But you know, there's a whole, vast majority of people who probably aren't sleeping because they're anxious, and also we see so much of the emphasis on sleeplessness now because as you age, your sleep tends to fall off, and we have that huge bulge of the baby-boom population getting older.
So I think that is a lot of the reason why we see such intense focus on sleep issues now.
ROBERTS: And a lot of focus on medication as a solution.
Ms. MORRISROE: Huge, huge. I mean, we spend something like $45 million a year on sleeping pills and by 2012, it's estimated the number will be close to 3.9 billion. So you know, the pharmaceutical companies have a huge stake in trying to make us believe that we are more sleep- deprived than perhaps we are.
ROBERTS: Did sleeping pills work for you?
Ms. MORRISROE: No, they didn't. You know, sleeping pills can work for some people, and they tend to work a lot better in helping people fall asleep. But for sleep maintenance insomnia, which is what I have - which is, you know, you fall asleep right away and then wake up three or four hours later, and then you have this, you know, yawning hole in the middle of the night - it's very difficult for sleeping pills to keep people asleep throughout the night.
So for me, no. I didn't they just did not work at all. I found them...
ROBERTS: So what did you do with that yawning hole?
Ms. MORRISROE: Well, I did a lot of things. You know, at times it would absolutely drive me crazy, and I'd be roaming around the house, and then for a period of time I finally said, oh, let me just go with it. And, you know, I'd sort of stay in bed and analyze my dreams and, you know, think up book ideas. And I know cognitive behavioral therapists would tear out their hair at the thought of that.
But what's interesting is that in some of the research that's come out, particularly Roger Ekirch's book, his history of the night, he talks about before the invention of electric light, people slept in segmented sleep.
They would sleep for a few hours, they'd be up for several hours, and then they'd be - fall back asleep again. So in many respects, that sleep pattern is fairly natural.
ROBERTS: What would cognitive behavioral therapists say you should be doing instead, if you're wide awake in the middle of the night?
Ms. MORRISROE: To get up. Do not associate your bed with lying awake. Associate it with sleep. They would say, you know, get up and read something - calming. But for a writer, you know, it's just - nothing you read is calming. Everything you read reminds you of, you know, the books you should be writing next.
So that didn't work for me. But they do say, you know, get out of bed. Get out of bed until you feel sleepy, and then go back to bed again.
ROBERTS: Let's hear from Greg in Ann Arbor, Michigan. Greg, welcome to TALK OF THE NATION.
GREG (Caller): Hi, hi. Yeah, I'm a person that usually wakes up about -exactly 3 o'clock in the morning, and I use mental imagery, open-water swimming - when I swim in the lakes - and it soothes me right down. And after 15 years of triathlon, I've learned that the best thing to do is to lay there and stay as relaxed as possible any way you can, and keep your heart rate down. That's the only way you get your rest.
ROBERTS: So how long are you generally awake, Greg?
GREG: (Technical difficulties)
ROBERTS: Oh, I'm afraid your cell phone is breaking up. But thanks for joining us. So I have a mental image of Greg lying there in his bed at 3 o'clock in the morning, picturing himself swimming in a lake - and then needing to pee.
(Soundbite of laughter)
ROBERTS: Does visualization work for a lot of people?
Ms. MORRISROE: I think it can. I mean, for me the main thing that I found after, you know, doing my three-year quest was meditation. Meditation was the was a real, major revelation for me, not only for my life but for my sleep. It really helped calm me down.
So I think if you can do any type of relaxation exercises, if you can practice, you know, breathing, I think that if you can do it, it's far more beneficial than, you know, going the pharmaceutical route.
ROBERTS: You know, I was curious reading your book, when you described your sort of sleep cocoon, that you felt that you could stay asleep if you were cocooned in sleep. Is that part of what you picture when you meditate, and does it still work for you, or have you had to try to sort of update your imagery?
Ms. MORRISROE: Well, you know, I also did hypnotherapy, and we went through a whole thing where I was to imagine myself in the cocoon of sleep. The cocoon does work except that sometimes, I can sort of let my imagination go and - becomes like one of those cocoons in the alien movies. So then it doesn't work.
(Soundbite of laughter)
Ms. MORRISROE: But you know, I think the water imagery - I mean, for me, I think being a writer - and I do tend to have an active imagination - if I can sort of not go near the imagery and just do the deep breathing, that's far more beneficial.
ROBERTS: Let's hear from Kay(ph) in Syracuse, New York. Kay, welcome to TALK OF THE NATION.
KAY (Caller): Thanks so much. This is actually, I think, really a far more critical issue than people who don't have sleep deprivation recognize, and my point to your screener was that I believe that some people are born with body chemistries and body clocks that wake them up every two to three hours.
I remember as a very young child - 6, 7 years old - I learned the constellations because I would wake up about 2 or 2:30 in the morning, which I still do, even with a sleeping assistant, and I would lean out the bathroom window on my back, with my little star book, and study the stars. And it lasted for decades and decades and decades until I finally, you know, talked to somebody about it.
And I think that - although I completely agree I used to teach yoga, I was a runner, I mean, you know, completely; I taught health fitness - I completely agree that pharmaceuticals are not the answer. But there are non-addictive, sleep-assistant drugs - and they are controlled substances -which really, really make a difference for people who have this, which I think is a metabolic difference.
And so I agree that visualization is great. Whatever you can do is great. But some people just have very powerful body chemistry that wakes them up every two to three hours and...
ROBERTS: Kay, thank you for your call. Well, you know, certainly we traditionally think of people who are natural night owls or, you know, early birds. It wouldn't be surprising if people had chemistry that made them sleep differently.
Ms. MORRISROE: Oh, I think that's very true, and they're finding out more and more with advances in, you know, neuro-imagery that that's the case. You know, the sleep doctor that I went to said to me, look, I can help you sleep better, but you'll never be a champion sleeper. And I think he's right.
You know, I sleep much better now, but you know, I am not a champion sleeper. But I'm also not a champion runner or anything else. So you know, I think you sort of have to accept that.
And what's been interesting to me is, you know, once people found out I was writing a book on sleep, the number of people who have told me how little they sleep, or the sleep difficulties they have. So that's been very interesting.
ROBERTS: Patricia Morrisroe's book is called "Wide Awake: A Memoir of Insomnia." We'll get to more of your calls in a moment. How do you handle your insomnia; 800-989-8255 or email firstname.lastname@example.org. I'm Rebecca Roberts. It's TALK OF THE NATION from NPR News.
(Soundbite of music)
ROBERTS: This is TALK OF THE NATION. Im Rebecca Roberts in Washington.
We're talking with Patricia Morrisroe, a fourth-generation insomniac. She set out to find a cure, and documented her search in the new book "Wide Awake: A Memoir of Insomnia." To read about her childhood in the house of punk sleep, where her grandfather and mother slept lightly, if at all, go to our website at npr.org, and click on TALK OF THE NATION.
If this sounds familiar to you, how do you handle your insomnia? Tell us your story, 800-989-8255. The email address is email@example.com, and you can join the conversation at our website. Go to npr.org, and click on TALK OF THE NATION.
ROBERTS: Patricia Morrisroe, you mentioned the recommended seven to nine hours, and certainly that eight hours of sleep is ingrained in the public consciousness. Where did that come from?
Ms. MORRISROE: I honestly don't know. I mean, I think that there were some studies done years ago, and I know one doctor told me that they had factored in children's sleep as well as with adult sleep. So that's how they got, you know, to the nine hours. But you know, I've asked a lot of people and they're not exactly sure where. And as I said, the one thing that I learned is that sleep is very, very individual.
You know, the studies the one study that they've done, involved with the American Cancer Society, they were following people involved in that and you know, they tracked people's mortality rates over a six-year period. And people who slept less than eight hours actually had a better mortality rate than people who slept more.
So while we hear about all of these health consequences in terms of not sleeping, you know, it's hard to know how much they bear out. I know my mother is a has always been a very poor sleeper, and she's almost 90 years old and still drives her car and, you know, was shoveling snow this winter. So from my perspective, you know, my family hasn't really slept that well and also, has been lucky enough to be pretty healthy.
ROBERTS: Well, those longevity figures should be comforting to Bill(ph) in Oklahoma City, who joins us now. Bill, welcome to TALK OF THE NATION.
BILL (Caller): How are you doing today?
BILL: Good, good. Yeah, I'm a chronic pain patient, and have been for about 10 years now. So unfortunately, I have to take a lot of medication, and some of the medication actually keeps me awake. But sleep medication is on the regimen. However, when I first started taking the medication, it seemed to work OK, but the problem with it was that it made me sleep too long. And when I would wake up, I would be in so much pain that I couldn't stand myself.
So I had to back off it a little bit, and consequently, now I tend to get anywhere from two to five hours of sleep a night.
ROBERTS: And youve just decided that's your normal, Bill?
BILL: I guess so. You know, I live with that. I get a little tired during the day but never really take a you know, I might take a nap every once in a while, but very seldom anymore.
ROBERTS: Bill, thanks for your call. Patricia Morrisroe, there are some interesting parallels between insomnia and chronic pain.
Ms. MORRISROE: Yes, well, certainly a lot of people with fibromyalgia have difficulty sleeping. And as we see, I think, you know, with the aging of the baby boomers, more and more issues with pain prevent you from sleeping. So yeah, look, it's hard to sleep if you're in a lot of pain.
ROBERTS: Well, also it's a sort of self-diagnosed, slightly fuzzy syndrome that is hard to, in both cases, often hard to parse out the causes and effects, and hard to find the right treatment.
Ms. MORRISROE: I think it is. I think also, you know, a lot of people tend to, for example, if they're suffering from depression, they may sleep too much, they may sleep too little. The doctors will put them on antidepressants, and sometimes antidepressants can exacerbate the insomnia. So when you're taking a lot of different medications, you know, sometimes that really does mess with your sleep.
ROBERTS: Let's hear from Corey(ph) in Richland, Washington. Corey, welcome to TALK OF THE NATION.
COREY (Caller): Oh, hi.
COREY: Yeah, I'm 46 years old, and my earliest memory is slamming my head against the pillow of my crib, trying to wear myself out to go to sleep. And I spent I spent some time in the military, and I tried to work day jobs, but I couldn't hold a day job for more than six months.
And about 15 years ago, I just gave up and went over to the dark side. I'm working graveyard, have been ever since, and I really haven't had that much trouble.
I worked one job for eight years. I'm in another job now where I've been there for two years, never lost a day or anything. And, you know, I just had to make a decision of how I was going to deal with it. I still don't get as nice a sleep as I'd like to, but it seems to work for me so far.
ROBERTS: Corey, thanks for your call. So, Corey just gave up and decided to work nights.
Ms. MORRISROE: Well, I think some people are very much natural larks. You know, they need they get up in the morning, and some people are owls. You know, if it works for someone and that, you know, allows you to get a little bit more sleep then, you know, that's probably fine.
ROBERTS: We have an email from Trudy(ph), who says: I've struggled with insomnia all my life, too. My best friend laughs when I tell her that by about 5 p.m., I can usually tell whether or not I'll sleep through the night. It comes down to the inside peace of mind for me. If I'm settled inside, and that often revolves around my teenagers' well-being for the day, I will sleep maybe six straight hours. But drugs do help me. Alcohol does not. Sometimes, even warm milk with vanilla and honey does. Meditation, relaxation sometimes helps; also a cool, even cold room with a lot of heavy blankets. But the worst is when you keep looking at the clock and say, well, I'll be OK; I still have four hours until I have to wake up.
Ms. MORRISROE: Well, I made a point of taking the clocks out of my room. So and I've trained my husband so that he can just wake up without an alarm. But I that was the one thing to go. There is not a clock in my room because I used to watch the clock, and it used to drive me crazy. So it really does help to have no clocks.
ROBERTS: We have an email from William(ph), who says: Im curious if your guest ever seriously tried to aid her sleeping with marijuana. As a smoker who does this every night before sleep, I wonder if this has ever helped your guest.
Ms. MORRISROE: I am really drug-sensitive. So the answer is no. You know, I have I've always had just very funny reaction to drugs. So, you know, even a little bit of sleeping pills, I can sort of hallucinate. So the answer is no.
ROBERTS: Let's take a call from Michelle(ph) in Cleveland, Ohio. Michelle, welcome to TALK OF THE NATION.
MICHELLE (Caller): Well, thanks for taking my call. It's funny, I'm listening to this conversation, and just recently well, not recently, about five years ago I was diagnosed with chronic sleep apnea. And I use a CPAP machine to sleep at night.
But at the beginning of the treatment for the CPAP, which is just forced air, there's no oxygen, I really was sleeping very well. But recently, I've noticed that even with the CPAP, that I'm waking up a little I'm sleeping a little bit shorter and shorter length of time. But the time that I'm sleeping is quality sleep because I am getting to REM.
So I'm glad that I'm actually able to dream, and I'm more coherent during the day. But the more I listen to your guest and the callers, this seems like there might be a combination of things. Can you be can you have sleep apnea and be an insomniac at the same time?
Ms. MORRISROE: Oh, sure. I mean, one thing doesn't preclude the other. I mean, you can take care of the sleep apnea but, you know, you may have other issues related to, you know, your insomnia. So...
ROBERTS: I want to talk about sleep apnea a little bit because the sort of trajectory of how it became diagnosed and treated among sleep studies is an interesting part of your book. Can you tell us a little bit more about that?
Ms. MORRISROE: Well, you know, up until 1972, when they discovered - a man, I believe in Australia, invented the CPAP machine, there was no the only thing that people could do for their sleep apnea was, you know, have a tracheostomy, which was cutting a hole in the throat.
So, once they invented CPAP, that really helped put the whole field of sleep medicine on the map because up until that point, they really didn't have - it didn't have a disease to call its own. I mean, there was narcolepsy, but that was just affects too small a percentage of people. Or you had insomnia, which as I said, was this great, vast, you know, puzzling disorder that so with sleep apnea, you had a disorder that you could fix with a CPAP machine.
So that really changed the course of sleep medicine very much. Prior to that, it was in the domain of psychiatrists and now increasingly, it's been, you know, in the domain of the pulmonologists.
ROBERTS: And has that increased the - sort of attention and research dollars and treatment?
Ms. MORRISROE: Yes, it has, and it certainly has increased the number of sleep labs. I mean, you know, two decades ago, there was maybe only a couple, and now there are thousands of them because you can go in, you can diagnose it and you know, everybody can feel good to come away with, you know, either you can put in a dental bite plate or a CPAP or a BiPAP machine. So you know, they had all of these sleep clinics and, you know, they can be used for a purpose.
ROBERTS: We have an email from Georgia(ph) in Cambridge, Massachusetts, who says: I'm a physician specializing in the nutritional management of common conditions, including insomnia, fibromyalgia and chronic fatigue. And I'm curious to know if your guest tried any dietary changes, as these are usually very helpful. Eliminating irritating foods, which vary from one individual to another, some of which we consider healthy, is usually the key.
Ms. MORRISROE: Certainly in terms of eliminating caffeine, being very careful about alcohol. I've always been a very, very careful eater and a very clean eater. So that, I sensed, was probably not going to be an issue for me. But certainly, in terms of the caffeine intake, you know, I changed my habits there.
ROBERTS: We have an email from Sarah(ph) in Utah, who says: I'm a champion-level sleeper. Nine hours, even more in the winter. I am married to a non-sleeper. He wakes up two to three times a night to read. He turns on the light. I have to put a pillow over my head, not just for the light, but the rustling of the newspaper really gets me.
How does your husband deal with you being a light sleeper?
Ms. MORRISROE: Oh, he's, you know - I'm beginning to think, the more stories I hear, that people marry people who are the opposite, maybe because you always need to have somebody on guard. But he's pretty good, and I can be really annoying - like, you know, elbowing him and announcing, hey, I'm awake, I'm awake. And that would drive me insane if he did that to me. But he's really good, and he just falls right back to sleep. He's just, you know, a really good sleeper.
ROBERTS: That's handy.
Ms. MORRISROE: It is. It is. And it's handy for him. So if anything goes wrong, he knows that, you know, I'm the vigilant one. I'll be up in two seconds. Or I am up.
(Soundbite of laughter)
ROBERTS: Let's hear from Elvie(ph) in San Francisco. Welcome to TALK OF THE NATION.
ELVIE (Caller): Hi. Thank you for taking my call.
ELVIE: I just wanted to say thank you for having this conversation. I wanted to add that I've struggled with sleep myself since I was a kid, and it's mostly, I believe, from PTSD associated with violence and not feeling safe enough to go into a sleep, you know, place, and then being violated by dreams and nightmares. It's so vivid. So it's equal to the attack of physical attack. And for myself, what I find is that I -almost like a child, I will resist going to sleep until I'm so exhausted that I will skip the dream state and go straight to REM. That's my solution.
So anyway, I don't know if that's considered insomnia, exactly, but it's a sleep issue that I struggle with since I was a kid, and still I have trouble explaining to others. You know, it's sort of a social stigma trying to relay this. And what she was saying about having somebody there is so much different, so much safer than being alone, you know, to be there in case you have a bad dream, or what have you.
ROBERTS: Elvie, thank you for your call. You're listening to TALK OF THE NATION from NPR News.
Patricia Morrisroe, do you think there are different - different people dream differently, that there are more vivid dreamers than others?
Ms. MORRISROE: Yes, I think there are, and I think the whole issue of post-traumatic stress disorder, we see, you know, with a lot of the soldiers coming back from Iraq and Afghanistan. And it's a huge issue. And then for anybody who is having difficulties like that, you know, there are many more specialists who are dealing with that. And it can be, from my understanding, be helped so much by going and talking to somebody who specializes in it.
ROBERTS: Talking to the insomniacs you researched for your book, hearing from our callers today, do most people ultimately find something that works for them, do you think?
Ms. MORRISROE: I don't necessarily think that's true. Sadly, I think the key is to try to find a certain acceptance of it and realize, you know, you may not always have great sleep. But I think the biggest worry, and the biggest problem you can have, is that you fear one bad - you have one bad night and that next night is going to spiral into another into another into another, and then you're on this downward slide. And I think if you just recognize, OK, I've had a bad night, you know, it hasn't killed me and - but the next night, I'll be OK. I mean, so much of this is triggered by your anxiety.
And as someone pointed out earlier, I mean, you can - you sort of make a decision about how you're going to sleep that day. I mean, if you're very, very hyper-aroused and anxious and tense during the day, there's a good chance you're going to have trouble sleeping that night.
ROBERTS: Well, also, you have to make a decision about how open you're going to be to treatments. I mean, when you described going to the 92nd Street Y and taking a meditation class and occasionally there were annoying and noisy people in the class, you know, you had to sort of decide that this was worth a shot.
Ms. MORRISROE: It was worth a shot for me because I had tried everything else. And I'd always wanted to do meditation. I knew it would help me, you know, stay a little bit calmer, and it has. You know, but some people - there are some people who find sleeping pills do work for them. You know, I think it's - the key, is sleep is so individual. I mean, and it's ultimately so mysterious. We're not even 100 percent sure why it is we sleep. So I think people just have to recognize what is right for them. Nobody can really tell you what to do in terms of insomnia, really. You have to sort of know yourself.
ROBERTS: Let's hear from Theresa in Spokane. Theresa, welcome to TALK OF THE NATION.
THERESA (Caller): Hi. I'm enjoying listening to your show, and I have to say, I felt like you were talking about me because I've had another night where I just didn't sleep. It's the classic you fall asleep, then you wake up in the middle of the night and there's that sinking feeling of, oh crap, I'm awake.
(Soundbite of laughter)
THERESA: So my current solution is, I'm - my daughter goes to school at 9, so I can not have a lot of coffee. When I get her off to school, I can come back home and go to bed. But that really doesn't, you know...
ROBERTS: It's not a long-term solution.
THERESA: No, it isn't. I don't know. Currently, my doctor seems to think it might be cyclical, which means I'm - you know, you get it every month, but it's for about a week. And so I'm trying to take melatonin, and that helps sometimes. But I don't know. It's just - there seems to be, you know - I guess you just wake up and your brain is awake, and you're thinking about all the things that you don't really need to be thinking about.
ROBERTS: Theresa, thank you for your call. You know, we're almost out of time. But she mentioned melatonin, which brings up the issue: Some of these drugs have been prescribed off-label for insomnia, that they were really originally meant for jet lag or depression or something else.
Ms. MORRISROE: Well, certainly drugs like trazodone, which is an antidepressant, has been prescribed. It's a very, very popular drug for insomnia. You know, melatonin, I think, is probably helpful for jet lag. But if you have issues waking up in the middle of the night, I'm not sure that there are any studies that support that it helps.
ROBERTS: Writer Patricia Morrisroe lives in New York City. Her most recent book is called "Wide Awake: A Memoir of Insomnia." To read more about Morrisroe's childhood, "The House of Punk Sleep," you can go to our website at npr.org, and click on TALK OF THE NATION. She joined us from our bureau in New York today. Patricia Morrisroe, thank you so much.
Ms. MORRISROE: Thanks.
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