A Book Review of "Insomniac" by Gayle Greene

By: John Scott
Submitted: 2008-05-16 13:01:11
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Well, yes, I am going to talk about a new book. Appropriately enough for a site devoted to Ambien, it is Insomniac by Gayle Greene (published by the University of California Press in March, 2008 — 978-0-520-24630-0). So here is an autobiographical take on what it is like to live with insomnia by a woman who ought to know. Gayle Greene has the distinction of being a non-professional member of the American Academy of Sleep Medicine (AASM). She wins this prize even though not a medical researcher because she is the “patient representative” on the board of the American Insomnia Association, which operates within the AASM’s umbrella. In her spare time (sic), she labours at the Scripps College, Claremont California as Professor of Literature and Women's Studies. This latest tome (quite heavy at 520 pages) adds to her impressive resume of academic publications.

This is a highly personal account by an articulate and intelligent woman who has been afflicted by insomnia for most of her adult life. In one sense, the only person who can really tell you what it is like in a foreign country is one who has been there. For those of us who have always been able to sleep without difficulty, insomnia is like a foreign country, and the idea of having to use a medication like Ambien as the passport to get into sleep is alien.

Conventional wisdom always says that insomnia is somehow related to anxiety or stress levels, perhaps aggravated by drinking too many cups of real coffee. Greene comes up with a simple and practical explanation of what insomnia is. Insomnia means nothing more than you cannot get the number of hours of sleep you need to feel good about yourself and function efficiently. There is no reason for this. It is nothing more than a failure to sleep. There should be no pejorative implication. To use stress as an excuse is to blame the person for being weak or neurotic when there is no reason to blame yourself or anyone else. Instead of looking for some psychological explanation or a less judgemental physical cause, we should just accept that it happens to about 20% of the population at one time or another during their lives. Such a vast number of people yet so little is spent on researching the condition and its causes. Greene comments that the National Institutes of Health in the United States spent less than $20m in 2005, whereas Sanofi-Aventis spent more than $120m promoting Ambien in the same year. This is neither to praise nor condemn Ambien. It is all a question of priorities. Why bother to spend Government money on researching the cause of a condition when private capital has already invented Ambien as a cure for it?

She debates what we really understand about cause and effect. It is so easy to get the cart before the horse, or should that be the other way round? Perhaps conventional wisdom has also got things back-to-front. Instead of stress and anxiety being the cause of insomnia, perhaps living with insomnia makes you stressed and anxious. Who is to say in these more modern times, that we did not have disturbed sleep patterns in past times living on the land? Folk tales may tell us that we went to sleep when dusk fell and waited for the cock to crow before waking. But was that actually the case? Who can say what the real biological norms were before electricity came along and gave everyone the chance to live through the darkness. As it stands, no researcher can actually explain why we have to sleep nor why some people sleep more than others. It is all guesswork.

All that we can say with any certainty is that those who are deprived of sleep do not do as well as those who sleep through the night. The sleepless so often end up demotivated, their sense of humour worn thin, their judgement warped. Some grow fat. Others find their immune system affected. Sleep seems so indispensable yet no-one can really control it. Greene describes everything she has tried over the years from relaxation therapies to medication like Ambien, but concludes that, like any intimate relationship, how we relate to sleep is always personal.

She is a passionate advocate for greater patient power to persuade disinterested bodies to research insomnia.

For one who has had to depend on Ambien and the other medications for so long, she feels she and all other sufferers deserve better answers than those served up by the pharmaceutical companies.

For one who has never had problems sleeping nor had to take Ambien, Insomniac was a riveting insight into the condition and the problems it causes. Required reading for everyone who reads this article.

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