This essay was written one frustrated morning. Amazingly, I managed to sleep well that evening and the next, but then my difficulties returned. It is based on my experiences from September '99 through, well, it ain't over yet.
Note that further medical investigation has suggested that my insomnia is not merely due to poor sleeping habits as the essay suggests. It is also influenced by respiratory problems (bad allergies, chronic congestion, nocturnal asthma). Thus it will take more than just willpower to solve.
by Patri Friedman (patri@izzy.com)
The first five minutes are
the hardest. The rest of the day is downhill, but getting there
is far from easy. I'd like to say that the willpower required
is like finishing a marathon when you've stumbled and fallen with
a mile to go. Its a good image - having to finish a marathon every
morning, just to get out of bed. But it doesn't ring quite true.
It takes a very different strength to push actively than to resist
passively. Not that the latter is as easy as it sounds. Passive
resistance: just don't close your eyes, just don't pull the covers
over your head, just don't grab your alarm clock and throw it
through the window to fall three stories and shatter on the street,
never again to disturb your priceless slumber. If you held an
art festival where every exhibit was an alarm clock destroyed
in a different way, insomniacs would come in droves, milling quietly,
looking at the remains with hatred in their red-rimmed eyes.
One of the things which makes the first five minutes so difficult
is the constant whispering of the Temptress. "Just another
couple hours. You don't have anywhere to be. You don't need to
go to class. Be good to yourself. You need the rest. Sleep is
important. What is the point of getting up if you are too tired
to deal with the day?" The words are filled with half-truths,
short-term plusses that lead to long-term misery. Listening to
those words got me to where I am today.
I slept all right as a teenager, I guess. I remember always being
tired in the mornings, but I had a routine that was inflicted
upon me by external forces, so I stuck to it, which made getting
through those first five a lot easier. College was another matter.
Staying up late means sleeping in late means staying up later.
Schedule was a polymorphous beast, constantly changing as social
and academic demands stretched it in contrary directions. For
awhile, my body managed. Then one night, my sophomore year, I
couldn't sleep. And the next, and the next, and the next. On the
fifth night, things were better, but from then on, I could never
take sleep for granted. Every now and then it would desert me,
and as my sleep debt grew, my habits got worse. I was more tired
in the morning, so I stayed in bed longer, and that cycle, eventually,
produced the first five minutes.
Being an insomniac is sort of like being a little stoned all the
time. The whole world has a constant tinge of surreality. Things
move a little slow or a little fast, your memory is shot, your
reactions are off, and many a word smears twixt lip and ears.
The worst part is, you never come down, never get to feel sharp,
never get to recuperate. Normal people know when they are stoned,
because the world just ain't like that otherwise. One of the most
frightening things about insomnia is that you can smoke pot and
then completely forget it until hours or days later. The surreality
of marijuana just blends into the surreality of everything else,
tinging it, tinting it, but not really changing it. Pot is like
insomnia on its good days, when it just makes you hyper and punchy,
when everything is funny. I don't know a drug like insomnia on
its bad days, but I find it hard to imagine it would be popular.
Driving didn't use to worry me. I was young and I trusted my reflexes
to keep my safe. Now my reactions are dulled, and on my bad days,
cars scare me. Some insomniacs, I know, have problems falling
asleep at the wheel. It is not one of my symptoms - I'm good at
staying awake, or at least, thats the optimistic way I sometimes
like to look at my condition. Falling asleep at a time when concentration
is vital is a large discrete step, a clear indication that someone
shouldn't drive. The slow, steady decay of reflexes and reasoning,
on the other hand, is subtler and perhaps more dangerous. When
will it get to the point where I am a danger as a driver? Will
I know? How will I be able to tell? I do a lot of walking now,
on the days when I am unable to confront those fears, when the
spectre of the first five minutes haunts the rest of the day.
Those questions strike right to the Hofstadterish heart of one
of the central issues of any chronic problem that messes with
our machinery for reasoning. How can we objectively examine the
part of us which examines things? If something goes wrong that
makes us unable to see that something is wrong, how will we ever
know? I think that I know about how I compare to what I'd be like
if I was well rested, the magnitude and direction of my mental
and emotional drift. But maybe I'm completely wrong, maybe I used
to be like this and this is just something to blame things on,
or maybe I'm even more fucked-up than I think and hanging onto
sanity by my fingernails.
There is one way, perhaps, to find out. Get better. Which brings
us back to that five-minute slice of hell. When insomnia is caused
by schedule irregularities, circadian rhythm offsets, and poor
sleep habits, the long-term, non-drug cure is pretty simple. Pick
a time. Get up every morning at that time. No sleeping in. No
naps. No rolling over. Get up. Every morning. Or you won't get
better. Getting up every morning is hard enough for normal sleepers.
Now imagine being on the ragged edge of exhaustion, suffering
from months or years of chronic sleep deprivation. You spend 11
hours in bed, most days, to get those precious 6 hours of sleep.
And thats on the good nights. On the bad, those 11 hours are tossing
and turning, and you get maybe 2 or 3, all of it light.
Then they tell you that for the next few months, you are going
to get even less sleep. That's right, less. You don't get to spend
11 hours in bed any more. The cure, as is often the case in life,
will at first be worse than the disease. For months, while you've
been miserable, you have at least allowed yourself the sweet luxury
of devoting a great deal of time towards trying to get sleep.
After all, thats the problem, right? Not enough sleep? So that
time in bed is your time, its good for you, or at least that's
what you have been telling yourself. Then they take that last
comfort away, leaving you with nothing but the first five minutes.
I'm not a marathon runner. I can't push my body towards its limits
with my willpower, climbing walls of pain and weariness. But I
can, I hope, endure. I can sit, and hang on, trying not to fall
into the seductive trap below. Its a different kind of strength.
Strength to remain, not to attain. But its what is needed, and
perhaps, if I have enough of it, if I get past those first five
minutes enough times, they will become the first three minutes
and then the first minute and then the first ten seconds and then
nothing at all, and I will be well again.
Last Modified: April, 2000
Patri Friedman / patri@izzy.com