by Gayle Greene
University of California Press, 2008
Reviewed by Dorothy Wall, author of Encounters with the Invisible: Unseen Illness, Controversy, and Chronic Fatigue Syndrome
Sleep problems are one of the cardinal symptoms of ME/CFS (and fibromyalgia), and if you've been "tired but wired" one too many nights, I strongly recommend a smart, eye-opening new book, Insomniac, by Gayle Greene.
In fact, what struck me most as I read Insomniac were the parallels between insomnia and ME/CFS.
Both are invisible, stigmatized epidemics.
Those with chronic insomnia face dismissive physicians who are all too ready to see insomniacs as neurotic or depressed.
Twice as many women as men deal with insomnia.
And, despite the seriousness and magnitude of the problem, there is astonishingly little research on the physiological basis for insomnia, even though the annual cost, from workplace absence and accidents, may be as high as $100 billion.
While most books on insomnia emphasize sleep hygiene (no naps, cut out caffeine, etc.) or cognitive behavioral therapy (just change your attitude), Greene's book insists that we consider the biological underpinnings of insomnia, and takes a broad look at the sleep industry itself.
She takes the reader with her to sleep conferences, where speakers promote "sleep restriction" or CBT and show little interest in questions of how hormones or gender impact sleep.
She talks to physicians and researchers who, focused on behavioral treatments, shrug when she asks about neuroendocrinology or the genetics of insomnia.
She interviews insomniacs themselves, whose words are wrenching and poignant. Their understanding of their problem seems far more nuanced than that of the providers from whom they seek help, offering yet another example of the importance of listening to patients.
Unlike for ME/CFS, a multitude of drugs is available to treat insomnia, and here Greene provides an invaluable service, reviewing all the major drug and alternative treatments, from AmbienR and XanaxR, to melatonin and homeopathy.
Greene is balanced in her approach, walking readers through the pros and cons of each treatment, considering the side effects that drug companies downplay, the problems of long-term use, and the necessity of making choices that are right for each individual. Ultimately, she helps readers understand their options and feel empowered to handle their insomnia in a way that works for them.
I have rarely read such an intelligent, probing book, by someone who asks all the right questions. And, for a book about sleep, it's a page-turner, as Greene combines the saga of her own slog through the land of sleepless nights with her pithy investigations and questions.
From the inside scoop on sleep clinics, to the fledgling science, to the need for grassroots activism, Insomniac tells the real story of insomnia. Anyone frustrated with the typical tired answers to sleep problems will value this revealing book.
Note: To read an excerpt from Insomniac, click here.
* Dorothy Wall (http://www.dorothywall.com) is author of Encounters with the Invisible: Unseen Illness, Controversy, and Chronic Fatigue Syndrome, winner of the "2007 Sand Castles Author & Book of the Year Award" from P.A.N.D.O.R.A., and coauthor of Finding Your Writer's Voice: A Guide to Creative Fiction.