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By Lambert Strether of Corrente.
Six, you say. I had a terrible struggle over the headline, because I wanted to make a witty allusion, but the one quotation that came to mind was Shakespeare’s lovely “sleep that knits up the ravelled sleeve of care” (close reading) but eesh, those words are spoken by Macbeth, and it’s unlikely that you or I cannot sleep for the same reasons that Macbeth, and Lady Macbeth can’t sleep. I struck out with lullabies, too, and also music and song lyrics about sleep (although the top hit, “I Don’t Want to Miss a Thing” expresses the beautiful sentiment that the singer doesn’t want to fall asleep because “I’d miss you baby,” and no, I’m not being ironic. I never would have thought it of Aerosmith). So I went with the clickbait. I apologize.
Anyhow, I thought I’d do a little research on sleep, because the topic “insomnia” started coming across my feed, presumably because of press releases on that topic, though maybe it was the oyster insomnia that did it (Hakai, picked up by The Atlantic).
We don’t know why we sleep (or why any creature that sleeps, sleeps[1]). From Wikipedia’s “List of unsolved problems in biology“:
What is the biological function of sleep? What is the purpose of dreaming? What are the underlying brain mechanisms? What is its relation to anesthesia?
We understand REM sleep and circadian rhythms. “The body’s natural sleep-and-wake cycle is reasonably attuned to a 24-hour period,” but “reasonably” is doing rather a lot of work, there. Why does the cycle exist in the first place? After all, with “nature red in tooth and claw,” sleep, which renders us completely vulnerable for approximately one-third of our existence, must be worth taking such a risk for. But worth what? Nobody seems sure. In fact, we know very little about what is most important to us. We don’t know why we are conscious, why we have (or don’t have) sex (verb or noun), or why we die. Similarly, in science, unanswered but important questions are: What is the nature of gravity? Why is time different from other dimensions? Is morality hardwired into the brain? How did flowers evolve?
Not only do we not know what causes sleep, a cursory search — sleep mavens, please correct me — suggests that our data on sleep isn’t all that great either. From the Lancet, September 2023:
[D]ata exist to suggest that objective measures of sleep are more accurate in assessing health outcomes, because self-reported sleep variables can be influenced by other physical and mental health factors. Objective measures provide a more accurate representation of sleep patterns, enabling clinicians to make more precise diagnoses, prognoses, and treatment plans for the disorder.
Objective measures, including the multiple sleep latency test, have been proposed as essential tools for assessing the severity of insomnia.
And:
Future large-scale, multisite, randomised, placebo-controlled trials should explore personalised treatments for different insomnia subtypes, thereby promoting healthy longevity for individuals worldwide.
You don’t have to be an RCT fetishist to accept that if studies like this don’t already exist, we may not know very much about sleep at all. To underline the difficulties with self-reporting — actually the fun part, which we’ll get to in the tips section — this preprint, also from September 2023:
We compared the percentage of those self-reporting usually having insomnia symptoms at UK Biobank baseline assessment (2006-2010) to those with a Read code for insomnia symptoms in their primary care records prior to baseline…. We found that 29% of the sample self-reported having insomnia symptoms, whilst only 6% had a Read code for insomnia symptoms in their primary care records. Only 10% of self-reported cases had an insomnia symptom Read code, whilst 49% of primary care cases self-reported having insomnia symptoms.
Sure, it’s easy to create the narrative that MD’s aren’t listening to patientsMR SUBLIMINAL Guffaw! Science fiction stuff but that’s still quite a discrepancy.
So we don’t know why sleep, our object of inquiry, exists, and the data about it is arguably bad, but that doesn’t mean we can’t try to define it. Once again from Wikipedia:
Sleep is a state of reduced mental and physical activity in which consciousness is altered and sensory activity is inhibited to a certain extent. During sleep, there is a decrease in muscle activity, and interactions with the surrounding environment. While sleep differs from wakefulness in terms of the ability to react to stimuli, it still involves active brain patterns, making it more reactive than a coma or disorders of consciousness.
(I’ve helpfully underlined the words and phrases I’d like to, well, have more clearly defined.) Reading these words literally, as a sort of checklist, it would seem that sleep and being drunk or stoned (“decrease in muscle activity”) are in the same bucket, but “I have heard” that the three states are actually quite different.
Be all these philosophical questions as they may, the CDC, characteristically, jumps right in:
A third of US adults report [see above] that they usually get less than the recommended amount of sleep. Not getting enough sleep is linked with many chronic diseases and conditions—such as type 2 diabetes, heart disease, obesity, and depression—that threaten our nation’s health. Not getting enough sleep can lead to motor vehicle crashes and mistakes at work, which cause a lot of injury and disability each year. Getting enough sleep is not a luxury—it is something people need for good health. Sleep disorders can also increase a person’s risk of health problems. However, these disorders can be diagnosed and treated, bringing relief to those who suffer from them.
Even if we don’t understand sleep, we still know what missing sleep means. We have a word for it: Insomnia. Of course there’s an NGO, the Sleep Foundation:
Insomnia is a sleep disorder characterized by difficulty falling asleep, staying asleep, or both, even if you have ample time and a bedroom environment conducive to restful sleep. An insomnia diagnosis requires these sleep troubles to also cause daytime impairments, such as sleepiness or difficulty concentrating.
Up to [oh] two-thirds of people occasionally experience insomnia symptoms. These bouts of sleeplessness may or may not meet the criteria for a formal diagnosis of insomnia [oh], depending on how long they last and whether they cause distress or interfere with daily functioning. But it is important for anyone who has concerns about their sleep to discuss them with a health professional for proper diagnosis and treatment.
It sound like “daytime impairments” means trouble in the workplace. The RAND article that littered my feed, “Insomnia: The Multibillion-Dollar Problem Sapping World Productivity,” concurs:
Workers who experience any symptoms of insomnia miss 14 days of work every year and spend another 30 days at work but not being fully productive, the researchers estimated. Chronic sufferers are absent for up to 18 days and present but not productive for up to 54 days.
Using those numbers, the researchers calculated that the United States loses more than 1 percent of its total economic output to chronic insomnia every year. That adds up to around $207.5 billion. The United Kingdom loses 1.3 percent of its output every year, or $41.4 billion. France forgoes around $36.3 billion, and Australia and Canada both lose more than $19 billion.
The key driver for insomnia is, apparently, rumination (“circling thoughts,” “racing thoughts”). One sleep psychologist characterizes rumination as a “mental loop” that goes on “for hours and hours”:
Through my research, I’ve found that the No. 1 sleep killer isn’t social media or an uncomfortable mattress — it’s rumination.
Rumination is a sleep-blocker because it keeps your mind aroused, especially in bed, when it’s dark and quiet.
Your attention is drawn back, again and again, to this thing that didn’t go well or to a regret. I’ve laid in bed and replayed a dumb comment I made at a party, even though the person I said it to probably forgot it moments later.
Negative thoughts and emotions like these are what neuroscientists call “”salient”” because they are so noticeable and loud.
There’s no magic switch to completely turn off rumination. Your brain’s job is to consolidate information and build new synapses by dredging up moments and memories from your day — even the things that upset you.
The best time to get ahead of worrying is during the day, when you have important things to do and don’t have time to get caught up in mental loops for hours and hours.
(The author then goes on to recommend worrying during the day, when worry is likely to be more productive).
The Kings College Student Counselling and Mental Health Support Service brochure on “Worry, Rumination & Insomnia” characterizes rumination as:
brooding or thinking in a circular and unhelpful way.
And recommends the following checklist:
Ask yourself:
- Have I made progress towards solving a problem?
- Do I understand something about a problem (or my feelings about it) that I haven’t understood before?
- Do I feel less self-critical or less depressed than before I started thinking
- about it?
If you didn’t answer ‘yes’ to at least one question, you are ruminating
They also present this handy chart:
But what if the “trigger” of the worry is not a problem that can be solved? What if the the answer to “Can I do anything about it?” is “No”? You would have to be a Zen Master or a Bodhisattva to “Let the worry go.” How is “do something else” useful when the “something else” is sleep?
There are, of course — besides Pharma — various cures for insomnia, like Cognitive Behavioral Therapy and other strategies, like mindfulness and so forth. However, none of these Soviet psychiatry-style cures them discuss what the “trigger” might be, when clearly economics — especially in the workplace — is likely to be both “salient” and insoluble, especially for those who must sell their labor power to survive. For example, this article from the Daily Mail, “How a sleep shrink helped CURE my insomnia nightmare: I’m getting 90 minutes more every night – and you could too, says INGEBORG VAN LOTRINGEN“, discusses cure after cure after cure, but in the middle, there’s this throwaway sentence:
I slept like a baby for nearly 40 years until a financial upset in 2008 — I had my life savings in an Icelandic bank . . . they vanished — meant I didn’t any longer.
Losing all her money in The Great Financial Crash caused her to lose sleep! And tens of millions of others! They should all go get Behavioral Cognitive Therapy! From Sleep Review:
Two of the studies asked employees to report their counterproductive work behaviors during the day and their off-work feelings and sleep quality at night over the course of 10 workdays. The researchers found that committing counterproductive behaviors at work was significantly related to work-related ruminative thoughts in the evening, which further led to insomnia at night.
“Counter-productive work behavior”! The idea! And from Asia in Science Daily:
The results showed that people in Asia have shorter sleep, and display higher variability in both sleep timing and duration on weekdays…. [P]eople in Asia also had lower sleep efficiency. This may be because factors that result in short sleep (e.g., work-related anxiety) also lead to lower quality sleep.
While there are many socio-cultural factors that affect sleep patterns, the team hypothesises that because it plays such a fundamental role in our lives, work (and the broader work culture) is one of the most influential factors affecting how we sleep. Previous evidence from time use studies have demonstrated a strong association between long work hours and short sleep. Additionally, there is evidence that preoccupation with work demands and the inability to stop thinking about work contribute to sleep disturbances.
Everybody wants to talk about triggers, but nobody wants to talk about the hand that holds the gun…
Having pointed to an obvious structural cause of the insomnia oddly not considered by the Sleep Industrial Complex[2], I will now turn to the sort of individualized anecdotes and solutions I previously deprecated, as practiced by me.
(1) My first tip is white noise. For a long time, I fell asleep to the white noise produced by a fan, winter and summer. More recently, to the fan, I searched YouTube for “train sleep sounds,” and to the fan added, IIRC, eight hours of a train going through the snow in Norway. Clickety-clack!
(2) I believe I picked up the idea of counting backwards in a Travis McGee novel. McGee, I believe, started from 10. I start from 400 or 500, count “499, 498….” then suddenly realize I’ve “lost my place” and restart the count from, say, “467.” Of course, I lost my place because I fell asleep. I learned this trick when I was living in a glorious apartment in Center City, Philadelphia, where my sleeping quarters were like six feet away from the all-enveloping, supersonic screaming of a ventilator hood from a 24-hour restaurant next door. I slept like a log!
(3) I thought I had a hard time falling asleep (why falling and not rising?) until I started listening to podcasts, because when I listened to the previous night’s podcast for a second time, I could spot when I fell asleep because the material was new. In fact, it takes me about ten minutes to fall asleep (correcting years of delusion that I didn’t all asleep easily). For a long time, my favorite was Mike Duncan’s History of Rome, which is not only good, but delivered in Duncan’s soothing voice. It was entertaining to fall asleep to Caesar being ransomed by pirates, and then wake to Augustus gelding the Senate. I really learned a lot! (Duncan’s excellent Revolutions podcast, and Rich and Tracy Youngdahl’s brilliant The Civil War[3] served the same function; again, wonderful “story arcs” delivered by soothing voices).
(4) Then came the war in Ukraine, and I moved on from history podcasts to nightly YouTube reports, the best for my purposes being Alexander Mercouris (“Good day”). Mercouris too has a soothing voice. Being now of an age to wake up during the night, I move the YouTube progress bar ahead each time I wake, and restart the podcast, so that by morning I can be said to have sampled most of the previous days events. However, since the Ukraine war seems headed for stasis — insofar as a meatgrinder can be said to be in stasis — I may move back to Rick and Tracy; they are now well past Gettysburg, and into the battle of Chickamauga (which Longstreet messed up all on his own, this time without any help from that bloody incompetent, Lee).
So there we are. We may not know why we sleep, or have good data on sleep, but we do have a name for not being able to sleep, and we know that when we can’t sleep, rumination may be the proximate cause, even if we want to erase the final economic cause. We know so much, and yet we know so little! Perhaps, readers, you will share tips on how you get to sleep in comments.
P.S. I should, however, add one more tip (5): If you’ve been ruminating and losing sleep because you have yet to donate to Naked Capitalism, the tip jar is to your right. Pleasant dreams!
NOTES
[1] Do we even know we are awake?
[2] Of course, insomnia is one effect of Covid; see here, here, here, and here.
[3] All these podcasts are multiyear projects, some approaching a decade of a podcast a week. I don’t know what it is about the podcast medium that encourages this.
APPENDIX
The final tip: (6) J.S. Bach’s “The Goldberg Variations” are said to have been written to relieve the insomnia of Count Hermann Karl von Keyserlingk, the former Russian ambassador to the electoral court of Saxony. So here is a playlist of them:
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