August 2016

The Medicine

Precious sleep

By Karen Hitchcock
Why do we do so little of something so good?

Legend has it that Margaret Thatcher needed only four hours sleep each night. It’s probably not true that that’s all she needed, though like some kind of sleep anorexic it may have been all she allowed herself. Mean appetites don’t tend to arise “naturally”. We’re greedy little animals when it comes to our so-called vegetative functions (sleeping, eating, drinking, sex). Sleep deprivation may even have accounted for Thatcher’s (equally legendary) hair-trigger tempers and baseline vile mood. Spending your whole life dog-tired, hungry, thirsty or sexually frustrated effectively turns anyone into an arsehole.

Last night, I slept for ten hours. For the first time in months I woke gradually to a clear, benevolent world. My vision was sharp, the air soft. It’s pretty rare for a working urbanite to sleep long and sound, and wake full term. And it’s unusual for us to allow something that feels this good to occur so rarely. You’d think we would have worked out some efficient and cheap way of fulfilling our requirements. After all, we can deal with the other basic bodily functions in this way: fast food, water bottles, porn. Why can’t we deliver a big fat sleep in a way that takes up less of our time?

Sleep can be a slippery little sucker, even when you have the time and the appetite for it. Doctors advise insomniacs to attend to their “sleep hygiene”, as if beds are some kind of viraemic cesspool that might be cleaned up with a splash of bleach. Michael Jackson bought and controlled his sleep with a nightly physician-delivered anaesthetic. It was the kind they give you before a colonoscopy and ask you to count to ten. Any substance that offers an extended period of knockout brings with it a pretty high chance of death. And most of the drugs that can give us a few hours of sleep on demand are extremely addictive. We haven’t worked out a safe way of buying and selling high-quality sleep, of getting it whenever and wherever we want, or how to get, in a packet, whatever it is that sleep gives us.

I was an insomniac child. Terrified to go to sleep, and then awake through the early hours. I don’t remember fatigue. Just the terrible wait for morning, intermittently peering behind the blind, hoping the orange crack was no longer from the sodium lamp, but from the sun. If I’d been taken to a doctor I may have been given a handful of diagnoses. Difficulty falling asleep: anxiety. Early morning wakening: depression.

Patients rarely report sleeping abundantly and well. They nap on the couch, at their desk, some more at the wheel. Or they’ve got it down to six hours and five coffees, supplemented with long catch-ups on the weekend. Or their soft bed, no matter how early they take to it, becomes a lumpen torture chamber lined with strangling damp sheets. Who hasn’t fallen exhausted into bed, hoping for respite, a little annihilation, only to find – the moment head and pillow collide – that their heart has been ousted by a crazed bat?

Sleep demands that we relinquish vigilance and embrace solitude. We dream thoughts we didn’t even know we had, in full-colour, 3D playgrounds. We must close our eyes and surrender, as if to death.

I once heard a colleague being interviewed on the radio about the ubiquity of chronic sleep deprivation. He asked the interviewer if she woke to her alarm. Yes, of course she did. “Well,” he primly said, “that means you don’t go to bed early enough.” The announcer gave a no-shit-Sherlock pause and then reeled off her excuses, ones we all know and would ourselves offer. We trade sleep for life. For non-work life. We trade it to talk and watch and eat and drink and relax and play. I’d happily pay with a day of feeling wobbly to watch a couple more episodes of UnREAL.

When I first heard about the Iron Lady’s four-hour regimen, I was jealous. All those extra hours of consciousness. I did the sums: she’d earned herself 13 bonus years. Maybe that additional stretch would be worth the lifetime spent feeling like crap? But sleep deprivation is not good for you. Apart from all the diseases it causes or accelerates, it also leads to impaired decision-making, a decline in empathy, a shrinking of perspective. A kind of recipe for neoliberalism.

Time – to paraphrase Seneca – is the most precious thing we have and the thing we most thoughtlessly squander. Thatcher and her four hours functioned as a paragon to which all good citizens should aspire. Why waste time sleeping like a weakling when you could be awake producing and profiting? And when that’s the goal, enough’s never enough. Should some mad scientist work out a way to keep us all going without sleep, we’d just polyfill the extra time and then want more.

We can rush and cram, lull and white-noise through our days. But, come night, we must climb into bed and close our eyes, if only to be reminded that our hours are limited, our life finite, our time priceless and relentlessly shrinking. Perhaps the epidemic of disordered sleep is actually a disorder of the way we are – or are not – living.

Karen Hitchcock

Karen Hitchcock is a doctor and writer. She is the author of a collection of short fiction, Little White Slips, and the Quarterly Essay Dear Life: On Caring for the Elderly.

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