Interview on The Savvy Insomniac with Lois Maharg
December 17, 2013
By Laura Mays Hoopes, biologist at Pomona College and author of Breaking Through the Spiral Ceiling
Lois, the book was, as you say in the subtitle, a “personal journey” for you as an insomniac. I remember Gayle Greene saying about her insomnia book that she was writing about her obsession. What can you tell us about how you decided to write this book?
Chronic insomnia has sapped my energy and muddled my thinking, and it’s claimed a lot of psychic space as well. But there’s not a lot of public recognition that insomnia is a serious problem. Doctors still dismiss it as trivial, and acquaintances have either been puzzled by my trouble sleeping or attributed it to mental “problems” or habits like drinking too much coffee. I felt driven to tackle the issue for three reasons: I wanted to get to the bottom of my own insomnia (if I could!), explore insomnia in the fullness I felt it deserved, and expose some of the common but mistaken assumptions about it.
You take the reader along as you try various recommendations for treatment, including the surprising Cognitive-Behavioral Therapy (CBT-I) that deprives insomniacs of sleep for a period. Why weren’t your acquaintances convinced when you described your gains in sleep from this treatment? Did you write the book partly to provide a stronger rationale?
Changes I made during cognitive-behavioral therapy are just a part of what led to my improved sleep and daytime stamina. But yes, CBT-I helped quite a bit. If my story lends credibility to a treatment that might at first sound misguided (it did to me), well and good. As for why some acquaintances are skeptical of the gains I’ve made, the issue here may be the amount of sleep I get. Five and a half hours can sound paltry to those who regularly need 7 or 8. Yet there’s a world of difference between waking up after 5½ solid hours of sleep and waking up after a night of fractured sleep and restless dreaming. I’ll take quality over quantity hands down.
I asked Gayle Greene earlier about the claim that Heath Ledger and Michael Jackson might still be alive if they hadn’t suffered from insomnia, and she responded that it surprised her that all actors don’t have it. Do you think insomnia is an occupational hazard for those choosing some careers?
There’s no doubt about it: high-stress, high-profile careers are a challenge for the sleepless. Some I interviewed were able to manage. Others had to scale down their ambitions and resign themselves to quieter pursuits. But I don’t see the careers themselves as necessarily giving rise to insomnia. I’ve met surgeons and trial lawyers who are champion sleepers. I’m convinced that how we handle stress and how well we sleep depends largely on genetic factors (tempered, of course, by early life experience and coping strategies we may develop later on). Twin and family studies now suggest that many aspects of sleep are under genetic control, including susceptibility to insomnia. A predisposition to insomnia is going to be a serious obstacle if you’re heading for a career in politics or the movies. I say this with regret.
Would you consider your book a How-To guide for people seeking to deal with their own insomnia?
One aim of my book is to help people improve their sleep. Yet The Savvy Insomniac is not prescriptive. It presents an array of treatments and outcomes, the idea being that readers will then be able to choose what’s most likely to work for them. Unlike most self-help books, my book does not claim that change is easy. “It’s the rare self-help book that acknowledges the true difficulty of helping the self,” Jonathan Franzen wrote last spring in the New York Times Book Review. Writing my book, I wanted to acknowledge the difficulty of taking action and making changes while at the same time motivating readers to act.
Your subtitle, “A Personal Journey through Science to Better Sleep,” left out a number of things you tried that I (as a biologist-writer) would not consider science. And I know a lot of readers are put off by the threat of reading science. So how did you choose this subtitle?
Ah, the subtitle. I spent many nights obsessing about that! How to suggest the mix of personal experience, cultural attitudes, history, science, and therapies treated in the book? The phrase personal experience would, I hoped, clue people in to the fact that the book is partly a memoir. Science was the other key element in the book—the element I found to be most fascinating and finally liberating. Will I lose some readers because of it? Perhaps. On the other hand, as one editor remarked, “You haven’t written Sleep for Dummies!” By placing science in the subtitle, I hoped to gain readers looking for an insomnia book with some heft. I saw the task as writing about science in a way general readers would find engaging.
You discussed some recent findings of scientists and social scientists that seem promising for future treatments, and talked about the extensive drug-company-sponsored research efforts. Do you consider it a problem that so much of the insomnia research is sponsored by drug companies? Do we need a more basic-science-of-sleep approach as some have claimed?
Of course there’s a conflict of interest when the people who stand to gain from a drug are the ones conducting the trials on safety and efficacy. Like almost everyone doing insomnia research, I’d like to see the NIH pick up more of the tab. I’d also like to see signs that more novel hypnotics were in the works. Right now, apart from the orexin receptor antagonists (which may or may not gain FDA approval), I’m not seeing much activity on this front. Sadly.
When people hear you have insomnia, what is their response? How do you cope with it?
It used to be that I didn’t talk about my insomnia to people unless I knew them pretty well. As I said above, acquaintances didn’t quite know what to make of it. Based on their responses, I could see they were making assumptions about me—that I had unresolved personal issues, was emotionally unstable, or drank too much coffee—that I didn’t care to have them make. Having written The Savvy Insomniac, I can’t hide in the closet any longer. The good news is that now when I talk about my research and my book, I see that some people are receptive to the idea that insomnia is more than a trivial concern. And the recent studies showing that treatment for insomnia can help people recover from depression may do much to change our thinking about what chronic insomnia is.
You’ve connected with insomniacs all over the world through conversations and blogs. What would you say is your most important insight from talking with all these sleepless people?
One thing I’m always struck by in conversations with insomniacs is how disruptive insomnia can be to people’s lives. If every fiber of your body craves respite yet you’re unable to fall asleep or sleep through the night, that’s misery! But the daytime symptoms people talk about sound even more onerous: debilitating fatigue, to the point where some insomniacs worry about their ability to function and survive; mood swings (in particular, how hard it is for some poor sleepers to control their tempers); and impaired cognitive processes, including the ability to concentrate, think, and learn. Surely these are grounds for the funding of further research and the honing of more effective treatments.
Speaking as a non-fiction author, do you have any advice on agents, publishing, e-publishing today?
Regardless of whether you sign with a publisher or self publish, unless you’re Malcolm Gladwell or Doris Kearns Goodwin, a lot of responsibility for publicizing and promoting a book now falls on the author. My advice is to start on this as early as possible. Contact potential reviewers in advance of the book’s publication. Set up speaking presentations and line up radio spots well in advance.
Do you use social media? What are the up and down sides to them for authors today?
I have mixed feelings about social media. I’m active on Facebook, Twitter, and Google Plus, and they’ve certainly helped me spread the word about The Savvy Insomniac. But maintaining a social media presence can take up quite a chunk of time. If you’re trying to keep up with trending topics and blogging as well, it’s hard to find time to move ahead with other projects. Frankly, I’m looking forward to unplugging now and enjoying a bit of down time over the holidays.