Insomnia at the Pinnacle of Power

We don’t hear much about the sleep of presidents and prime ministers except for the hours they get: President Obama, 6; George W. Bush, 8: Margaret Thatcher, 4. Their personal habits matter little compared with the decisions they make and the work they do in office.

But Dr. Li Zhisui wrote about insomnia at length in his biography of Mao Zedong, The Private Life of Chairman Mao, suggesting that our leaders’ sleep (or sleeplessness) may affect their decisions and behavior more than we think.

Insomnia was a problem for Mao ZedongWe don’t hear much about the sleep of presidents and prime ministers except for the hours they get: President Obama, 6; George W. Bush, 8: Margaret Thatcher, 4. Their personal habits matter little compared with the decisions they make and the work they do in office.

But Dr. Li Zhisui wrote about insomnia at length in his biography of Mao Zedong, The Private Life of Chairman Mao, suggesting that our leaders’ sleep (or sleeplessness) may affect their decisions and behavior more than we think.

Mao’s Stress-Related Insomnia

As Mao’s personal physician, Li was expected to give up all other duties to see to the chairman’s health and wellbeing. So he worked and lived in the ruler’s compound, observing him at close range and eventually becoming Mao’s confidant.

Li noted right away that Mao’s sleep was erratic. Anticipatory anxiety would keep him awake on nights before public events where he was to address the masses.

“Often he would get no sleep at all the night before the festivities,” Li wrote. “He was exhilarated by the crowds and their adulation, and his energy always carried him through the event, but he often caught cold afterward. Sometimes the cold would become bronchitis, and he would be miserable for weeks.”

A Possible Circadian Rhythm Disorder

But Li observed that Mao’s erratic sleep patterns seemed to be driven by internal as well as external factors. Mao was a night owl who tended to be awake when most other people were sleeping.

“His body refused to be set to the 24-hour day,” Li wrote. “He stayed awake longer than others, and much of his activity took place at night. If he went to bed one day at midnight, the next night he might not sleep until 3 in the morning, and the day after that he would not sleep until 6. His waking hours grew longer and longer until he would stay awake for 24, or even 36 or 48, hours at a stretch. Then he could sleep 10 or 12 hours continuously, and no amount of noise or commotion would wake him.”

This erratic sleep pattern would probably be classified as a circadian rhythm disorder today. It might be delayed sleep phase disorder, a diagnosis often given to night owls who prefer to be up at night and sleep in late in the morning. It might also be non-24-hour sleep-wake disorder, a problem often seen in people who are blind, who cannot detect daylight and whose body clocks—as a result—are not set to the 24-hour day.

Whatever the diagnosis, the problem may have been amplified by Mao’s unusual lifestyle. He spent most of his time indoors—in his bedroom, according to Li, where thick dark curtains blocked out the sunlight. Without exposure to sunlight, his circadian rhythms may have become desynchronized, a situation that could easily give rise to insomnia.

But Li felt Mao’s problem was partly organic, and that he’d simply been born with a wayward body clock predisposed to run on its own time.

Insomnia Affected Mao’s Behavior

People with sleep problems like Mao’s don’t usually have easy lives. Perennial lateness and poor performance interfere with relationships and jobs.

But Mao rose to a leadership position despite his strange sleep habits and, as Chairman of the Communist Party, he called the shots. Without regard for the sleep needs of his associates, he would call impromptu staff meetings at 3 a.m. On the spur of the moment he would order his whole staff to get up early to prepare for a 4 a.m. departure by train.

As disruptive as his strange sleep habits were to others, they were a source of great anxiety to Mao himself, Li said. Mao tried swimming, dancing, and walking to wear himself out, and he took up to 4 times the recommended dosage of powerful sleeping pills. But often, Li said, nothing worked.

Could there be a relationship between the tight-fisted control Mao insisted on exerting over his country and the lack of control he seemingly had over his sleep? What do you think?

Most Famous Insomniacs: A Contender from the East

Every list of famous insomniacs is full of artists and actors, as well as historical giants such as Napoleon, Churchill, and Lincoln. Every person on the list is of European descent.

But research on insomnia is now coming out of the East, suggesting that insomnia is a phenomenon in Asian cultures too.

The insomnia experienced by Mao may have been a circadian rhythm disorderEvery list of famous insomniacs is full of artists and actors, as well as historical giants such as Napoleon, Churchill, and Lincoln. Every person on the list is of European descent, so you might get the idea that the genetic roots of the affliction lie across the Atlantic.

But research on insomnia is now coming out of the East, suggesting that insomnia is a phenomenon in Asian cultures too. Who knew?

Dr. Li Zhisui, private physician of Mao Zedong, knew all about Mao’s struggle with sleep and, though the doctor shared his story in The Private Life of Chairman Mao, Mao has yet to be mentioned in any list of famous insomniacs I’ve seen. But his trouble sleeping could be counted among the worst on record, if Li’s portrait is accurate.

All Wound Up

Mao actually suffered from two types of insomnia, according to Li. One was the acute insomnia typically associated with stress. Mao got all wound up when he had to get up early to preside over crowds and speak at big celebrations.

“Often he would get no sleep at all the night before the festivities,” Li writes. “He was exhilarated by the crowds and their adulation, and his energy always carried him through the event, but he often caught cold afterward. Sometimes the cold would become bronchitis, and he would be miserable for weeks.”

An Abnormal Body Clock

Mao’s other sleep problem sounds even more debilitating: an erratic biological clock.

“His body refused to be set to the 24-hour day,” said Li. “He stayed awake longer than others, and much of his activity took place at night. If he went to bed one day at midnight, the next night he might not sleep until 3 in the morning, and the day after that he would not sleep until 6. His waking hours grew longer and longer until he would stay awake for 24, or even 36 or 48, hours at a stretch. Then he could sleep 10 or 12 hours continuously, and no amount of noise or commotion would wake him.”

Today, Mao might be diagnosed with a circadian rhythm disorder. “Non-24-Hour Sleep-Wake Disorder,” where the body clock cycles in periods longer than 24 hours, is uncommon except in people who are blind, whose internal clocks do not receive input from sunlight and do not get reset to a 24-hour day.

The problem with Mao’s biological clock may have been exacerbated by his unusual lifestyle. He spent lots of time holed up in his bedroom, where thick curtains blocked out the sunlight. But Li suspects Mao’s problem was partly organic, and that “possibly his biological clock had always been askew.”

How Insomnia Affected His Habits

People with sleep problems of this magnitude generally have a hard time getting ahead. Tardiness, absence, and poor performance get in the way of holding on to jobs. But as Chairman of the Communist Party, Mao was the drummer whose beat the others had to march to. He often called meetings at 3 a.m. Sometimes he ordered his whole staff awakened in the wee hours to prepare for a 4 a.m. departure by train.

You might think being able to call the shots would make these sleep problems easier to bear, but Mao’s story suggests otherwise. He tried swimming, dancing, and walking to wear himself out, and he took up to 4 times the recommended dosage of powerful sleeping pills. But often, Li said, nothing worked.

Mao holds the world record for perpetrating genocide, with the deaths attributable to his policies numbering in the tens of millions. But surely he also deserves a place on the list of Most Famous Insomniacs, a more onerous but less odious distinction. I rest my case.