Excerpt from Hello Sleep: The Science and Art of Overcoming Insomnia Without Medications

By Dr. Jade Wu

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Prologue: Sleep is a friend, not an engineering problem

When I first met Kate, she had a wild look in her eyes. When I asked her what brought her to the Duke Behavioral Sleep Medicine Clinic, her voice cracked. She told me, "My sleep is broken. And I'm so, so tired." Kate was a petite woman in her midforties with an easy smile and a mane of luxurious blonde hair. I could tell at first glance that she was all business. She had arrived before the clinic opened, clutching a laptop bag and thick folio of papers. She looked like a pint-sized Erin Brockovich ready to tackle her toughest case.

In a way, Kate was a detective. By day she worked as a software engineer, but by night she devoted her time to catching the thief who had stolen her sleep. 

The folio she carried, it turned out, contained four months' worth of data she had amassed, including nightly sleep stats, daily food and drink intake, stress level fluctuations, and a record of her daily activities. It was an impressive compendium of evidence, complete with graphs and summary statistics. She was trying to find some pattern, some spark of understanding, that would crack the code of where her sleep had gone. My heart went out to her—she was working so hard! 

But her investigation had hit a dead end.

Kate explained that some four years ago she had gone through a stressful time at work. She was answering emails at 11:00 p.M. to placate an unreasonable boss, and as part of an ultracompetitive team, was always made to feel like she could be fired at any time. 

Understandably, she started having trouble falling asleep because she would mentally plan work tasks for the next day or worry about some snide remark a coworker had made. At some point, almost imperceptibly, "insomnia" snuck into the vocabulary of her life.

But even after starting a new job where she felt valued, could flex her creativity, and enjoy her team's supportive culture, her ability to sleep somehow continued to get worse. 

By the time I met her, it was taking Kate at least one to two hours to fall asleep on most nights. She no longer had work worries, but her mind always managed to churn anyway, even if it was just replaying a Christmas song for the seventeenth time. After tossing and turning and desperately trying to shut down her mind, she'd eventually fall into a fitful sleep. But she would only stay asleep for three hours before waking up again, and again, and again ... every hour, on the hour. She would get up in the morning feeling like she'd been run over by a truck.

Kate is not alone. She might have been exceptional in her devotion to data-gathering, but the agony of her nighttime hours is something legions of the sleepless understand. While insomnia is one of the loneliest human experiences, it's also nearly universal. Almost everyone has a bout of sleeplessness at some point in life, and a surprisingly large number end up struggling with it for years or even decades.

You may be one of the chronically sleepless. Even if you feel alone in the impenetrable night, know that 24.5 million other American adults! are also wondering if they're losing their mind, if the sleep center of their brain is broken. Perhaps, like them, you manage to get through the day, but it feels as if you're dragging your feet through mud and your brain through molasses. Perhaps, like Kate, you snap at your kids when you don't mean to because insomnia has shortened your fuse and frayed your edges. Then you spend the rest of the day feeling both tired and guilty.

Perhaps, like so many others, you feel that sleep has betrayed you.

At one point during our first conversation, Kate threw up her hands and exclaimed, "And the craziest thing is—I can't even nap! Sometimes I'm so exhausted and I just want to curl up and catch ten minutes. Not asking for too much, right? But I lie there wide awake until I'm too frustrated to keep trying."

"It sounds like you're tired but wired during the day?" I asked.

"Exactly. And this is in the evenings too. Sometimes I'm actually nodding off on the couch while watching TV, and I think that if I just go veeeery quietly to bed, I'll trick my brain into keeping on sleeping. But nope. As soon as I lie down in bed, it's like a switch flips on. And from there it's just busy, busy, busy in my head. Why is my brain doing this to me?"

Why, indeed? What had Kate (and what have you) done to deserve this? You go to bed at a decent hour. You worship caffeine in the mornings but avoid it like the plague after noon. You manage stress as well as one can (other than the whole not-sleeping thing). You follow all the sleep hygiene rules better than you've followed any diet. You bought an expensive mattress and tried three different brands of melatonin, or perhaps prescription drugs like Ambien or Lunesta. You meditate like your life depends on it.

Or maybe you haven't been perfect in any of these domains, but then again, why should you be? Sleep shouldn't be this hard, right?

You've somehow lost control of sleep. And like Kate, all you want to do is figure out why, and how this happened, and most important, how you can get it back in line. Should you stop looking at electronic screens by 8:00 P.M.? (Spoiler: nope, you don't need to do that.) Should you buy special white noise machines, or Himalayan salt lamps, or lavender mist, or a wearable sleep tracker with the latest features? (Nope. That may backfire.) Should you make sure to be in bed at the same time every night? (Definitely nope. That will surely backfire.) Should you try melatonin again? (You could, but it won't help.)

So, what's the answer?

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From the book Hello Sleep by Jade Wu, copyright (c) 2023 by Jade Wu. Published with the permission of St. Martin’s Press, an imprint of the St. Martin’s Publishing Group.