Jennifer Senior (2:59)

Oh God.

Alison Stewart (3:00)

It kind of came at you. According to your article, it came at you out of. Out of nowhere.

Jennifer Senior (3:06)

Right?

Alison Stewart (3:06)

What happened?

Jennifer Senior (3:09)

Well, I guess by definition, because it came out of nowhere. I don't know. That was what was so upsetting.

Caller (3:16)

Like.

Jennifer Senior (3:18)

Oh, but you mean what happened like, what did the insomnia look like? I wasn't trying to mock the question. I mean, like I'm trying to play up. Yeah, I felt like I'd been poisoned. I mean, it was so, so weird. So, I mean, just to back up, I slept with almost annoying regularity. I slept from 1:00 o' clock to 9:00', clock, 1:00 clock to 9 o', clock, 1:00 clock To 9:00 clock every night. It was alienating to boyfriends, it was remarkable to friends. I didn't need an alarm clock when I lost mine. I bought a new one when I had an early morning flight to catch. But I was really supremely well regulated. And then suddenly, without the circumstances of my life having changed one iota, I one night, rather than falling asleep at my customary one o', clock, was up until five and I thought weird, but didn't think anything of it. And then it started. It happened again a few nights later and then again a few nights after that until it was closer and closer together. And then I started pulling involuntary all nighters. And you can imagine my bewilderment and then my anxiety and then my outright panic over this because it was without explanation and it couldn't be subdued no matter what. I tried and I tried everything at its worst.

Alison Stewart (4:42)

How has insomnia affected the way that you live your life day to day?

Jennifer Senior (4:46)

Well, I mean, now it's regulated. I take something for it. I have learned. I meditate when I can. And that always makes some kind of difference. It doesn't banish it. I know the right things to tell myself at night. But when I was leading a life of acute stress, namely when I was a book critic for the New York Times and one of the daily book critics. So I had three books to review every two weeks. So do the math on that. And they were nonfiction. They were often these big fat doorstops. I couldn't afford a night of no sleep and I was a wreck. And I would often not get out of bed. I couldn't plan socializing. I was. It was a nightmare. I Mean, it was really, truly terrible. I had to change jobs essentially, is what I had to do. I couldn't do it.

Caller (5:42)

Let's talk to Mike from Seville, Long Island. Hi, Mike, thanks for calling, all of it.

Mike (5:47)

Hi, how you doing? I was struck when she said it happened in my late 20s. It happened to me when I was 27. I slept fine till then. And then boom, out of nowhere, nothing. I'm 66 now. I'm still struggling with it, still trying to figure it out. I have a routine that kind of works. I got an Ambien prescription, 10 milligrams. I break it in half. I take 1/2 45 minutes before I go to bed. Then I do fall asleep because that was my big trouble, is my gears grind, I think, I think, I think so. Then, then I get up about 3 o' clock in the morning to go to the bathroom. It's a one shot deal. And I take the other half. And that seemed to work okay. I tried gummies and I didn't like them. I don't like, you know, being stoned. But what I have tried lately and it seems to be working. When I get up in the middle of night to take the second half of the Ambien, I take a gummy and they take like an hour to kick in. So I'm already asleep. And I now, since I've been doing that, which is only recent, I do feel a lot better in the morning. Mike, that's all I got.

Alison Stewart (6:59)

Yeah, I'm glad you feel better. He had a lot of information in that question.

Caller (7:03)

First of all, Ambien.

Alison Stewart (7:07)

How do you feel about Ambien? What did the experts tell you about Ambien? When is it good to take Ambien?

Jennifer Senior (7:14)

Right. I am here not to pass judgment. And I take something every night too. I take the lowest dose of Klonopin. I have tried every therapy out there, including the gold standard, cognitive behavioral therapy. And sleep compression is a major feature of it. And it's really, really agonizing for some people, including me. I've tried it twice. Sleep restriction. And I would like to make another run at it. I will tell you about Ambien. I also. Can I focus on one thing that he said also?

Caller (7:46)

Sure.

Jennifer Senior (7:46)

Go grinding his gears at night. Often it's the anxiety about not sleeping, regardless of what started it, that keeps people from sleeping eventually like that, that almost takes over and become. It assumes a life of its own. The anxiety surrounding and the neuroticism about leading up to it and fearing the nighttime and the dread of Night, as I think it was Kafka who said it. Yeah, dread of night. Dread of not night, I believe was the quote. Anyway, so Ambien, obviously people don't consider this the optimal solution. It is a very popular solution. Taking drugs for sleep, 18.4% of Americans do it either every night or some nights. So I'm not talking about. It's a. And when I mentioned this to an academic who's a giant in the field, she said, that's low, suggesting people are either embarrassed to cop to it, or maybe they don't consider melatonin or weed, you know, an actual sleep medication. Who knows? But ambient. Look, if the primary and only side effect of being on a drug is dependence on the drug, and one does develop dependence, although you can wean yourself off. And if you're not escalating in dosage, and believe it or not, it's actually quite rare to escalate beyond the prescribed dose. 7% of those who've been on benzodiazepines, which includes like, Ambien and Ativan and Klonopin and all these things. Only 7% of a giant Swedish cohort did this after three years of being on it nightly. The real risks are falling at night as you get older cognitive decrements. It's better to get off of it, of course. And for some people, the benefits outweigh the risks. And that's a personal choice. It's not the first line of therapy, and it shouldn't be. There are other things you can do. You can meditate. You can do cognitive behavioral therapy for insomnia that just has the cognitive component, where you're just changing your thoughts about sleep and not being so terrified at night about not getting a good night's sleep.

Caller (10:14)

Actually, I want to go to a caller who has tried cognitive behavioral therapy. That's Steve from Astoria. Hey, Steve, tell us your story.

Steve (10:24)

Yeah, I had insomnia back in 18 and 19, and, you know, I totally get the anxiety. It only takes a couple of weeks to feel like it's totally ruining your life and you go to try anything, you know, and I did use, you know, melatonin. I went to therapists. I went to. I used some other. I can't remember the name of it, but a friend of mine sort of warned me, you know, that it's easy to get addicted. And so I weaned myself off of it over a period of months. But I did use basically this, the sleep restriction or compression. And seriously, like, I would go to bed strictly 1 o' clock and get up at 7 o'. Clock. And no matter how much or how little I slept, I just had to do that. You're not allowed to lie down the rest of the day. You're not allowed to take a nap. And eventually, by September, which was about nine months into it, eventually, I had a week where, hey, the whole week I didn't have insomnia. It's amazing. So I'm a big proponent of that cognitive behavioral therapy, which I did from a book, not from a therapist, because very few therapists are covered by insurance.

Caller (11:49)

Yeah, so you did, you did the cognitive behavioral therapy. And the restriction is that what you.

Steve (11:55)

Did, there's record keeping. Like you write down on a grid what time you got into bed when you were awake during the night, how much sleep you got at the end of the. You know, when you wake up in the morning.

Jennifer Senior (12:08)

I gotcha.

Caller (12:09)

I gotcha. Does this sound familiar to you, Jennifer?

Jennifer Senior (12:11)

Yes. And it actually includes cognitive behavioral therapy for insomnia. Includes the main tentpole is sleep restriction. It's just the hardest to endure. And props to you, it is really effective if people can do it. You got six hours. I was told to start with five, I think. And I was only sleeping every other night by the time I went in to get it. And that just. I was just desperate for relief. And yet I tried it anyway and my sleep would not contract. And I was out of my head with exhaustion and with. I was so depressed from not having slept. It can be hard, but for those who can stick with is fantastic. And it's very impressive. Not enough therapists do it as. And as the caller said, they are not. Most don't take insurance. It's tough. And the other piece of cognitive behavioral therapy, you don't only restrict your sleep, you think differently about your sleep. You keep those diaries so that if you have these thoughts about, oh, I'll never be able to function the next day, you can consult your diary and think, oh, you know, and see, oh, actually I kind of did function. Okay. Or when you're lying in bed, rather than going, oh, my God, oh my God, oh my God, you say, so what? So what? And you don't look at the clock. It's all sorts of restrictions there in terms of your behaviors. Like you don't. You. You keep the bed only for sex and for sleeping, and that's it. You stay out of it. All the things he said.

Caller (13:51)

We're talking to Jennifer, senior staff writer at the Atlantic. We're talking about her recent piece, why Can't Americans sleep. Are you someone who struggles with insomnia? When did it begin? And what have you done to sleep better? Our phone number is 2124-3396-9221-2433. WNYC. We'll have more after a quick break. This is all of it.

Alison Stewart (14:22)

You are listening to all of it on wnyc. I'm Alison Stewart. My guest is Jennifer Senior, staff writer for the Atlantic. She wrote a great piece called why Can't Americans Sleep? Which looks into how Americans struggle with sl. I did want to ask you a question from your research. How do the insomnia statistics change depending on a person's race, their employment, their social class?

Jennifer Senior (14:49)

Yeah, yeah, it's a great question. So African American women have the worst rates, I believe.

Alison Stewart (14:58)

I mean, I know I'm talking about now.

Jennifer Senior (15:00)

Sorry, but it's true. I mean, and it's correlated with clothes, class. But I'm sure it's also correlated with what happens when you move through the world. As an African American, I'm sure it's about woman. I'm sure it's about, you know, race and gender and racism and sexism. I'm, I'm sure that there's also. And Latinos sleep worse. Black men sleep worse. Poor people sleep worse. If you look at sort of geographically where the lousy sleep patterns are in the United States, they run across the south and through Appalachia. And we know that. And it's correlated by income. We also know that 16.4% of Americans work non standard hours. And that's just a formula for disastrous sleep. It's finding your own biological rhythms essentially, so that even the most basic things like keeping your room dark and making sure that your body gets the right cues, you're coming home, commuting home in broad daylight. It's hard to make your room dark when it's light outside. And the World Health Organization has identified night shift work as a probable carcinogenic. So this is tough stuff.

Alison Stewart (16:27)

It's interesting hearing you talk. You're describing everything that happens outside of the bedroom affects what happens in the bedroom, correct?

Jennifer Senior (16:37)

That is exactly right. And I think you can extend this more broadly. Electrification really laid waste to our circadian rhythms a long time ago. Midnight was no longer midnight, Right. I mean, midnight is now when many of us stay up, behaviors outside. Yeah. I mean, we go to restaurants that are brightly lit. We watch television which has blue light emitting from it. Kids do their homework and socializing on screens which has blue light emitting coming from it. And that suppresses melatonin. If you're working, if you're a professional, you've got. Your boss is bugging you on weekends after hours. I mean, everything affects your sleep, rhythms in your sleep. Absolutely. And if you're, as I said, if you're a shift worker, if you've got a second job, forget it. Forget it.

Alison Stewart (17:34)

Let's take a couple of calls. Let's talk to Alice, who's calling from the East Village. Hi, Alice, thanks for taking the time to call, all of it today.

Alice (17:43)

Hi, yes, I think there's a lot of things going on. I did the sleep study at Langone and I saw every single sleep official. They never talked to each other. And I started to feel like my. That I had a lot of shame when I couldn't sleep regular hours. And now I've just decided that that is who I am. I go to bed at around 12:45, I wake up at 5:30. I function and then I have to take a nap. And, you know, and that's all there is to it. And I feel like in some weird way it reflects me trying to be so normal and I just can't be.

Alison Stewart (18:25)

Alice, thank you for calling in. Let's talk to Lisa from Chelsea. Hey, Elisa, thank you for making the time to call all of it today.

Caller (18:32)

Hi, Allison and Jennifer, thanks for taking my call. I really loved your emphasis, Jennifer, in the article about medications. And I'm somewhere someone who suffered from insomnia from my teenage years, and I'm in my 50s now, and, you know, years and years where I would ask doctors, you know, can you give me something? And they would say, oh, you know, there's a million other things you should try first, we don't want you to be Valley of the Dolls, et cetera, et cetera. In addition to, I think, you know, being from a family who thought medication for sleep was absolutely not something I should pursue. And I finally, at the recommendation of a friend, saw a psychiatrist. And, you know, I'm a lawyer, I'm a mother, I live in New York City. I'm a wife. You know, life is stressful. And every doctor would say, you know, can you reduce your stress? And I would just burst out laughing. You know, what am I supposed to do? And so, you know, when I, when I had, you know, this recommendation from a friend to see a psychiatrist, I saw her and I'm not exaggerating that within 15 minutes of just speaking to me, she said, lisa, you have anxiety. You have actual anxiety, and I'm going to put you on Some medication for that, and let's see how it goes. And this is three years ago, and I'm a new person, and I. And like the last caller, I feel like I felt guilty or shame about the fact that I just can't sleep. And there was a solution for me and, you know, one day I'll consider weaning myself off it, et cetera, but it wasn't worth it for me to avoid it all these years. Not even close. I'm a new person now.

Jennifer Senior (20:21)

Can I please, please, please say something? I am so desperate to say something. Oh, may I go? Okay. I am so glad. I'm so thankful to you both for phoning in and saying this. One of my main goals in writing this was to destigmatize the solutions people seek, including pharmacological ones and the fact that some people can't sleep. The Parker Posey character on White Lotus, I found her as hilarious as the next person. But her narcotizing herself into La La Land at every step and both at night and during the day, she was a punchline. And I don't think that sleep meds, as a culture, we no longer stigmatize depression and taking Zoloft and Paxil and all these things and Prozac, we still stigmatize this stuff. And failure to sleep looks like a failure of will, a failure of discipline. You're too frail, you're a neurotic. You. I don't know, we don't have the same kind of expansiveness and compassion. And there's also all this misunderstandings that you're going to turn into Judy Garland and suddenly need, like a fistful of pills and a fifth of vodka. She, I think, overdosed on pills, which was tragic, you know, to sleep when most people don't even up their doses, even if they're regular takers of sleep medication. This is not to say, and I tried everything. Exercise, acupressure, acupuncture, neurofeedback, meditation. I tried everything. And I would like to go back to those things. I've tried two runs at CBT i3, actually, in a way, and I'd like to do more. But when benefits outweigh the risks, I think people who are relying on whatever they're relying on have to stop feeling shame and people have to stop shaming them.

Alison Stewart (22:16)

Jennifer, why do you think there is still a judgment, a judgmental tone about how we deal with our sleep issues?

Jennifer Senior (22:25)

Well, I think that some of it might have to do with the idea that to the extent that people Associate it with neuroticism. It's just not as romantic or interesting as depression or as that might be some of it. Or anxiety, you know, I mean, but I think the anxiety gets interpreted as neuroticism, which is sort of ugly. I think that because medications can be abused there or used for fun and there's misconceptions about them that they. It means escalating doses. There can be some. There's also. There used to be a study that was quite influential that said that benzodiazepines, which were the Ambiens and Klonopins and Xanaxes and Valiums of the world, that those things caused dementia. And then two years later another study came along saying, no, sorry, nothing to look at here. That could be wrong too. We don't know. But that probably contributed to a stigma. Hard to say. And I think a number of things.

Alison Stewart (23:27)

Are you sleeping well now?

Jennifer Senior (23:30)

I have long Covid so at first I slept. Yeah. Well, I'm an immunocompromised wreck. I always have been. Oh, yeah. So like, I mean, I knew this going in. I'm just grateful I'm alive, honestly. But I mean, yeah. And I'm sure it's also connected because those with immune issues and sleep issues were more prone to get long Covid but my immune issues started from when I was a baby and they were patented. They're measurable. My mom has, you know, an autoimmune disease. But anyway, my sleep, okay, you know, it's. I'm calmer about it. It's regulated and it fluctuates with my symptoms.

Caller (24:10)

We are sending you our very best, Jennifer. Jennifer Sr. Has written why Can't Americans Sleep for the Atlantic. We wish you our best, Jennifer.

Jennifer Senior (24:20)

Thank you. And right back at you. We quilt this city with a comfy roll. Colton. Quilted Northern is quilted with three cushy.

Lisa (24:29)

Layers for your comfort.

Jennifer Senior (24:31)

The quilted comfort of Quilted Northern.

Lisa (24:35)

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