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Tired of being tired
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Content
Tired of Being Tired
Tuija Pallaste
The Master’s Project for Master of Arts in Specialized Journalism, JOUR 594A
Professor Michael Parks, Annenberg School for Communication and Journalism,
University of Southern California
August, 2016
2
Contents
Paradoxical Insomniac in Arizona 3
Prevalence of Insomnia 3
Sleeplessness is a Global Problem 4
Pulmonologist’s Three P’s 5
Why Sleeping Pills Do Not Work? 8
Fifty-eight Million Prescriptions 10
How Is Sleep Measured? 11
Sleep Deprivation Costs Billions 12
Meeting a Sleep Therapist 13
Hyperaroused People 15
I Have to Stop Pushing 16
Bibliography 18
3
I am tired and fed up. I want to give up but won’t. That’s how I would describe going through the
motions of a day after a sleepless night. I know those days and I know those nights. I’ve spent
thousands of them in the past 20 years. But never before have I spent such a day in the middle of a
desert in Arizona, and yet here I stand.
The sun is too bright but I take a little walk to calm myself as I am nervous to meet Dr. Rubin
Naiman, an assistant professor of alternative medicine at the University of Arizona in Tuscon. He is the
founder of the famous Canyon Ranch Resort sleep clinic, which is the first sleep clinic outside of a
hospital in the U.S. He is a psychologist, yoga instructor and author of several books on sleep. He has
healed thousands of sleep deprived people. Today he’s going to meet me. I am about to enter his
reception room in the town of Tubac, 40 miles outside of Tucson.
I moved to the U.S. a couple of months ago from Finland and decided to face my problem: I’ve lost
my ability to sleep. At least, that is what I think. Academics call this type of condition paradoxical
insomnia, and it is thought to be most common in young and middle-aged adults like myself. The
American Academy of Sleep Medicine defines it as ”a complaint of severe insomnia occurs even
though there is no objective evidence of a sleep disturbance.”
1
There is nothing wrong with me
physically (at least not that I know of) – I just lose my sleep whenever I am stressed or something out
of ordinary occurs. And that is always.
For a long time, I believed that sleeping problems were very Finnish problems. The National
Organization of Health and Welfare in my home country of Finland estimates that up to 9.2 percent of
working-age Finns suffer from chronic insomnia and up to 45 percent have occasional insomnia-related
symptoms.
2
4
By definition, insomnia means that a person has a difficulty falling asleep or staying asleep. It is
classified as ”chronic” if it occurs at least three nights a week and lasts at least three months.
3
In my
case, it has lasted years.
There is no clear reason why that many Finns are such bad sleepers. The amount of sunlight in
Northern Europe might play a role. In the winter, the sun is up for only a few hours a day, whereas in
the summer it does not set at all for weeks at a time. That kind of lighting messes up people’s circadian
rhythms. But then why are people sleep deprived in the U.S. too?
The National Sleep Foundation reports that 44 percent of Americans do not get a “good night’s
sleep” on a typical work or school night.
4
The U.S. Institute of Medicine estimates that around 50-70
million American adults have sleep or wakefulness disorder.
5
During the sleepless nights, I have felt
incredibly alone and hopeless. Yet, I have experienced these feelings with millions – or even billions -
of co-sufferers on this planet. I am not sure if this fact is a relief. Indian neurologists outline the
prevalence of insomnia in India in Annals of Indian Academy of Neurology:
Insomnia is a disorder characterized by inability to sleep or a total lack of sleep,
prevalence of which ranges from 10 to 15% among the general population with
increased rates seen among older ages, female gender, white population and presence of
medical or psychiatric illness.
6
Insomnia is not just a Western disease of affluence, it is a global problem. You could also make the
case that sleeplessness is a global business. We pay top dollar for relaxing massages, spas, and yoga.
We devour coffees, energy drinks, smoothies and energy bars to stay awake. There is a wide selection
of services, gadgets and products offering us relaxation and rest - or giving us a boost. There are sleep
5
consultants and therapists, mattress salesmen and pillow makers whose target customers are us
insomniacs. Arianna Huffington, founder of The Huffington Post, has written a new book called Sleep
Revolution, Transforming Your Life, One Night at a Time, which is on track to become a best-seller
even before it is published in April 2016. In it, Huffington claims that ”the big idea” that will shape the
year 2016, is sleep.
7
She could be right, though sleep has been a hot topic already for quite a long time. Amazon gives
more than 48,000 results when searching for books on sleep. The site’s health and personal care
department offers over 27,000 sleep related products.
8
Sleep is so widely searched for on the internet
that it was among the 10 most commonly searched for ’conditions’ on WebMD.com, one of the top
health and medical news websites in the U.S.
9
Sleep-related spending increased nearly nine percent between 2008 and 2012, and according to The
Fiscal Times, the sleep industry reached a volume of $32.4 billion in 2012, based on estimations by the
health care market analytics company IMS Health.
10
Imagine if you could just sleep – which costs nothing.
That is just one of the many ironies of sleeplessness. The more we spend on sleep remedies, it
seems, the worse we actually do sleep. There was 266 percent increase in the number of health care
visits in the U.S. for which a sleep-related diagnosis was recorded between 1999 and 2010.
11
Yet another paradox about sleeplessness is that it is a vital function and basic intrinsic trait. We
shouldn’t need doctors, remedies or products for it.
The first sleep expert I met with in the U.S. was Dr. Tisha Wang, a pulmonologist who treats people
with sleep disorders at the Ronald Reagan UCLA Medical Center in Westwood, California.
6
We sat at a cafe on campus at the University of California, Los Angeles and laughed at Wang saying
that even doctors won’t get enough sleep. Doctor Wang makes two things clear during our
conversation.
12
First, her role, and that of other physicians, in treating insomnia is to rule out that there
is a physical explanation to the problem, such as sleep apnea, narcolepsia, or restless leg syndrome.
Without that, then doctors cannot do much. They can prescribe sleeping pills, but these are only a
short-term solution, if a solution at all. Second, there are a lot of tired people out there who want the
physicians to solve their problem.
”With my colleagues, we joke that we should start a ‘Southern California Sleep and Wellness
Center.’ We would make so much more money than now,” Wang says jokingly.
Many sleepless people are reluctant to accept the fact that doctors may not be able to help them. People
would pay anything for a promise of sleep. While physicians can’t promise us that, they do however
have information and advice that is worth repeating.
We often hear that we should get at least seven to nine hours sleep per night to be healthy and
functioning. Actually no, we shouldn’t.
“We are born with a certain sleep pattern and with a different need for sleep,” Wang says. “If you
look at thousands and thousands of people, those people do better who have seven to nine hours sleep.
But it doesn’t mean that it implies to each individual. There are people who function well after just four
hours sleep.”
Wang says that the amount of sleep an individual needs can only be found out by – ironically –
sleeping. If I could spontaneously fall sleep, how many hours would pass before I woke up and felt
functional, she asks. I don’t know the answer. I wish I did.
First, she advises, I should start trying to sleep spontaneously. There are numerous tips to get there.
Women’s magazines and health websites offer us numbered lists that we’re all familiar with: ”5 ways
7
to improve your sleep” or ”5 facts about sleep hygiene” or ”5 things that make you sleep” . It is also
good to know that:
1. If a person follows a steady circadian rhythm, he or she is likely to have a steady sleep
pattern as well. That’s why many insomniacs are advised to restrict their sleep at first so that they will
get tired, leading to a healthy routine of sleeping and waking up.
13
2. Cool bedroom temperatures may facilitate falling asleep. When sleeping, our body
temperature falls naturally.
14
3. Darkness, emulated by using blackout curtains in the bedroom, also helps. A hormone
called melatonin reacts to light conditions. When it gets dark, our bodies secrete melatonin which
makes us sleepy. That is why additional melatonin intake does help some to get sleep. The blue light
emitted by electronic gadgets is also well-known to disturb sleep. A study at Harvard University
recently found that readers of e-books had a lower quality of sleep than those who read a traditional
book in bed.
15
4. It seems almost too obvious to mention avoiding stimulants in the evening, such as
coffee, chocolate, soft drinks, non-herbal teas, diet drugs, and some pain medicines. But it might be
wise to eat something before going to bed. Also, poor diet and low blood sugar are linked to keeping
people awake.
16
5. The sympathetic nervous system is increased after performing hard labor and heavy
exercise, and may prevent one from sleeping. It’s not wise to go to bed straight after coming off a work
shift or exercise.
However, I can tell you from experience that it’s possible to put all these tips into practice and still
not be able to sleep.
Wang nods in agreement. “It’s a very complex system.”
8
Besides all possible lifestyle and nutrition factors, there are three basic P’s that contribute to
insomnia: predisposing, precipitating, and perpetuating factors. In other words, genetics, childhood and
adult life conditions mess up the sleep, and a neurotic mind takes care of the rest. “In the end, you get
conditioned,” Wang says.
Many sleep-deprived people will try every ”trick” in the books but nothing helps because they have
already associated their poor quality of sleep with negativity. Sleep is something they can’t get;
therefore, it is a problem.
“They have to first uncondition themselves,” Wang says. ”Undo the condition pattern.”
This is why she refers insomniacs to a sleep therapist who does cognitive behavioral therapy (CBT).
“CBT tries to fix the last two of the three P’s of sleeplessness even though you are predisposed.”
Wang looks straight at me. “You have to train yourself to wind down.”
I have, however, one sure fire way to fall asleep – no matter how conditioned, aroused, or agitated I
might be: sleeping pills. Pills do not need to work around my routines or the temperature in my
bedroom they just make me fall asleep. And that is their problem. Sleeping pills make us fall asleep -
but they do not make us sleep well. Insomnia and sleep deprivation are already serious enough health
problems but, in a way, western medicine has only managed to make them worse.
Michael Wincor, associate professor of clinical pharmacy, psychiatry, and the behavioral sciences at
the University of Southern California, sat down with me to explain why the sleeping pills currently
available on the market still aren’t getting better.
17
He starts his short lecture talking about a hormone called gamma-aminobutyric acid (GABA).
GABA is the main inhibitory neurotransmitter in our central nervous system. It reduces neuronal
9
excitability throughout the neuronal system and is directly responsible for the regulation of muscle
tone. It is essential in sleep.
Up until the 1970s, sleeping pills were benzodiatzepines that contained gamma-aminobutyric acid.
They did not give people a ”good night’s sleep” but stunned them quickly - and lost their effectiveness
in a very short time. People kept increasing their dosages and eventually it stopped working for them,
but they could not stop taking the pills either because the withdrawal effects were so severe.
Wincor points out that the study of sleeplessness has a short academic history, as does the study of
sleep medicines. It was only in the early 1970s that a small group of scientists interested in sleep started
to hold yearly meetings in the U.S. They developed very early sleep disorder diagnostics, which were
published in 1979 in the medical journal SLEEP. Along with the rise of sleep study, scientists began to
examine benzodiatzepines more thoroughly. They discovered that some receptors in the brain reacting
to benzodiatzepines had more to do with sleep while some others were more involved, for example, in
muscle relaxations or anxiety. They set out to create a sleeping pill that would only affect the receptors
that made people fall asleep.
They succeeded in creating GABA agonists that mimicked the action of gamma-aminobutyric acid.
Agonists – as well as antagonists - are key players in the chemistry of the human body. An agonist acts
like another substance and thus stimulates an action.
18
GABA agonists worked in a similar way to the
benzodiazepine drugs inside the brain and thereby induced sleepiness, but they didn’t have the same
side effects. The pharmaceutical industry very soon made their own versions of them, and the drugs all
got names that started with the letter Z. Currently, modern prescription sleeping pills are still referred to
within the industry as ”z-drugs,” although American consumers know them by their market names like
Ambien, Lunesta, and Sonata.
10
It seems Big Pharma succeeded in its mission to bring sleep to the masses. Fifty-eight million
prescriptions were issued in 2012, up 10 percent from 2007, The Wall Street Journal reported in May
2013.
19
And yet, the chemical structure of America’s best-known sleeping pills is the same as it is in
the old z-drugs of the 1970s. The GABA agonists are still the most used sleeping pills, says Wincor.
”They are not perfect,” he says, then emphasizes that ”there are no perfect sleeping pills.”
Those of us who have used them – and there are a lot of us – know that they are far from perfect. No
matter how ”new generation” they claimed to be, they do have side effects; nausea and dizziness are
common, among others. If taken regularly, they lose effectiveness. Some researchers suggest there’s a
link between the use of z-drugs and some cancers. Other studies have shown that some people
sleepwalk after taking z-drugs, and some people have reported driving without being aware of
it.
20
They also make us forget things. When getting involved in the receptors that make us fall asleep,
they also seem to get involved in some receptors that work on our memory. Sleeping pills increase a
risk of amnesia; how big that risk is, we don’t yet know, says Wincor.
The Z-drugs have only been used since the 1970s. There are no long-term studies on the correlation
between sleeping pills and amnesia, at least not yet.
Wincor, a pioneer in sleep research in the U.S, says that no pills can produce what is essential in
”good” sleep – that is rapid eye movement, better known as REM, sleep. This is a unique period of
sleep when the eyes are moving rapidly, the muscle tone is completely released, and he or she is likely
to dream. It takes us usually about 70 to 90 minutes after falling asleep to reach this stage. Sleep has
different stages, and comes in cycles.
21
11
The REM sleep is still mostly a mystery to scientists, Wincor notes. He studied to be a biologist but
soon became interested in the interplay between biology and psychology. Sleep is all about this
interplay. The origins of sleep are inside the brain and in the mind, he says. Unfortunately scientists
cannot see into the human mind. They must rely on measurements taken on the surface of the brain.
Sleep is mainly measured by differences in brain waves – with the help of an electroencephalogram
(EEG) - and by monitoring muscle tone and eye movements. Four types of brain wave patterns have
been differentiated and named with the Greek alphabet. Wincor and the National Institute of
Neurological Disorders and Stroke
22
helped me to understand these patterns.
Our brains produce both Alpha and Beta waves when we are awake. Alpha waves are slower than
Beta waves. They take over when we are awake but relaxed, such as when we are daydreaming or
dozing off. The Beta waves are the normal daytime waves that are highest in frequency and lowest in
amplitude. This means they are fast but not very powerful and reflect the many motor, cognitive, and
sensory tasks we process when we are active.
The actual sleep brain waves are called Theta and Delta. Theta waves happen when we gradually
and subtly fall asleep. During the Theta waves, we enter stages one and two of light sleep.
Sleeping pills can guarantee only light sleep, meaning they actually deprive users of the deep sleep
that they really need. In looking at my own issues, I suppose I am typically getting mostly light sleep.
My impression of having hardly slept at all for years probably means that I have slept, but much of it
has been Theta waves and stage 1 or 2 sleep. Scientists have noted that when a person wakes up during
light sleep, he or she usually does not recall having slept at all.
12
The most important sleep brain wave type is Delta, which includes the most important stages of
sleep, three and four. Delta sleep is our deepest sleep. Only during Delta waves can we reach REM
sleep.
”We need deep sleep,” Wincor states. REM sleep makes our brains recover.
It sweeps away our fatigue. It rejuvenates us a billion times better than any energy drink, pill, massage,
or gadget does. Delta or REM sleep cannot be produced with a chemical. It is a miracle in our own
body and mind, and as an insomniac, I am irritated that I cannot buy that miracle.
Yet another paradox of sleeplessness is that when we sacrifice our sleep to be more productive at work,
we actually become less productive.
Harvard University Medical School found out five years ago exactly how much sleep deprivation
costs to companies and the national economy.
23
Researchers at the Department of Health Care Policy
gathered a national sample of 7,428 adults over age 18 who were employed health plan subscribers.
They then filled out the World Health Organization’s ”Health and Work Performance Questionnaire”
and ”Brief Insomnia Questionnaire” as part of the larger American Insomnia Study
24
and were
interviewed over the phone.
Approximately 23 percent of the interviewees were identified as those who suffered from “broadly
defined insomnia” and were differentiated from normal sleepers. Then researchers studied the
associations between insomnia and work performance scores, and concluded that insomnia did not
directly cause absences at work but it contributed significantly to lost work performance.
The researchers calculated the amount of lost work performance at an individual level over the
course of a year. They estimated that insomniacs lose approximately 7.8 work days a year because of
their reduced ability to work due to sleeplessness. Translated into a dollar amount, this was on average
13
$2.28 million per individual worker and $63.2 billion when applied to the total U.S. workforce. No
wonder that corporations like Google and Goldman Sachs now provide their workers with sleep
consultancy.
25
Sleep makes people prosper – and keeps us alive. According to the Centers for Disease
Control and Prevention’s Morbidity and Mortality Report in March 2011, ”drowsy driving, one of the
most lethal consequences of inadequate sleep, has been responsible for an estimated 1,550 fatalities and
40,000 nonfatal injuries annually in the United States.”
26
But back to me...Here I am in the Arizona desert, about to meet a psychologist and a sleep expert as if
it’s my first time seeking help when in fact I already know plenty about insomnia. I have gone through
treatment for it. I did not tell Dr.Wang, but I have even tried Cognitive Behavioral Therapy. It surely
works for many, but it did not work for me. I felt like Pavlov’s Dog, and I am not a dog. So what am I
to ask Dr. Naiman?
Rubin Naiman has grey hair and incredibly blue eyes. His gaze is gentle and striking. I know his
background from reading his writings
27
and checking his website.
28
He moved to Arizona from the East
Coast, founded the sleep clinic of Canyon Ranch Resort and met the famous physician Andrew Weil, a
pioneer in holistic health and integrative medicine.
29
I sit down on the sofa in Naiman’s home office. It has the look of a typical therapist's room with an
exceptional view of the desert and the mountains on the edge of it. I tell him about myself and my
project. It seems that Dr. Naiman is used to dealing with insomniacs who are so desperate to find a
cure, they end up crying on his couch. By the time I’m done talking, the sun has gone down outside and
I feel so relieved that I burst into tears. He hands me a handkerchief.
“You do some web research and get literally millions of results on insomnia. Most of them define
sleep as a bio-medical condition,” Naiman says. I nod. “They look at what is going on in your brain, in
14
your body, in your neuro-transmitters. There is medication. Mattresses.” I know of all these things
already. “Sleep is reduced to technical things. I am not saying that this couldn’t be helpful, but we lose
sight of a fact that sleep is extremely personal experience.”
Naiman does prescribe some conventional sleep medicines – “they are good interventions but aren’t
doing the trick” - but his approach is broader.
30
He thinks we should stop medicalizing sleep and,
instead, really understand sleep.
Naiman has been a contributing writer to The Huffington Post for years. He says, with some
amusement, that when he writes a serious piece on why a generic list of sleep tips don’t work, it gets
buried immediately. But if the editor puts a number on the headline...”5 reasons, 17 things you
shouldn’t do”… it immediately gets a lot of attention. ”Numbers give a feeling that it is highly
scientific,” he says. ”But it is a mistake to think that we can reduce sleep into science. Science is there
to support sleep.”
Naiman says that the most common question he hears is how many hours should I sleep?
“It’s like asking how many calories should I eat? Answer is: it depends. It really is the quality of sleep
that matters,” he says.
When asked about the natural rhythm of life, Naiman answers simply, “Things wake up and they go
to sleep. They wake up and they go to sleep.”
“We think of waking and sleeping as different places, but they are actually continuous,” he says.
”There is connectedness. There is continuity in consciousness that we fail to recognize. It goes back to
this notion that sleep resides in us, it’s default in consciousness and we never really have to go there.”
I begin to get the picture. We do not get sleep. We do not go to sleep.
15
“These verbs make us think that we are in control of sleep," Naiman explains, “and that the part of
us called I, the waking part of us, controls sleep – and it really doesn’t. The greatest simple challenge of
getting to sleep in the western world is that we have to make it happen.”
What Naiman says is obvious. It sounds easy. Sleep is already inside of us, I don’t need to chase it. But
still, I cannot find sleep inside of me.
Are all the sleep products, therapies and programs for nothing? No. “Everything you will do to
improve your sleep will improve your waking life. Unless there is that hyperarousal,” Dr. Naiman
replies.
Hyperarousal? I instantly feel like I can relate to that word.
Hyperaroused people are, in a way, battling against gravity, Naiman says. “If you allow your hand
to pull down, can you feel the heaviness of your hand?” he asks me. Yes, I can. “It’s right there, right?
You don’t have to make it happen. Gravity pulls us down. Gravity is sleep in the world. We just have
to stop being awake, stop pushing.”
Hyperaroused people are pushing all the time. Thay are like planes that are flying too high –
unnecessarily high, describes Naiman. “If we are hyperaroused, we get far away from sleep. To keep
sleep close at hand is to keep sleep with you. It does not mean you are sleepy, but you keep quiet and
serenity with you.”
Hyperarousal is a known syndrome but it’s not diagnosed. It is a physical condition with symptoms
of high EEG, elevated cortisol and reduced melatonin. Cortisol is the human body’s response to stress
and inflammation, but if its release is continuous, it becomes harmful. As Naiman puts it,
”hyperarousal is a result of a chronic posture toward life.” He says that after doing therapy for years, he
16
has a sense that most hyperaroused people are trying to run from something. It is a
”very, very common” syndrome. If it is so common, why didn’t any experts bring it up to me before?
Maybe I wasn’t listening to the right people. No known drug can conjure a hyperactive person from
one end of active daytime brain waves to the other of deep sleep waves. I can, however, learn to wind
myself down toward Delta waves. As an instructor, Naiman recommends practicing yoga, and there are
studies supporting its effectiveness. Very experienced yoga nidra practitioners have even been
measured to have Delta waves of deep sleep while being conscious and practicing. Not surprisingly,
yoga nidra is often referred to as “yogic sleep.”
Mindfulness and meditation are also researched ways to calm down the hyperactive mind.
I have to stop pushing. Naiman says it’s a question of willingness. Am I willing to let go? Am I willing
to encounter night?
“The best sleeping medication, in my opinion, is night,” he says. “You can profoundly correct
people’s circadian rhythms and their sleep by taking them out camping for a week with no electronic
light,” he says, sounding decidedly more pragmatic and less philosophical.
Then he advises me to fall in love with sleep. “Falling in love with sleep is really important.
Remembering how delicious it is, how sensual it is. When we think of sleep as being unconscious, we
think it’s not an experience. It is like diving into a beautiful lake of warm, dark, sweet water. It carries
you.”
We are finished with our meeting now, and I am standing in the parking lot outside his house. It’s
dark. I cannot see the desert or the mountains on the edge of it.
17
Naiman believes that insomnia is a physical, psychological, and spiritual issue. I opposed the
spiritual aspect, as I am not religious, but he explained that even if I did not have an image of God
inside of me, I do have an inner conception of the universe. What is it like when I see the desert and the
mountains in the daylight -- are they good or bad? How about in the darkness of the night, are they
good or bad for me? Am I ready to lean on my universe when I fall asleep?
When I think about how to answer those questions, I almost unconsciously begin running my
fingers over some scratches on my elbow that I got from accidentally brushing against a small desert
cactus earlier the day. The universe is unpredictable, but I guess I can count on it.
In my everyday sleepless life, I am constantly flying high and at a breakneck speed. I have my work
and my studies. I am responding to my child's needs, to my family's needs. I have my hobbies and my
friends and sometimes even late nights out. I am keeping myself up with such a determination that it is
not easy to land and let go when I go to bed. If I let go, I might not be able to get up again at all. That is
what I fear. That is the paradoxical insomnia of young and middle-aged adults.
With all of this on my mind, I drive to my motel across the dark desert. It is time to go to bed. I hear
Dr. Naiman’s words. We never sleep alone. We sleep with the world. Right now on Planet Earth, there
are approximately two billion people asleep.
18
Bibliography
1. ”Insomnia.” The American Academy of Sleep Medicine. Accessed March 20, 2016.
http://www.aasmnet.org/resources/factsheets/insomnia.pdf.
2. Kronholm, Erkki, Timo Partonen, Mikko Härmä, Christer Hublin, Lallukka Tea, Markku Peltonen,
and Tina Laatikainen. ”Prevalence of insomnia-related symptoms continues to increase in the
Finnish working-age population,” Journal of Sleep Research, February 2016. Accessed March 20,
2016.www.researchgate.net/publication/294258673_Prevalence_of_insomniarelated_symptoms_co
ntinues_to_increase_in_the_Finnish_working-age_population.
3. ”Insomnia.” University of Maryland Medical Center Medical Reference Guide. Accessed March 20,
2016. http://umm.edu/health/medical/reports/articles/insomnia.
4. ”2013 International Bedroom Poll.” National Sleep Foundation. Accessed March 20, 2016.
https://sleepfoundation.org/sites/default/files/RPT495a.pdf.
5. Colten, Harvey R., and Bruce Altevogt, editors. ”Sleep Disorders and Sleep Deprivation – An Unmet
Public Health Problem.” Institute of Medicine (US) Committee on Sleep Medicine and Research.
Washington DC: National Academies Press (US), 2006. Accessed March 20, 2016.
http://www.ncbi.nlm.nih.gov/books/NBK19960.
6. Saddicha, Sahoo. ”Diagnosis and treatment of chronic insomnia.” Annals of Indian Academy of
Neurology 13 (2010) 94–102.
Accessed March 20, 2016, doi: 10.4103/0972-2327.64628.
7. Huffington, Arianna. ”A Sleep Revolution Will Allow Us To Better Solve The World’s Problems.”
The Huffington Post. Accessed March 20, 2016. http://www.huffingtonpost.com/arianna-
huffington/a-sleep-revolution-will-allow-us-to-better-solve-the-worlds-problems_b_8818656.html.
8. Amazon.”Sleep” search terms, accessed March 20, 2016.
9. Fox, Susannah. ”Health Topics: 80% of internet users look for health information online.” Pew
Research Center’s Internet & American Life Project (2011). Accessed March 20, 2016.
http://www.pewinternet.org/files/old-media/Files/Reports/2011/PIP_Health_Topics.pdf.
19
10. Mackey, Maureen. ”Sleepless in America: A $32.4 Billion Business.” The Fiscal Times, July 23,
2012. Accessed March 20, 2016. http://www.thefiscaltimes.com/Articles/2012/07/23/Sleepless-in-
America-A-32-4- Billion-Business.
11. Ford, Earl S., Anne G. Wheaton, Timothy J. Cunningham, Wayne H. Giles, Daniel P. Chapman,
and Janet B. Croft. ”Trends in Outpatient Visits for Insomnia, Sleep Apnea, and Prescriptions for
Sleep Medications among US Adults: Findings from the National Ambulatory Medical Care
Survey 1999-2010,” SLEEP (2011): 37(8): 1283-1291. Accessed March 20, 2016.
http://dx.doi.org/10.5665/sleep.3914.
12. Tisha Wang, MD (pulmonologist), interview, September 28, 2015.
13. Hauri, Peter, The Sleep Disorders, chapter 2. Accessed March 20, 2016.
http://sleepdisorders.sleepfoundation.org/chapter-2-insomnia/cbt-overview/cbt-sleep-restriction.
14. ”What Happens When You Sleep?” National Sleep Foundation. Accessed March 20, 2016.
https://sleepfoundation.org/how-sleep-works/what-happens-when-you-sleep.
15. St. Peter, Elaine. ”E-Readers foil good nights sleep.” Harvard Medical School News, January,
2015. Accessed March 20, 2016. https://hms.harvard.edu/news/e-readers-foil-good-nights-sleep.
16. Zadeh, Sara Sarrafi and Begum Khyrunnisa. ”Comparison of nutrient intake by sleep status in
selected adults in Mysore, India.” Journal Nutrition Research and Practise. June 2011, 230–235.
Accessed March 20, 2016, doi: 10.4162/nrp.2011.5.3.230.
17. Michael Wincor (Associate Dean, Global Initiatives and Technology;
Associate Professor of Clinical Pharmacy, Psychiatry and the Behavioral Sciences, University of
Southern California Schools of Pharmacy and Medicine), interview, November 24, 2015.
18. ”Medical Terms,” MedicineNet. Accessed March 20, 2016.
http://www.medicinenet.com/script/main/art.asp?articlekey=7835.
20
19. Marte, Jonnelle. ”...the Sleep Industry Won’t Say.” Wall Street Journal, May 18, 2013. Accessed
March 20, 2016. www.wsj.com/articles/SB90001424127887323582904578487194292468554.
20. Pressman, Mark R. ”Sleep driving: Sleepwalking variant or misuse of z-drugs?” Sleep Medicine
Reviews. Vol.2, Issue 5, 2011, 285–292. Accessed March 20, 2016.
www.sciencedirect.com/science/article/pii/S1087079210001528.
21. ”Brain Basics: Understanding Sleep.” National Institute of Neurological Disorders and Sleep.
Accessed March 20, 2016. www.ninds.nih.gov/disorders/brain_basics/understanding_sleep.htm.
22. ”Brain Basics: Understanding Sleep.” National Institute of Neurological Disorders and Sleep.
Accessed March 20, 2016. www.ninds.nih.gov/disorders/brain_basics/understanding_sleep.htm.
23. Kessler, Ronald C., Patricia Berglund, Catherine Coulouvrat, Hajak Goeran, Thomas Roth, Victoria
Shahly, Alicia C. Shillington, Judith J. Stephenson, and James K. Walsh. ”Insomnia and the
Performance of US Workers: Results from the American Insomnia Survey,” SLEEP (2011): 34(9):
1161–1171, doi: 10.5665/SLEEP.1230.
24. ”Insomnia Costing U.S. Workforce $63.2 Billion a Year, Researchers Estimate,” Harvard Medical
School News, September 2, 2011. Accessed March 20, 2016.
https://hms.harvard.edu/news/insomnia-costing-us-workforce-632-billion-year-
researchers-estimate-9-2-11.
25. McGregor, Jena.”The average worker loses 11 days of productivity each year due to insomnia, and
companies are taking notice.” Washington Post. July 30, 2015. Accessed March 20, 2016.
www.washingtonpost.com/news/on-leadership/wp/2015/07/30/the-average-worker-loses-11-days-
of-productivity-each-year-due-to-insomnia-and-companies-are-taking-
notice/?postshare=1641438314050566
26. ”Morbidity and Mortality Weekly Report,” U.S. Department of Health & Human Services, Centers
for Disease Control and Prevention, March 2011. Accessed March 20, 2016.
http://www.cdc.gov/mmwr/pdf/wk/mm6008.pdf.
27. Naiman, Rubin R. Healing Night: The Science and Spirit of Sleeping, Dreaming, and Awakening.
(Minneapolis, Syren Book Company, 2006).
21
28. ”About Dr.Naiman,” Rubin Naiman Official Website. Accessed March 20, 2016.
http://drnaiman.com
29. Weil, Andrew and Rubin Naiman. Healthy Sleep: Fall Asleep Easily, Sleep More Deeply,
Sleep Through the Night, Wake up Refreshed. (Body & Soul Omnimedia, 2007), audiobook.
30. Rubin Naiman, interview, November 13, 2015.
Abstract (if available)
Abstract
Western medicine keeps people alive and awake, but when it tries to make us sleep, it becomes useless. As a longtime insomniac, I wanted to know why. I interviewed Pulmonologist and Sleep Specialist Tisha Wang, Professor of Clinical Pharmacy Michale Wincor and Sleep Therapist Rubin Naiman.
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Creator
Pallaste, Tuija Elina
(author)
Core Title
Tired of being tired
School
Annenberg School for Communication
Degree
Master of Arts
Degree Program
Specialized Journalism
Publication Date
08/02/2016
Defense Date
07/28/2016
Publisher
University of Southern California
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Tag
insomnia,OAI-PMH Harvest,sleeping pills,sleeplessness
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English
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), Celis, William (
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), Saltzman, Joe (
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)
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Tags
insomnia
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