Is sleeplessness killing you softly?

Despite stacks of research on how sleeplessness kills you in insidious ways, being a borderline insomniac has never bothered me. I'd rather be up doing nothing particularly useful than asleep doing, well, nothing that I'm conscious of.

Of course, when I say sleeping kills, I don't mean getting killed in an accident from sleeping over the wheel while driving. What I had in mind was sleeplessness killing you softly by triggering high blood pressure, raising stress hormone levels and inflammation, all factors that raise heart disease and stroke risk. Truncated sleep also interferes with metabolism, causing glucose intolerance, type-2 diabetes and obesity by altering metabolic functions, such carbohydrate processing and storage.

All this is old hat. So when I came across a disease called Fatal Familial Insomnia (FFI), I almost put the book away. Anything termed 'fatal' obviously kills you, and it gets seriously worrying when it precedes a disorder you may be suffering from. But the word 'familial' was comforting - my parents and extended family have no sleep disorders that I could have inherited - so I read on.

FFI is a very rare (great news) and incurable disorder that afflicts only 100 people worldwide (even better news). Caused by a mutation to the brain protein PrPC, it leads to progressively worsening insomnia till the sufferers starts hallucinating and losing their minds from lack of sleep. It kills within 18 months, which must seem a bit longer to someone who cannot sleep at all.

So I turned the page again and came across the Strange and Horrific Death of Michael Corke, a music teacher from Chicago, who turned into a rabid insomniac immediately after his fortieth birthday in 1991. Within months, he had to be hospitalised because he lost his mind along with his ability to sleep. Even inducing a coma using sedatives couldn't shut his brain down. Corke died a month before his forty-first birthday, after being sleepless for six months.

It still read a bit like a page out of Ripley's Believe it or Not, so my interest remained purely academic. But then the author Matthew Wolf-Meyer muddied the waters by describing a non-inherited even rarer form of the disorder called sporadic fatal insomnia that spontaneously appeared in people with no inherited mutation in mid life - read that as over the age of 40. That's when I started losing some more sleep wondering if my brain was battling mutant proteins that were kicking it awake when it really wanted to sleep.

But having slept over it, The Slumbering Masses proved to be a good read. Anthropologist Wolf-Meyer argues that sleep patterns are societal, not biological, and designed to fit the schedule of cultures that want you alert and functioning at the break of day after eight hours of sleep. Sleeping pills at bedtime and coffee at daybreak, he proposes, are meant to make you adhere to socially-acceptable sleep-wake cycles.

Sleep experts say most of us are not getting as much sleep as our parents did, which is leading to sleeping pill-dependence, jagged nerves and a host of mood and brain disorders, from as depression to Alzheimer's disease, the most common form of age-related dementia. A sleepless night or two or a short-lived bout of insomnia is generally nothing to worry about, but if your sleeplessness is interfering with your life, it may be a good idea to find out what is causing it before popping sleeping pills.

But as Wolf-Meyer points out, you don't have to stick to the eight-hour schedule. Some people make do with five hours a night, while others need up to 9 hours. Ideally, you should target for 7 to 8 hours, but if you function fine without getting enough, don't to lose sleep - or your mind - over it.


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