Can't sleep? Journalist Jennifer Senior says you're not alone in your insomnia

18 hours ago

TERRY GROSS, HOST:

This is FRESH AIR. I'm Terry Gross. If you've ever had problem sleeping, you cognize that nan much you interest astir not being capable to autumn asleep, nan much apt you are to support staying awake. So what do you do? Pills, therapy, meditation, aliases conscionable study to judge that you'll consciousness for illustration a zombie nan adjacent day? My guest, Jennifer Senior, knows this feeling. She abruptly went from sleeping done nan nighttime to suffering from insomnia. That started astir 25 years agone erstwhile she was 29.

Senior is simply a unit writer astatine The Atlantic magazine, truthful she yet decided to constitute an article astir her ain insomnia and nan latest subject surrounding slumber and insomnia. She interviewed immoderate of nan apical slumber researchers. Her article successful nan caller rumor of The Atlantic is titled "Why Can't Americans Sleep? Insomnia Has Become A Public Health Emergency." It's connected The Atlantic website. The newsstand version will beryllium disposable July 15. Her article successful The Atlantic astir grief, love, nonaccomplishment and representation won a Pulitzer Prize. She besides won 2 National Magazine Awards. She spent 5 years astatine The New York Times arsenic a book professional and sentiment columnist and 18 years astatine New York Magazine. She's besides nan writer of nan book "All Joy And No Fun: The Paradox Of Modern Parenthood."

Jennifer Senior, invited backmost to FRESH AIR.

JENNIFER SENIOR: Thank you truthful overmuch for having me. It's awesome to beryllium here.

GROSS: It's awesome to person you. As mentation for this interview, I had problem sleeping past nighttime (laughter). At astir 5 a.m., I couldn't get backmost to sleep. Occasionally, I'd autumn backmost dormant and aftermath up and look astatine nan clock. And each clip that happened, only 5 minutes had elapsed. So I slept for a afloat 5 minutes, woke up, tossed and turned, and past slept 5 minutes more, et cetera, et cetera. I wanted to get retired of furniture desperately. I was, like, emotion hopeless and uncomfortable. But I knew I'd regret it during nan day. So I conscionable thought I'd show you a small spot of backstory. I don't person insomnia, per se, but I person my nights erstwhile it's just, like, really difficult to sleep. I've travel to deliberation of slumber arsenic a talent, you know, that immoderate group person and immoderate group don't (laughter).

SENIOR: You cognize what? I would telephone it a gift. I mean, a talent suggests that, like, group person worked astatine it. And immoderate group have. I want to convey you for telling maine that. It is interesting, post-publication, really galore group person written maine saying, I'm a chap traveler. And you wouldn't know.

GROSS: You write, I for illustration to show group that nan nighttime earlier I stopped sleeping, I slept, not only that, I slept well. And you spell connected to opportunity that you utilized to slumber done nan night. Like, you'd spell to furniture and you'd just, like, aftermath up 7 aliases 8 hours later. That's astonishing to me. I don't deliberation I've ever slept done nan full nighttime successful my life. What was that first sleepless nighttime like?

SENIOR: Puzzling. I mean, it's a cliche among slumber clinicians that everyone idealizes their pre-insomnia selves, right? They opportunity that everybody says, oh, my slumber was perfect. I'm sorry, my slumber was really great. And it was truthful accordant that I didn't request an siren timepiece erstwhile I, like, mislaid one. I ever slept from 1 until 9. And I had opinionated appointments at, like, 10 o'clock that I'd ne'er miss. I mean, it was truthful remarkably regular. So that erstwhile it first happened, I thought, like, person I been poisoned?

(LAUGHTER)

SENIOR: I mean, I had nary idea. I mean, I greeted it pinch bafflement and benignant of curiosity much than thing else. It wasn't alarm. It was conscionable like, oh, that's weird. I thought benignant of thing of it until it became regular and past really regular, and past ace intense. And past I wasn't waking up astatine 5 successful nan morning. I was conscionable staying up each night. So, you know, it sewage bad successful a hurry.

GROSS: Did it lead to...

SENIOR: Or arsenic Ron Burgundy says successful "Anchorman," you know, that escalated quickly. I mean, it conscionable sewage bad.

GROSS: (Laughter) Did it lead to panic successful bed?

SENIOR: Yeah. Oh, God, a lot. And I retrieve 1 clip I did precisely nan incorrect thing. You're ne'er expected to do this, for anybody who's suffering. I near a batch of runway. I went to furniture astatine 8 o'clock moreover though, you know, I was a 1 o'clock sleeper because I was exhausted and because I wanted to slumber and I wanted to time off a batch of other time. And I happened to autumn dormant very quickly and past woke up thinking, oh, great, I slept done nan night. And I had slept until 10:30, truthful 2 hours.

GROSS: What did you deliberation was incorrect pinch you?

SENIOR: I didn't know. I mean, this is nan problem. I was not perseverating aliases stressing aliases lying awake reasoning astir anything. People would opportunity to me, what are you reasoning about? What are you obsessing about? And I would opportunity my mind is simply a whistling prairie. It's a whistling cockleshell. There is thing successful my caput astatine all. I'm conscionable lying location expecting to autumn asleep. And truthful I couldn't find what happened, honestly. I really...

GROSS: The only point I deliberation you were reasoning was like, I can't autumn asleep. Oh, God, springiness maine - (laughter) like, I can't sleep.

SENIOR: Oh, truthful eventually, you do nan countdown clock. Absolutely. OK, truthful that's, like, down nan road. In nan beginning, it was conscionable each bewilderment and like, this must beryllium biologically driven. What happened? Eventually, it was sheer blinding panic, wherever my mind was racing and I was going, what's going on? Something must beryllium happening. Oh, my God. And I'd beryllium staring astatine nan timepiece and going, oh, my God, now I only person 5 hours to sleep. Now I only person 4 hours to sleep. Now I only person 3 now, I only person two, now I only person one. Now I person 20 minutes.

I mean, that was surely happening. And location would besides beryllium this benignant of sound unreality of, I'm going to get fired. I'm not going to beryllium capable to do my job. I'll ne'er beryllium an appealing girlfriend, immoderate of these things, right? Like, nan things that you deliberation erstwhile you're 29. You know, I'll beryllium perceived arsenic a handbasket case. Or I'll not beryllium capable to exercise. You know, I was rather active. I'd run. I'd do whatever. Oh, and eventually, I would person these weird repetitive thoughts.

At nan time, I was covering, like, theater. It was a really nosy job. I was covering theatre for New York Magazine for nary money, conscionable penning each these benignant of squibs astir things that would open. And I would spot each these benignant of cool musicals for illustration "Hedwig And The Angry Inch" and, you know, cool stuff. And snippets of songs would tally done my head. And I would conscionable beryllium location and think, would nan orchestra please battalion up and spell home?

GROSS: (Laughter).

SENIOR: I can't woody pinch this.

GROSS: So among nan things you tried early connected were acupuncture, Tylenol PM, melatonin, moving 4 miles, breathing exercises, listening to a meditation tape. What did you study astir those approaches and really effective they were for you? And what did you study astir yourself aft trying them?

SENIOR: I learned I'd ne'er done acupuncture before. And I learned that it was wonderful, conscionable not peculiarly adjuvant for that. I did acupressure, too, and aforesaid deal. I conjecture I learned besides that location was this full replacement medicine benignant of protector world that was starting to bloom backmost successful nan precocious '90s, possibly it moreover had before. I learned that erstwhile you're successful a definite authorities of panic, trying to meditate is very difficult - right? - because it's thing that astir group neglect astatine initially.

I mean, there's nary specified point arsenic failing erstwhile you meditate. You ever person to bring yourself backmost to paying attraction to your assemblage aliases to a mantra aliases immoderate shape of meditation you do. Your mind is prone to wander. That's what it does. But if you're having problem sleeping, that's a ace alarming value to beryllium noticing successful yourself. And it's wandering to catastrophic thoughts. So I noticed that. I noticed that melatonin, peculiarly successful nan megawatt doses that Americans return conscionable makes you feel...

GROSS: What do you see megawatt?

SENIOR: Oh, truthful it's often sold successful 3 milligram and 5 milligram doses. You tin moreover find 10. The group who really look astatine this worldly will show you, first of all, if you return it precocious astatine night, that's erstwhile your melatonin peaks anyway. What melatonin does is modulate your circadian rhythms, truthful it's not needfully what your assemblage responds to for slumber itself. So it starts signaling erstwhile you're expected to upwind down and erstwhile slumber is coming and erstwhile it's expected to happen. But taking these elephantine doses, which successful immoderate countries, are regulated, you know, like, they're wide disposable present for 3 milligrams and 5 milligrams. That benignant of worldly is regulated successful immoderate countries successful Europe. It's not needfully nan champion solution for everyone, truthful - and it wasn't for me. And...

GROSS: 'Cause if you're going to furniture it's already acheronian and you're connected a regular schedule, it's not going to thief your circadium rhythms. Is that nan theory?

SENIOR: Yes. The mentation is that your assemblage is already producing rather a spot of it, truthful conscionable hammering it pinch much won't needfully show it, you know, to spell to bed. It's already being told to spell to bed, and it mightiness conscionable make you consciousness off. If you really want to usage it right, you tin order, like, 300 microgram doses online and commencement taking them, you know, return 1 erstwhile nan sun sets, return different possibly 2 hours later to commencement telling your body, hey, hey, hey, it's time. But that would beryllium nan measurement to do it for me.

GROSS: So you interviewed a batch of slumber researchers, and nan first mobility you asked each of them was, what's nan story astir slumber that you'd astir for illustration to debunk? So what was nan astir predominant answer?

SENIOR: That you request 8 hours.

GROSS: You know, erstwhile I publication that, I shouted because...

SENIOR: (Laughter).

GROSS: ...For me, if I'm successful bed, hide really overmuch of nan clip successful furniture I'm really sleeping, but if I'm successful furniture for 7 hours, I consciousness for illustration triumph is mine. 'Cause much typically, it's for illustration six and a half hours, and I consciousness truthful bad. I consciousness for illustration you're harming yourself. You really person to find a measurement to get much sleep, but it ne'er seems to work. And truthful that was really awesome to publication that. But everybody told you that? That you really don't request 8 hours of sleep?

SENIOR: It wasn't that they said you really don't request it. They said that this was this story retired location that was conscionable a benignant of tyranny, and I'll explicate why. And I said to truthful galore group that I was really struck by really galore group did opportunity it. So present are nan things to carnivore successful mind. Obviously, group vary, right? And there's moreover this vanishingly - but it's really absorbing - mini number of group who are called short sleepers, who request only 4 to six hours. Very fewer group are for illustration that, but you tin ever benignant of show who they are. They hurdle done nan world arsenic if they've been fired from a slingshot. They're conscionable benignant of amazing. But it varies from personification to person. It varies depending connected your age. So a batch of clinicians would show maine astir group successful their precocious 60s aliases their 70s coming into their session and saying I can't slumber 8 hours, and nan doctors would conscionable look astatine them - aliases therapists would look astatine them and opportunity well, astatine this age, you're not expected to. It's a bummer, but it's true.

GROSS: And why is that?

SENIOR: We don't usability optimally arsenic we get older successful astir ways, and location are cognitive decrements successful ways that nan brain, you know, changes, right? So I'm judge it's broadly a portion of that. But nan specifics and circadian signaling, you know, there's immoderate thought that are - we're designed to slumber biphasically - successful 2 episodes. As we get older, that seems to happen. We look to aftermath up early, and if we had capable time, we could astir apt autumn backmost dormant but don't 'cause our jobs show america we can't aliases we conscionable person to get connected pinch our days. But it seems that we settee into that hit again. So that's immoderate of it.

But location is simply a really robust assemblage of literature. One of them was done by this celebrated feline named Kripke, looking at, like, a cardinal people, and 6.5 hours to 7.4 was associated pinch nan champion wellness outcomes. Now, location are creation issues pinch each of these studies, right? It's - because they are, almost by definition, going to beryllium observational. They're not going to beryllium randomized. Also, you tin only power for what you tin power for. It's conscionable what you tin deliberation of. So you tin power for age, for assemblage weight, for - do you smoke, for sex, did you erstwhile person crab - things for illustration this. But to quote Donald Rumsfeld, location are chartless unknowns, right? So location are things you conscionable can't deliberation of to power for. So location are group who judge Kripke's information and group who don't. These benignant of studies person been replicated, though.

GROSS: So group who are nighttime owls usually get scolded by nan remainder of their family, like, you're staying up excessively late. It's not healthy. Is it not healthy? Like, arsenic agelong arsenic you could get a capable magnitude of slumber and slumber later successful nan day, is it not healthy?

SENIOR: You person conscionable put your digit connected what I deliberation group are coming astir to believing. I said to a Circadian rhythms master who said precisely this, that nan studies that show, oh, nighttime owls person worse wellness outcomes. It's apt because we nighttime owls person to emergence early for our jobs, and if we were fixed much clip to sleep, we'd beryllium fine. And past location was 1 different study that precocious came on that said actually, it's that nighttime owls benignant of are much apt to portion much aliases to fume cigarettes. So if you - correct, if you don't for illustration your Jamesons aliases if you don't fume your Marlboros, you're OK, right? So yeah, that's correct.

GROSS: Well, fto maine present you here. We person to return a break.

My impermanent is Jennifer Senior. He caller article connected The Atlantic is titled "Why Can't Americans Sleep: Insomnia Has Become A Public Health Emergency." We'll beryllium correct back. This is FRESH AIR.

(SOUNDBITE OF JAKE SHIMABUKURO'S "143 (KELLY'S SONG)")

GROSS: This is FRESH AIR. Let's get backmost to my question and reply pinch Jennifer Senior, a unit writer astatine The Atlantic. Her latest article, titled "Why Can't Americans Sleep," is astir her insomnia and nan latest investigation into insomnia and therapies for it.

So, you opportunity you want to reframe nan chat astir narcotics that are utilized arsenic sleeping aids. And I'd for illustration to talk pinch you astir immoderate of nan narcotics astir often recommended for slumber and nan advantages and disadvantages of them. But let's commencement pinch why do you deliberation nan chat astir narcotics needs to beryllium reframed?

SENIOR: I'm truthful gladsome you asked maine that. I really deliberation it does. I've, since penning astir this, besides discovered what a batch of group take, you know, and that a batch of group trust connected stuff. And why do I deliberation it should beryllium reframed? Well, because I deliberation that location is simply a existent stigma associated pinch slumber narcotics and taking narcotics for slumber that is nary longer associated with, say, taking antidepressants. I deliberation we've travel a singular region arsenic a civilization successful talking openly astir slump and destigmatizing antidepressants. I don't deliberation that's existent astatine each for sleep. I deliberation group still deliberation of slumber meds arsenic being you're addicted to them. Think astir - I'm hoping a number of group successful nan assemblage person - aliases a bully percent person watched "White Lotus." I mean, deliberation astir Parker Posey conscionable narcotizing herself into la la onshore each night, which is wherever she resided during nan day, too, frankly. That was not a favorable depiction. There's immoderate beautiful disfigured associations pinch slumber meds.

GROSS: You quote an editorial from 2024 successful The American Journal of Psychiatry, and I want to publication that, publication nan portion that you quote.

(Reading) Weak science, alarming FDA achromatic container warnings and media reporting person fueled an anti-benzodiazepine movement. This has created an ambiance of fearfulness and stigma among patients, galore of whom tin use from specified medications.

Now, I'm not judge if that editorial was referring to nan usage of benzos for insomnia. But is that thing you recovered different doctors agreed with, that location was a stigma astir taking medicine for sleep?

SENIOR: Interestingly, yes. And often, by nan way, it is group who prescribe who talk astir nan stigma, you know, I should beryllium clear. Although, I deliberation clinicians would opportunity this, too, who don't, that location shouldn't beryllium a stigma, you know? There was a chap named Andrew Krystal, who was connected a slumber panel. He is simply a prescribing doctor. He said during a slumber sheet that I attended past twelvemonth astatine this large slumber convention that he was ever conscionable benignant of saddened by really galore accomplished group and well-educated group - it was really astir well-educated people. This was nan difference. Who he would say, look, let's conscionable commencement you connected something. There's nary shame successful this.

And they would instantly look astatine him and deliberation that they were astir to tumble into nan gutter. That was, like, his phrase, you know, that they'd upwind up successful nan gutter if they took this stuff. And that was my fearfulness erstwhile I first developed insomnia. I refused, refused to return thing to help, reasoning that I would go an addict. And nan irony now is that I refused for truthful agelong that now I person developed a dependence. I deliberation nan different point - aliases if you want to talk astir immoderate of nan misconceptions retired location aliases immoderate of nan misleading worldly that this editorial was referring to, location was a very well-publicized study that came retired that said that benzos were associated aliases caused dementia.

But 2 years later, different study came on successful nan nonstop aforesaid journal, nan British Medical Journal, saying, actually, there's nary relation betwixt benzodiazepines and dementia astatine all. So it's really difficult to find these things. More activity needs to beryllium done. It's very difficult to see. But group were really anxious for 2 years. And group who had gone wholly disconnected nan rails and were abruptly successful a panic and could've benefited from, let's say, short-term usage of benzos astir apt were very acrophobic of them connected relationship of that, right? And you person to benignant of measurement benefits and risks. And I deliberation that's what I'd opportunity astir this.

GROSS: What medications travel to nan class of benzos, benzodiazepines?

SENIOR: Ah, awesome question. Valium, Ativan, Restoril, Klonopin, Xanax. I'm judge I'm missing some. Oh, actually, Ambien is considered 1 for nan intent of these studies. I deliberation its system of action is somewhat different. But erstwhile they're doing this lump, they're talking astir Ambien arsenic well. And also, for that matter, nan quote-unquote "Z-drugs," Ambien has siblings arsenic well.

GROSS: So erstwhile you talk astir group taking those drugs, you're talking astir a batch of people.

SENIOR: Oh, yeah.

GROSS: Are you conscionable counting group who return them for insomnia aliases those group who return it for different things, for illustration conscionable anxiety?

SENIOR: So present is nan statistic that I deliberation is nan astir relevant. Eighteen percent of Americans return slumber medicine each nighttime aliases immoderate nights. And that's a batch of people. And erstwhile I mentioned that to personification arsenic I was fact-checking, it was a expert who was 1 of nan astir salient successful nan field, Suzanne Bertisch from Brigham and Women's. She wrote maine backmost and she said, that can't beryllium right. That's excessively low. I mean, so...

(LAUGHTER)

SENIOR: It's a lot. You know, truthful I don't know. Were group lying successful this survey? I don't really know. But a batch of group return stuff. And, you know, 30% to 35% of Americans suffer from immoderate symptoms of insomnia, astatine slightest temporarily. And 12% suffer from insomnia arsenic a really obdurate condition. And that's an astatine least, astatine slightest 12%. And if you're a millennial, that number goes to 15. So there's a batch of group retired location who are suffering.

GROSS: Yeah. Well, fto maine reintroduce you again. My impermanent is Jennifer Senior, a unit writer astatine The Atlantic. Her latest article, called "Why Americans Can't Sleep," is astir her insomnia and nan latest investigation into insomnia and ways of treating it. We'll talk much aft a break. I'm Terry Gross, and this is FRESH AIR.

(SOUNDBITE OF BRAD MEHLDAU'S "GOLDEN SLUMBERS")

GROSS: This is FRESH AIR. I'm Terry Gross. Let's get backmost to my question and reply pinch Jennifer Senior. After years of sleeping done nan night, she started to get insomnia astir 25 years ago, erstwhile she was 29. Nothing large had changed successful her life, truthful she had nary mentation for why, suddenly, she couldn't sleep. The insomnia didn't spell away. Her caller article successful nan August rumor of The Atlantic is titled "Why Americans Can't Sleep" (ph). It's already connected nan website. The article is astir her insomnia and nan latest investigation into insomnia and nan treatments for it, respective of which she's tried. Jennifer Senior is simply a unit writer astatine The Atlantic and nan victor of 2 National Magazine Awards and a Pulitzer Prize.

So we've been talking astir immoderate aesculapian treatments - you know, medicines - that are prescribed for insomnia. Let's talk astir psychological therapies that are tried for insomnia, and 1 of them is CBTI. So that stands for cognitive behavioral therapy for insomnia. So would you picture what that therapy is? You've publication astir it. You've besides tried it twice.

SENIOR: Yes, I have. OK, truthful it is simply a very effective therapy. It's conscionable very difficult to do. But present is what it is successful a nutshell. You person to alteration your reasoning astir not sleeping. That's nan cognitive part, right? And you person to alteration your behaviors astir sleep. So you benignant of group nan aforesaid bedtimes and wake-up times, and arsenic you said, you effort to respect nan furniture only as, like, a spot to slumber and person sex. You don't want to subordinate it pinch a area of full torment. You want to upwind down astatine night. But nan large behavioral displacement that you want to do - this is, like, nan tentpole of cognitive behavioral therapy, and it's ace torturous. I mean, it's execution for immoderate people, and it surely was for me. But it's effective if you tin instrumentality pinch it - is you want to do slumber restriction.

So you fundamentally - let's say, from looking complete your slumber diaries, you observe that you walk 9 hours successful bed, but you only slumber 5 hours of them. You compress those 5 hours into a teeny, mini window. You determine erstwhile you want to aftermath up each morning, let's opportunity astatine 7, and you only spell to furniture astatine 2. So you tin only get those 5 hours successful that model from 2 to 7. That's it. You person to beryllium retired of furniture too that. And erstwhile you've done a mostly of nights for that 2 to 7 period, you tin reward yourself pinch 15 other minutes - going to furniture 15 other minutes earlier. It's really difficult because astir group can't conscionable strafe that slumber in. Sleep is not for illustration immoderate accordion you tin statement into a case. So it's difficult and group driblet out. But nan thought is that you conscionable yet some capitulate to exhaustion, and you benignant of reregulate. And you reset, and you accumulate this slumber indebtedness and yet commencement really falling asleep. There's slumber unit is what they telephone it.

GROSS: Yeah, I tin spot if it typically takes you a while to autumn dormant and you're only allowing yourself 5 hours, you won't needfully get nan 5 hours' slumber 'cause it's going to possibly return you an hr to autumn asleep, moreover if you're tired. Is that nan problem?

SENIOR: That's nan problem. There's besides nan soundtrack of panic successful your head. Oh, no. Now I've only sewage 4 hours. Now I've only sewage three. There's different paradoxical benignant of soundtrack. I mean, this is nan cognitive portion of CBT, which is that you person to alteration your reasoning astir sleep. What nan astir persuasive personification astir this, you know, connected this taxable told maine was - he's a feline named Wilfred Pigeon, and he was conscionable delightful. What he said to maine was, look, conscionable because you've smoked for 20 years doesn't mean you shouldn't extremity smoking, right? You're looking from this constituent guardant - right? - and what wellness benefits you're going to get from not smoking from this infinitesimal forward. Same pinch not sleeping. Like, conscionable hide it, right? Like, you're done, and now you've sewage to refocus and think, oh, this is going to beryllium truthful bully for my health.

GROSS: I'm going to paraphrase you here. You opportunity that passim nan night, group pinch insomnia - nan arousal centers of nan encephalon support chattering aliases clattering away, arsenic does nan prefrontal cortex, which is successful complaint of readying and decision-making. So successful regular sleepers, those regions of nan encephalon spell offline. They quiet down. So nan parts of nan encephalon that should beryllium resting aren't resting if you person insomnia. Can you spell into that successful immoderate much detail?

SENIOR: So peculiarly successful depressed insomniacs, successful depressed group - and insomnia is simply a really bully look for slump - your brain, erstwhile you are successful REM sleep, it's overmuch much intense. And truthful that portion of your encephalon is much active, right? And that's nan portion pinch each nan primal drives. It's your fears and your anger. It's not needfully nan worldly that you're basking in, right? So that's 1 thing. And also, yeah, nan portion of you that's really expected to spell offline is your prefrontal cortex, which plans. It's nan executive usability part. It's decision-making, each that stuff. And that really is expected to spell offline erstwhile you sleep, which is why your dreams tin beryllium truthful chaotic and benignant of person nary logic. It's because there's nary head there, right? But successful insomniacs aliases mediocre sleepers, it's half there. It's not wholly offline. So erstwhile group opportunity they haven't slept a wink, successful immoderate ways that's what they consciousness for illustration 'cause they consciousness for illustration their waking encephalon was still active, and successful constituent of fact, to immoderate degree, it was.

GROSS: And though parts of your encephalon spell offline erstwhile you're sleeping, parts of nan encephalon are doing really important stuff. What are nan parts of nan encephalon doing erstwhile you're sleeping?

SENIOR: The astir important thing, which I've only precocious discovered, is rinsing retired toxins, which is ace fascinating. It's called nan glymphatic system. This is thing that they conscionable found, and it's this waterway successful your encephalon of these benignant of microcanals that flush retired each sorts of unspeakable worldly out, including amyloid proteins, which are associated pinch dementia. I mean, truthful ideate nan value successful that way, too. And past there's conscionable each nan treatment that goes connected during sleep. There's - your bosom is repairing. Your muscles are repairing. Sleep is basal to regeneration and growth. Adolescents request it for this reason, and older group request it conscionable to heal, you know? So there's that, excessively - oh, and besides affectional regulation. Let's not hide that, right? You know, and we each cognize that. You aftermath up, and you haven't slept, and you're irritable and awful.

GROSS: I want to inquire you astir antidepressants because that's thing that you tried successful nan hopes that it would thief you sleep, and it did. I don't cognize really agelong you stayed connected nan antidepressant you were taking. But are antidepressants often prescribed for insomnia?

SENIOR: Yes. And sometimes they help, and sometimes they don't. If slump is astatine nan root, past perfectly they can. Although, it's important to statement - and this is perfectly existent for maine - galore antidepressants tin person a paradoxical effect and make you highly wakeful. So it's important for group who are seeking alleviation not to suffer dream if they effort 1 antidepressant and it does not work. They each person somewhat different - aliases very different, depends - mechanisms of action. Some of them are not good known. They're mysterious. But they person different effects connected different people.

GROSS: Is it sometimes difficult to show whether nan slump was caused by nan insomnia aliases nan insomnia was caused by nan depression?

SENIOR: Totally, yes. And I was told that I was conscionable depressed, and my insomnia was a symptom. And I didn't judge it because no, I wasn't (laughter), you know? But it made maine depressed. I mean, it made maine depressed reasonably quickly 'cause you can't unrecorded for very agelong if you are highly sleep-deprived and not beryllium really miserable. So I was responsive erstwhile I took nan antidepressant, but nan 1 that I took made maine really vague. It blew retired each nan circuitry that was responsible for generating metaphors, which is what I do arsenic a writer. So it made my penning really level and unexciting. So I had to spell disconnected that. And arsenic soon arsenic I went connected 1 that near my metaphors intact, I needed a slumber medicine too. So I don't know. It made maine consciousness better, but it didn't benignant of lick nan slumber problem.

The problem is, arsenic doctors for illustration to say, bidirectional. Depression tin origin insomnia. Insomnia tin origin depression. It tin beryllium a loop. There's now immoderate reasoning that it's much often that insomnia causes slump than nan different measurement around. It's conscionable very difficult to know, you know?

GROSS: Let maine reintroduce you because I want to talk astir agelong COVID aft nan break. If you're conscionable joining us, my impermanent is Jennifer Senior. Her caller article successful The Atlantic is titled "Why Can't Americans Sleep? Insomnia Has Become A Public-Health Emergency." We'll beryllium correct back. This is FRESH AIR.

(SOUNDBITE OF JULIAN LAGE'S "SUPERA")

GROSS: This is FRESH AIR. Let's get backmost to my question and reply pinch Jennifer Senior, a unit writer astatine The Atlantic. Her latest article, titled "Why Can't Americans Sleep?" is astir her insomnia, nan latest investigation into insomnia and therapies for it.

So I want to move distant from insomnia to talk astir agelong COVID, which you have. Although, I fishy there's astir apt immoderate interconnection there. But successful 2022, and this was agelong aft you developed insomnia, you sewage COVID, and a very mild case. You were hardly symptomatic. You fundamentally still went astir your day. But aft that, you sewage agelong COVID. And you wrote an article astir it successful The Atlantic, and nan article was titled "What Not To Ask Me About My Long COVID." And you write, asking - are you doing immoderate better? - doesn't help. You person to deliberation of it arsenic a chronic illness.

But I do want to inquire you because I think, pinch each year, we cognize a small spot much astir agelong COVID - though truthful overmuch of it is still a enigma because COVID itself is truthful caller - but person you improved complete time? Has it changed for amended aliases worse complete time? And my follow-up will be, like, person you learned much astir it? Do you consciousness for illustration you cognize much astir what it is?

SENIOR: Thank you for asking. I don't see that a ridiculous mobility now, peculiarly because it's been - my three-year day was, like, June 28. And nan symptoms really started, like, connected Day 6 erstwhile I was affirmative nan first clip and conscionable waxed until they were really debilitating and benignant of unbearable. I'm worse. I'm a batch worse. And I deliberation immoderate of it is conscionable that I sewage reinfected, and that makes you worse. I couldn't conflict it once, and I was already weakened. And I deliberation it was conscionable different assault. I sewage nan Novavax, which long-haulers love. It improves immoderate of them. And I sewage that 1 year, and it really improved me. It functioned arsenic a medicine. But I sewage it this year, and it made maine worse. So, you cognize - and I'm judge that each anti-vaxxer successful nan world is going to prehend connected this, but, you know, nan truth is that boosters and vaccinations trim nan consequence of agelong COVID by astir a third. So I deliberation erstwhile you person it, it's really difficult to cognize really things are going to go.

So galore group study emotion amended aft vaccines. And for illustration I said, erstwhile I sewage vaccinated once, I felt truthful overmuch better. So, you know, we cognize much astir it, and we don't. We still don't really understand nan underlying pathophysiology, actually. We still - everybody successful my agelong COVID Zoom group talks astir this. No one's really recovered thing that's worked for them successful immoderate important way. I mean, it's really enraging. And now, of course, nan budget's been slashed. It's down to very - you know, it was 11 billion. Now it's 2 cardinal for research. And there's an - and it's an management that's very vaccine-hostile and is very dispute to investigation generally. So that's very dispiriting. And I person a mates of things that are good known. They hap post-virus to tons of people. They're happening to much group now because truthful galore group sewage COVID.

So I person 2 autoimmune things. One is called POTS, and different is called MCAS. They are acronyms for, if you care, postural orthostatic tachycardia syndrome. It intends that erstwhile I guidelines up, my bosom races and my humor unit plunges, and my autonomic tense system, like, my - it's conscionable wholly offline. People cognize immoderate worldly astir that. They can't - they tin dainty it. There's nary cure. Mast compartment activation syndrome is nan other. It fundamentally intends that histamines are moving rampant done your body. They tin dainty it. They can't cure it. What I really person is perpetual dizziness, and it's awful. I'm dizzy now. I'm dizzy sitting up. I'm dizzy standing. The world bounces successful my section of vision. It's for illustration I - everything looks for illustration "The Blair Witch Project." It's really tough. And group can't really fig it out, and that's upsetting.

GROSS: That sounds truthful life-changing. Has it changed your consciousness of identity, too?

SENIOR: Totally. And it is life-changing. I'm taking an 18-month time off from The Atlantic.

GROSS: Oh.

SENIOR: I mightiness constitute a book astir - yeah, I - this communicative was nan past point I'm doing for a while. I mightiness constitute a book astir surviving successful a surgery body, but I won't return an beforehand for it 'cause that would beryllium excessively stressful and I mightiness not want to do it, though my earthy inclination is to person astir experiences into writing, so, you know, whether it's excavation aliases different people's experiences. I really constitute astir myself very little. This was, like, nan first clip I really did it, and I don't cognize really I consciousness astir it. But it has wholly changed my personality - and not. You want to cognize what?

It's almost worse to not person my personality changed. It's almost worse to aftermath up each greeting and think, oh, I tin conscionable guidelines up and get retired of furniture and brushwood my teeth and spell astir my day. I forget, actually, immoderate of nan time. A batch of nan time, and I hide erstwhile I'm lying down. And I still scheme for illustration a person, sometimes, who has each this power and past sputter retired and retrieve I'm not. It's very strange. And besides we're each trapped successful limbo because this is still new. So immoderate of america are - I mean, it's ridiculous astatine this constituent - but are benignant of hanging connected to nan thought that group will get a amended bead connected it. But, you know, my assemblage hasn't fixed itself successful 3 years. Who americium I kidding?

GROSS: Does nan agelong COVID and nan insomnia person immoderate interconnection?

SENIOR: Yes, very perchance - there's a confound here. Autoimmune diseases tally successful my family. My mother has one. She has besides an immunodeficiency. The captious infantrymen successful her immune strategy are not there, and she has already an autoimmune disease. My boy has an autoimmune disease. I was immunocompromised. I had a shortage of earthy slayer cells going into this, you know, epidemic, and nan ones that I did person were inert. I was sickly starting from nan clip I was a kid.

It could person been that I would person gotten agelong COVID nary matter what. God knows I sewage each imaginable infectious illness earlier this pandemic, including spinal meningitis, like, really awesome things. That said, group who person insomnia are earthy slayer compartment deficient, and insomniacs were much apt to get agelong COVID. They recovered this retired from a study of, I believe, nurses who had gotten little slumber versus those who had not. They were much apt to create agelong COVID. So possibly it's difficult to know, right? It's really difficult to know.

GROSS: So 1 much mobility astir insomnia - are you acrophobic to spell to - do you, like, dread going to furniture astatine night?

SENIOR: Oh, no. No, and I haven't for a agelong time. No, no, no. I've learned capable of nan cognitive benignant of restructuring worldly to opportunity to myself, peculiarly since I've changed jobs. I'm nary longer being fed for illustration a foie gras goose arsenic a book professional having to reappraisal truthful galore books successful specified a short play of time. I now person a schedule wherever I tin think, OK, a mislaid nighttime of slumber is fine, you know? And if I don't slumber tonight, I'll slumber nan adjacent night, and it's OK. And I cognize really to meditate. So, you know, I tin do that. So no, I'm nary longer beset by those kinds of terrors, decidedly not.

GROSS: All right, well, listen, I wish you good pinch your slumber and your health.

SENIOR: Thank you.

GROSS: And convey you truthful overmuch for coming backmost to FRESH AIR.

SENIOR: Thank you truthful overmuch for having maine backmost on.

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