Nights of Misery

Insomnia through the ages

Jan 22, 2025

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A 14th-century depiction of insomnia (public domain)

The Book of Job starts with an argument between God and Satan. God brags that Job is one of his most devoted servants. Satan counters with the idea that Job is only loyal to God because God has provided him with a happy and satisfying life. So God tells Satan to go ahead and ruin Job’s life to test his loyalty.

Satan proceeds to kill Job’s livestock and children and plagues him with boils and worms. On top of that, Job doesn’t get to sleep. Job complains:

Like a slave longing for the evening shadows,
or a hired laborer waiting to be paid,
so I have been allotted months of futility,
and nights of misery have been assigned to me.
When I lie down I think, ‘How long before I get up?’
The night drags on, and I toss and turn until dawn…
When I think my bed will comfort me
and my couch will ease my complaint,
even then you frighten me with dreams
and terrify me with visions,
so that I prefer strangling and death,
rather than this body of mine.
I despise my life; I would not live forever.
Let me alone; my days have no meaning.

Job’s immense suffering is compounded by the fact that Satan won’t let him escape from his misery into the silence of sleep. Job is forced to lie awake all night, contemplating his misfortune.

I hope you are not covered in boils and have not had your family killed by God, but I bet you’ve experienced the agony of insomnia. Most people do, at some point in their lives. We think our beds will comfort us but, instead, the night drags on and, like Job, we despise our lives.

The torture of insomnia was a common problem 2,500 years ago, when the Book of Job was written, and it remains one today. Humans have interpreted and treated insomnia in all sorts of different ways throughout our history. But I don’t know if we’re any closer to conquering it.

Wouldn’t it be great if you didn’t have to sleep? You’d reclaim a third of your life; you’d get so much more done!

Some superhuman people seem to have needed less sleep than others. Thomas Edison, for example, thought that sleep was a waste of time and pushed himself and his employees to work through the night. He bragged about getting four hours or less of sleep a night, sometimes falling asleep with a spoon in his hand so that he’d wake right back up when the utensil clattered to the floor.

The idea that the most impressive people can go without sleep goes all the way back to humanity’s oldest story, the Epic of Gilgamesh. Gilgamesh, a semi-divine Mesopotamian king, is more vital and restless than ordinary people, “not sleeping [la salilu] day and night.” At first, this drives him to Edison-like productivity as he builds the walls of Uruk and undertakes all manner of heroic exploits.

In the story, a “wild man” named Enkidu is also positively transformed by sleeplessness — he is kept awake for seven days and nights of sex (!), at the end of which he becomes a civilized man. A woman tells him that this week of sleeplessness has improved him: “You have become wise, like a god, Enkidu.”

But, even 4,000 years ago, Mesopotamians knew that sleeplessness was a double-edged sword. Later in the epic, Gilgamesh starts losing sleep to nightmares and, after Enkidu dies (sorry, no spoiler alerts for a book that’s been out for millennia), Gilgamesh enters a state of wild-eyed insomnia, looking frantically for a way to ward off the inevitability of death.

Finally, a god challenges Gilgamesh to stay awake for seven nights to see if he’s worthy of immortality. The exhausted king immediately drifts off to sleep, telling the reader that death — like sleep — can’t be avoided forever.

The ancient Greeks, too, combined their understanding of sleep’s medical effects with mythology. They believed that the god Hypnos — a brother of Thanatos, or death — personified sleep. To be denied sleep was literally to be abandoned by a god.

Hippocrates, the father of medicine, identified sleep as a crucial component of health. He encouraged his patients to sleep a moderate amount — too much sleep could be as damaging as not enough. Unnatural or unhealthy sleep patterns were a sign of an underlying problem.

The Romans, like the Mesopotamians, made a distinction between two forms of insomnia. They spoke of vigilia, a purposeful state of sleeplessness in which soldiers might keep watch or parents might keep an eye on their children. This was contrasted with insomnium, an involuntary state of sleeplessness. Insomnium referred to any state that disturbed the peacefulness of sleep, including nightmares. Roman history also records the earliest use of sleeplessness as deliberate torture. The Roman general Marcus Attilius Regulus was captured by the Carthaginians; they cut out his eyelids so that he could not sleep or shield his eyes from the sun. When he’d had enough, they crushed him with an elephant.

One of my least favorite flavors of insomnia is when I burst, wide awake, out of a dream only to look over at my clock and see that it’s 2:00 AM. If I’m unlucky, this means that I’ll be cursed to lie there, sleepless, until morning.

Though ancient and medieval people understood insomnia to be a curse, they didn’t necessarily fear lying awake at night like we do. Sleep historian Roger Ekirch finds that, in premodern times, sleep was “segmented” — that is, people would go to sleep around sundown, wake up and do stuff for a little while after midnight, and then go back to sleep until morning.

This “biphasic” sleep was so common that people didn’t talk about it explicitly. It was just something that everyone did. Once Ekirch got an inkling about the practice from some early modern court transcripts, he started looking for references to “first” and “second sleep” and found them not just in court documents but songs, poems, and medical texts.

What did people do during their period of wakefulness? Well, some people did pretty normal middle-of-the-night stuff like going to the bathroom or having sex (people were thought to be especially fertile during this time). Others lay there and thought or prayed (Martin Luther wrote that “Almost every night when I wake up the devil is there and wants to dispute with me. When the argument… doesn’t help, I instantly chase him away with a fart.”) Some chatted with others, which was often unavoidable since a lot of people shared beds. Others even knocked out a few chores in the wee hours. When they had emptied their bladders and worked through their problems, people went back to sleep.

Ekirch and his devotees have argued that many of our sleep problems come from the fact that, these days, we’re trying to sleep in an unnatural way. We’re not built to sleep for eight straight hours. Like most mammals (think of your dog or cat), maybe humans are meant to sleep on and off over the course of a 24-hour period.

If this theory is right, and many of our modern problems with insomnia are the product of the fact that we are stupidly trying to force our minds and bodies to do something they’re not meant to do, how did we get on the wrong track?

The modern concept of insomnia emerged with the massive lifestyle changes of the Industrial Revolution. Insomnia expert Philippa Martyr notes that even today, people with industrialized lifestyles are much more likely to have sleep problems:

In countries without industrialisation, insomnia is quite rare. Only around 1–2% of the population will experience it. Compare this with modern United Kingdom, where the estimated insomnia rates are 10–48%, depending on the study.

How did industrialization break our sleep? In a lot of ways, actually:

Workers lost control over when they rose and went to bed. Rather than rising with the sun (or the noises of farm animals), people had to go to work at times that didn’t sync much with natural rhythms. People’s sleep cycles started to track the factory whistle rather than the rooster’s crowing.
Cities were bright all the time. In the late 1700s, cities started to line their streets with coal-gas lamps. By the next century, big cities like London and Paris were lit well beyond sunset, meaning that they were both safer at night and able to offer genuine nightlife. The lighting of cities, combined with the increased availability of stimulants like coffee and tea, meant that people no longer had to follow their bodies’ natural rhythms. It was now much more fun and much less scary to stay up late. People stopped going to bed early and then waking in the middle of the night.
At the time, observers blamed the hectic pace of modern life. In 1894, the British Medical Journal observed that “The subject of sleeplessness is once more under public discussion… The hurry and excitement of modern life is quite correctly held to be responsible for much of the insomnia of which we hear.”

With the rise of insomnia came an industry promising to cure it, drawing on the latest ideas in medical science and psychology.

Some companies advertised drugs that would cure sleeplessness. In Australia, advertisements pushed “Indian cigarettes” which featured cannabis as an ingredient. Other companies introduced barbiturates like Veronal, which promised an easier night’s sleep. Hermann von Husen, one of the early pioneers of these drugs, tested them on himself in the early twentieth century. They seemed to work, although they were difficult to calibrate:

I fell into a growing state of dejection that led to deep sleep after around 30 minutes. After half a gram of Veronal I slept for 8 hours, and after a whole gram, around 9 hours. On the first morning I awoke fresh and rested; on the second morning, after the higher dose, I found it difficult to get out of bed.

There were other, less scientific theories in the early twentieth century, as well. One home encyclopedia advised people:

Nervous persons, who are troubled with wakefulness and excitability, usually have a strong tendency of blood on the brain, with cold extremities. The pressure of the blood on the brain keeps it in a stimulated or wakeful state […] rise and chafe the body and extremities with a brush or towel, or rub smartly with the hands to promote circulation, and withdraw the excessive amount of blood from the brain, and they will fall asleep in a few moments. A cold bath, or a sponge bath and rubbing […] will aid in equalising circulation and promoting sleep.

Psychologists and neurologists diagnosed people with neurasthenia, which was a fancy name for the old concepts of nervous exhaustion and hysteria. One of its symptoms — the main one, according to many doctors — was sleeplessness. Neurologist George Beard blamed modernity:

The chief and primary cause of this development and very rapid increase of nervousness is modern civilization, which is distinguished from the ancient by these five characteristics: steam-power, the periodical press, the telegraph, the sciences, and the mental activity of women.

Other scientists spoke of the “neurotic insomniac,” who seemed to be more common among the middle class than the working class. People who worked hard all day with their bodies were expected to sleep well, while those who worked hard with their minds were doomed to lie awake at night.

Sometimes, it seemed like nobody could sleep. A New York Times article reported that, in 1900, something like two-thirds of the city had sleep problems.

According to the most trustworthy statistics obtainable there are in New York 684 352 insomniacs, by which is meant people who sleep very little and are possessed of the delusion that they do not sleep at all. In addition to this there are 1 287 364 light and restless sleepers, who wake at the least sound and to whom the customary street noises occurring prior to 6:30 in the morning are extremely disturbing. There are also 556 200 night hawks who sleep well enough if they wait until nearly daylight before trying, but for whom early retirement means a recourse to the mathematical recreations by which sleep is more often wooed than won.

Over the course of the twentieth century, science found new drugs and new techniques. Now, instead of popping a Veronal you might take an Ambien. Instead of being diagnosed with nervous exhaustion, you might be told that you have ADHD or an anxiety disorder. We worry more about sleep hygiene and screens now than the impact of the telegraph.

I’d love to say that, after writing this piece, I’ve seen the metaphorical light and gotten back in touch with my natural rhythms. That I hit the hay at 9 pm, wake up for an hour or two, and then slumber until sunrise. But, to be honest, I have my alarm set for 5:45 every weekday, and, in the winter months at least, I have to be at work before the sun comes up. I think I have decent sleep habits, but, especially during the long nights of winter, I find myself lying awake at night, wishing I could find a way to get a little more rest.

The insomnia problem seems largely unsolved — the Cleveland Clinic says that “more than 50 million people in the United States have a sleep disorder.” Despite millennia of trying to understand and combat insomnia, we seem to be sleeping worse than ever.

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