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Patricia Morrisroe

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'Wide Awake' In Vegas

Posted: 05/24/10 04:52 PM ET

Nobody sleeps in Las Vegas. I know that's a gross generalization, but having spent nearly a week there for my new book Wide Awake: A Memoir of Insomnia, I came away with the distinct impression that Vegas, at least sleep-wise, was the Village of the Damned. Along with several hundred doctors, many of whom were constantly swilling coffee, I was there for a continuing medical education course entitled "Everything You Always Wanted to Know about Sleep Disorders." What I wanted to know was how to alleviate the insomnia that had plagued me for most of my life. As a child, I'd always been a light sleeper, but as I grew older my sleep tended to split in two. Around 3 a.m., I'd routinely be confronted with a big yawning hole in the night. I longed to fill it with sleep. Instead, I packed it with waking thoughts, my mind taking me on an exhilarating, exhausting joy ride.

Here's what I learned from the conference: Sleep doctors who treat insomnia tend to fall into two different camps: the ones who champion cognitive behavioral therapy (CBT) and the ones who champion drugs. It is probably no coincidence that ones who favor CBT practice the therapy and the ones who favor sleeping pills have links to the pharmaceutical companies. (My own sleep doctor back in New York favored a duel approach, advising me that I might have to take medication the rest of my life, which left me wondering why I needed to follow the "sleep hygiene rules," such as not watching TV in the bedroom. Weren't the drugs effective enough to counteract TV's stimulating effects?)

In between my courses, I interviewed the first surgeon to be certified in sleep medicine. What did it say about Las Vegas, or indeed about sleep, that he was now primarily focused on cosmetic surgery, specializing in facelifts, "nose beautification" and liposuction? Later, at the MGM Grand's casino, I was confronted by hordes of sleepy-looking gamblers, in an environment that felt like nighttime, no matter the real time. A 2007 study published in the journal SLEEP found that sleep deprivation adversely affects a person's decision-making ability by elevating expectations of gains, but it also mutes the emotional impact of losing. Tired gamblers are a big plus for the casinos. Employees are often tired too, especially if they work the graveyard or even worse, the rotating shift. Once they've adjusted to one shift, they're shifting again, with the result that they suffer from the equivalent of permanent jetlag. Shift-work can lead to insomnia, gastrointestinal problems, obesity, heart disease and possibly cancer.

After only five days in the city, I couldn't tell if it was day or night. My vintage Rolex, as if in sympathy, stopped running. Sleep is regulated by exposure to light and darkness, but in Vegas nature has been turned on its head. The neon metropolis is so bright that astronauts reported seeing the tip of the Luxor's pyramid as they hurtled through outer space. Its "sky glow" is visible from eight national parks and is brighter than the planet Venus as seen from Dante's View in Death Valley. The late Nevada historian Hal K. Rothman once described the city as a symbol of the "new America," writing that "what people see in the Las Vegas today ... is what they can expect everywhere in the near future." And what is that? Gazing out my hotel window at the Eiffel Tower in "Paris," which wasn't far from an equally incandescent "New York," "Venice," "Lake Como," and Mandalay Bay," I saw the whole electrified world before me - and it was wide awake.

Study in SLEEP: www.ncbi.nlm.nih.gov/pubmed/17552375