You came to Manhattan because of the nightlife, but nobody bothered to tell you about the city’s work ethic–you know, getting up at the crack of dawn and showing up at the office before the markets open. If you had your way, you’d party all night and wake up at noon, or later.
People called you lazy and you had no defense. Now you do: You, too, are a victim. You are suffering from what certified medical professionals call “delayed-sleep-phase syndrome,” informally known as “phase lag.”
It can strike anybody, at any time, but it is found primarily in young, carefree Manhattan singles. The symptoms are as follows: a strong urge to stay out late at parties, followed by a sickening inability to wake up when the alarm goes off.
“No one knows what causes this,” said Dr. Michael Thorpy, who heads the sleep-disorders clinic at Montefiore Medical Center. “That’s why delayed sleep phase is called a syndrome. All we have is a set of symptoms.” The symptoms tend to develop in early adolescence and last into adulthood. Dr. Thorpy said the timing leads some scientists to “speculate that it has something to do with sex hormones.” But, he added, “nothing’s been proven.”
“More and more people seem to have it,” Dr. Thorpy said. “It’s definitely getting more normal.” He estimated that around 7 percent of all young Americans now suffer from phase lag.
Sleep deprivation, of course, is hardly new: Insomnia has long been the psychosomatic malady of choice for serious people. On the list of tortured sleepers are Charles Dickens, Thomas Edison, Franz Kafka, Audie Murphy and Richard Nixon. Even the seemingly unflappable Groucho Marx had trouble sleeping–of course, that chapter in his life coincided with his losses in the stock market in 1929. (When Eddie Cantor told him his late uncle had diabetes at 45, Groucho replied, “That’s nothing. I had Chrysler at 110.”) Marx tried everything he could find to get to sleep. Hot Ovaltine. Peaceful music. Sleeping nude. Sleeping clothed. Nothing worked. When he got desperate, he even bathed himself in a special pine-needle solution just before bed. It worked so well he dozed off and nearly drowned.
If only he had known about phase lag.
“He had phase lag big-time,” asserted Josh Stone, a self-employed systems analyst. “I know. Because I have felt that pain.” Mr. Stone was talking about his own sleep problems late one night at the Chelsea Eye. “When I’d stay up late enough,” he said, “I’d get this weird feeling like I was the only person still awake on the Eastern Seaboard. It was spooky, depressing. So I’d watch motivational infomercials. Like, you know, Tony Robbins.” He missed a lot of work. “That just made things worse,” he said. “I’d stay up late worrying. Sometimes I’d walk around my studio and talk to my furniture about problems I was having at work–I couldn’t get a raise, I couldn’t get promoted. On the bright side, I got very close to my armchair.”
At bedtime, phase lag seems like other kinds of insomnia. You toss. You turn. You can’t fall asleep. You talk to your furniture. You watch infomercials.
At around 3 or 4 a.m., though, phase lag diverges from other sleep disorders. Mr. Stone would actually start to get tired and would soon fall asleep. If left undisturbed, he would sleep until 10 or 11 a.m. But if, as he often had to, Mr. Stone woke up at 7:30, he’d feel physically ill. “I’d feel so tired,” he said. “I really didn’t want to wake up and go to work.”
Not surprisingly, a fair number of partygoers at the Chelsea Eye claimed to suffer from phase lag–after a little prompting. “Yes! I’ve got it,” said cable-TV maven Robin Byrd. “Oh my God. What’s it called?”
Ms. Byrd’s friend and fellow sexophile Al Goldstein said that despite his abundance of sex hormones, at 65 years old, phase lag isn’t a problem for him. “I have sleep apnea,” he said. “That’s my problem.” He mentioned, however, that his friend Joey Buttafuoco’s sleep phases do seem to lag. “Joey stays up late,” he said. “He has to. He’ll work a girl for hours. Like I went to Lot 61 to try to pick up girls–get some models. I got there at 10:15; I wanted to go home and go to sleep pretty soon. Joey would stay at a place like that till 3. And sleep in. You call it phase lag. I call it laziness.” Mr. Buttafuoco could not be reached for comment.
Beware of 9 to 5
Brad Bailey, meanwhile, was sipping white wine in a corner. Mr. Bailey, a recent Princeton graduate, said that he, too, likes to stay up late and sleep in. He hadn’t realized he was suffering from a sleep disorder. “But I have tried to stay away from 9-to-5 jobs,” he said. Still, it has been pretty hard to get up every day. “You know, I’ve been thinking,” he said. “Maybe I do have–what did you call it? Because it is so, so bad. Even if I get six or seven hours sleep, if I get up at 8, I’m like, ‘God!’ It’s so bad. Is this really a disease?”
One man, who didn’t want his name used, insisted that it is. He said he lost his job at a major publishing house because he simply couldn’t wake up early enough. His supervisors cajoled him almost daily, and he tried–he really tried–to come in at 8:30. But he couldn’t fall asleep before 3, and he couldn’t wake up early enough. “They assumed that I didn’t care enough about the job to be there when it was supposed to start. I always made it a point to stay later, but I think they just assumed that I chose not to get there on time, instead of being unable to.” So he became a freelance writer to stop working regular hours.
After he read The Enchanted World of Sleep , by Dr. Peretz Lavie, he was convinced he had phase lag. “To people who don’t believe in it, I would say: Do you ever have trouble staying awake when you feel tired? A lot of so-called normal people, they do have trouble staying awake. It’s the same thing for me, except the opposite.” Dr. Lavie shares this view. In his book, he writes: “Once the coordination between the biological clock and the environment is lost, the sleep disorder causes severe functional disorder.”
Still, no one except Mr. Stone admitted to seeking medical help. Mr. Stone spent a long while in light-box therapy–he sat near a very bright light early in the morning before work. No one knows quite how it works, but the bright light seems to advance the patient’s circadian rhythms (conversely, sitting near a bright light in the evening generally delays sleep). “I’m telling you, man, a light box would have helped Groucho,” Mr. Stone said. It certainly changed Mr. Stone’s life. “Now I go to bed early,” he said. “Like midnight.” Still, he admitted, “getting to work in the morning, for some reason, still isn’t too much easier.”
Dr. Thorpy treats his own patients with a different method: “chronotherapy.” A typical regimen might take a week. On the first night, the patient might go to bed at 4 a.m. and wake at noon. On the second night, bedtime might be at 7 a.m., wake time at 3 p.m. On the third night, bedtime might be at 10 a.m., wake time at 6 p.m., and so on until on the seventh night, when the patient goes to bed at 10 p.m. and wakes up 6 a.m. Dr. Thorpy said he has had success with this method, but it’s hard to find anyone with the time to go through it.
For those with less patience, phase lag invites a certain amount of self-medicating. Jessica Winter, an associate editor at The Village Voice , often has trouble falling asleep. Like a lot of phase-lag patients, though, once she does fall asleep, she can sleep soundly into the afternoon. “I tried to treat it,” she said. “About a year ago, I was drinking before I went to bed–I would drink vodka with soda chasers. I’d have like four shots and fall asleep. It wasn’t social. It was very purposeful drinking–and it worked.” But soon, Ms. Winter began to feel that she’d cured her sleeping problem with a drinking problem. “I’d just pass out. I decided that was as unhealthy as insomnia. It wasn’t your natural sleep–you know, the way God intended.” Now she spends late nights writing her movie reviews.
In cases like Ms. Winter’s, Dr. Thorpy said, phase lag can interact with other forms of insomnia to produce weird symptoms. The later she lay awake, the more worried Ms. Winter would get about her health. By the time she got tired–around4or5 a.m.–Ms. Winter was too tense to go to sleep. That’s why drinking helped. “I got over my inhibitions about staying up so late and I could sleep,” she said.
Ms. Winter is not the only person in Manhattan to drink through her phase lag. Around 10:30 p.m.onApril19, velvet-roped Eugene near the Flatiron was full of hormone-addled sleep-disorder convalescents. A pert businesswoman named Liza Boyd was sitting with a male friend, downing cocktails. “I work 9 to 5,” she said. “And I hate it.” She said she goes out a lot. “I go to places where there are a lot of people and they want to stay out late. A lot of my friends seem to suffer from this, um, affliction, too.”
Dr. Richard Goodman, a dentist, was having a drink with a friend, Mark Hentgen, a computer consultant. Dr. Goodman likes to sleep in; in fact, he won’t see patients before 1 p.m. Still, he said, “I’ve been a late-night bird since I was in high school. I wish I could go to bed before 3. But I really can’t. Isn’t that weird?”
So what’s to be done? Mr. Stone had some advice. “I’m thinking, a big bright light, maybe on the Empire State Building, flashing like a million lux to wake everyone up at 8 a.m. That’d take care of everything.”