Sleeplees in Taipei

We spend one-third of our lives asleep and yet know so little about the phenomenon. The number of Taiwanese experiencing difficulty sleeping has risen substantially in the last five years, as has the economic burden on the national health insurance (NHI) system. Funding for research is almost non-existent, according to local physicians who say the government and public can no longer afford to ignore what is becoming a serious issue.

Data obtained from the Office of Statistics at the Department of Health (DOH) found that number of outpatient visits to a hospital or clinic jumped from 52, 657 in 1998 to 681,146 last year, causing an increase of NT$120 million in NHI medical expenditures within five years.

"Sleeping disorders do not only effect individuals, they cost society as well," said Lee Yue-joe (李宇宙), physician and professor in the Department of Psychiatry at National Taiwan University Hospital (NYUH). Increased medical expenditures, traffic accidents and lost productivity at work can all be related to the burden of sleep deprivation, he said.

Lee is one of the nation's leading researchers in the field of sleep disorders. The most common condition, he said, is insomnia. It is defined as difficulty falling asleep, unable to maintain sleep, or waking up too early. This can happen as the result of a change in one's life or daily routine caused by surgery, moving, or a new job. After a period of adjustment, a normal sleeping pattern usually resumes.

"When one's regular sleeping behavior does not return then one should be alarmed," Lee said.

Chronic insomnia is understood to be a sleeping problem that occurs at least three times a week and persists for one month. Lee said studies conducted in Taipei showed 20 percent of the population suffer from chronic insomnia, and up to 40 percent of those will do nothing about it.

"If someone is having a problem sleeping they don't want to spend their days worrying about it too. Most people believe when their body gets tired enough they will sleep. But if you ignore a medical condition, it doesn't go away on its own," he said. "If insomnia continues for more than a few nights, it can become chronic and cause a sleep deficit that is extremely detrimental to the sufferer's well-being."

The consensus among the Taiwanese medical community is that chronic insomnia is not a disease but a symptom of other physical or mental ailments that leads to wakeful nights. Left untreated it can lead to additional psychiatric, or anxiety disorders and likewise without proper diagnosis the underlying causes cannot be sought out and diagnosed.

"Before prescribing any medication or further treatment the first step is to determine the reason behind the inability to sleep," Lee said. "But for many people this won't be clear."

Better than counting sheep

Yuan Hsu-hu (袁緒虎), 34, works as a graphic designer. He never had difficulty sleeping at night until he began freelancing five years ago. He worked long shifts and sometimes worked through the night to meet deadlines. Although he would go to bed exhausted, as soon as his head hit the pillow, his eyes would open and his mind would start racing.

"Suddenly, all the things I never had time to think about during the day would start playing over in my mind."

After a few weeks, however, the wakeful nights became agonizing.