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Nino Ricci’s first symptoms appeared while he was finishing his 2002 novel Testament. He was constantly tired, subject to a hot sizzle in the back of his neck while speaking and unable to concentrate on finishing the work of historical fiction.

The acclaimed Canadian novelist, whose work includes the bestselling Lives of the Saints series, proclaimed by the New York Times to be a “genuine achievement," suspected he had a sleep disorder. After reading up on the subject, he eventually went to a clinic; a battery of tests later, he was diagnosed with narcolepsy and given a daily cocktail of Ritalin, Modafinil and other potent drugs.

Such a drastic lifestyle change would throw off many, but Ricci understood the necessity of the new regimen — and became fascinated with the subject of rest. “I hadn’t really read up on sleep before I came down with the disorder and I didn’t know how central a role it plays in so many of our physiological and psychological functions,” he says. “I became so intrigued, not only by what sleep controls, but also how we as a society try to push it away and the drastic repercussions of that.”

The intrigue resulted in his new novel, aptly titled Sleep. Centered around David Pace, an unlikeable historian whose insomnia sends him searching for new and troubling ways to stay awake and feel alive, it’s a muscular meditation on the impact of sleep on the psyche and the lengths we go to escape life's monotany. We spoke to Ricci about his new novel, his recent diagnosis and how learning about sleep has made his mind more awake.

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So when did you first start to consider you might be a narcoleptic?

Well, I started having trouble staying awake for more than a few hours as I worked on my book. And then I was feeling sleepless at night, which came in as later symptom. And I guess that’s one of the deeper causes of narcolepsy — your nighttime sleep starts to break down and you’re losing consolidated deep sleep, which is resulting in the daytime sleepiness. What really triggered me to the diagnosis was I started getting symptoms of cataplexy before I had even done a sleep study, so I had a pretty good idea of what I was suffering.

Cataplexy often leads to fits of laughter. Did that happen to you?

No, but I spoke a lot. The British website for narcolepsy cheekily describes it as “witty repartee,” and that’s what hit me.

And so you went through a battery of clinic visits. What was that experience like?

It was fairly painless. I did a nighttime study and a daytime sleep latency study. All that was involved was laying down every couple of hours and going to sleep. But I had a revelation during this process about the amount that can be known and measured about sleep. 

I knew in a layman’s way that there was REM sleep and there were other phases, but I never really thought deeply about how they cycle through in a night and what their interrelation might be and the fact that so many different kinds of brain states are occurring over the course of sleep as opposed to this blank state, which is how I had thought of it. 

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It’s amazing how much the world of sleep contains.

It is! So I started reading up on it, and reading a lot of brain books as well, and it was quite staggering when I understood how complex sleep patterns are and how much they have to do also with consciousness and with our own self-image.

One of the studies I looked at, for instance, involved divorced people. And it looked at their dreams right after the divorce and then a year later. What it consistently found was that people who were sleeping well and dreaming well were at a better place the year after divorce than those who weren’t. And researchers were able to trace through their dreams and sleep that the subjects were actually resolving a lot of their anxieties and frustrations around the divorce during the dream process.

So, one of part of sleep is to downgrade the humiliations and failures you suffer. That’s an amazing thing. 

And that’s just one of the many purposes.

Yes. And when you think of it that way, and you think of a whole civilization going around sleep-deprived, the potential ramifications could be quite extreme. I mean, increased violence, increased aggression, lower levels of social adjustment and self-esteem and so on. It could take quite a toll. That notion is fascinating.

One of part of sleep is to downgrade the humiliations and failures you suffer. That’s an amazing thing.

As a result of your narcolepsy you were put on medication.

Yes. I was originally prescribed Modafinil — what many are referring to as the smart drug that will give you 72 hours of wakefulness at a stretch. I was also on Ritalin for a time.

I found that on the Modafinil I was not getting the same wakefulness effect as I was on Ritalin and I also found it a lot harder to work while taking it.  As a writer, the most important thing I have to be able to do is make aesthetic choices and on Modafinil I found it very hard to do that. I was writing 12 or 15 versions of a paragraph and was unable to choose amongst them to devise which of them was the best.

So I worked out a kind of cocktail of drugs that I take, so various formulations of methylphenidate, including Concerta, which is engineered to time-release throughout the course of a day. And along with that I will take Modafinill, and I’ll take some shorter-acting Ritalin to keep my head clear.  

The disorder, the medication — all of this amounts to a complex issue that is now a big part of your life. And it’s found its way into your work. Was this a natural inclination?

I often start with personal experiences, looking at them as raw material to cannibalize for my fixation. So when I write a book, it's not to encapsulate my personal experience or even understand it, per se. 

So, yeah, it was my disorder that got me thinking about sleep and how large an issue it is and how sleep-deprived a society we’ve become, and how much we’ve done to push back the boundaries of rest. It’s no surprise that sleep disorders are becoming a type of epidemic, and along with that, this entire industry has risen up to treat it, one that’s often interested in its own profits rather than helping people.

So we’re coming into so much trouble and that interested me as a writer to be in that world. As did the metaphorical considerations of sleep — the fact that we’re lost in this addictive validation loop that itself becomes a kind of dormancy, a kind of sleep. 

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Where did David Pace come from? 

Well, I wanted a main character who was a roman historian so I could put sleep into a historical perspective, as that allowed me to look at a society like Rome, which reached this pinnacle of civilization, but also a kind of boredom that required more and more outrageous forms of stimulation until eventually it led to decadence and collapse.

Aside from that? I don’t know. He’s not like me, except perhaps in my head — the darkened corners.

In dreams we’re projecting scenarios in which we don’t want to live, but we can work our way through them so that we’re prepared to do just that. Which is exactly what happens in fiction as well.

So how did you come to terms with your disorder and the new creative inspiration it’s brought. Or have you not

I have. In my day-to-day life, it’s just a practical matter of managing to stay awake and at night to sleep properly so I can carry on a fairly normal life. More broadly, it has in many ways shifted the way I think about the world.

There was that moment, in some description I read, about how, during dreams, the brain is doing exactly the same thing as it’s doing during the day: it’s putting together this reality. Now in dreams there is no external input, but given how mediated that external input is, it makes the distance seem a lot smaller between what we do when we dream and what we do when we’re awake. And that in itself has shifted who I am.

Part of what I was doing in the novel was trying to look at what happens when you suddenly start seeing all these different selves that form a part of you that you just close out and don’t recognize as part of your consciousness.

It’s all connected.  Nightmares, for instance, are a way for us to confront situations that we’re worried about. Our brain helps us work through certain fears so that we're better able to handle them. 

In dreams we’re projecting scenarios in which we don’t want to live, but we can work our way through them so that we’re prepared to do just that. Which is exactly what happens in fiction as well.