There exist Londoners who do not wish to spend their nights partying or raising their hands in the air at the behest of a sweaty, badly-shaven man nodding his head behind a pair of turntables. These Londoners only desire is to sleep. But, for reasons that they can't quite gauge, their bodies and minds won't let them. They have been barred from sleep. They feel jammed, frozen. Trapped in the glare of an endless midnight sun.
And so, each weekday evening, a select handful of them will head towards a hospital near Westminster Bridge where they will be masked, wired, strapped up and lain down in rooms that insulate them from whatever is going on in the city. For the next few hours, up to and beyond dawn, every snore, spasm and twitch of their eyes will be monitored by men and women with a very unusual job: they are sleep technicians.
We're a nocturnal gang. We're a special unit, a minority unit of people who not only work odd hours, but beat the rat race. Think about it: every day you have 22 million people commuting to London, the nerve centre of the UK, as well as the eight million who already live here. Even with those numbers, we see and hear things that no one else does. We're guardians of the unknown.
Londoners today get 25% less sleep each night than they did when HV Morton was out noctambulating. Fewer and fewer workers are allowed to leave their work behind at the office: they are foisted with mobile phones, Blackberries, wi-fi connections - technologies that allow them to be linked and live-wired to the demands of their employers. They are held in a digital lasso, forced to dispense with the idea of down time, and spending late-night hours pinging draft spreadsheets to equally bleary-eyed colleagues. Sleep, according to the rules of the post-industrial game, is for losers, for those who can't hack it in the upper echelons of the new information economy.
Capitalism detests sleep because it's a time when nothing gets sold or consumed. It used to be that television and radio stations shut down at midnight. Now hundreds of cable channels exist to peddle gaudy trinkets, soft rock box-sets and re-runs of 1970s cop shows. Disc jockeys, whether smooth-tongued presenters of mellow gold or hyped-up jabberers on the pirates, boast that they are up all night. The flats of Londoners have become entertainments arcades full of games consoles, sound systems and ever-growing flat screens and monitors: the party, whether or not there is anyone else to share it with, need never stop. The shift from dial-up to broadband means they can inexpensively while away the darkness chatting and surfing and paying bills. The computers are always on; and so, it seems, are growing numbers of Londoners.
Super-stimulated by the buzz of entertainment and the pressure of work deadlines, Londoners, to a far greater degree than people elsewhere in the country, are falling prey to sleep sicknesses. Their body clocks are all over the place; they skip key meals, but pop down the local 24-7 to stock up on coffee or cheap bars of chocolate.
Maybe they douse themselves with a glass or three of Shiraz. Drugged up, overdosing on excess, thrusting their brains and bodies into conflict, Londoners are hitting epidemic levels of obesity and courting diabetes as never before. Shift workers, forced to do 8-12-hour stints at irregular intervals, are most likely to get ulcers or heart diseases.
Sleep technicians are sure that poor diet is one of the key reasons why London is unable to sleep. They calculate that over a third of its population suffers from insomnia, and that it interferes with the working lives of ten per cent. Yet they say it's a topic that they study for only nine minutes as part of their four-year-long medical educations.
They also say that sleeplessness is a scandal politicians do not wish to broach, not only because dealing with all its victims would bankrupt the NHS, but because the kinds of changes needed to combat the problem would require a social and economic revolution.
I haven't been able to sleep for so long. Every night I'm still up and it's like someone's hit me over the head. My mind's doing a 100-metre dash, someone's removed the finish line and it just keeps going and going and going until you literally feel like your head's a cage and there are mice running around in it. You can feel them with their claws burrowing at your skull further and further until as if they're going to emerge. You feel the physical pain in your head because your mind's just racing racing and you just cannot shut it off.
Nights begin at around 7.30pm. That's when the patients, from kids whose snoring can be heard at a distance of thirty feet to men in their seventies, start to arrive. Many suffer from apnea, a condition that stops people from breathing for periods of up to a couple of minutes and makes them explode in volcanic gasps during which they try to get some oxygen. Though they often complain of feeling sleepy – understandable since they may wake up 800 times a night – it's common for them not to know anything about their maladies; it is their long-suffering spouses who haul them along to the clinics.
After all the consent forms and allergy questionnaires have been completed, the patients get into their bed clothes and then sit for up to an hour while they are prepared for their sleep tests. Silver nodes and a series of wires are attached to different parts of their heads, fingers, faces and bodies using conductive paste that allows technicians to check brain activity and whether certain muscles are overactive. It can be a tricky procedure: some middle-aged men and fashion princesses turn out to have hairpieces or weaves stitched into their scalp wigs making it hard for the techs to fasten the wires.
Some of the patients get excited by having to don electrical wardrobes. They take mobile-phone pictures of themselves which they send to friends across the city, and are thrilled by the idea that, just like Big Brother contestants, there will be cameras filming them throughout the night. Other patients are more nervy and diffident. They regard the idea of being watched as they sleep as voyeuristic, a breach of the privacy that the darkness of night time is meant to usher in. They feel naked without the protective armour that cosmetics provide. They worry about being caught dribbling or reciting names it would be politic to keep to themselves.
More than that, they have become used to sleeping badly, and worry that they will have to adopt new regimes. They fear the electrodes are miniature cattle prods that will shock or electrocute them. As they get hooked up they confide in the technicians about how they have not had sex with their partner for two decades, or how they once became so bleary and depressed they tried to take their lives.
The technicians have not been trained as marriage counsellors or as psychologists, but they soon develop a strong awareness of how vulnerable the sleepless can feel, even when shown the equipment that might improve their symptoms. It is common for patients to panic upon learning that they will have to wear a respiratory mask as part of their examination. Younger ones, who suspect the tests will determine they have to wear those masks all their lives, cry out of vanity; they fear no one will ever kiss them again, or that their partners will regard them as life-support-machine victims. Even older patients claim they will feel muzzled, claustrophobic; a fireman, whose job forced him to wear a mask all day, began to hyperventilate at the prospect of being attached to another one all night, so much so that he ran out of the hospital.
People have strange ideas about what we can and cannot see. There was one time a girl came in to help out her mother who didn't speak much English. But she was pretty old fashioned herself. I explained to them both about the cameras and that I'd be using them to see exactly what was going on in the mother's brain while she tried to sleep. The daughter totally misunderstood: she thought we could read and work out exactly what her mother was dreaming. She thought the images would appear on the TV screen. She started warning her mother: "I know you don't like my husband Jorge. But you'd better not be saying bad things about him, or I'll be really mad at you."
Sleep technicians are security guards who watch over their patients' physical and abstracted selves. They use their eyes and infra-red cameras to monitor pulses, the flow of breath, rates of desaturation, all of which give indications of long-term breathing and sleeping problems. The screens are high-powered enough to allow them to pop to the toilet and rewind the action just like TiVo on their return. They'll spot tics and twitches, violent teeth grinders, kicky leg shakers who can't contain their restlessness. The effect, especially when they notice men playing with themselves, can be peepshow-prurient.
The apnea sufferers, especially those with a history of heart disease, are regarded as the worst. Their airways collapse. They stop breathing for long intervals, are totally still, and then erupt; they are, in effect, fighting for their lives every couple of minutes. Their heads may keep shaking, and they often raise their arms in the air, like drowning men out at sea waving for attention. It is common for younger technicians, in spite of their training, to panic and assume that the patients are in the middle of a sustained seizure. But even more experienced staff can be upset by the violent noises and their own helplessness. They feel morbid, mute witnesses to a dark, disturbing sorrow.
By 2am, most of the patients have drifted off. They can look like overgrown babies, some anguished, others wreathed in subtly beatific smiles. Most of them though, breathing masks covering their faces and all muscle tone having disappeared, resemble bodies laid out in a mortuary.
The technicians who watch them from adjacent rooms stare at them sometimes, trying to gauge their characters from their obscured physiognomies and dormant postures, but it's impossible; the images on screen are transmissions from another galaxy.
Even the research scientists in less well-funded units, who spend nights in the same room as their patients, admit that the men and women sleeping a couple of yards from them, behind a drawn curtain, may as well be miles away.
These technicians betray their own beliefs every time they come to work. They know full well, and they tell their patients as much, that it's sensible not to work long shifts.
That regular breaks are vital for sustained good health. Yet they themselves routinely work for twelve hours. By 3am, they need artificial highs to stay alert. The Krispy Kremes come out.
They start swigging sports drinks or listening to techno on their i-Pods. Graduate researchers who tend to work with less afflicted sleepers, will lie on the floor, using small torches to read journal articles or comic novels, all the time conscious that they mustn't laugh out aloud.
You could say the patient, to us, is a series of lines and shapes on a screen. We spend the night reading polysomnographs. We read waves, not books. We're checking the frequency and depth of brainwaves. They all have a different shape and character. Clear alpha waves look gorgeous, like lovely big fat rolling hills. Then you have delta waves. Then if there's something going wrong you see on the monitor these violent spikes: awkkkk!
Sleep is a cave, an Anderson shelter to which city dwellers can retreat from the stresses and strains of metropolitan life. It's a departure lounge, where men and women can use dreams to rewind and choreograph afresh dismal past events, and where they can fly away to strange new zones more brilliant and polymorphous than those with which they have to put up normally. Without sleep, and without dreams, they feel trapped in the middle of a violent, concussive city. And yet, they also feel invisible, insubstantial. They want to apologise to friends for not really being present. They lose their train of thought easily. Sentences fizzle out. The whole day becomes a series of stuttering, apologetic ellipses.
Insomnia is smog, perpetual drizzle. Sufferers feel foggy all the time, as if they have scarfed down a bottle of Prozac. Stupid too: how can an activity so simple and basic become such a problem? They study and restudy their diaries, paranoid self-scrutineers berating themselves about the double espresso they ordered at a restaurant the evening before and how it must be the reason they only got two hours of shut-eye. They begrudge sleeping partners their restfulness for it compounds their isolation and unhappiness. Radio becomes a fix, a late-hours accomplice. Night starts to take over day: they think and stress about it when they should be working. They become afraid of it, hoping and worrying that the next evening will finally be the one they manage to enjoy some quality sleep. They worry that they might be in no fit state to deliver their boardroom presentation the next morning. All the time they feel broken, in pieces.
Sleep, for insomniacs, is a wan, portable concept. They catch it while they can, whether it's a couple of minutes at the work's canteen while their pals are discussing Orient's recent dire form, or slumped over the free papers on the tube ride back home. But it's never remotely enough for them to stop envying their more functional friends for whom the night is an orderly, sequential experience: get back to the flat, have dinner, clean up, watch telly for an hour, go to bed, fall asleep by 11. "At 2am," says a care worker, "I find myself looking down a long corridor that stretches forward to the morning. It is lined with a bed, sheets, pyjamas, blanket, clock, gown. But I find that the spaces between all of these things keep opening up and extending. I can't navigate through."
For insomniacs, night has no end and the day no beginning: looking at the clock merely compounds their suffering. The beds they climb into irritate and annoy: sheets feel rough, pillows too lumpy, even the night clothes are prickly. They lie on their sides, facing the ceiling, at oblique angles; but they can never find a comfortable spot. They feel lonely and homeless, that there is no place in the world that they can treat as a safe haven. So they drift, always gauzy, often walking into doors or ending up with scratches or bruises on their legs without any idea of how they got there: "You don't have any barrier or shield to protect you. It's as if all your edges are permeable. If someone were to draw you it would be - a wavy line."
Insomnia corrodes memory. The sleepless can't remember if they locked the back door or fed the cat. They're not sure which afternoon they're meant to be attending their children's sports day. None of their experiences are processed or filed properly. They become trapped in the present, unable to mature or evolve. They feel insensate, estranged: all of London, its adventures and incremental wisdoms, is negated. It becomes a faded photo.
Sleeplessness renders the bedroom a holding cell, a deprivation chamber. Some insomniacs, fearing that the Heart DJ will play Come Away With Me for the fifth night in succession, flee outdoors. The streets of London are populated with men and women who are not going anywhere, but wraith around trying to kill time until they feel capable of falling asleep. They describe themselves as the undead, zombies in overcoats. Amidst the crowds of Soho and Tottenham Court Road they stand; pieces of blotting paper that absorb the colour and noise around them. They are part of the city and standing outside of it, immersed yet detached. They look up at the sky to make a wish. They stare into the distance. But there is no dark at the end of the tunnel.
"I used to think people who slept were bourgeois and conservative," admits a lawyer. "I saw them as belonging to the bovine, complacent herd of Londoners I despised. I thought life in London was a competition, and that not sleeping gave me a competitive edge. I don't so much now, but I wouldn't say that being an insomniac makes you a more caring person. When I'm wandering around King's Cross at night, I occasionally see people who look like me and I just scurry away. I worry we might compound each other's sleeplessness."
Insomniacs inhabit a strange, hushed universe in which even the thoughts that go through their mind seem a jangling transgression of night's silence. Increasingly, though, and whether or not they traipse the streets alone, they know that London is a persistent noise field. Whether or not they open their windows at 3.30 to let some air in, they're sensitive to every horn-honk, avian-police helicopter and knot of hooded youths cussing and laughing. They hear the illegal construction crews of east European labourers getting ready to work. They hear brewing company workers rolling steel barrels of ale across the pavement to local pubs. They swear that even the birds are tweeting and crowing noisier and earlier these days.
What's good about not being able to sleep? Well, I know a lot of facts about inorganic chemistry from all the Open University programmes I've watched. I know to ask directions of a stranger in lots of European languages. Mainly I've learned how crabby and deprived insomnia leaves you feeling. I can see the Thames from my flat. Some nights I feel like I'm drowning. I want to rush out and climb St Paul's or hang off the London Eye. But I never even leave the front door. My life, my dreams: they've become totally dimmed.
Sleep technicians are often annoyed – by patients who keep asking if they can get up to go to the toilet, when some of the wires fall off at 5am invalidating the whole night's tests – but they are rarely scared. Those that work in the older hospitals, places widely believed by both medics and administrators to be haunted by ghosts, recall hearing bumping noises or creaking staircases. But the most scary moments, more so than the patients' erratic breathing patterns which are ultimately physiological, are the nightmares. Patients will scream and yell at the tops of their voices. They will make violent threats and start to rain down curses on family members. The technicians are initially fascinated and eager to hear more. Soon though, they start hearing fragmented re-enactments about the sleeper being molested, or molesting someone, close to them. They back off quickly, and try to focus on the polysomnographs.
Some sleepers even suffer from night terrors, traumatic occurrences usually the preserve of pre-teens who feel they are being attacked by amorphous black shapes in the corner of the room. During these terrors, the victim, whose eyes will be fully open though they are actually asleep, will scream hysterically for up to half an hour. One technician was monitoring a patient who had five terror attacks in one night. He ripped off his mask and flung it across the room. Then he started leaping on the side of the bed where he though his wife was lying, in order to protect her from the creeping blackness. All the while he sobbed uncontrollably.
This is a rational universe, right? And London's a modern city, no? Well, I've seen kids not even drawing breath they're flailing and shaking and screaming so hard. You think: their vocal chords can't take it. It's like the devil is in the child. You want to comfort them and wake them, but that might make it worse. You're their carer and you're powerless. They're totally non-responsive. I know of so many parents who don't want the neighbours getting upset; they strap their screaming kids in the back of their car and go driving around London. Round and round and round - till the rhythm drugs the child.
Early morning in a sleep laboratory has its own smell. Every technician, whether giggling or groaning, will admit as much. In summer time, the machines can give off up to 40-degree heat. The odour of methane, plus the fetid breath when patients' masks are removed from their faces, makes for a distinctive perfume. Windows and doors are opened hurriedly.
The patients themselves tend to be bewildered. Decades of fragmented sleep have left them with no knowledge of what it means to get a good night's rest; they take their grogginess and irascibility for granted.
Now they look around, shorn of the uniforms or fancy threads that give them status during the working day, suddenly becalmed and beaming. They stare at the technicians as if they are miracle-agents who have brought them back to life, wrought Lazarus-like transformations.
When told that the only remedy for their condition is to wear breathing masks every night for the rest of their lives many are upset and dejected. Others, especially older patients, don't care: "It's not as if me and the missus are having sex all the time anyway."
They calculate it's better and more effective than sleeping pills. A lorry driver says: "I used to feel that my soul had been taken away from me. I felt shallow and empty. I knew there was something missing. I'd love to spend the next few years getting back all the sleep I've missed in my life."
Being a sleep technician is rewarding, but it's damn hard work. By the morning I'm knackered and a moody bastard. I see all the commuters coming into London with their blood-shot eyes and their fat necks; I know they're not breathing or sleeping well. You think to yourself: half the people in this city are ghosts. Still, I go home through Hyde Park; sometimes, no matter how shit I feel, I see the mist on the ground and the steam rising from the lakes and I can't help but smile. I always think: the city's waking up. The city's given a bit of soul back to me.