To Stay Awake

Anna Sumner craved sleep, and therefore figured she must need sleep. She slept more and more from the time she was a teenager until it interfered with her job as a lawyer, sometimes for days at a time. After Sumner was diagnosed with "hypersomnolence," neurologist David Rye of Emory University and his team looked for the cause, but only got a clue from the reactions of different drugs that were prescribed to help her stay awake.

Rye’s group and several others around the world had also noticed that flumazenil had positive effects on some people with hypersomnolence. But in the wake of the scandal, Rye put this line of research on hold. “People got a very bad taste in their mouths,” he says. The general feeling in the field was “we got duped on this one, and that’s not going to happen again.”

But when Anna Sumner came along, Rye’s team at Emory thought it was time to dust off the old theory. In May 2007, they gave her a spinal tap, an invasive procedure that collects cerebrospinal fluid (CSF), the clear substance that’s produced in the middle of the brain and flows down the spinal cord. CSF protects the brain mechanically, by keeping it buoyant, but it’s also chock-full of proteins and chemicals involved in brain-cell communication.

Sumner’s CSF was quantifiably abnormal. It contained a high level of a substance that, like benzodiazepines, activates the chemical messenger GABA. This neurotransmitter acts as a shutdown switch in the brain, dialing down consciousness so we can sleep. Sumner, it seemed, was carrying a bona fide endozepine.

Andy Jenkins, an anesthesiologist at Emory working on Sumner’s case, joked with her that if another woman were carrying around the same amount of GABA-activating sedative, she could practically be operated on. “That’s what I was walking around with on a daily basis,” Sumner says.

Scandal? Yes, researchers thought they'd identified an "endozepine," or naturally-occurring benzodiazepine (drugs used in sleeping pills) produced by the brain before, in a case from Italy in the 1980s. That research was exposed as useless, a turn down the wrong alley, and it only made Rye's newer discovery harder for the scientific community to swallow. Meanwhile, Sumner and other sufferers of hypersomnolence had to pay the price for less-than-rigorous research from decades earlier, as the effective medicine (flumazenil) is not easy to obtain or to administer. After years of rigorous research, Rye and his team still cannot fully identify the chemical compound that caused Sumner's sleepiness, but what they do know has finally been published. Finding the exact brain chemical that causes hypersomnolence may lead to more effective sleeping aids, better help for insomnia sufferers, and yes, big profits for pharmaceutical companies. Read the fascinating story of Sumner and her malady at The Last Word On Nothing.