From “Look At the Harlequins!”, Vladimir Nabokov

This is the last sleep reblog for now. Look At The Harlequins! has subtle autobiographical play (but it would be a mistake to see the narrator as a stand-in Nabokov) – I am unsure whether this sleep phenomenon is something Nabokov himself experienced.

Séamus Sweeney

“At its worst it went like this: An hour or so after falling asleep (generally well after midnight and with the humble assistance of a little Old Mead or Chartreuse) I would wake up (or rather ‘wake in’) momentarily mad. The hideous pang in my brain was triggered by some hint of faint light in the line of my sight, for no matter how carefully I might have topped the well-meaning efforts of a servant by my own struggles with blinds and purblinds, there always remained some damned slit, some atom or dimmet of artificial streetlight or natural moonlight that signaled inexpressible peril when I raised my head with a gasp above the level of a choking dream. Along the dim slit brighter points traveled with dreadful meaningful intervals between them. These dots corresponded, perhaps, to my rapid heartbeats or were connected optically with the blinking of wet eyelashes but…

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“Sleep.” Bravig Imbs

There is a vast literature on dreams and dreaming. Yet the literature of sleep is much smaller. Sleep is a human universal, perhaps the only human universal. Yet the direct experience of sleep is not one we have access to – so the literature is full of twilight states, hypnapompism, hypnagogism. This poem, especially the last stanza, captures something of sleep itself (yet even then, as an absence (“the violins were no more nor eyes nor arms)

Séamus Sweeney


slowly the ponderous doors of lead imponderous

pushed by a wedging force unthinking opened

how like a cloud I floated down the dim green air

unthinking of the soft violence of odorous winds

the falling plaint of hidden violins

and eyes



doors unto doors unfolded downward

and I was like unto a sailing ship

stern downward sailing on a dim green sea

unmindful of the rich push of flowery winds

the melting voices of far seraphims

and arms



slowly the ponderous doors of lead imponderous

lowered above my head in absolute slow closing

quiet as a shadow on a dim green wall

I rested in my dark and ivory vault

the violins were no more nor eyes nor arms

hours on hours


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Extract from a paper in progress on sleep in J G Ballard’s fiction

I’m afraid this is just as “in progress” as it was when I posted this originally. Someday!

Séamus Sweeney

“Manhole 69 follows three volunteers, Avery, Lang and Gorrell, who have undertook a procedure which has removed the ability to sleep. The primary investigator, Dr Neill, reflects with scorn on sleep: “this is as big an advance as the step the first ichthyoid took out of the protozoic sea 300 millions years ago. At last we’ve freed the mind, raised it out of that archaic sump called sleep, its nightly retreat into the medulla. With virtually one cut of the scalpel we’ve added twenty years to those men’s lives … For the first time Man will be living a full twenty-four hour day, not spending a third of it an invalid, snoring his way through an eight-hour peepshow of infantile erotica.” Later on, he declares. “the further we hold back back the unconscious the better. We’re reclaiming some of the marshland. Physiologically sleep is nothing more than an inconvenient symptoms of…

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Heraclitus on sleep: from “The Poetry of Thought”, George Steiner

I greatly enjoy Steiner. Although I also found this scathing review valid: .

Séamus Sweeney

Grammatical construction can make of an apparent riddle or paradox a font of expanding intuition: “Death is all things we see awake; all we see asleep is sleep.” Ring-structures spiral into esoteric depths which we might, mistakenly, sense as psychoanalytic: “Living, he touches the dead in his sleep; waking, he touches the sleeper” (Heraclitus is our great thinker on sleep).

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From “The Mighty Dead: Why Homer Matters” by Adam Nicolson

“Entha kai entha”, what a lovely description of insomniac turning and turning…

Séamus Sweeney

So uncatchable is Odysseus that when the poem describes his state of mind, you can never be certain where to find him. When he is lying in bed, anxious and unable to sleep. Homer says he is ‘tossing backwards and forwards, like a sausage that a man is turning backwards and forwards above the burning coals, doing it on one side, then the other, wanting it cook quickly. So Odysseus was turning backwards and fowards, thinking what he should do.’ Entha kai entha, backwards and forwards, hither and tither, literally ‘there and there’: Homer repeats the phrase three times in five lines. It must be branded on his hero’s heart. But is Odysseus the cook or the sausage? Is he turning or being turned? Is he the passive victim of his life or its principal actor? Or both?

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From “Correction”, Thomas Bernhard (trans. Sarah Wilkins)

A very typical example of Bernhard’s style, which I find compulsive. I have a feeling Bernhard would have despised me saying this, but I have found his dyspeptic, nihilistic works … quite life-affirming. Go figure. I also found “Correction” an excellent book to read before bed, because (I think) it forces a kind of focused attention. Someday I may try to empirically study this phenomenon….

Séamus Sweeney

What a terrible situation I’ve let myself in for by accepting Hoeller’s invitation and moving into Hoeller’s garret, I thought. I looked down at Hoeller’s workshop windows and I thought, there he is working away on and on because he can’t sleep, and then I thought that he must be thinking that I can’t sleep either, which is why I keep pacing the floor of the garret. People are always having to face things that upset and disturb them, mostly it’s at the very moment when they suppose themselves to be at peace, that they’re catapulted into turmoil, when they feel well balanced, they’re thrown out of balance. All we ever have is an illusion of peace, because at the very moment at which peace could enter into us, could could could, I say, we’re right back in the worst turmoil. So Hoeller down there in his workshop, his…

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From “Rituals” by Cees Nooteboom

Sleep is one of the areas where my literary and clinical interests intersect. I have been collecting sleep-related passages from various texts as I have found them, and posting them on my other blog. For what its worth, I am going to reblog them here also.

Séamus Sweeney

“I sleep very little,” said Philip Taads. He was sitting in the same place as yesterday and wore a plain blue kimono. “Sleeping is senseless. A peculiar form of absence that has no meaning. One of all the people you are is resting, the others remain awake. The fewer people you are, the better you sleep.”

“If you don’t sleep, what do you do?”

“I sit here.”

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Filter It. Reviews of “Take Me To The Source” by Rupert Wright and “The Blue Death” by Robert D Morris, TLS, 17/10/08

I have previously posted the submitted text of this review on A Medical Education, but this is the published text (courtesy of Maren Meinhardt of the TLS)

Séamus Sweeney

previously posted my submitted text of this reviews but, thanks again to Maren Meinhardt, I am herein re-posting the actual published text.


Rupert Wright TAKE ME TO THE SOURCE In search of water 276pp. Harvill Secker. £12.99.

978 1 84655 071 3

Robert D. Morris THE BLUE DEATH Disease, disaster, and the water we drink 310pp. Oneworld Publications. £16.99 (US $14.95).

978 1 85168 575 2

Thales of Miletus (c636-c546 bc), perhaps the earliest identifiable philosopher and scientist, held that “everything is water”. That this was the first philosophical and first scientific statement is no accident; water is central to human existence.

In the West, however, the words of Jake Gittes in Chinatown are apt – “I turned on the faucet, it came out hot and cold, I didn’t think there was a thing to it”. Rupert Wright, who has previously written books about life in the Languedoc region, begins his…

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“The Doctor” – Elizabeth Shane

Elizabeth Shane (1877-1951) was a Belfast-born poet who lived most of her life in Donegal. “Tales of the Donegal Coast and Islands” is a volume of poetry initially published in 1921, though this edition is a 1927 reprint.


Shane contributes a foreword:

These little tales of the west coast and islands of Donegal were begun without any idea of publication. They were simply written for my own and my ‘Mate’s’ pleasure, record of happy days in the place we love best, and of the simple everyday doings of a warm-hearted people among whom we count many friends.
Dialect in verse is apt to become burdensome; I have therefore not attempted to do more than suggest the speech of the district by occasional spelling, and by a characteristic turn of the sentences. The brogue is somewhat elusive, and much slighter than that which one hears further south.

I am inclined to wish Shane took her own strictures about dialect in verse being “apt to become burdensome” a little more to heart. Orwell wrote that Kipling’s verse is much improved by being read without the various dropped aitches and “an'”s and “th'”s that characterise him.

It would be curious to know how much the island doctor has changed – aside from being brought in by helicopter of course.


The Doctor


The doctor’s called to Tory now

An’ his boat is at the pier.

Och! his is not an aisy job

At any time o’year

For he’d need be half a sailor-man

That would be doctor here.


There’s many a day he’ll be to start

An’ face a winter gale,

An’ himself would make no fuss at all,

But tell the boys to sail;

Wi’ the thought o’ one in pain beyond,

He’s not the man to fail.


There’s Neal down workin’ at the boat,

And the rest is with him too,

‘Tis the four o’ them do always go

To make the doctor’s crew;

For ’tis Tory is long miles away,

An’ no less o’ them would do.


‘Have ye tackle there?’ the doctor sez,

‘For the mackerel’s in,’ sez he:

‘We can trawl a bit as we go for luck.

Sure, we might get two or three’

But sez Neal, ‘The speed’ll be rayther much

Wi’ this wind in the open sea.’


Sez the doctor, ‘Tis a soldier’s wind,

We’ll be home ere night,’ he cried,

So they’re slippin’ from the harbour now

Down channel wi’ the tide,

An’ the swell is aisy on the bar

Though the wind is fresh outside.


‘Tis lonesome out on the wide, grey sea,

An’ the boat she does be small,

Yet where sickness is, be it calm or storm,

They will answer to the call.

Och! there’s brave things done an’ little said

On the shores o’ Donegal.

Here is a rather badly taken image of the poem as originally set:


Can you put your hands around your own neck?

Full text available here. Readers will be delighted to learn I can do it (just)  – but as the authors point out this doesn’t particularly rule OSA out…

A pilot study of the inability to fit hands around neck as a predictor of obstructive sleep apnea. 

Background: Considering the high estimates of undiagnosed and untreated obstructive sleep apnea (OSA), there is a need for simple and accurate diagnostic tests. Neck circumference has long been correlated with OSA, but its usefulness as a diagnostic tool has been limited.

Aims: We proposed to evaluate the value of a simple neck grasp test to help identify OSA. We hypothesized that the inability of a patient in a sleep clinic to fit their hands around their neck is predictive of OSA.

Materials and Methods: A retrospective review of medical records of patients evaluated in a general sleep clinic was performed. Easy sleep apnea predictor (ESAP) positive was defined as the inability to place the hands around the neck with digits touching in the anterior and posterior. ESAP negative was the ability to place hands around the neck. Positive for OSA in this symptomatic sleep clinic population was defined as an apnea-hypopnea index (AHI) of ≥5.


Results: A total of 47 subjects (36% female) had ESAP data available, which were reviewed. The mean age was 51.6 years (SD 14.4, range 29-81 years). The mean body mass index (BMI) was 38.8 (SD 9.9, range 20.4-69.5). Review showed 87.2% (N = 41) tested positive for OSA by AHI of ≥5. The sensitivity and specificity of ESAP were 68.3% and 100%, respectively. The positive predictive power was 100% and the negative predictive power was 31.6%.


As we hypothesized, ESAP positive (inability to span neck) was predictive of OSA in a population of sleep clinic patients. An ESAP positive test was 100% predictive of the presence of OSA (AHI of ≥5). ESAP shows promise for ease of clinical use to predict the presence of OSA in a general sleep clinic population.