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Vitals & Bits # 16: Gamma-aminobutyric acid (GABA)

When my older sister and I were around 1 and 2 years old, my parents snapped a photo of us sleeping next to one another. In the quarter century that has passed since then, the deep symbolism that was accidentally captured in that photo has slowly emerged. The photo is now the stuff of family legend, an important historical document that is used to explain why things are the way they are.

You see, my sister Emily is the tidy, polished, pretty, immaculately dressed and expertly coifed fiancé of a famous opera star. And I … well, I like cats. And books. And books about cats. My hair automatically assumes the shape of the ponytail I wear everyday, and every single article of clothing that crosses my path bears some kind of oil or mustard or ink or baby vomit stain.

The aforementioned photo has become a famous family document because it perfectly captures, in one elegant little 4X6 time capsule, Emily’s and my future personalities. Two-year-old little Emily sleeps prettily on her side in a sweet little white nightgown, her blond hair gracefully and neatly spread around her relaxed, angelic face. And there I am next to her, fitfully sleeping with my mouth open, my hair hopelessly deranged and my body awkwardly tangled in a bizarre mountain of blankets and partially removed pajamas.

From this photo and other various scraps of anecdote, I’ve come to believe that a person’s sleeping habits can tell us a lot about that person’s personality, which itself is influenced by brain chemistry. My own brain has always been a tortured little theater of cognitive dissonance.

As the photo of Emily and me exemplifies, my sleep habits reflect this. In the miraculous event that I actually fall asleep, I toss and turn and toil away at unsolvable homework problems and an endless series of nonsensical tasks in my dreams. I wake up numerous times throughout the night, and by morning I’m usually more exhausted than I was the night before. Emily, on the other hand, presses energetically and cheerfully through her day and falls into bed sleepy, satisfied and generally unburdened by the useless emotional heft of global death and destruction. Twenty-five years after that photo was snapped, she still sleeps like an angel, and I like a Tasmanian devil.

I’ve always just kinda dealt with my insomnia. I’ve never sought therapy or anything like that for it. But a few years back, a rogue Ambien crossed my path and I, chronically tired and sick of not sleeping, decided to try it. Around 10 pm, I made a cup of decaf tea and drew a bath. Before entering the bath, I took about a quarter of the Ambien pill, thinking it would take effect just as I was ready to emerge from the bathtub and hit the hay. I washed the pill down with tea and stepped into the tub, closing my eyes.

I don’t remember anything between when I closed my eyes and when I opened them again, startled and shivering in a tub of cold water. I attempted to crawl out of the bathtub but couldn’t. My body was trying to go back to sleep, and I couldn’t find the strength or mental focus to remove my freezing naked flesh from the cold tub. I splashed my face with water and tried again, this time managing to drag myself out of the bathtub. After stumbling to my bed, I fell onto my mattress without drying off and pulled a blanket over me, falling asleep again almost immediately.

Ambien, which is a trade name for the generic drug zolpidem, works by enhancing the action of a neurotransmitter (or a chemical used to transmit signals from brain cell to brain cell) called gamma-aminobutyric acid (GABA). While most neurotransmitters stimulate brain activity, GABA actually inhibits brain activity. The ability to inhibit neural activity is absolutely crucial for brain function. Without it, each thought or sensation or active neuron would trigger a full-blown seizure. The brain must have some mechanism of terminating nerve impulses so they don’t just keep firing over and over again.

Neurons talk to one another via chemicals. If a neuron’s job is to activate other neurons, it’ll usually send out a neurotransmitter called glutamate. Glutamate is like a party invitation, and other neurons get all excited when they receive their glutamate invitation. However, if a neuron’s job is to shut the party down, it releases GABA. GABA is like a cease-and-desist notice. It’s like the cops knocking on your door at 3 a.m., busting up the party. So glutamate and GABA (along with a host of other neurotransmitters) work together to regulate brain activity. When you take an Ambien, the inhibitory effects of GABA take over, allowing the brain to slow down. This helps you fall asleep.

However, the “sleep” you get on Ambien is not the same as natural sleep. This is because natural sleep is a very active process requiring all sorts of highly organized brain activity. Inhibiting brain activity may allow you to fall asleep, but it can also stunt your brain’s ability to progresses through the normal sleep cycles. So, like any drug, Ambien has a bunch of risks along with the benefits. It works great for short-term use, to help quiet a noisy brain so that sleep is possible. It’s not so great to use every night, or to help someone stay asleep. And, as my bathtub experience demonstrates, it’s mighty powerful. Tinkering with the brain’s excitatory/inhibitory balance can lead to all sorts of bizarre things, from blacking out in bathtubs to memory loss to sleep eating and sleep driving. Yikes. Use with caution, and never without a prescription. Do as I say, not as I do, dammit!

So there you have it. GABA. Now you can rest easy.

 
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