Dinges may face an even harder fight in the years ahead. She belongs to a family carrying the gene for fatal familial insomnia. The main symptom of FFI, as the disease is often called, is the inability to sleep. First the ability to nap disappears, then the ability to get a full night's sleep, until the patient cannot sleep at all. The syndrome usually strikes when the sufferer is in his or her 50s, ordinarily lasts about a year, and, as the name indicates, always ends in death. Dinges has declined to be tested for the gene. "I was afraid that if I knew that this was something I had, I would not try as hard in life. I would allow myself to give up."
FFI is an awful disease, made even worse by the fact that we know so little about how it works. After years of study, researchers have figured out that in a patient with FFI, malformed proteins called prions attack the sufferer's thalamus, a structure deep in the brain, and that a damaged thalamus interferes with sleep. But they don't know why this happens, or how to stop it, or ease its brutal symptoms. Before FFI was investigated, most researchers didn't even know the thalamus had anything to do with sleep. FFI is exceedingly rare, known in only 40 families worldwide. But in one respect, it's a lot like the less serious kinds of insomnia plaguing millions of people today: It's pretty much a mystery.
If we don't know why we can't sleep, it's in part because we don't really know why we need to sleep in the first place. We know we miss it if we don't have it. And we know that no matter how much we try to resist it, sleep conquers us in the end. We know that seven to nine hours after giving in to sleep, most of us are ready to get up again, and 15 to 17 hours after that we are tired once more. We have known for 50 years that we divide our slumber between periods of deep-wave sleep and what is called rapid eye movement (REM) sleep, when the brain is as active as when we're awake, but our voluntary muscles are paralyzed. We know that all mammals and birds sleep. A dolphin sleeps with half its brain awake so it can remain aware of its underwater environment. When mallard ducks sleep in a line, the two outermost birds are able to keep half of their brains alert and one eye open to guard against predators. Fish, reptiles, and insects all experience some kind of repose too.
All this downtime comes at a price. An animal must lie still for a great stretch of time, during which it is easy prey for predators. What can possibly be the payback for such risk? "If sleep doesn't serve an absolutely vital function," the renowned sleep researcher Allan Rechtschaffen once said, "it is the greatest mistake evolution ever made."
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http://ngm.nationalgeographic.com/print/2010/05/sleep/max-text
