Living Nightmare - transcript

NARRATOR (DILLY BARLOW): This is a story of people caught in a strange world, a place where they are trapped by a shadowy force. In this world they are tortured by nightmares that can drive them to the edge of despair.

GAYNOR CARR: I had felt suicidal and thought about it quite a few times, but I'm not that brave.

NARRATOR: The irony is that what torments them is something the rest of us love: sleep, but now, thanks to these people, science stands on the brink of an astonishing breakthrough, a breakthrough with the power to transform all our lives. Imagine really living life to the full, every minute of every day being used for work, for your family or for play. No need to break. You just keep on going day in, day out without stop. At the moment that's just not possible. Every night something occurs that no one can avoid: we go to sleep. Every single creature on this planet does it and yet, strange though it may sound, science, until very recently, had not the slightest idea why.

DR JERRY SIEGEL (University of California, Los Angeles): Amazingly, it's one of the greatest unanswered biological mysteries. We spend eight hours a day in this state, we know that if you lose it for extended periods of time it can have a tremendous impact on your health, but we don't know exactly what's going on in the body that makes this such a, a tremendous requirement.

NARRATOR: The only thing we do know is that sleep is about far more than rest. Your brain can actually use more energy when asleep than awake.

DR THOMAS KILDUFF (Stanford Research Institute International): Sleep is not what you think. It's not just a period of rest. Clearly there are certain areas, certain times during sleep, when the brain is much more active than it is even during wakefulness.

NARRATOR: It all makes sleep such a mystery. Everyone does it, everyone needs it, yet science has almost no idea about what is going on, or why, but now this great biological puzzle may be about to be solved and it is all because of a group of people with a very strange condition indeed: narcolepsy. For years scientists have been aware of a group of people with a truly bizarre set of symptoms: they constantly fell asleep, apparently right out of the blue. For Gaynor Carr every day is a battle to stay awake.

GAYNOR CARR: At the moment I'm shattered. It's killing me to keep me eyes open, it's killing me to think straight and to speak properly. I just feel like everything's coming out a load of mumbo-jumbo 'cos I can't think straight. I can't focus properly. Me sight's dead blurry and me eyelids are like concrete.

NARRATOR: Gaynor fell under the spell of this disease when she was a young girl growing up in Liverpool.

GAYNOR CARR: I can remember nodding off all the time, when I was about seven. I can remember that far back like things in school or when I was in the Brownies and used to have little meetings and I'd be falling off the chair and things like that.

NARRATOR: Gaynor was experiencing the first signs of narcolepsy. It's a condition that made holding down any job impossible.

GAYNOR CARR: Every job I've had since I've left school has been, well most of them have been in sewing factories which isn't an ideal job for someone with narcolepsy. Had a tendency to butt the sewing machine when I'd fall asleep, or just make a mess and I've had to stick things in me pocket to take home and fix 'em and bring 'em back the next day and shovel it back into the bundle of work that I was doing. I've had that many jobs in sewing factories I've probably been round every sewing factory in Liverpool.

NARRATOR: Although she wants to, Gaynor has not worked for years. Gary Beattie had just started work on a building site. Then he realised something was seriously wrong.

GARY BEATTIE: It was extremely dangerous working on a building site 'cos there's been a few instances that I fell asleep 20ft up a ladder and I just put my back against the ladder and fell asleep for I think it was 15 minutes or something.

NARRATOR: And in Gary's case he had more than just the desire to sleep. There was another, more dramatic symptom that struck without warning.

GARY BEATTIE: My face turns to, it feels as if it's all shaking, like my jaw and stuff like that, the muscles in my face, but a major attack is, I just feel like all jelly inside. I try and keep myself up by holding onto something and that, but my legs are like buckling underneath us. If I can't hold myself up and somebody can't like help me to stay up I just hit the floor like a ton of bricks.

NARRATOR: Gary's collapses are what scientists call a cataplectic attack: a sudden and total loss of muscle control causing complete paralysis. He could hear and see everything, but couldn't move a single muscle and when doctors studied cases like his a pattern emerged. The attacks were triggered by emotions: happiness, anger or sadness.

GAYNOR CARR: It usually comes on when I start laughing. I get like, I just call it wobbly-gob.

NARRATOR: A fear of cataplexy can force narcoleptics to suppress their natural personality.

GAYNOR CARR: Just become a bore. I mean when you want to laugh your head off or something and I'll just go (EFFECT) like try not to, try to hold it in a bit so I don't, so me face doesn't wobble.

NARRATOR: Bill Baird had a very different life before narcolepsy brought his career to a halt. Bill worked in the high stress world of finance, in one of America's top investment houses, not a good place to be a narcoleptic. As a stockbroker he was under relentless pressure, but then this happened. This is a film of Bill 25 years ago. These cataplectic attacks would happen every time he was near to closing a deal.

BILL BAIRD: As I began to establish an emotional rapport with a client, or potential client, that would trigger cataplexy so it would be a race between whether or not I could convert this person to a client before I converted myself to a lump on the floor.

NARRATOR: And in his case there was an extra twist. He found himself in a strange world in which he was awake but still dreaming. It was a world of hallucinations and nightmares.

BILL BAIRD: I could hear someone downstairs at the door. They knocked. Of course I couldn't get up and answer and they tried the door and it wouldn't open and they went around the side of the house and I could hear the window opening and hear them coming in, bumping into furniture, going across and down the hall, through the rooms and coming closer and closer to my bedroom and, you know, it was really terrifying.

NARRATOR: The biggest problem for narcoleptics is that they have to live with these symptoms day in, day out. For Gaynor it has shattered her most precious dream of having children.

GAYNOR CARR: That's one of them subjects where I sort of like kid meself. I kid meself into saying now, well it's not… Always get a bit choppy on that bit. I have felt suicidal and I've thought about it quite a few times, but I'm not that brave.

NARRATOR: What made matters even worse for narcoleptics was that even the people closest to them often didn't believe there was anything wrong with them at all.

BILL BAIRD: It would be nice if narcolepsy resulted in some oh you know terrible disfigurement. Then people would know, they would notice it.

GAYNOR CARR: You fall asleep and you're a dosser, you're lazy, you've gone to bed too late, you've been out the night before, or you're on something, but if I'd just had the shakes or some other, something else.

NARRATOR: For years many in the medical profession did not even accept the condition really existed. Instead they thought it had to be a symptom of something else.

GAYNOR CARR: Started going to the doctors and it was, I was just fobbed off all the time with blood-tests for this, that and the other and come for another one in six months, something might show up then.

BILL BAIRD: You need more exercise, maybe you need glasses, you're trying to carry too heavy a load at school, you've got to cut back on the classes or the work.

GAYNOR CARR: Under-active thyroid gland, anaemia and like mostly dietary problems.

GARY BEATTIE: Because of the cataplexy and the small fits and stuff I had, they thought it was isolated epilepsy that I had. It was almost diagnosed to start with.

GAYNOR CARR: Are you allowed to say that that your doctor's crap?

NARRATOR: Narcoleptics seem to be stuck. Few people believe them and no one could help, but then something happened that would alter the whole view of the medical profession and it would also be the first step in unravelling the great mystery of sleep and it was something truly bizarre. In early 1973 a pack of dogs behaving strangely were brought to the University of Stanford. They kept falling asleep and collapsed when excited. Animals cannot fake their symptoms. The conclusion was: the dogs had narcolepsy. It was the first cast-iron proof that the condition really did exist.

BILL BAIRD: The dogs did convince many people that narcolepsy was a real medical condition, not a psychological one. I mean these animals did not all have some sort of psychological problems and they very consistently demonstrated they had cataplexy. You'd feed them and they would go down. You tell me a joke - if I listen I would go down.

NARRATOR: People's perceptions of narcolepsy were transformed. Soon television dramas were including storylines about it.

CHILD: I want a drink.

GAIL: Hang on.

NARRATOR: It was a programme like this that changed Bill's life.

BILL BAIRD: I saw a TV show in which one of these super-doctors mentioned something about thinking his patient had narcolepsy and I thought ah-ha, that's me, so I went to a doctor and said something's wrong, I think I might have narcolepsy.

WOMAN: Go on.

GAIL: Have these nightmares, so everything goes really weird like you're looking down a tunnel at everything.

BILL BAIRD: I guess he went back and read up what is narcolepsy and said yep, you've got it.

GAIL: Told my mate about it. She thought I was just popping pills.

WOMAN: These sound like fairly classic symptoms.

GAIL: What of?

WOMAN: I think you may have narcolepsy, Gail.

NARRATOR: Gaynor, too, benefited from the increased awareness. Although her doctor still hadn't recognised her symptoms, a nurse at her local surgery did.

GAYNOR CARR: I went in, had to see the nurse and it was a locum nurse anyway, I mean I'd never seen her before and for someone to sit there in the same room as me and say yeah, I, I know where you're coming from, I've heard of things, like people fall asleep all the time and it is a medical condition. She says I'll look into it for you and just felt like kissing her feet and everything else, like thanks, you know, I knew I wasn't just a lazy dosser.

NARRATOR: For narcoleptics there now seemed to be real hope. At last science had to take them seriously. What particularly intrigued scientists about narcolepsy was the chance of cracking an even bigger mystery: why we sleep. They were convinced that such a severe sleep disorder had to hold the key. Among the first to get involved was Tom Kilduff.

THOMAS KILDUFF: Since narcolepsy is thought to be a pure sleep disorder, if we can understand the basis of what has gone wrong in narcolepsy we may actually find something useful to tell us about why it is that we sleep.

NARRATOR: Kilduff set about breeding a colony of narcoleptic Dobermans for research purposes, but then he hit trouble. The man who thought he was on the verge of a scientific breakthrough found that his Dobermans made poor patients.

THOMAS KILDUFF: Although having this animal model of narcolepsy, the narcoleptic dog, was an exciting opportunity for sleep research when it came down to actually working with the dogs it was a bit of a nightmare. It was very time-consuming when you're breeding the dogs, there are two cycles per year. Because of these and other problems of maintaining the colony, I personally got very frustrated with working on the narcolepsy research.

NARRATOR: And what he did manage to learn from the dogs proved to be useless. Their narcolepsy turned out to be caused by one simple genetic defect and it was clearly very different in humans, so the dogs told him almost nothing.

THOMAS KILDUFF: It was clear that even though understanding narcolepsy was a noble cause thought at that point in my career it was better to turn in, my research into a different direction, not directly related to narcolepsy.

NARRATOR: So Kilduff abandoned his dogs and their problems. There was still no prospect of a cure for narcolepsy. For narcoleptics the only option for leading a normal life was to resort to drugs, drugs which didn't really deal with their condition, but which were the best science could come up with. Gaynor has been on the pills for six years. Her doctor has tried every option for her.

GAYNOR CARR: I've been on medication since 96. First I was on Carbomazopine, then I was on the dex-amphetamines but I was only on 20mg a day. Then I went on Modafinil and then I came off Modafinil and I went back on the dex-amphetamines. Now I'm on the higher dosage. I take 60mg a day which is six in the morning and then I take another six round about midday.

NARRATOR: Dex-amphetamine is the most powerful stimulant there is and even though Gaynor is on the highest possible dose, these drugs are starting to fail her.

GAYNOR CARR: At the moment on the high dosage of the amphetamines I seem to be building up a tolerance to them. Halfway through the day I start feeling sleepy again, so I don't know what happens next.

NARRATOR: But it's not just the fact that the drugs don't always work that plagues narcoleptics. Amphetamines are no good for anyone.

GAYNOR CARR: Dex-Amphetamine, it's speed and it keeps you awake, but it has horrific side effects as well. I twitch, I come out in sweats and I get paranoid and I get depressed and I've had anxiety attacks and panic attacks.

NARRATOR: For Gary the combination of narcolepsy and the drugs destroyed his life. His relationship with his girlfriend collapsed.

GARY BEATTIE: I would say in the last two years the relationship got really bad because no just during my sleeping problems, you know, the narcolepsy stuff, but because the side effects of the drugs. It killed my sex drive.

NARRATOR: Eventually, after seven years together, Gary's partner split up with him and their son Jason now lives with her.

GARY BEATTIE: She just found it was getting to the stage it was too hard to deal with because it was like looking after two children, Jason who was three at the time, he's now four, and myself. Miss him like crazy because from day one from when he was born I was with him 24 hours a day, 7 days a week and then she stopped me from seeing him. I feel very lonely, very, very lonely.

NARRATOR: For people like Gary there seemed to be no hope, but there was about to be another breakthrough. Once again it would come from a most unlikely source. It began with one of America's biggest problems: obesity. Stopping people from eating themselves into an early grave has now become a major area of scientific research. By chance, one of narcolepsy's great experts found himself right in the middle of this field. Having left his dogs, Tom Kilduff had gone off in an entirely new direction: the brain, and in particular, one small structure within it - the hypothalamus. It's the area responsible for controlling our appetites.

THOMAS KILDUFF: The hypothalamus is a control centre for many different physiological functions, one of which is the control of bodyweight regulation and food intake.

NARRATOR: Kilduff's aim was to find a type of chemical in the hypothalamus called a neurotransmitter.

THOMAS KILDUFF: A neurotransmitter is simply a chemical signal that one cell releases to communicate with another cell.

NARRATOR: Neurotransmitters are the signals our brain sends out to switch on and off all our various functions. Different neurotransmitters enable our brain to control our speech, our movement, even our emotions. To find a neurotransmitter that controlled our appetite would be a remarkable breakthrough in the fight against obesity. Kilduff decided to experiment with a new technique for finding neurotransmitters. He took special X-ray photographs of the brain. As the images started to develop something caught his eye.

THOMAS KILDUFF: I had certainly never seen anything like this before and I think it's fair to say that right away we knew we had gold, but we didn't know exactly what it was.

NARRATOR: To his surprise on his very first attempt Kilduff had found something completely new. On one set of X-rays he could see the clear trace of a neurotransmitter found only in the hypothalamus. He concluded it must have some vital role in regulating how fat we become.

THOMAS KILDUFF: This particular area of the hypothalamus was dead on the centre for the areas that have previously been shown to be involved in the regulation of bodyweight, so we thought we had found a molecule that was probably intimately controlled, involved in the control of bodyweight.

NARRATOR: Orexin, as Kilduff's new neurotransmitter was called, was hailed as the Holy Grail of the slimming industry. It would lead, many hoped, to an easy cure for obesity, but what no one realised, least of all Tom Kilduff, was that he had actually got closer than ever before to a breakthrough in understanding narcolepsy and also in cracking the mystery of sleep. Obesity is big business. Scientists all over the world were intrigued by orexin and its possibilities. Among the very first to get to work on it was Masashi Yanagisawa. He's a scientific investigator, a specialist in uncovering secrets about the human body. If there was going to be a major advance in obesity he was going to be part of it. His theory was that orexin must stimulate the appetite, so he decided to conduct an experiment. He bred a strain of mice with no orexin in their brain at all. If he was right then their appetite should be vastly reduced and they should become thinner.

DR MASASHI YANAGISAWA (University of Texas): So these mice, they don't have orexin, so our first expectation was that probably they will eat less. That was our hypothesis to be tested. We simply measure their food intake per day and lo and behold they ate less, so it was a very satisfying moment for us, initially at least.

NARRATOR: So it seemed his theory about orexin was true. It really was the switch for controlling appetite, but then he spotted something strange.

MASASHI YANAGISAWA: Despite their eating less, they tended to gain weight, which is paradoxical, but we immediately realised that what orexin is doing is a little bit more complex.

NARRATOR: It just didn't add up. Lack of orexin caused the mice to eat less, but they were getting fatter anyway, so he spent several days in the lab watching them. Were they doing anything especially unusual?

MASASHI YANAGISAWA: We looked at these mice very carefully in terms of behaviour. Is there any obvious abnormalities how they behave or, or how they eat, how they drink? We didn't see any abnormalities.

NARRATOR: So they decided to film the mice at night when they are more active. They set up special infrared cameras to record them. As they watched the footage they noticed something very odd.

MASASHI YANAGISAWA: This guy's very vigorously grooming himself and then all of a sudden he wobbles around a little bit and then his head is down, his body is bottom down and he became completely immobile, like this. He's just out there completely immobile as if he's dead, so we wondered what the heck is going on here. We initially thought that this must be some kind of seizure, epilepsy.

NARRATOR: So he measured their brainwaves looking for the tell-tale signs of epilepsy and the brainwaves did show the clear signature of a disease, but it wasn't epilepsy. The patterns were typical of a cataplectic attack. The mice had narcolepsy. It was an astonishing discovery. Orexin was not controlling obesity. In fact it was the first chemical in the brain directly connected to narcolepsy and so, perhaps, to sleep. For Tom Kilduff it was a moment laced with irony. He had devoted years to sleep research and he had made the discovery that could change everything. It was simply that he hadn't realised it.

THOMAS KILDUFF: The coincidence of that occurring was just… I don't know how to put it in words quite frankly.

NARRATOR: The news of orexin's link to narcolepsy bewitched the world of sleep science. The very first person to see the findings was Jerry Seigel, one of the world's great experts on sleep, at the University of Los Angeles.

JERRY SIEGEL: I felt like I was in some sort of B-movie because science doesn't really usually progress that way. It progresses incrementally and you think about things and you get ideas and here it was, this huge advance. We knew that this potentially could be of enormous importance and it was very exciting to think that we might be able to identify the cause of narcolepsy and all the wonderful things that would happen.

NARRATOR: So Siegel immediately began his own investigations. His aim was to establish precisely how Orexin worked in human narcoleptics and to see if any wider conclusions could be drawn about its role in sleep, so he began to compare the brains of narcoleptics to those of ordinary people.

JERRY SIEGEL: We really didn't know what to expect in the narcoleptic brains, but we suspected that there might be some damage to this kind of brain cell that creates the chemical orexin.

NARRATOR: First he took the hypothalamus of an ordinary person's brain and then slowly sliced through it, layer upon layer. Next he did exactly the same process with a narcoleptic's brain. Then he put slices from each brain onto slides and examined them under a microscope to make comparisons. As he looked at slices from deeper and deeper inside the hypothalamus he started to find the cells that make orexin in the normal brain. Then he compared it with slices from the narcoleptic brain.

JERRY SIEGEL: When we counted the orexin cells in the normal human brain we saw thousands of them, but when we looked at the narcoleptic brain the picture was totally different. We saw only 10% of the number of the normal brain and immediately when we saw this huge difference we realised that we had the cause of human narcolepsy.

NARRATOR: After decades of research, Jerry Siegel had found the answer. The brain cells that make orexin were almost entirely missing in narcoleptics and without orexin these people could not control their sleep. The cause of human narcolepsy had been found. For Gaynor, Gary and other narcoleptics the news that their condition has a clear medical cause has been a godsend. It means there is now a real hope that they can find a way out of their shadowy world. If lack of orexin causes their condition, then turning orexin into a drug could cure them.

GAYNOR CARR: If I was offered orexins I'd definitely say yeah. I'd leg it up there and grab it off them because that's what I've been waiting for.

BILL BAIRD: Would I take orexin? Yes, absolutely, yeah without any doubt. If it gave any hopes whatsoever of having some normal years, or months I'd take it.

NARRATOR: For Gary there is now a chance his world will be transformed. orexin may give him the opportunity to restart his life.

GARY BEATTIE: I'd be really, really keen to try it in respects that I've tried everything else, there's nothing else left. I'd be first in the queue I think.

NARRATOR: But the possibilities of orexin do not end there. Its implications go way beyond narcolepsy. Some now think it could change all our lives in ways we almost cannot imagine. Thanks to orexin our entire understanding of sleep has been transformed.

JERRY SIEGEL: The discovery of orexin and the discovery of its role in narcolepsy is, kind of fills a missing link in the story of sleep.

MASASHI YANAGISAWA: This series of discovery, the discovery of orexin itself and then the discovery that orexin's very important for sleep is my biggest moment in my entire career.

JERRY SIEGEL: All these elements came together all of a sudden, you know, almost like, almost like an atomic bomb. There, there was this critical mass and then there was this explosion of discoveries,

NARRATOR: As scientists studied orexin they began to work out exactly how it affects us. It seems that naturally we would always be asleep, but then orexin floods into our brains waking us up.

JERRY SIEGEL: Orexin controls a broad spectrum of wake promoting systems in the brain. It has direct connections to many different systems and it excites them very strongly and at the appropriate time orexin is released in higher amounts and this causes arousal.

NARRATOR: So orexin keeps you awake during the day. Without it you would fall instantly back to sleep, just as narcoleptics do.

JERRY SIEGEL: Orexin is able to activate all your arousal systems, so it's an important component of keeping you awake, keeping you alert and preventing you from having any lapses in attention.

NARRATOR: At night your body clock tells the hypothalamus to reduce the release of orexin. In turn, this signals to your brain to slow down and so gradually you go back to sleep. This discovery is the single biggest breakthrough in understanding the mystery of sleep. It seems we would never be awake without orexin. Finding a natural substance our body itself uses raises the possibility of making drugs that could keep us awake without any side effects at all. The implications are massive. The military were among the first to realise the potential of orexin. In war tiredness could be an enemy.

OFFICER DAVE TALARCZYK (US Army Helicopter Pilot): At the altitudes and the air speeds that we fly at your reactions have to be very quick.

NARRATOR: Pilots on long-distance bombing raids have to be constantly alert, often flying hour after hour, day after day, with little sleep.

DAVE TALARCZYK: We don't have any special devices that, you know that monitor you in flight to say hey, wake up bonehead, so what can happen is we just, we could, you know what they call C-FIT, controlled flight into terrain, you basically, you know you nodded off and you flew the helicopter right to the ground at 120 miles an hour, so you could pretty much figure out the end of that.

NARRATOR: Preventing pilots from falling asleep is a serious issue, but to date the military can only use the same drugs as narcoleptics, with all their problems.

PROF NEIL DOUGLAS (University of Edinburgh): Many military pilots already use amphetamines to stay awake and this is not ideal 'cos as well as producing wakefulness it also produces anxiety and jumpiness and could well lead to them firing missiles at an inappropriate time and the development of more specific wakefulness promoting agent, such as orexin, would be much preferable.

NARRATOR: Jumpy pilots can be extremely dangerous. They can attack innocent targets, even on their own side. The military has long sought a drug that can keep its flyers alert, but calm.

DAVE TALARCZYK: My personal opinion if we had some sort of a device, or a drug, that didn't have any sort of side effects that the aviator could take it say at a certain point along a mission that would enhance their state, their alertness, in my personal opinion that, I think that might be a good thing to have.

NARRATOR: It seems that orexin, if it could be made side effect free, could be the military's perfect drug and it may be that a drug that can keep people awake without any harm could spread far beyond the armed forces. If orexin can remove the need for sleep, then some think we may be about to enter an exciting new age. It could take us into a brave, new, non-stop world where every day we could have an extra eight hours to work and play.

JERRY SIEGEL: Now for me personally it would be great because I'm feeling a lot of pressure, a lot of things I want to do, so I can get that extra edge and get all these things off my desk.

NEIL DOUGLAS: It would obviously be attractive to many people to not lose eight hours a day being in bed asleep and they could enjoy themselves more, see their family more, or even work more if they wished.

NARRATOR: There could be serious uses for a drug like orexin. Surgeons need not break the critical flow of long, life-saving operations. They could stay alert for days on end. Emergency services and searches could be truly relentless, but perhaps for most of us the biggest change would come in our own day-to-day life.

NEIL DOUGLAS: And I think if orexins come on the market as a side effect free wakefulness producing agent they will be widely used and the biggest market probably would be shift workers.

NARRATOR: This is where the worries about orexin begin. Being able to work for long hours may not only be a good thing, it may also herald a world of relentless pressure.

JERRY SIEGEL: Obviously everybody ultimately has to be concerned about their own health and welfare and well the prospect of staying awake continuously may seem wonderful. The reality may be something different.

NARRATOR: The big fear is that orexin could be used to turn us all into automatons. The whole world could become one huge hive of worker drones.

NEIL DOUGLAS: I think the 24 hour society would be hell. I think people would get very fed up with constant encounters with other people and being pressurised to work 24 hours a day.

NARRATOR: Orexin, some think could lead our society onto a 24 hour treadmill of drudgery. This then is the paradox of orexin. To scientists it is a colossal breakthrough, a huge leap in our understanding of one of medicine's greatest mysteries: sleep.

JERRY SIEGEL: This is the biggest, most important finding that's been made in our understanding of sleep and in our understanding of sleep disorders.

NARRATOR: To narcoleptics, like Bill, Gary and Gaynor, Orexin may grant them their dearest wish, the thing they have most longed for: the chance of a normal life.

GAYNOR CARR: It's like going in for a competition and you've won the big prize. It's like, it could end it all, it could make a normal day-to-day life.

GARY BEATTIE: I would give my left arm, right arm, left leg, right leg just to find some sort of cure or balance that I can get on with my life and be some sort of normal person again.

BILL BAIRD: God, what life must be like without narcolepsy.

NARRATOR: But for the rest of us orexin could be about to alter our society beyond recognition. The nightmare may just be about to begin.