I knew I had a problem when I woke up in a Motel 6 in Fresno. I’d driven there from Los Angeles late the previous afternoon, barreling for hours through the Central Valley, its furrowed green farmland rippling out on either side of the interstate. Humid wind blew through the windows, heavy with the smell of fertile earth.
I checked into my room after dark and went straight to bed.

Fresno State University had invited me to appear on a panel at their annual writers’ conference – at least I remembered that much when I opened my eyes the next morning. Still bleary from a long night’s sleep, I had a harder time recalling the panel’s title – ‘The Memoir: Unforgotten Recollections of the Past’, or some such redundancy. In which direction was the lobby? I wondered. Where had I parked my car? Every moment of disorientation turned out to be temporary and could easily be blamed on the effects of waking up in a strange place. But the same couldn’t be said of what happened next.

As I sat up in bed, I heard a faint rustling and looked down to see dozens of foil and paper wrappers cascade off my chest and land in my lap. Cookie crumbs had gathered in the folds of my T-shirt. Around me lay several half-eaten crackers and a cube or two of Cheddar cheese. Gummy bears were strewn across the blanket like colorful, rubbery carnage.

My heart started racing. It was as if someone had snuck into the room while I’d slept and smashed a piñata above the bed. I scanned the room for evidence of an intruder – the year was 1996 and ‘home invasion robberies’ had started making national headlines – but the door to my room was closed and bolted, and the placard requesting privacy please, in both Spanish and English, dangled from the knob. My wallet lay untouched on the nightstand along with my car keys, eyeglasses, an amber vial of Ambien and the book I’d been reading. Nothing had been disturbed except for me. I considered calling the front desk, though exactly how to phrase my complaint presented a challenge: pretty much any words I chose ­– I’m in room 103, covered in crumbs! – would make me sound crazy.

As I sat there, baffled, an image slowly formed in my mind, perhaps a scene from a dream I’d had the night before.

I’m standing at the intersection of four long hallways. Before me rises a monolith that glows from within. I stare through its huge glass window at metal coils arranged in rows like the innersprings of a luminous mattress. One of the coils corkscrews toward me, pushing before it a foil-wrapped package that drops into a shallow trough near my knees and lands with a thud. The sound fills me with satisfaction; I want more thuds. I press a bunch of numbered buttons and another coil begins to turn, and still another, the bounty piling up.

The shadowy figure of a man approaches. We exchange a few words. Paper money is traded for coins. I quickly pivot back toward the machine, but my face now burns with embarrassment; I’ve been dressed in boxer shorts and a threadbare T-shirt this whole time.The man who gave me change is gone, but he’s left me with the realization that my dream is peopled. While shoving quarters into the slot, I become dimly aware of comings and goings along the corridors. At the rounded sound of a nearby bell, several strangers walk out of the wall. Although some remote part of me realizes that the phenomenon of people emerging from the wall can be explained by the word ‘elevator’, the word is elusive and, once I’ve found it, hard to retain. Still, none of this is alarming enough to send me scurrying back to my room; that people rise and descend inside a box is a fact that belongs to the physics of my waking life, about which I seem to possess a faint knowledge. What is alarming is how the people who land in the hallway turn and glance at the holes in my T-shirt, at my hairy legs and bare feet. I attempt, with great effort, a nonchalant smile. I can barely keep hold of all the junk food gripped in my fists.

Back in Los Angeles, I told myself that my raid on the vending machine was an anomaly. I didn’t bother mentioning the incident to my partner, Brian, though he was a psychotherapist and no stranger to aberrations in human behavior. Before I’d left for Fresno, there’d been a precipitous drop in his T-cell count (he was HIV-positive and I was HIV-negative), edging him closer to a diagnosis of full-blown Aids, and so, in the larger scheme of things, my having gorged on Gummy bears hardly seemed worth his concern.

My tale of gluttony might also have been an unpleasant reminder to Brian that the primary symptom of his failing immune system was his growing inability to metabolize food, no matter how much he ate, no matter how rich or frequent his meals. We’d learned of the difference in our HIV status in 1986 – two years into our twenty-three-year relationship – soon after the HIV antibody test became available and national trials were being planned to determine the efficacy of a promising new drug called azidothymidine, or AZT. We’d discussed at length the risks involved in Brian’s decision to try and become a participant in the trial. He had majored in psychology and minored in statistical research; he believed that his grasp of the methodology behind ‘blind’ scientific studies would render him a candidate able to articulate the effects of AZT in both medical and anecdotal terms, which in turn would give him a slightly better than 50/50 chance of not only being chosen for the study, but of being placed in the control group who received the drug instead of a placebo.

He was right on both counts. Waves of nausea offered him reassurance that he was ingesting the real thing, as did the neuropathy that stung his hands and feet like needles. In a world turned inside out, side effects were a harbinger of hope. Knowing that he would be called upon to describe these side effects allowed him a kind of dominion over their existence; he had to stand outside of himself and assume the observant, clinical distance he practiced when listening to his clients. This obliged Brian to find words for what might otherwise have been a kind of misery he could neither name nor escape. By 1987, the Center for Disease Control estimated that, in the United States, 50,352 Aids cases had been reported and 40,849 deaths had occurred.

What no one involved with the AZT study could have foreseen was that the high dose prescribed to Brian’s cohort resulted in all sixty men developing a resistance to the drug, which the virus rapidly mutated to reject. It was learned in a subsequent trial that AZT is effective only when administered at lower doses and in conjunction with other drugs, the combinations of which had to be switched like shells in a shell game in order to constantly trick the virus. During the trial, the tissue lining Brian’s intestinal walls had been damaged, which meant he then absorbed fewer nutrients from food. Unable to benefit from the drug cocktail or reverse the effect on his intestines, Brian’s wasting became difficult to stop. The lower his T-cell count, the more weight he lost, as if the absence of the cells themselves was measurable on a bathroom scale. At five foot nine, Brian had been 135 pounds when we’d first met at a local bar, and although he’d jokingly referred to himself that night as a ‘runt’, I saw his remark for what it was: a ploy to elicit the compliments I was glad to offer if they paved the way to sex. I told him I’d never met a runt with such well-developed pecs and biceps. Now veins became prominent on his calves and forearms. His collars grew roomy, his belt loops too few.

I hadn’t sidestepped the Fresno story solely to spare Brian’s feelings. That night of snacking nagged at me with its utter surrender to impulse. I hadn’t consciously made the decision to leave my room and look for food, and for the first time in my life I imagined the shock and indignity a somnambulist might feel when he wakes up and finds himself somewhere other than where he went to sleep, suddenly confronted with the understanding that his urges have a life of their own. The bout of morning amnesia had particularly unnerved me, reliant as I am on memory in my writing; the sheer amount of food I’d devoured was proof of a powerful craving I’d obeyed yet couldn’t recall. Still, no matter how hungry I might have been, I’m too shy a person to walk into a public place wearing boxer shorts and a tattered T-shirt (a shirt I couldn’t bring myself to throw away because its over-laundered softness held the very promise of sleep), though neither am I the kind of person who’d have to put on dress shoes before fleeing a burning house. I suspected that Ambien might have played a role in all this, but at that point I’d been taking it regularly for over a year and had enjoyed a run of predictable, restorative sleep without any episodes of nocturnal binging. In the end, the simplest explanation for what happened at the Motel 6 seemed to be this: disinhibited by a sleeping pill, I’d gone in search of something to eat, having found myself far hungrier after the long drive than I’d realized.

My doctor, after all, had instructed me not to take Ambien with food. The drug’s active ingredient, zolpidem tartrate, is absorbed into the bloodstream through the stomach, so the emptier one’s gut, the faster the medication works. I’d been fairly disciplined about not eating close to bedtime because I wanted the drug to metabolize as quickly as possible; I’ve experienced chronic insomnia since my late twenties, and I was never the kind of stayer-awake who could make those late hours productive by doing the laundry, say, or paying bills. Instead, I’d lie there and worry about how groggy and out of sorts I’d be the next day.

Under the influence of Ambien, however, I was knocked unconscious by what I’d come to think of as the chemical equivalent of a velvet sledgehammer. I could be turning the last, engaging pages of a novel, or watching a forensic expert on TV explain blood-spatter patterns from a double homicide, when the need to sleep abruptly trumped every reason to stay awake.

Ambien doesn’t work for everyone, but for the 26 million who make it America’s most prescribed sleeping aid, its effectiveness is unequivocal. It acts as a central nervous system depressant and within about twenty minutes of ingestion, it relaxes muscles and slows brain activity by increasing gamma-aminobutyric acid, a naturally occurring neurotransmitter in the brain that inhibits messages between other neurotransmitters. It allows me to turn off the whirring thought-machine – an occupational hazard for many writers – and to stop strip-mining the day’s events, images and snippets of conversation for potential insights into human nature in general, or my own nature in particular, all the while wondering how I might make use of these ruminations in my work. Consciousness may be sublime, but it’s also exhausting. Six hours later, Ambien’s targeted molecules are flushed from the bloodstream, which is why relatively few users experience fogginess or lingering fatigue the next morning.