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The inmates of Litchfield Penitentiary, the fictional setting for the Netflix TV series Orange is the New Black, are not shy women.
They've landed in prison for murder, fraud, stalking, drug-smuggling, theft, and political activism. They do illegal activities behind the officers' backs. They make their opinions known loud and clear to one another. And they're not opposed to throwing a few punches, if duty calls.
But all will cease if you threaten to send them to the SHU. Why?
The SHU (pronounced "shoe"), or "security housing unit," is a separate prison facility designed to isolate inmates from any human contact. While sometimes used to protect the prisoner from harm by others or to themselves (to implement suicide watch, for example), it's often used as punishment for violating prison regulations. At last count, it's been estimated that over 80,000 prisoners in the U.S. are housed in the SHU - more than any other democratic country. And while inmates in minimum security may be held in the SHU for a few days at most, those in maximum security prisons can be in solitary for as long as five years.
Although there's no single agreed-upon definition of solitary confinement, the United Nations describes it as any routine where prisoners are held in small cells for at least 22 hours a day under constant video surveillance. The cramped, concrete cells, often just 6 x 10 feet, are constantly illuminated by fluorescent light and contain a bed, sink, toilet, and not much else. Except for prison guards, inmates are intentionally deprived of other people and stimuli, including television, radio, and perhaps no more than a few books. "The only thing left to do is go crazy-just sit and talk to the walls," a juvenile detainee in Florida was quoted, describing their time in the SHU. "Sometimes I feel like, ‘why am I even living'?"
Humans are social animals. We feel safer and happier in the company of others, seek friends and family for company and solace, and desire acceptance, friendship, and love. Our neocortex, the outermost layer of our brain, is comparatively larger than that of other primates and implicated in conscious thought, language, emotional regulation, empathy, and higher social cognition.
So it's no wonder that psychologists and human rights advocates consider solitary confinement one of the worst possible forms of psychological torture. In simple terms, the SHU "destroys people as human beings," according to psychologist Terry Kupers.
Literature reviews published in the last decade associate prisoner isolation with anxiety, panic attacks, depression, anger and hostility, poor memory and disorientation, and self-harm. With so much time spent alone, individuals become prone to hallucinations-particularly seeing people or hearing voices that aren't there-paranoid thoughts, and distorted sensations, like perceiving the walls closing in on them. Of course, these mental health problems are often exacerbated by the fact that mentally ill patients are more likely to end up in the SHU in the first place. As ruled in Ruiz v. Johnson (2001), "[Solitary confinement] units are virtual incubators of psychoses-seeding illness in otherwise healthy inmates and exacerbating illness in those already suffering from mental infirmities."
There's also evidence suggesting that solitary confinement results in increased recidivism, perhaps due to lingering mental illness; more likely, though, the punishment does nothing to correct bad behavior. It's estimated that 24.2% of prisoners in solitary are later reconvicted of a violent crime compared to 20.5% of general population prisoners.
Long-term effects of solitary confinement likely depend on the individual and the type and duration of their experience. No follow-up studies, however, have been conducted on formerly isolated prisoners following their prison release. Many acute effects of solitary confinement are thought to subside over time, though psychiatrists have speculated that difficulties in social interaction, maintaining interpersonal relationships, and reintegrating oneself back to the "real world" persist as a result of long periods of solitary confinement. Other studies have reported sleep disturbances, depression, phobias, emotional dependence, and impaired memory and concentration years after release from similar types of isolated environments.
At the end of Orange is the New Black Season 3, we see a major character being led to the SHU by three guards, where she'll stay for an indeterminate amount of time "for her own protection."
We haven't yet gotten to know any characters who have spent long periods of time in solitary, but I'm willing to bet we'll see some unpleasant aftereffects when Season 4 premieres next year.
I recently wrote about the terrible sleep habits of the characters in House of Cards. I disapproved of Frank Underwood's late-night computer work in the Oval Office, his new midnight iPad gaming habit, and Claire taking her laptop to bed with her.But I must confess my hypocrisy.
Despite my preaching - and despite being a sleep researcher myself - the last thing I do before I flip off the lights and snuggle into my bedsheets is play games on my iPhone.
I know, I'm bad - but I also know I'm not the only guilty person here.
Although evidence suggests that the blue light emanating from phones, tablets, laptops, televisions and e-readers can affect the quality of our sleep - in turn affecting our health and well-being - many of us can't help logging in and tapping away when we should be winding down. A Time/Qualcomm poll of 5,000 people worldwide suggests that nearly a quarter of those between the ages of 18 and 24 generally don't sleep as well because of technology. Even worse, 40-75% of folks across all age groups report keeping their phones within reach while they sleep at night.
But there might be a solution. Earlier this month, orange-tinted glasses, or "blue blockers," were touted by the New York Times as a good option for those who simply can't avoid technology before bed.
As a concerned scientist, I decided to do an experiment on myself. I hopped onto Amazon, bought an $8 pair of orange glasses, and formulated my research plan. Without changing any of my other habits, would wearing these glasses an hour before bed improve the quality of my sleep?
Blue light and the brain
Near the center of our brain, tucked between the folds of an important brain structure called the thalamus, we have a small endocrine gland called the pineal gland. When light-sensitive cells in the eye's retina detect light, a signal is sent to a tiny region called the suprachiasmatic nucleus, which is important for synching our bodies with nature's 24-hour light/dark cycle. Nerves from the suprachiasmatic nucleus then travel through several different tracts and eventually reach the pineal gland. At night time, when it's dark, the pineal gland is activated to produce a hormone called melatonin, which promotes feelings of sleepiness.
Although all wavelengths of light suppress melatonin production, the pineal gland is particularly sensitive to light in the blue range (460-480 nanometers). In a 2006 study by Steven Lockley and Harvard colleagues, 16 healthy adults were exposed to 6.5 hours of either blue or green light. Compared to green light, blue light exposure suppressed melatonin production for more than twice as long (90 versus 40 minutes). Blue light was also associated with decreased feelings of sleepiness and decreased delta ("slow-wave") brain activity while awake, suggesting that blue light enhances alertness both subjectively and objectively.
Unfortunately for us, the alluring glow of our devices is primarily composed of blue light - and it's estimated that 95% of Americans use one of these devices at least one hour before bedtime. In December, Penn State University professor Anne-Marie Chang and Harvard colleagues reported that, compared to reading a paper book before bed, iPad use increases the time it takes to fall asleep, decreases rapid eye movement (REM, or dreaming) sleep and decreases feelings of sleepiness in the evening as well as alertness the next morning.
So how can we block out the blue? In 2009, a pair of doctors at Samaritan Health in Oregon had 20 volunteers try either blue-blocking (amber) glasses, or yellow-tinted glasses (the control group, which only blocks ultraviolet light). Compared to controls, those who wore amber glasses for three hours before bedtime reported increased sleep quality and enhanced overall mood.
In a similar study published in January, Stéphanie van der Lely and colleagues in Switzerland studied 13 teenage males who used LED screens before bedtime. Wearing blue-blocking glasses for two weeks, compared to clear lenses, significantly increased melatonin production in the evening and decreased alertness before bedtime. Their EEG sleep study, however, yielded no differences in sleep stages between the two groups.
My experiment

On a typical workday, I go to bed at 11:30pm and set my alarm for 7:30am, so I did my best to adhere to this strict schedule for two weeks for my experiment. During the first week, I recorded baseline data. In the second week, I donned my glasses for one hour before bed, but otherwise engaged in my normal night time routine of TV-watching, phone-browsing, reading, and kitty playtime.
I collected data in two ways. For objective data, I wore my Fitbit Flex, a wireless activity tracker that tells me how long I sleep and how many times I'm "restless" throughout the night. Devices like Fitbits and research actigraphs tend to overestimate total sleep time and misidentify "wake" as "sleep" compared to standard sleep measures. But reliability is still high for Fitbit (97-99%), meaning that even if my data are not as accurate as that from a sleep lab, I can still trust that the device is measuring my sleep consistently from night to night.
I also recorded subjective (self-reported) data. While the average scientist may put more focus on objective data, subjective reports are equally important in the field of sleep medicine. After all, these are a major component of how insomnia is diagnosed.
Week 1 vs. Week 2

Wearing orange-tinted glasses for an hour before bed increased my total sleep time by an average of 20 minutes per night (425.8 vs 446.0 minutes, on average) in Week 2. This difference, however, is not statistically significant. The p-value was 0.20, meaning that I would expect any differences between Week 1 and Week 2 to be due to random chance 20% of the time, which is too high. Typically, we like to see a p-value of 0.05 or less to feel reasonably confident about our test groups being different. Performing more trials (in other words, exposing myself to each condition for more than seven days each) would likely reduce my night-to-night variability in sleep time, thus lowering the p-value.
I then analyzed the Fitbit data for the number of times I was recorded as being "restless." While I was restless an average of 15.3 times each night during Week 1, this dropped to an average of 11.4 times per night when I wore my orange glasses for an hour before bed. This was a statistically significant difference, as the p-value was equal to 0.05.

Subjectively, I felt that I slept better on nights when I wore my glasses before bed. I typically find myself waking on and off between 5:30am and 7:30am, but on days when I wore my glasses, I didn't wake until 7am. Most of my notes also indicate that I felt more refreshed on awakening during week two. Of course, I knew what I what test condition I was experiencing and what I "should" expect from each - so I cannot be objective in my interpretation of these data.
Orange-tinted glasses aren't the miracle cure for the world's sleep deprivation woes, of course. But if you're looking for a simple way to potentially improve the quality of your sleep, there's no harm in giving them a try. They're inexpensive, and sleep aids like melatonin supplements are shown to lose their effectiveness over long-term use, nor has their long-term safety been tested. There are also computer programs like f.lux and phone apps like Twilight to block the blue light from your screens during evening hours, and you can even purchase blue light screen filters for your devices.
But everybody is different. If you have persistent, troublesome sleep problems, consider seeing a sleep medicine specialist. Or you can just exercise self-control (unlike me) and avoid blue light-emitting electronics before bedtime. Or, like me, test out a pair of orange glasses.
Hodor hodor hodor. Hodor hodor? Hodor. Hodor-hodor. Hodor!
Oh, um, excuse me. Did you catch what I said?
Fans of Game of Thrones, the fifth season of which premieres this Sunday, know what I'm referencing, anyway. Hodor is the brawny, simple-minded stableboy of the Stark family in Winterfell. His defining characteristic, of course, is that he only speaks a single word: Hodor.
But close readers of the Song of Ice and Fire books from which the TV show sprung may know something that fans of the show don't: his name isn't actually Hodor. According to his great-grandmother Old Nan, his real name is Walder. "No one knew where ‘Hodor' had come from," she says, "but when he started saying it, they started calling him by it. It was the only word he had."
So what can account for Hodor's incessant Hodor-ing? Whether he intended it or not, George R. R. Martin created a character with a textbook example of a neurological condition called expressive aphasia.
The condition dates back to the French physician Paul Broca. In 1861, Broca was introduced to a man named Louis-Victor Leborgne. While his comprehension and mental functioning remained relatively normal, Leborgne had progressively lost the ability to produce meaningful speech over a period of 20 years. Like Hodor, the man was nicknamed Tan because he only spoke a single word: Tan.
Just a few days after meeting Broca, Leborgne passed away. Broca's autopsy found a lesion in the frontal lobe of Leborgne's left brain hemisphere, just next to a brain fold called the lateral sulcus. Over the next two years, Broca acquired brains from 12 more patients with Leborgne's symptoms, and found strikingly consistent damage in that area.
Neuroscientists are still examining this small region of the brain, now often referred to as "Broca's area," in an attempt to work out its many functions. While most research has focused on a patient's inability to form syntactically complex sentences when this area is damaged, more recent work using functional magnetic resonance imaging (fMRI) has also reported that Broca's area is active during language comprehension tasks, interpretation of movement, and comprehending various gestures also associated with speech, such as waving good-bye.
In collaboration with French scientists in 2007, a group at the University of California used magnetic resonance imaging to revisit the brains of Leborgne and Lelong (another of Broca's patients who could only speak five words). One of their most interesting findings was that their lesions extended much deeper than Broca had reported, suggesting that multiple brain regions were probably contributing to their profound speech deficits.
This evidence of widespread damage is unsurprising. Leborgne, Lelong - and even Hodor - are actually more extreme examples of individuals with expressive aphasia. More commonly, a person with the disorder will express themselves in "telegraphic speech," which usually comprises three or so words, including a noun and a verb. For example, someone may say, "Anne, dog, walk" to mean "I walked the dog with Anne today."
The most common cause of expressive aphasia is stroke, which occurs when a blood clot blocks a vessel in the brain, resulting in tissue damage due to a lack of oxygen. It's estimated that expressive aphasia occurs in 12 percent of stroke patients, while roughly 35 percent of stroke patients suffer from a language aphasia of some form.
Expressive aphasia can also be caused by a tumor, a hemorrhage, a hematoma in the membrane covering of the brain, or trauma to the head. It has been reported that Leborgne suffered from epileptic seizures as a child - some have speculated that he may have experienced head trauma during one such episode.
So what's Hodor's story? Did he sustain a blow to the head, suffer a stroke, or was he simply a giant baby dropped by his mother? Martin hasn't offered any hints to readers or viewers.
So while Hodor may only speak one word, he may have just as interesting a backstory as the other characters in Martin's epic.
