Dr. Arthur J. Spielman passed away on July 25, 2015, leaving his family and the entire sleep community bereft of a singularly compassionate and intellectually-engaged individual. While nearly all researchers and practitioners will know his name, if only from their studies in insomnia, a surprising percentage would also say they have lost a dear friend. This is perhaps the best measure of Art's wondrous knack for connection. He had an intuitive sense of the collegial foundation of science, and would enliven our conference proceedings with his presentations and astute questions just as gracefully as he brightened the social gatherings that followed.
Dr. Arthur J. Spielman, PhD
Dr. Arthur J. Spielman, PhD
Art was awarded a BA in Psychology from City College of New York in 1970 and went on to obtain his PhD from the Doctoral Program in Clinical Psychology of the City University of New York (CUNY) in 1979. Two years later Art joined the Cognitive Neuroscience faculty at CUNY, and so began a teaching career at that institution spanning nearly 35 years. From 1990 he was Professor in the Department of Psychology. Art was also a founding staff member of the Montefiore Sleep-Wake Disorders Center, among the first two clinical sleep disorders centers in America. In 2001 he became associated with the Weill Cornell Medical College Center for Sleep Medicine, from 2009 serving as its Co-Director.
Art's professional career could certainly be represented by the commendations and awards he received, culminating in the Outstanding Achievement Award of the Sleep Research Society, bestowed at the 2015 Annual Meeting of the APSS. It could be indexed by his more than fifty papers and book chapters, his dozens of committee memberships, the many clinicians and researchers he mentored and the fifteen journals for which he served as a reviewer. Yet perhaps Art's main legacy is that he fundamentally changed the way clinicians think about insomnia, and then followed up by changing the way they treat it.
The initial challenge Art faced was a profound disconnect between how insomnia is perceived by the sleepless as compared to by their doctors.
Sleep disturbance was and indeed remains a mystery to most people with chronic insomnia. Heedless and even mocking of concerted efforts to attain repose, sleep seems rather to show up at random. The upshot of this capriciousness is that often patients just throw up their hands and improvise in terms of bedtimes, oversleeping, medications, naps and other sleep-related choices.
For most doctors, however, insomnia was roughly as interesting as a cough or a rash—that is, a symptom of something else such as depression or thyroid dysfunction. It was an invitation to look deeper to see “what's really the matter.” When Art attended the first NIH Consensus Conference on Insomnia in the early 1990s, he and other specialists were not able to alter this prevailing view.
By that time, however, Art had already published a model of insomnia of growing impact, which posited the disorder at the confluence of well-delineated Predisposing, Precipitating and Perpetuating Factors. Spielman's 3P Model (1986) drove home the point that insomnia has a life of its own, and that even if Predisposing Factors such as depression were successfully treated, Perpetuating Factors such as newfound anxiety over going to bed or compensatory napping could maintain the sleep disturbance indefinitely. No longer merely a symptom, insomnia became a comorbidity demanding specialized attention. This revision has been repeatedly confirmed and extended, and Art had the satisfaction of attending a second Consensus Conference twenty years after the first where his view was finally endorsed.
The 3P Model has guided insomnia research and clinical practice for three decades; standing alone it could have signaled an accomplished professional life. Yet the very next year Art and two colleagues published a paper showing how chronic insomnia responded to the very counterintuitive notion of restricting time in bed. Sleep Restriction Therapy has already benefited tens of thousands of patients as a core component of Cognitive Behavioral Treatment for Insomnia. With the advent of group and internet-based CBT-I therapies, it holds the promise of helping millions more attain better sleep.
We mourn Art's untimely loss and send our condolences to his wife Marlene, his sons Evan and David and his three grandchildren. Yet we are also heartened that Art lived to see such fruits of his work, and spurred to emulate his expansive thinking and professional generosity.