The following version of this book was used to create the guide: Russell, Karen. Sleep Donation. Vintage Books, 2020.

Karen Russell's dystopian novella Sleep Donation is written from Trish Edgewater's first person point of view, and in the present tense. The narrative is divided into 24 titled chapters, and progresses in a largely linear fashion. Disruptions to this structure appear in the form of expositional passages, and passages of flashback. The following summary adheres to a linear mode of explanation.

Trish Edgewater grows up with an older sister named Dori. Ever since her youth, Dori has been an insomniac. For many years, Dori's insomnia is treatable with medication. Then, when she turns 20, her body stops responding to the medications. For a time, she can sleep no more than three or four hours at a time. Over the years, her condition worsens. She eventually dies of organ failure after over 20 days without sleep.

Not long afterwards, an insomnia epidemic sweeps the nation. A wealth of experts attempt to rationalize and confront the issue. Other members of the American population contest the veracity of the condition altogether. Then, brothers Jim and Rudy Storch found the Slumber Corps. The organization works to recruit donations from healthy sleepers. These donations are transfused to ailing insomniacs in order to save their lives.

After demoting themselves to mere supervisors, Jim and Rudy appoint Trish as one of their first recruiters. Over the years, the brothers laud Trish as the best Corps recruiter. Trish is proud of these accolades, and devotes herself entirely to her work. Her secret is to use the story of Dori's death in her recruitment pitch to secure new donors. Because she has never allowed herself to confront and heal from her sister's passing, Trish's grief remains raw, omnipresent, and convincing.

One day during a sleep drive, Trish meets Justine Harkonnen, and convinces her and her husband, Felix, to start donating their baby's sleep to the Corps. The baby is known as Baby A, and is just over six months when the Corps begins taking draws of her sleep.

The more involved Trish becomes with Baby A and the Harkonnens, the more conflicted Trish feels about her work. The emergence of Donor Y similarly challenges Trish's ethical code. Donor Y is an anonymous donor who inadvertently donated hours of sleep infected with terrifying nightmares to a local sleep bank. In the weeks and months following his donations, innumerable insomniacs are infected with Donor Y's nightmare. The cure suddenly appears worse than the insomnia disease. Trish is particularly disturbed by Donor Y, because she notices similarities between what he has done and the work she does. She begins questioning her pitch, and the way she has been exploiting not only Dori's story, but Baby A's innocence.

One night, Felix picks Trish up and takes her to a local Night World. The Night Worlds are tent communities where insomniacs gather to talk and drink. During their time at Night World, Trish experiences a series of revelations. In the weeks following, she revises her pitch, and decides to report Jim for illegally selling Baby A's sleep to an overseas lab. Though she knows this decision might halt scientific progress associated with curing chronic insomnia, Trish knows she has acted from her conscience.