Thursday, October 25, 2007

Sleep Deprivation

It sickens me that not only physical torture but also psychological torture of sleep deprivation, sensory deprivation (the hoods), and isolation are used by our government. To everyone who has gone for long stretches without sleeping with all the loss of judgement that goes with it, this article in Psyciatric Times is an interesting one as you are not alone:
When sleep deprivation becomes great enough, the effects mimic those of psychosis. The failure of the scientific world to recognize this is due to some extent to the folklore that has grown up around the sleepless marathon of high school student Randy Gardner in 1964.

To gain an entry into the Guiness Book of World Records, he remained awake for 264 hours (11 days). Summaries of this case usually report that Gardner suffered no hallucinations, no paranoia or other negative mood changes, and that his mental, motor and sensory abilities were quite good throughout the entire episode. This conclusion is so widespread that it has now become a stock "fact" presented in virtually any psychology or psychiatry book that has a chapter on sleep.

This conclusion seems to be based on two items of information. The first was the observation that there were no obvious lasting physical or mental problems encountered by Gardner when he began to sleep again. The second was based upon observations of researcher William Dement (Dement, 1992), who interviewed Gardner on Day 10 of the experiment. He reported that he took Gardner to a restaurant and then played pinball with him, noting that Gardner played the game well and even won. Lt. Cmdr. John J. Ross of the U.S. Navy Medical Neuropsychiatric Research Unit in San Diego, who was called in by Gardner's worried parents to monitor his condition, tells a quite different story (Ross, 1965). Gardner's symptoms that Ross reported included:

Day 2: Difficulty focusing eyes and signs of astereognosis (difficulty recognizing objects only by touch).

Day 3: Moodiness, some signs of ataxia (inability to repeat simple tongue twisters).

Day 4: Irritability and uncooperative attitude, memory lapses and difficulty concentrating. Gardner's first hallucination was that a street sign was a person, followed by a delusional episode in which he imagined that he was a famous black football player.

Day 5: More hallucinations (e.g., seeing a path extending from the room in front of him down through a quiet forest). These were sometimes described as "hypnagogic reveries" since Gardner recognized, at least after a short while, that the visions were illusionary in nature.

Day 6: Speech slowing and difficulty naming common objects.

Day 7 and 8: Irritability, speech slurring and increased memory lapses.

Day 9: Episodes of fragmented thinking; frequently beginning, but not finishing, his sentences.

Day 10: Paranoia focused on a radio show host who Gardner felt was trying to make him appear foolish because he ws having difficulty remembering some details about his vigil.

Day 11: Expressionless appearance, speech slurred and without intonation; had to be encouraged to talk to get him to respond at all. His attention span was very short and his mental abilities were diminished. In a serial sevens test, where the respondent starts with the number 100 and proceeds downward by subtracting seven each time, Gardner got back to 65 (only five subtractions) and then stopped. When asked why he had stopped he claimed that he couldn't remember what he was supposed to be doing.

In many respects Gardner's symptoms were similar to those experienced by a New York disk jockey, Peter Tripp, who endured a 200-hour sleepless marathon to raise money for the March of Dimes. During the course of his ordeal his thoughts became increasingly distorted and there were marked periods of irrationality. By the end of four days he could not successfully execute simple tests requiring focused attention. In addition, he began to have hallucinations and distorted visual perceptions. At one point Tripp became quite upset when he thought that the spots on a table were insects. He thought that there were spiders crawling around the booth and even once complained that they had spun cobwebs on his shoes.

He showed the same increasing moodiness and paranoia that Gardner did. On his last day, a neurologist was called to examine Tripp before sending him home. When Tripp looked up at this doctor in his dark, old-fashioned suit, he had the delusion that the doctor was really an undertaker who was about to bury him alive. Overtaken with fear, he let loose a scream and bolted for the door. Half-dressed, Tripp ran down the hall with doctors and psychologists in pursuit. He could no longer distinguish the difference between reality and nightmare.

This same pattern of mental deterioration that mimicks psychotic symptoms appears in several more systematic studies of sleep deprivation and extreme sleep debt. Thus, prolonged sleep deprivation does lead to the appearance of serious mental symptoms. In addition, even moderate amounts of sleep deprivation can lead to losses in mental efficiency that can threaten public and personal safety.

William Dement is regarded as the expert on sleeping and he was so wrong on this aspect. One has to question his reliability when he says that schizophrenics have the same sleep and REM patterns as normals.


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