Matt Sinclair: “Goodnight Wolfgang. Sleep well.”
Wolfgang has taken a small white pill. In about an hour he’ll begin to lose consciousness. Gradually, his brain waves will warp into a succession of strange patterns. As the hours pass, periodic paralysis will grip his muscles so completely that he won’t be able to move. Vibrant hallucinations, some terrifying and some pleasant, will fill his altered consciousness; and his eyes will follow the vivid scenes as if he were watching a movie. The drug which he has taken is only a mild sleeping pill. Wolfgang is going to sleep, and here at the Navy’s sleep laboratory in Balboa Hospital, we have come to observe his complex odyssey through the night.
Cheryl Spinweber: "After two nights without sleep, it looks Iike that 4 to 6 a. m. nap is nothing."
I’ve come in order to learn more about sleep research. This San Diego facility should be a good place to start; it is the biggest sleep research lab in the U.S. defense department, and one of the most productive sleep labs of the forty or fifty now operating in this country. It was founded in 1960, which was early in the annals of sleep research. Although humans have roamed this planet for almost 100,000 years, and have undoubtedly slept through a third of that time, serious study of sleep only began in the 1950s. Even today, sleep research is a vast frontier containing huge expanses of unexplored wilderness, and this Navy lab was one of the first outposts of exploration.
Next he swiftly glues nine electrodes attached to wires, one by one, to precise points on the scalp.
The Navy actually has two sleep facilities in San Diego; these simple quarters in one dingy building of Balboa Naval Hospital in the park, plus additional rooms squirreled away near the lighthouse on the top of Point Loma. The hospital-based lab concentrates on research relating to people with sleep problems, while researchers at the Point Loma lab use normal sleepers as subjects in experiments relating to such things as sleep loss, naps, fragmented sleep, and so on. The Point Loma lab is quiet this month (work will probably begin again there in September) but the hospital lab is working at the moment on a major research project. It focuses on a drug named triazolam; its brand name will be Halcion when it appears (any day now) in drug stores. Cheryl Spinweber wants to know what it does to the sleep of young enlisted men like Wolfgang.
The polygraph holds a spool of unwinding paper; on it eight pens capture in ink the signals racing through the resting subject.
Spinweber has a doctorate in psychology and she’s directing the drug study. A petite twenty-nine year old with a teenager’s voice, she wears wire-rimmed glasses and long blond hair and she pads around the lab in the wee hours in jeans, thongs, and a T-shirt. She drinks a lot of coffee, smokes a lot of Viceroys, and she can lucidly explain why it makes sense for the Navy to spend money to study Halcion. She points out that in any population, a significant percentage of people have trouble sleeping (most estimates say ten percent of the general population), plus Navy life harbors some special sleep hazards. “A lot of things about the work environment screw up your normal sleep cycle: being on watch all night, being flown across country, being a pilot and flying back and forth across time zones. So there’s a lot of reasons why these people might want to take a sleeping pill. The question is: what sleeping pill is the best one to take?” The San Diego lab has already uncovered some important information about Dalmane, the most widely prescribed sleeping pill in America: it puts people to sleep, but it leaves users seriously “hung over”; they feel groggy and their reflexes can be impaired. (Thus it’s not something a pilot would want to take the night before flying.) Halcion (like Valium and Librium) is a chemical relative of Dalmane, only it disappears from the body more quickly, so now the sleep researchers want to know if it also packs less of a hangover.
Spinweber’s subjects in this study (twenty will be used in all) are volunteers drawn from the Navy’s medical corps school. All are poor sleepers selected from the results of a sleep questionnaire and an interview. Wolfgang, for example, is a burly, stolid twenty-three year old who’s been tormented by insomnia for as long as he can remember. Yet Spinweber won’t simply accept his haggard assertion of sleep frustration. Some people who complain (sincerely) about a lack of sleep overestimate both the time it takes them to fall asleep and the poorness of their sleep, according to Spinweber. (Sleep researchers have even found many tortured individuals who only think they’re insomniacs — people who are genuinely dumfounded when the results of the sleep lab show them to be sleeping eight hours or more per night. Sometimes this revelation alone can help such sufferers.) To sort out the real non-sleepers, Spinweber and her assistants first test subjects in the lab; on Wolfgang’s first night it took him two hours to fall asleep.
Wolfgang will spend twelve consecutive nights here. Some nights he’ll get a placebo, some nights he’ll ingest the Halcion, and since this is a double blind study neither he nor the researchers will be told which is which. Bedtime comes at 10 p.m. so Matt Sinclair, this night’s research assistant, begins to wire up Wolfgang’s body at 9:15. Sinclair works deftly; he’s done this for seven years. First he tapes a red wire the width of a strand of spaghetti to Wolfgang’s cheekbone just below the right eye. A white wire goes to the left side of the face and these will supply the electrooculogram (EOG) the measurement of Wolfgang’s eye movements during the night. Next he swiftly glues nine electrodes attached to wires, one by one, to precise points on the scalp beneath Wolfgang’s thick head of wiry hair. The electroencephalogram (EEG) which these wires will supply data for is the record of electrical activity occurring within Wolfgang’s head. Finally, he tapes one lead for an electrocardiogram to the subject’s right shoulder; a second one goes on the left lower chest, and together they will measure the heartbeat throughout the night. Sinclair finishes by binding the multicolored strands together into a long ponytail which Wolfgang says hasn’t bothered him so far. Yet the wires sprouting from his body make him look forlorn and dehumanized, like some damaged android. The look of alienation intensifies when Wolfgang enters the sleep room.
The cramped quarters would make a hospital room look cozy. Above the pillow there’s a receptacle into which the clump of wires plugs, and the few furnishings in the room are spartan. Wolfgang nonetheless says it’s much better than the place where he normally struggles to get some rest: an open bay housing thirty-two men and a chorus of nocturnal noises. He climbs into bed and Sinclair shuts the door after him; in the windowless control room located just outside the room, the technician runs through a last-minute test of the equipment. Sinclair turns off Wolfgang's lights with a remote switch precisely as a digital clock flashes 22:00:00 (10 p.m.)
“Okay, goodnight, Wolfgang,” Sinclair says into the intercom which connects with the unseen sleeper.
“Night, night. Goodnight, Dr. Spinweber, the young man answers.
“Goodnight, Wolfgang. Sleep well,” the psychologist says gently.
This control room is the nerve center of the sleep lab, although it looks like an overcrowded closet. White tiles perforated with little holes cover the walls and three large fluorescent lights glare down. Three tall monitoring machines tower over the dozens of red, yellow, green, black, and white wires which hang out, exposed. A GE air conditioner hums in one comer. The room is actually throbbing with movement, the subtle kind of movement which takes a few moments to be noticed. On one of the tall machines seven orange blips travel continuously across a gray screen; each one originates in one of the wires connected to Wolfgang’s body. Beneath that screen, two large reels are slowly turning, recording the data on magnetic tape which later will be fed into a computer for analysis. As the clock flashes each passing second, other colored lights wink like a movie computer; they’re clustered around the third and most interesting machine in the comer. It’s a polygraph and it holds a spool of unwinding paper; on it eight pens capture in ink the signals racing through the resting subject. The paper will flow all night long, folding up into a neat pile, one fold for every thirty seconds, and by morning the stack will grow into a document as thick as a New York City phone book.
Now Spinweber and Sinclair read the first sections of it as eagerly as the morning’s headlines. The recordings from Wolfgang’s brain look like the edge of a forest seen from a distance. They bristle sharply, short uneven strokes packed closely together. Here and there, Spinweber can pick out a section of alpha waves, the distinctive symmetrical brain rhythm which indicates the unfocused mental relaxation which precedes descent into slumber. But Wolfgang’s brain isn’t producing many of them as yet; it will be a while before the alphas multiply, and then a while longer before they begin to flatten out. Then the uppermost line of squiggles on the page will see a change. Instead of coming out on an even plane, the tracings from the eyes will begin to wander up and down, like the horizon of a gently rolling landscape, as Wolfgang’s eyes slowly swing back and forth, another precursor to sleep. Finally, his mind will cross that precipitous border, and at a single moment in time his awareness of the world will miraculously and instantaneously switch off.
Most of the sleep research of the past productive twenty-five years has sprung from settings very similar to this one. The scientific discovery which touched off the explosion of interest in sleep came in just such a lab located at the University of Chicago in 1953. Some scattered research had occurred before then; the first sleep deprivation studies were done in the 1890s, and by the 1930s some scientists were measuring sleep electrically with EEGs. But by the early 1950s, still only a few researchers really cared about the subject. One of those — indeed the father of experimental sleep research — was Nathaniel Kleitman, who ran the Chicago lab.
The breakthrough which galvanized the field came as a result of one idea of Kleitman’s. He’d become interested in the slow rolling eye movements before sleep (such as those Wolfgang is about to have), and had assigned a psychology graduate student named Eugene Aserinsky the task of watching for such movements during the night. To Aserinsky’s shock, he soon discovered an entirely different type of nocturnal eye activity: periodically his subjects’ eyes would dart about furiously under their lids. “It would be difficult today to understand how skeptical we were,” wrote William Dement, another of Kleitman’s young colleagues at the time (who went on to become America’s most famous sleep researcher). “These eye movements, which had all the attributes of waking eye movements, had absolutely no business appearing in sleep. In those days, sleep was conceived of as a state of neural depression or inhibition — quiescence, rest. It was definitely not a condition in which the brain could be generating highly coordinated eye movements that were, in many instances, faster and sharper than the subject could execute while awake.” Yet when Kleitman and his cohorts further explored these states of “rapid eye movement’’ (REM), they found that other striking physiological changes from the normal quiet sleep pattern always accompanied them. They found that people who were awakened during REM sleep remembered vivid, detailed dreams eighty percent of the time, in contrast with people awakened during non-REM periods (only 6.9 percent of them remembered their dreams). It seemed as if Kleitman and his people had stumbled on "the royal road to the unconscious,” in the words of one psychologist, and in the excitement that followed, sleep labs sprouted like spring poppies.
In those dizzy years of the boom, heaviest interest centered on dreams and sleep deprivation, and one of the most notable deprivation experiments thrust the Navy’s San Diego lab into the limelight. The catalyst was a seventeen-year-old Point Loma High School student named Randy Gardner, who hankered for a slot in the Guinness Book of World Records, and figured that he could go longer without sleep than anyone else on earth. Dement, who was working at Stanford, and Laverne Johnson (then and now the director of the Navy’s sleep lab) heard about the effort and decided this was a perfect opportunity to document extended sleeplessness. Like all experiments involving sleep deprivation, it turned into an exhausting, grueling marathon.
By the second week of Randy’s endeavor, he’d reached a kind of plateau of sleepiness, and his observers had to use virtually constant stimulation to keep him awake. One source of it came from the host of national reporters who flocked to San Diego; as the days passed, the youth’s growing celebrity status helped to maintain his motivation. Johnson recalls that ammonia was another successful tool. Every few moments, the researchers would waft it under Randy’s nose, the pungent odor would prompt him to jerk his head back, and the action would help him to retain his tenuous grip on wakefulness. As urgent as was Randy’s desire to sleep, however, the lack of slumber caused no dramatic changes in him. Although some of Dement ’s earlier research had made him suspect that humans become psychotic without sleep, Randy’s experience contradicted that hypothesis. He didn’t become paranoid; he displayed no serious emotional changes. The lack of sleep drastically impaired his cognitive facilities (he could barely add or remember simple things, for example) but some of his motor abilities remained untouched: Dement recalls that when he and Randy spent the last night in a downtown penny arcade, they played about a hundred games on a baseball machine — and Randy won every one.
Finally, exactly eleven days and twelve minutes after he had last awakened, Randy dozed off — wired up in Johnson’s sleep lab. He slept for only fourteen hours and forty minutes and when he woke he essentially had returned to normal (except that he had acquired an interest in sleep research, and worked with Johnson’s lab for several years while a student at San Diego State until he finally dropped out of school and retired to Alpine to raise tomatoes). Today Johnson says that Randy’s vigil remains one of the longest ever recorded — primarily ’’because it’s so dad-blasted hard” to find a subject and researchers willing to endure the unpleasantness of extended wakefulness.
Johnson says that research interests in general have shifted over the years; now far more attention is centering on drugs and sleep disorders. ‘‘For one thing, there’s less money available for sleep research, period, and also I think as you begin to get some basic understanding of how sleep works, then you can begin to apply that understanding to problem areas. ” However, some work still is being done on questions of sleep deprivation and fragmented sleep, like the experiment just recently completed at the Navy’s Point Loma sleep lab.
Cheryl Spinweber was one of the people who worked on it, and she says it yielded the kind of shocking information which every so often makes this drowsy work spine-tingling. The sleep scientists took a group of normal sleepers and they kept them awake for two nights straight. By the end of the second night, performance had started to noticeably erode (short-term memory deteriorated, for example). Finally they gave the subjects a two-hour nap at 4 a.m. on the morning of the second night, then they tested their performance after the nap. It didn’t improve, and in fact even worsened in a few areas. After a second two-hour nap between noon and 2 p.m. that day, however, the subjects seemed to bounce back to normal. The shock came when the researchers took another group of subjects on another occasion, kept them all awake, gave this group one two-hour nap at noon (after the second night without sleep) — and performance went up as much as it had for the first group which had had two two-hour naps. The startling conclusion: that after two nights without sleep,’ it looks I ike that 4 to 6 am nap is nothing. It probably doesn’t do anything for you,’’Spinweber says. “So if I’m a field commander and my guys are storming a beach and I know that I have to schedule them so that they almost have to work twenty-two hours out of twenty-four, well I’m certainly not going to say, ‘Hey, Smith, go to sleep between 4 and 6 a.m.’ I’m going to say, ‘You wait till noon, ’cause you’re going to get the most out of it then.’ ” But why is that noon to 2 p.m. nap so effective? Would a 1 p.m. to 3 p.m. nap be even better? Spinweber has no idea. “We haven’t totally answered the question,” she shrugs.
Sinclair pokes his head into Spinweber’s office and interrupts her. Wolfgang has fallen asleep, so Spinweber scurries into the control room and examines the recording paper. Wolfgang’s brainwaves have flattened out now; they’re still jagged, but now they come as close to approximating a straight line as any living brain ever does. Wolfgang has passed through what the scientists call “stage one” and now his brain is starting to produce two new shapes on the paper. Every now and then Spinweber spots little bursts of brain waves called “spindles.” as well as “K-complexes” (isolated brain waves which look like small, asymmetrical mountain peaks). The spindles are one sure indicator of sleep, and Spinweber searches through the last few pages to find . the first one of the night. The machine will also analyze Wolfgang’s sleep, counting every spindle, every delta wave, every K-complex, but Spinweber says humans still do a better job of evaluating the complex shapes. She spots a good-looking one and circles it on the page; Wolfgang’s sleep began forty seconds after 10:40 p.m.
Now Spinweber and Sinclair have to hustle to prepare for the first "arousal” of the night. As part of the study, they want to know how deeply the drugged subjects sleep. ‘You don’t want a drug that ’ll zonk ’em out so completely that they won’t hear the smoke alarm,” Spinweber explains. So on three nights out of the twelve, the scientists wake up the subject five times during the course of the sleep time. To interrupt Wolfgang’s slumber, they will use a musical tone which they tested on him before he fell asleep tonight. During the test, Wolfgang had indicated that he could hear the tone when it was played at a loudness of twenty decibels. Now at 10:45, Sinclair uses a remote control to sound the tone in the sleep room at forty decibels. Wolfgang snoozes right through it, and every sixteen seconds, a slightly louder tone sounds. Wolfgang sleeps through forty-five decibels, through fifty, through sixty. Then at seventy decibels, loud enough that I can hear the tone in the control room, the pens on the moving paper buck; Wolfgang has moved. The K-complexes evaporate, and the sleepy voice comes over the intercom. “I am awake,” he announces at 10:46:13.
"Okay, good, Wolfgang,” Sinclair answers. “Go back to sleep.”
The order is difficult for Wolfgang to follow, Spinweber notes as she studies the unwinding paper and waits to see the spindles appear again. Finally about seven minutes later, Wolfgang drifts out of conscious awareness. Now the researchers must wait about twenty minutes before they perform another interruption. Wolfgang's mind must journey downwards to the very deepest levels of slumber, stages three and four.
Outside the control room, in the main part of the office, Sinclair and Spinweber glance at the 11 p.m. television newscast, but I remain engrossed in watching Wolfgang's cerebral journey. Now the heart monitor graphically reflects the number of beats per minute, and the rate has slowed; it seems to gently fluctuate between about sixty and seventy-five beats per minute. As the seconds tick by, more and more mountainous outlines take shape in the changing electronic landscape. These are the first delta waves, the slow, high-amplitude brain pulses which seem to signal arrival at the quietest, least accessible level of somnolence. Underneath the roll of paper, three lights are built into the machine. A blue one lights up whenever the machine counts an alpha wave, a white light signals the sleep spindles, and a yellow light announces the presence of the languid deltas. The yellow light is flashing at least every few seconds when Sinclair and Spinweber re-enter the room to try and rouse Wolfgang from his mental depths.
Spinweber explains to me that the difference between the third and fourth stages of sleep is only a numerical one relating to the total percentage of delta waves. Differentiating the two is one of the jobs that the computer handles best. But now either stage three or four will serve the purposes of the experiment, and Sinclair sounds the first tone at 11:20. The greater depth of Wolfgang’s sleep is obvious. Seventy decibels of noise disturbs him no more than a gentle breeze passing over the ocean’s waves, but when the noise builds to eighty decibels, a startling change occurs. The tall elegant delta waves shrivel up on the paper, and the recording machine hisses audibly, as Wolfgang’s brain quivers with a sudden burst of alphas. His heartbeat races up to more than a hundred beats per minute. Every time he moves, the mechanical pens scribble wildly across the paper, spinning a dark web of ink. But Wolfgang fails to give the proper response to the eighty decibel tone, so it signals again at eighty-five. “I am awake,” come the words, coated heavily with drowsiness. “Okay Wolfgang, back to sleep.”
This time, the subject obeys almost instantaneously. Spinweber notes that it takes him just eight seconds to lapse back into slumber. We have at least another hour until the next arousal, so we move into her office. I ask whether it doesn’t seriously impair a subject’s sleep to be plagued with so many nocturnal interruptions.
“Subjectively, it’s not so bad,” she replies. “Something about memory changes during sleep, so if you’re not awake for very long, you don’t remember the things that happen to you during the night.” In fact, most people wake up briefly several times a night, but aren’t even aware of it, although repeated awakening can have a more subtle objective effect. “Objectively, waking up repeatedly can keep you from going into the deeper stages of sleep. We know that the normal transition is to be awake, then to go into stage one for a while, then two, three, and four — that’s the basic transition. If there’s too much noise and you keep waking up, or if you move around too much, you will not make that transition.” (The sleep researchers don’t yet know what that does to you, however.) Spinweber adds that the ongoing experiment has been designed to avoid that distortion; five brief arousals during the night won’t block Wolfgang’s access to the lower stages of sleep.
The question does remind Spinweber of another fascinating finding by Alain Muzet, a French scientist now visiting the San Diego sleep lab. Spinweber says that Muzet once used noise to disturb the sleep of subjects for weeks at a time. At first, the sleepers repeatedly awoke. Their brain waves snapped into alertness, their heartbeats raced, and during the days they complained about the quality of their sleep. Then gradually they got used to the interruptions. They stopped waking up, they stopped complaining about feeling bad. and their sleep reverted to its normal patterns — but one factor never habituated, Spinweber says.' Muzet’s study showed that the sleepers’ hearts never grew accustomed to the periodic disturbances. "Weeks later, he was playing the same noise. The people were sleeping right through it, although their heart rates were going up every time. So the implication is maybe that’s what happens to people who live next to airports.” She cites the study that was done of people who lived next to the Los Angeles airport. It revealed that they have higher rates of high blood pressure, stroke, and heart attack than the general population. "These were well-habituated people. They had lived there for at least six years; they weren’t complaining about the noise anymore. But you can just imagine what was happening to their heart rate every time one of those planes went over."
It’s past midnight, and Spinweber still seems wide awake, even though she told me that one summer she consciously monitored her sleep appetite and discovered that she feels the happiest on nine hours a night. (Sleep needs vary hugely from one person to another, with some individuals functioning blissfully on four hours while others feel bad with less than ten or eleven hours of sleep. The average is seven and a half to eight hours, however.) Although the psychologist may crave nine hours of sleep, she adds that she has never had much trouble completely skipping a night periodically; she may draw encouragement from one revelation of the sleep lab. Spinweber says that depriving the average person of one night of sleep may make him feel tired and cranky, but it’s almost impossible to detect any deterioration of performance (using a battery of diverse tasks) after one night’s sleep loss. "We have to use special tasks that are long and boring to begin to show any effects at all, ” she says. She says she finds herself sharing that information to calm the occasional panicked insomniac. "People worry incredibly about their sleep. ... I have to say, ‘Hey, don’t worry about it. One night of sleep loss is not going to hurt you. 1 do it all the time.’ ”
About 12:30 a.m., Spinweber and Sinclair prepare to interrupt Wolfgang’s sleep for a third time. The machine is drawing a few scattered delta waves, but Spinweber decides Wolfgang is back in the second stage, the desired level for this particular arousal. But at the sound of the tone, Wolfgang’s sleeping brain rebels and slips into some of the best slow wave sleep Spinweber has yet seen him produce. They leave him in peace for fifteen minutes and when they return they find him generating classic-looking second-stage waves. This time eighty decibels of sound wakes him at 12:50 a.m., and he falls asleep two minutes and ten seconds later.
Although the Navy’s two San Diego sleep labs do devote some time to diagnosing sleep disorders (problems such as sleep apnea, a condition in which sufferers forget to breathe when they sleep, or narcolepsy, in which they fall asleep uncontrollably), the Navy facilities don’t function as a treatment clinic (nor does the only other sleep lab in San Diego, Dan Kripke’s facility at the VA Hospital in La Jolla. Spinweber says the closest clinic treating the general public is Jon Sassin's lab housed in the medical center at UC Irvine). She nonetheless predicts that sleep clinics soon will be as common as sex therapists. In the meantime. Spinweber has been offering the insomniac participants in the Halcion study the chance to come in after their twelve-night stints to discuss the meaning of their sleep records. Although some cases of insomnia baffle scientists and can’t yet be helped much, Spinweber says in other cases a little counseling can go a long way.
First and foremost, she advises insomniacs not to simply lie in bed for hours, struggling to attain sleep. Such behavior only reinforces bad habits; it teaches the poor sleeper that bed is a place where one futilely tosses and turns. One ploy which Spinweber recommends instead is for the poor sleeper to give himself ten or fifteen minutes to sleep, then to get out of bed for an hour if he doesn’t succeed. Then try for another ten minutes, and if that fails, get up again, and so on. "Most people who try this will tend to be awake the entire first night," she says. “But the next night, they sleep." Since another common cause of chronic sleeplessness are worries which preoccupy the struggling insomniac’s mind, Spinweber tries to suggest alternatives, such as reserving an hour to focus on one’s problems during the day. Finally, she takes a look at whatever chemicals the insomniac may be ingesting for aid since sleeping pills themselves are one of the major causes of sleeplessness in America.
Spinweber says some sleeping pills (all barbiturates, for example) lose their effectiveness if taken for weeks or longer at a time and furthermore stop their users from sleeping naturally without the use of the pills. Even more disturbing, all "hypnotics” in current use dramatically change the normal electrical patterns of the brain. (They change the percentages of time spent in certain sleep stages; they can greatly increase the number of some brain waves like deltas; and so on.) Spinweber says the changes are so extreme that she has to make a conscious effort just to look at a specific brain pattern and not the overall patterning or else she can tell whether the subject has had the sleeping pill or the placebo (thus spoiling the purity of the double blind experiment). She says researchers don’t yet know if the changes in the brain waves are actually bad for the users. “But my suspicion is, it’s not very good for you to have your brain activity changed so dramatically. So while the benzodiazepines are very safe, in the sense that it’s almost impossible to kill yourself on them [unless you combine them with alcohol], these changed brain waves have to mean something.”
Spinweber has never had prolonged trouble sleeping, so she’s a little puzzled by her own passionate commitment to helping insomniacs. Her efforts have focused upon the search for some natural substance which will induce sleep and avoid those probably deleterious brain changes. In particular, she’s excited by the promise of an amino acid called 1-tryptophan.
Found in all protein foods, such as meat and milk, tryptophan has been shown by researchers both in Boston and here to help people cross the threshold into slumber without changing their brains’ electrical activity, according to Spinweber. Health food stores already are selling the substance in tablet form (Spinweber says another aid is a glass of milk before bedtime — milk of any temperature). The psychologist says that early studies even have shown that tryptophan can help insomniacs; she says the remaining question is whether it helps those of the severe, chronic variety, an area of study which she hopes to tackle soon. "If tryptophan works in chronic insomniacs that means we may have found a substance that helps them without the terrible side effects.”
The night is deepening and I excuse myself to watch Wolfgang’s EEG, in its own way more gripping than the late show flickering on TV. Wolfgang, as is normal, already has had one short period of rapid eye movement which occurred about ninety minutes after he first dozed off. Since I missed that one. I’m anxious to view the next, although there should be several more periods of REM before morning. (In general they tend to last longer and come more frequently as the evening progresses.)
The EEG in the control room once more displays shallow, gentle waves, although occasionally I spot what looks like a K-complex. My own drowsiness is building and I notice only numbly when the lines which reveal the presence or absence of delta waves and spindles show that they’ve disappeared. I try to stare at the placid EOG (eye movement) line and I find myself struggling to keep my own eyes open. Then I blink hard and focus on what’s happening; the EOG pen has suddenly veered upward crazily, and a chubby-mountain now towers over the two very flat brain wave lines.
The pen moves calmly for a few seconds, then it launches upward again. A REM period must be starting, but its patterns astonish me. Instead of darting back and forth evenly, like the eyes of a fan at a tennis match, Wolfgang’s eyes seem to be following some more complex attraction. Here the eye recording meanders gently for a minute or so, and then bam! bam! bam! here come three startling eye shifts. The little metallic pen is moving as if it were independently guided by some unseen artist, swept by sudden bursts of inspiration. I know almost certainly that the man lying in the next room is dreaming and the realization tantalizes me. I find myself wishing that the pen could break free and draw free-form images, sketches of the characters now populating Wolfgang’s sleeping brain: perhaps some friend fondly remembered from childhood, or the enticements of a bosomy woman, or the hot breath of slavering tigers close on his heels.
If the REM recordings aren’t literal depictions of Wolfgang’s dream content, sleep researchers have found links between the REMs and dreams which are almost as amazing. In one famous study. Dement and an associate woke up sleepers while they were having REMs and asked them to describe what they were dreaming about. On the basis of such verbal descriptions, one of the researchers successfully predicted what the accompanying REM record would look like. (In one of the’ "hits,” for example, the dreamer told of walking up five or six stairs, then joining a circle of dancers. When the researcher predicted a series of five vertical upward movements followed by a few seconds with only some very small horizontal movement, the electronic record matched it exactly.) Dement concluded that the brain is doing the same thing in a REM state as it does in the waking state, one reason why dreams seem to convey such a feeling of reality. The sleeping body might also follow suit — i .e., jump up out of bed to chase the tempting blonde or to escape the menacing tiger — were it not for a drastic protective mechanism, a powerful physiological response which paralyzes the arms, legs, and trunk of every sleeper right before each REM. Thus Wolfgang at the moment can breathe, have an erection, and twitch a bit, but for all practical purposes, his body is glued to the bed until his dream ends.
For all the information gathered about REM sleep, however, many mysteries surrounding it have only deepened with greater study. The sleep scientists know that people systematically deprived of REM sleep try harder and harder to catch up on it, but the early assumption that REM sleep was essential to sanity hasn’t been borne out. Similarly, the early "conclusion” that dreaming occurs only in REM and none occurs out of it also has dissolved into controversy. Even the contention that eyes move during REM sleep because they’re following dream-generated pictures has its share of critics. Some point out that all mammals have REMs and in fact some animals, such as opossums, have even more than humans. Why should opossums follow mental pictures with their eyes more avidly than we do? And what about human infants, who spend at least half of their sleep time in REM (compared to about twenty-five percent in adult humans). What kind of pictures can they be following, only days removed from the womb?
At 2:30 a.m., Spinweber and Sinclair begin the fourth arousal, and it again takes eighty decibels to wake Wolfgang, He falls asleep at 2:38, six minutes after responding over the intercom. Spinweber returns to work in her office, Sinclair curls up in a comfortable chair, and I find myself shivering, a function of the great circadian rhythm, which usually sends people’s temperatures plummeting to their lowest point of the twenty-four-hour cycle at this quiet hour of the night. In fact, that’s part of another explanation for sleep: some say it protects humans during their period of greatest physical vulnerability. Now time itself seems to have slowed, along with Wolfgang’s heart and lungs. Suddenly I realize why every sleep researcher I’ve read of or talked to seems impressed by the fact that humans spend a third of their lives in.sleep. In this lab, as removed from sleep as a biologist is removed from the bug under his microscope, eight hours seems like a great deal of time, an interval too impossibly large to dismiss blithely every day. Yet all around me, the sleeping city surrounds the hospital like a fog, and I think of something that Spinweber mentioned earlier, about how shift workers complain abnormally about their daytime sleep. Maybe sleep in the daytime is physiologically different, she’d said, or maybe it’s just that staying awake all night every night alienates one so drastically from friends, family, the bulk of the human species. Sitting in the control room, staring at the record of the marvelous brain waves emanating from Wolfgang, I’m grateful for the insight, yet I realize that I’ll never be one to begrudge sleeping, to rail at the wasted time and resent the need for it.
Spinweber declares, furthermore, that the question of the need for sleep is one which has been effectively answered. Sleep is necessary, she says flatly; there’s only been one documented case of a human not sleeping at all, a seriously ill man in France who went for months before finally dying of a rare neurological disease. “All other people sleep at least an hour a day. No matter what culture you’re in, whether it’s a well-developed culture or a primitive culture, whether it’s in a climate that shows seasons or in a place where there’s six months of daylight and six months of darkness — people still sleep seven and a half to eight hours a night on the average, and the range is still about the same: two percent of the people sleep less than five hours and two percent sleep more than ten hours and everybody else just falls on the normal curve.”
What we don’t know, even after twenty-five years of research, is why people sleep, she says. “We don’t exactly know what it does for you and how it does it.” Spinweber suspects that the key lies in chemistry — either in neurotransmitter production or in protein synthesis or in some chemical process. “But the chemistry has only begun to be done. . . . The EEG simply isn’t giving us the answer. The more and more study we do, the less and less we have faith in the meaning of the sleep stages.” Work with the EEGs has yielded a battalion of sleep measures, Spinweber says, “but none of those things really correlates with whether a person slept well or not.” After all this time, Spinweber says the best way to find that out is simply to wake up the subject in the morning and ask him. Only long after such elementary holes in our knowledge have been filled in will sleep researchers move on to the science-fiction-style questions: such as whether sleep can be fundamentally altered, whether it can be put to work, whether it can be done away with.
The last arousal experiment finally comes just after 4:30, and now a mere seventy decibel tone succeeds at interrupting Wolfgang’s gentle snoring. Yet even this close to his reveille, he slips back into sleep again as easily as a youngster snuggling under the covers. An hour later, Spinweber and Sinclair repeat the procedure, but when Wolfgang announces “I’m awake” for the sixth time this night, they turn on the bedroom light switch and welcome him to the day.
On some mornings, the subjects perform a battery of tests, sorting cards, memorizing something, and so forth, but today Wolfgang only has to fill out a brief questionnaire. When he trudges off to the bedroom, I steal a look at his hasty answers. He estimates that it took him “a little shorter than usual” to fall asleep. He guesses thirty minutes (it took him forty). Although he describes himself as feeling “awake but relaxed,” he says he slept about the same amount of time as usual and he underestimates the true amount; he thinks he slept about four hours while in fact he slept more than six. He claims he remembers waking all five times.
Outside the hospital, the morning gray is thinning and at least two life forms are stirring, the earliest birds and one or two rumpled-looking hospital workers. As I head for my car, I think of poor Wolfgang, convinced that he’s slept for only four hours and liable to carry the effects of his wretched night around with him all day, a psychic ball and chain, slowing him down, weighing upon him, and making him dread the hour when he’ll face the darkness again. In contrast, I find myself struggling to hold on to the experience of the night. Already it slips away like the memory of a dream. Barreling along the freeway, through the growing dawn, I find myself looking forward to my own sleep, not only in anticipation, but with a newfound sense of wonder.