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Can sleepwalking kill me, or is inattention more lethal? (12/13/10)

December 13, 2010

A Killing in Scarborough

In 1987 Kenneth Parks, a 23 year old embezzler and gambler who had recently lost his job, drove 14 miles to the home of his mother and father-in-law in Scarborough, Ontario.  Taking out a tire iron he beat them both before stabbing them with kitchen knives, killing his mother-in-law and leaving his father-in-law close to death. Later, he drove  with bloodied hands and turned himself in to the police.

As told by Roger Broughton, a neurology professor at the University of Ottawa, Parks’ strange behavior caused his prison warden to give Broughton a call.  Though conditions were unforgiving, Broughton discovered that Parks was a violent sleepwalker.

He had no virtually no recollection of what he had done.  Parks felt great contrition, and loved his parents-in-law.  He had not been sleeping well and had been drinking, setting him up for the increased deep sleep that provokes the worst kind of sleepwalking.  Parks was acquitted in 1988, though appeals continued until 1992.  Television movies and innumerable articles followed.

Calgary, 2007

Gary Garden Yuen had invited his regular prostitute into his home, setting out big bills for his customary $1000 fee.  Over the next 90 minutes he hit her with a baseball, choked her and left her unconscious.  She woke up finding him lying on top and raping her.  She ran from his apartment, and was picked up by a passing motorist.  Doctors later said she would have died had she not quickly gotten to hospital.

Yuen knows he did the crime, but says he can’t remember anything. Professor Colin Shapiro of the University of Toronto studied him and told him he had REM behavior disorder, that he had raped and attacked while in dream sleep.

Dr. Patrick Hanly, a Calgary sleep doctor, is having none of that.  He thinks wiping the blood off the walls is not consistent with REM behavior disorder, nor Yuen’s frequent looking away from the eyes of the victim constitutes anything but conscious activity.  He also believes that 90 minutes of such behavior was way too long for any confusional sleep  disorder.

Canada, Our Friendly Neighbor to the North

Is this all a Canadian phenomenon?  Canadian sleep specialists are prominent in the field.  Dr. Meir Kryger, a well known sleep researcher now working in summery Connecticut,  once gave 5 reasons why Canadian sleep researchers were so well regarded – “November, December, January, February, March – there’s nothing else to do except work.”

It turns out weird actions in sleep, including violence, are more common than people knew.  Somewhere up to 8% of people coming into sleep labs, especially academic ones,  have “sexsomnias” or violent actions during sleep.

However, cases like Parks and Yuen are very rare, though attempts by defense attorneys to use sleep disorders to explain murder and sex crimes continue to increase.  Creating at least a “shadow of a doubt” is what an attorney needs to do in capital cases, but their job has not been made easier by people clearly attempting to make premeditated crimes appear  unconscious acts – which was not the case with Parks or Yuen.

What’s more important to you is understanding a little about consciousness and attention.

Am I Really Awake?

People tend to see consciousness the way they do machinery – click on, click off.  It may take some seconds for your computer to turn off, but sleep and wakefulness are like that, right?

Not even close.

1. To get to sleep, large areas of the brain have to move in concert from wakefulness to local changes in the pre-optic region initiating sleep to full engagement of the rest of the brain and cortex.  Not only does this take time, but it’s often incomplete – watch people jerk in a lecture hall and you’ll see one example of imperfect sleep initiation.

2. If awakened, which happens very frequently, much of the sleep process has to start over again.

3. Once in sleep, amnesia begins, often extending beyond to the minutes before sleep.  Unless up six, eight, ten minutes, people often don’t know they were awake at all.  My record – 1200 arousals during the night by a patient who thanked the sleep technicians for her uninterrupted night of sleep. Her longest uninterrupted bout of sleep was 90 seconds.

4. Very poor understanding of when you’re awake.  One study at Henry Ford Hospital observed people in stage 1 sleep for ten minutes, monitored and videoed – 50% thought themselves awake the whole time.

5. People have frequent microsleeps and often don’t know.   Torbjorn Akerstedt found his Swedish train drivers would fall asleep standing up with their eyes open – and not know they had fallen asleep.

What this all means is that there are many intermediate states of consciousness.  Indeed there may be many different kinds of consciousness, with different sleep stages representing a few and different forms of inebriation, intoxication, drug effects and anesthesia representing others – all with different levels of intensity.

Yet none of this may be as critically important as attention itself.

Paying Attention to Attention

Just as consciousness varies greatly, what researchers call a “continuous variable,” like blood pressure, so attention changes.

Quite fast, one may add.

Let’s say you’re driving the middle lane of the highway.  Your phone chirps.  You’ve got a text.

You pick up the phone. It’s your girlfriend. You’ve had some difficulties of late, so you really need to text back.  You slow down to 68 mph, 110 kilometers an hour.

As your attention shifts to texting your love,  in 3 seconds your car will speed past a football field. Your text takes far longer than 3 seconds.

What if another car moves into your lane? A truck decides without signaling to get away from a slow SUV in the right lane?

You might be toast.  That’s how thousands will die.

Consciousness and Attention

Attention is all the brain really has.  Attention, like consciousness, waxes and wanes.  Yet attention is required for thought, for achievement, for getting anything done.

You want to guard your attention and keep it sharp.  Without proper rest you won’t have full attention. Rest is regeneration.  Without it, your brain doesn’t work.

So think attentively of attention.  Attention can give you the greatest pleasures and despite what drug dealers might tell you, the highest highs.  Sharpness of thought allows for both joy and creativity.

You need full consciousness – and attention – to get them.

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