This week’s featured PhD…
Jack Barton, PhD Student
University of Manchester
I am a PhD student at the University of Manchester who likes to study, talk, and occasionally even take time to, sleep. Before you ask, despite having given a talk on the subject, no, I cannot interpret your dreams. So, I’ll have no mention of giant chickens giving you a surprise test while only in your underwear. You have been warned.
Sleep loss, unusual experiences, and eager students
What’s the longest you have gone without sleep? Maybe you’ve gone a day or two? I’m sure it has probably been long enough to notice the extreme tiredness which follows and a few other weird experiences. The longest I have gone without any consolidated period of sleep was during my freshers’ week at university. I was enjoying myself free from adult supervision and during this time I probably averaged about an hour or two sleep a night. I only realised how exhausted I was when one day in my room, preparing for another night out, I closed my eyes and the floor in front of me suddenly burst to life. A crowd of people emerged from the ether chatting to one another, dancing, and generally having a good time. None of them payed any attention to me but I could hear a mass of indistinguishable voices. Upon opening my eyes this phantasmagorical party vanished. I closed my eyes again and they waltzed their way back into my room. Unless someone was playing an extremely elaborate prank on me, I was clearly hallucinating scenes from the past few days. As a psychology student, I found this weird but more importantly, incredibly interesting. It has been several years since that experience but upon starting a PhD in sleep I have hunted down, systematically, research to back-up the ghostly party I witnessed during my first foray in university life.
Studies conducted in the 1950s and 1960s collaborated my own experiences. In 1962, a small group of healthy medical students were deprived of sleep for 4 days and what they saw, heard, and felt were recorded during the study. You can read about their experiences in detail here (http://bjp.rcpsych.org/content/108/455/457). To begin with, the students experienced complex visual hallucinations whereby they saw an angry elderly woman. After she finished staring at them she would creepily disappear face last in homage to the Cheshire Cat from Alice in Wonderland. As time went on, these sleepy students also experienced hallucinatory distortions of surfaces, and persecutory delusions whereby one participant felt they were being drugged by the experimenters to make sure they produced interesting results. This particular student found clues in everything to confirm this delusion despite there being (I hope) no basis for their belief.
Alongside scientific studies, there have been attempts to try to set world records for sleep loss including such able contenders as a spate of radio DJs in the late 50s and early 60s keen to kickstart their careers (https://www.youtube.com/watch?v=4MT8ekBGyM4). The most famous attempt at setting the record was by a young student named Randy Gardner. Young Gardner managed to stay awake for 264.4 hours (11 days 24 minutes). I know, I’m not quite sure how he managed it either. Interestingly, in a similar fashion to the participants above, Gardner started to show signs of psychosis during his marathon wakeathon. These promptly disappeared when he eventually slept at the end of the study. Gardner isn’t the only one to attempt to break sleep loss records but the Guinness Book of Records now refuses to acknowledge these given the known risks of extreme sleep loss. Therefore, despite the fact we know of a few instances of this such as a woman claiming to beat the previous record during a rocking chair competition (yup, http://sleep.lovetoknow.com/Record_For_No_Sleep), there are no official reports validating these attempts.
Since Gardner, there were very few sleep deprivation studies which looked at whether sleep loss could induce psychosis symptoms in otherwise healthy people. However, recently, and under a tighter controlled laboratory environment, participants have been sleep deprived for 1-2 days at a time to try to understand and validate these early studies. Unsurprisingly, given these early findings, participants in these studies showed an increase in hallucinations and delusion-like thinking (e.g. feeling more paranoid).
How does this lead into my work?
So, why am I telling you all of this, besides it being incredibly interesting, of course? Well this is where my research fits in. It is all well and good saying there is a link between sleep loss and psychosis but I’m interested in the awkward ‘why’. Why does a lack of sleep produce these symptoms? Are some people more vulnerable to the effects of sleep loss? Does naturally occurring sleep loss (e.g. insomnia) lead to hallucinatory / paranoia experiences and again why might this be? These questions form the basis of my PhD.
What am I currently working on?
My PhD research involves tracking participants’ sleep over long periods of time to see how difficulties in sleep might predict later psychosis experiences in otherwise healthy people. I also track the sleep of those at higher risk for psychosis with a FitBit-like device in order to assess whether pre-existing risk for psychosis makes individuals more vulnerable to the effects of naturally occurring sleep loss. This is important because if those at a higher risk are more sensitive to sleep loss it would highlight the importance of intervening to improve sleep in those vulnerable to developing psychosis. My participants are young adults aged 18-24 years old and it is during this period that a first episode of psychosis can present itself. If improving sleep can be shown to reduce that risk then this is something which can be taken advantage of relatively cheaply.
What is the future of this work?
Recent preliminary studies have highlighted that treating sleep problems in psychosis can lead to a reduction in hallucinations and paranoia (http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(15)00314-4/abstract). This is still early research but if we can understand better the link between sleep loss and psychosis then we can better tailor interventions to help mitigate this. If nothing else, treating sleep within vulnerable populations is a worthwhile target to improve functioning and wellbeing.
So far, my research is still ongoing but I hope to try to understand the mechanisms by which sleep loss can produce psychotic experiences. My final study aims to build on the legacy of classic sleep deprivation studies I started this article with. The hope is that by studying these experiences it might be possible to understand how severe sleep loss might be responsible for strange experiences. In turn, this might have implications for individuals with psychiatric disorders such as schizophrenia further down the line. It is still early days for this research but it is an exciting and fascinating area to study. There are plenty of questions yet to answer and indeed, even ask.
Oh, and for anyone who’s interested, my sleep habits have somewhat stabilised since my undergraduate years…
For the interested
Here is a review which highlights the bulk of the research conducted in my area (http://www.smrv-journal.com/article/S1087-0792(16)00003-4/abstract)
A great video on the effects of sleep deprivation (in case you’re not convinced that losing sleep is bad from this article or from common sense; https://www.youtube.com/watch?v=dqONk48l5vY&t=206s).
An interesting article outlining the importance of sleep (http://www.huffingtonpost.co.uk/entry/the-truth-about-sleep-7-things-learned-from-bbcs-new-documentary_uk_59146817e4b00b643ebbca48)
For anyone struggling with sleep here are some useful resources from sleep experts (https://www.sleepio.com/articles/sleep-tips/)
Finally, for a fictional story about sleep loss which people frequently ask me whether it’s true or not (http://creepypasta.wikia.com/wiki/The_Russian_Sleep_Experiment)