During the pop singer’s wrongful-death trial, Dr. Charles Czeisler, a Harvard Medical School sleep expert testified against concert promoter AEG Live that propofol infusions, on which Jackson allegedly relied nightly, disrupt the body’s ability to go into rapid-eye-movement (REM) sleep.
Propofol interferes with the body’s normal sleep cycle and prohibits it from getting REM sleep, CNN reports. During REM sleep, brain activity looks similar to that of people who are awake, since this is the time that memories are created and during which dreams occur. People taking propofol wake up feeling well rested but don’t actually experience the full effect of being asleep.
“It would be like eating some sort of cellulose pellets instead of dinner. Your stomach would be full and you would not be hungry, but it would be zero calories and not fulfill any of your nutrition needs,” Czeisler said during his testimony on Thursday. He said that Jackson’s alleged propofol use, administered by his physician Conrad Murray, amounted to the equivalent of being sleepless for 60 straight days.
Could that have contributed to Jackson’s death? It’s not entirely clear what happens biologically when the body is chronically sleep-deprived in this way — aside from feeling tired and having trouble focusing. “There is one old animal model that shows that sleep deprivation ultimately caused death in rats, but this hasn’t been replicated in other animal models at all,” says Jerome Siegel, a UCLA professor of psychiatry, director of the Center for Sleep Research and chief of neurobiology research at the Veterans Administration Greater Los Angeles Healthcare System.
Siegel says there is a misconception that less sleep can lead to a higher risk of sudden death. “Unfortunately, this drives people to take sleeping pills thinking they are preventing early death, when really, there is epidemiological evidence that chronic use of sleeping pills themselves shortens lifespan, whereas people with insomnia not taking sleeping pills have normal lifespan,” he says. “Often when people are losing sleep it means they are stressed in one way or another and high levels of stress certainly do shorten lifespan, but it doesn’t appear to be the sleep loss itself.”
Relying on pills to doze off, can, in fact, be dangerous, since medications with benzodiazepines and nonbenzodiazepines, like Lunesta or Ambien, can have a wide range of effects of different body systems. “It seems nonsensical, but the benzodiazepine receptors which these pills react on are not localized to some sleep center in the brain, they are on almost every cell in the body,” says Siegel. “They are in the heart, lungs, the circulatory system; T-cells have them. The effect of taking a larger dose puts you to sleep, but in no way is it a selective activation of the sleep system, so it is not surprising there will be side effects.”
Dealing with poor sleep in other ways, including making behavioral adjustments, may be safer, he says. “It’s simply [about] keeping regular hours. You want to avoid caffeine late in the day, you want to have a regular bedtime routine, you want to minimize light and sound. It helps to keep a sleep diary to know you are doing these things,” says Siegel.
And not getting anxious over your inability to sleep can also help. He says it is important to remember that it is normal to wake up in the middle of the night on occasion, but worrying about your sleep cycles will only make dozing off more elusive.