Stalking the netherworld of sleep

Even an expert needs to fine-tune his sleep ritual

Credit: Steve Fisch Photography

William Dement has spent decades studying how people sleep and has done groundbreaking work on REM sleep and dreams.

William Dement, the father of sleep medicine, struggles to get a good night's sleep. Just like the rest of us.

One of the world's foremost experts on sleep disorders, legendary for his research on dreams and one of the most popular lecturers on the Stanford campus, even Dement has had his fair share of insomnia.

In his 45 years as a Stanford professor, it was the pressure of grant proposals and on-site evaluations that were the most frequent culprits. These days, as he approaches his 80th birthday, it's mostly due to his age.

'Unfortunately,' he said, 'sleep deteriorates with age just like everything else, and I have achieved considerable seniority.'

The nightly routine for the white-haired grandfather is to head upstairs to his bedroom between 9 and 10 p.m. 'I have come up with a pretty successful method to help me fall asleep,' said Dement, MD, PhD, the Lowell W. and Josephine Q. Berry Professor of Psychiatry and Behavioral Sciences. 'My method is to have something going on in the environment that's distracting, but not exciting, like a very dull television or radio program.

'Most of TV sets and radios have automatic turnoffs,' he added. 'It's so easy. Go ahead, do it,' Dement said in the booming voice that has lectured 15,000 Stanford students on the perils of sleep deprivation since the 1970s. 'The bed becomes the battleground. You need to distract yourself.'

Who's going to argue sleep tips with 'Mr. Sandman' - a man who has spent literally decades up all night, sipping coffee, watching other people sleep? Entering his ninth decade, he still refuses to end his lifetime quest to unravel the mystery of sleep.

'For 56 years, I've stalked the sleeping self to understand what happens when we sleep,' Dement wrote in his book, The Promise of Sleep. 'Night after night, I've watched people in our lab and our clinic undergo the commonplace and profound transformation called falling asleep.'

The fabled researcher of sleep, the man who draws crowds of admiring sleep researchers when he enters the Stanford Sleep Disorders Clinic, admitted the final, fundamental secrets of sleep remain, well, a secret.

'I still don't know what the heck it's for,' he said.

The story of how Dement's obsession with sleep took hold and wouldn't let go began in the 1950s, when he was a medical student working in the University of Chicago laboratory where REM (rapid eye movement) sleep was first discovered.

At that time, most scientists considered sleep a kind of 'turning off' of the brain, a state that held little scientific interest. With the technological advent of EEG electroencephalography testing, researchers were able to chart brain activity during the night by attaching electrodes to the head and scalp. They discovered that the sleeping brain exists in two entirely different states that cycle regularly through the night. One of these states would soon be dubbed REM sleep during which the eyes constantly flicker back and forth and up and down beneath closed eyelids, and the brain is busy dreaming.

The discovery launched Dement on his future career and toward the discovery of a whole new scientific field of research.

'When you do something for the first time, you don't stop,' said Dement, explaining the excitement of those early days, an excitement he never really seems to have lost. Suddenly, he had no trouble staying up all night watching other people sleep.

Dement began running EEG sleep experiments even on himself, initially entrusting his wife to wake him during REM sleep to study the effects of dream deprivation. Intrigued by Freud's theory that dreams were a psychotic relief valve, he tested schizophrenics at the Manteno State Hospital near Chicago to see if there was a connection between dreams and mental illness.

Dement soon abandoned the notion that dream deprivation could lead to mental illness, but he continued studies of dream deprivation. In a New York apartment he set up a sleep lab where he REM-sleep deprived several Rockettes, the famous dancers, because they happened to answer his newspaper ad. Because volunteers were scarce, he REM-sleep deprived students, relatives, and even his wife Pat.

The final study involved several cats including a lively black male named Othello who made it 70 days without any real adverse effects from lack of REM sleep.

'Dement, you'd REM-deprive your own mother,' one fellow sleepwatcher is quoted as saying in another of Dement's books, The Sleepwatchers.

Dement learned that dreams aren't instantaneous, that on average we dream two hours a night, that babies dream more than adults. But still, the purpose of REM sleep has remained elusive, evading seekers. It's this mystery that obsesses him still.

The dreaming brain creates an entire world in the absence of sensory stimulus every night for two hours. Why does it do this? The body seems to function well without REM sleep. Studies show it's not a safety valve of the mind.

'It's very puzzling,' he said. 'What can it be for? Can it be some kind of cosmic joke?'

In 1970, Dement moved to Stanford where he founded the world's first sleep disorders clinic. Today there are at least 1,430 sleep disorder clinics across the country where patients are treated for more than 80 specific disorders that include sleep apnea, insomnia, narcolepsy and more.

'When I started the field of sleep disorders,' Dement said, 'it was, in fact, a new discipline. It wasn't psychiatry. It was sleep medicine.'

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In his later years, Dement has turned his focus from primarily research to educating the public about sleep, the health dangers of sleep disorders, such as sleep apnea and narcolepsy, and the dangers of sleep debt.

'All lost sleep accumulates as a debt which gets larger and larger,' he said, 'and we finally have a very dangerous tendency to fall asleep in hazardous situations.' His exhortation to thousands of students and the general public is, 'Drowsiness is red alert!'

As his 80th birthday approached, Dement had no plans to retire. Still, he's thoughtful about his aging, and in particular has noticed how it has affected a change in his dreams.

'I've started to have dreams about facing mortality. Dreams of being lost, or going back to a place, and it's not there anymore.'

He shrugged and looked thoughtful.

'The fundamental purpose of dreams and sleep,' he said, 'is still a complete mystery.'

Birthday celebration planned for Dement

William Dement, MD, PhD, a pioneer of sleep medicine, is turning 80 years old. In celebration of his birthday and his 45 years of service to Stanford, a closed celebration featuring political figures, campus leaders, family, friends and colleagues will be held on the campus July 26.

Dement, who will continue teaching his undergraduate class 'Sleep and Dreams' and advocating for sleep research and sleep awareness, is stepping down as the chief of the division of sleep medicine, passing the baton to Emmanuel Mignot, MD, PhD, professor of psychiatry and behavioral sciences.

As part of the celebration, donations are being accepted for the William C. Dement Tribute Fund for Sleep Medicine. Proceeds will go to the Stanford Sleep Medicine Research Program. To donate, contact William Gray at: 234-0668 or bgray@stanford.edu.