#i mean i'm sure killing bacteria probably also helps with mental health

[aurumacadicus]

As someone who was unable to dust her entire room for the entirety of the kitchen reno, kiddos, I beg thee: Dust your stuff at least once a month. Weekly if you can manage it but once a month at least. I'm dying. I've never sneezed so much in my life. No wonder I couldn't breathe well even after the "heavy" stuff was done.

Also open your blinds during the day. This isn't a mental health thing this is a "UV light can help kill bacteria" thing.

[scripttorture]

I'm working on something set in the Star Wars universe. The charcter I'm writing with is being stalked by someone using the Force to induce nightmares, soon after he first hits REM sleep, leaving my character with about 90 to 120 minutes of anxiety spiked sleep a night for over six months. I know short term what this does to a person's body and mind, but long term, less so. Can you help me out with sleep deprivation as torture?

Iam very glad I invested in those new books on sleep. :)

Partof why this one (and the other ask focused on sleep deprivation) tookso long is because I felt I needed to do more reading in order toaddress them properly. And having done at least some of that extrareading- I think this is a good idea in terms of story potential butI think this scenario might be too extreme for the time frame you'reproposing.

BothNREM and REM sleep are necessary for continued health and well being.As well as, well life.

Bycutting off sleep at 90-120 minutes the body is being deprived ofhuge chunks of both.It’salso worth noting that the patterns of NREM and REM sleep atdifferent times of the night might well be doing different things.Experiments where researchers have interrupted particular chunks ofsleep at particular times seem to suggest different effects.

Allthe experiments I’m aware of that do that with people have beenpretty short term (the longest I’ve seen was a few days) andtorture/abuse scenarios don’t generally tend to focus on oneparticular type of sleep.  

Therearesome experiments on rats from uh- the days before ethics committeescared about rats. Researchers deprived rats of sleep until they died.Then they tried depriving rats of particular kinds of sleep to see ifthat makes a difference. Deprived of REM sleep rats die as quickly asthey do from total sleep deprivation. Deprived of NREM sleep ratsstill die, but it takes three times longer. Around 15 days and around45 days if you’re interested, (please be kind to rats).

Forhopefully obvious ethical reasons I’ve got no idea how this maps onto humans.

Myinstinct here is that the 6 month time frame is probably going to bemore important to the story then where exactly in the sleep cycle thecharacter wakes. I can see exactly where you’ve got the 90-120minutes from, it’s the first cycle of REM sleep. It’s alsotypically one of the shorter periods of REM sleep.

ButI’m not sure how survivable 6 months on 2 hours of sleep is.

Unlessthe character was already ill, injured or immuno-compromised then I'mnot sure it would be directly fatal. By which I mean- I don't thinkthey'd be dying from the kind of gut bacteria rapidly infecting theentire body in a lethal way that killed those experimental rats. Butthere's still a lot of ways that this extreme state of sleepdeprivation could more indirectly lead to death.

Forinstance it massively increases the chances of a heart attack orstroke in adults. And that chance rises still further the longer aperson is sleep deprived. The drop in reaction speed, processinginformation, working memory and coordination can all lead to seriousaccidents. Combined over the long term accidents are almostguaranteed.

I'vefound individual cases of real people surviving periods similar toyour character on similar amounts of sleep. But every case I've foundseemed to involve someone who was hospitalised for most of that time.

Youcouldplausibly have the character live but he’d need some prettyintensive care. Because of how agitated and emotionally volatilesleep deprived people can be (coupled with the memory loss it causes)I think he’d need to be watched round the clock. He’d need peoplethere to tell him where he was and why occasionally. He’d needpeople who could persuade him not to leave the sick room, not to dodangerous things or to just calm him down.

Thislevel of sleep deprivation for this time would effectively take himout of the story. If that’s what you want and the story is centredon other characters saving him, that’s absolutely fine. But if youwant this character playing a more active role then I thinkincreasing the length of time he’s sleeping nightly is going to benecessary.

I’vegot some suggestions for that I think could fit with the story idea,first I think I should talk about the likely effects of what you’vegot.

Ithink the first thing to really grasp is that there isn’t really aleveling out effect with sleep deprivation. There isn’t a pointwhen any of these factors stop getting worse. Not until the charactergets some sleep. In that sense it’s very much like starvation:there’s only one way to treat the problem and even then there’s arisk the damage already caused is too great for total recovery.

Inthe long term, ie after he’s able to sleep normally again and pastimmediate recovery, this character will still have a hugely increasedrisk of a whole host of problems. Cancer, virtually every sort, seemsto become more likely with sleep deprivation. Heart attacks, strokes,diabetes. Vaccines become less effective (sometimes ineffective) ifthey’re administered when someone is sleep deprived. Which can leadto problems later. There’s a decrease in fertility for both men andwomen. Increased risk of Alzheimer’s. There are also effects on theDNA some of which may be permanent. Most of the effects I’ve readabout are effectively ‘ageing’ the DNA, shortening the protectivetelomere caps on chromosomes. This means that changes may not bepassed on to children but I’ve not seen an epigenetic study on thesubject.

Theremight well be generational effects.

He’dcertainly be looking at a shorter life span generally.

Interms of when he’s actually being deprived of sleep. Well over thistime frame with this extent of sleep deprivation it would be prettycatastrophic.

Hismemory would… probably pretty much fail from a functionalstandpoint. He’d very quickly reach a point where he’s forgettingmost of the time he’s awake.

He'dbecome extremely emotionally unbalanced. Depressive symptoms, extremeagitation, aggression and anxiety are all common. Highs of positiveemotions are possible too, technically. But I've only ever seen thatdescribed in cases where sleep deprivation was voluntary. Sleepdeprived people don't tend to stay in one of these moods but havepretty severe mood swings between them. Unless they're alreadysuffering from a condition effecting mood.

Ifthe character has a pre-existing mental health problem this willprobably set it off. Sleep deprivation for one night has been shownto knock people with manic depression from a 'stable' emotional stateinto either a depressive episode or a manic episode. Sleepdeprivation has also been linked with increased suicide attemptsacross a variety of mental health problems.

Thelack of REM sleep in particular would effect his ability to processemotions. It stops us from...decoupling intense emotion from memory.That doesn’t just mean that negative experiences feel moreintensely negative for longer. It more broadly effects emotions and aperson’s ability to navigate them.

Italso interferes with our ability to accurately recognise otherpeople’s emotions. And when sleep deprived we tend to err towardsseeing other people as threatening.So we don’t just misread their emotions but we tend to read theworst possible intent.

Lackof REM sleep also effects creativity and problem solving. Buthonestly, given the extent of sleep deprivation here generally Idon’t think that would be distinguishable from the character’sother symptoms. His memory would likely be so bad that creativeproblem solving would be impossible anyway.

He’dprobably talk nonsense pretty regularly and he’d hallucinate. Mostsleep deprivation hallucinations I’ve heard of have been eitherneutral or negative. A lot of them sound pretty threatening andfrightening. And they’re likely to further feed into negativeemotional states.

Physicallyspeaking he’d have extremely slow reaction times. He’d sometimesfail to react completely. Within the first week I think he’dstruggle with fine motor control, things like doing up buttons. He’dget shakes. By the first month I’m not sure he’d be able to walk.

He’dget sick much more easily and even simple colds would have a muchbigger impact on him. He’d take longer to recover. Wounds wouldtake longer to heal and infections would be more likely.

He’dfeel more hungry and a lot of the food he’d crave would be fattyand sugary.

Ontop of all this sleep deprived people have been consistently shown tounderestimate the effect of not having enough sleep. Like drunks whoinsist they’re sober sleep deprived people thinktheyare capable of doing things they’re in no state to attempt.

AndI feel like it’s worth stressing that this ispainful. It’s a kind of pain that’s difficult to describe becauseit’s not really associated with anything other than lack of sleep.But it is pain. It is the marked lack of something essential to oursurvival.

Maybe this is exactly what you’re going for; it would be a good way totake a character out of the plot for a while. However if you want thecharacter playing a more active role then I think allowing him moresleep is essential.

Obviouslyyou want to keep the connection to REM sleep and dreaming (it’sgenius, you want to keep it). So I’d suggest rather than cuttingoff sleep at 90-120 minutes during the first short period of REMsleep at ‘cycle 1’, do so during the longer period of REM sleepat around 5-5 ½ hours in ‘cycle 4’.

Theselater cycles of REM sleep are longer and may be more intense. Easilydouble the length of time of the first REM sleep cycle. They’realso the periods of REM sleep that currently seem to be judged asmost significant.

Andthis would stillleave your character on death’s door in the time frame you’vegot, he’d just have a longer period where he could play a moreactive role in the plot.

Fivehours sleep a night, rather like some of the crazily extreme dietsout there, is incredibly damaging and very much normalised.

Forinstance, sleeping about 6 hours a night rather than about 8 raisesthe risk of serious injury in professional athletes from about 35% (8hours) to about 75% (six hours). That’s not ‘over a prolongedperiod’. That’s one night of missed sleep.

Aftersix nights the response time of someone who is regularly sleeping forabout 4 hours is at the same level as someone who didn’t sleep atall for a night. That’s an average drop of 400%. (From separatetests, someone driving on 4-5 hours sleep is almost four and a halftimes more likely to crash).

There’sa delightfulexperiment where a scientist squirted live cold viruses up the nosesof volunteers. Which showed that if someone slept an average of fivehours over the week before their infection rate was around 50%,whereas at seven hours or more the infection rate is around 18%. Asimilar level of sleep restriction (4-6 hours a night for a week)leads to a 50% drop in immune response to vaccines. And a singlenight on four hours sleep leads to a 70% drop in natural killercells.

Ander- testosterone levels fall to a degree that effectively ‘ages’men by 10-15 years.  

Practicallyspeaking what this wall of statistics means for your character isthat he’d be able to functionfor a good period of that six months. Perhaps as long as 3-4 months.But he’d show a noticeable drop in ability across- basicallyeverything.

It’sa drop that he’d gradually become acclimatised too. He’d probablyclaim that he’s ‘used to it’ and can do things again. Eventhough his actual performance would say otherwise. He’d also besubject to the same intense emotions and mood swings and significantmemory problems.  

Andas with the more extreme scenario every aspect would be getting worseevery day. Neither scenario has a 'leveling out' affect where he'sat a steady physical/mental performance. A long term sleepdeprivation story is about decline. What I'm suggesting here ismaking the decline less steep. Because the original scenario wouldvery quickly rob the character of his ability to remember, physicallyperform tasks, think coherently, communicate and survive.

Someoneon five hours of sleep for six months is probably also going to behallucinating, occasionally incoherent, unable to concentrate andparanoid by the end. But I think someone who was only sleeping fortwo hours a night could get to that stage in the first or secondmonth. One of the sleep scientists I've been reading compares theemotional and mental effects of sleep deprivation to severe mentalillness and from everything I can see he isn't wrong. The paranoiaand hallucinations are reminiscent of psychosis, the extreme moodswings are reminiscent of manic-depression. The upswing in suicideattempts is frankly terrifying, especially when put into the largersocial context encouraging long term lack of sleep. Sleepdeprivation, even in the relatively short term, causes structuralchanges in the brain.

Iwant to leave you with both options because I think that the'appropriate' level of sleep for this character is really dependenton your story and what you want the character to do. If you want thecharacter to be active in fixing the problem and able to communicatehis situation with any coherency beyond the first few days then Ithink you need to change how long he's asleep for. If on the otherhand you need him out of the story for a period of time and you wantother characters to fix the situation for him then the first scenarioworks perfectly well.

Ofall the books I've read on sleep and the lack of it recently, I thinkthe one most relevant to this ask (and most readable) is M Walker'sWhyWe Sleep(Penguin 2017). He doesn't explicitly reference every study he quotesbut he does give credit to the scientists who conducted the work andfurther details can be found by looking up their universities in mostcases. I think you'd also benefit from taking a look at some survivoraccounts of sleep deprivation. So far as I can tell none of thesurvivors in Monroe's book were sleep deprived and Alleg doesn'treally describe it in 'TheQuestion'.

Ithink the best book you could get hold of is an old Russian one byMenachem Begin called WhiteNights.I haven’t gotten hold of a decent copy yet but it’s one of thesurvivor accounts of sleep deprivation everyone references. For aninside view of what it feels like I think you should give it a look.

Ihope this helps. :)

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