Meaning of a Dream

The Man Who Never Slept may sound like an urban legend - but it's actually the title of a BBC television documentary about Fatal Familial Insomnia (FFI). This is a tragic genetic disease that kills its victims through total sleep deprivation. It affects only a few dozen families around the world and often strikes after the child-bearing years are over. It is a cruel disease, but the study of total insomnia has taught us a lot about the human brain and the need to sleep.

The man who never slept was named Michael Corke, a music teacher from Chicago. He slept fine all his life until one day, shortly after his 40th birthday in 1991, Corke began having trouble sleeping. In the following weeks, his sleeplessness grew worse and his health deteriorated. Eventually he was plagued by total insomnia - he could not sleep at all.

Doctors were baffled by Corke's condition and he was with Multiple Sclerosis, even though insomnia is not a symptom of MS. Nobody understood why he couldn't sleep, or why sleeping pills and barbiturates made it worse. Tragically, Michael Corke died in hospital after six months of total sleep deprivation.

After hearing about the man who never slept, I researched Fatal Familial Insomnia by reading The Family That Couldn't Sleep: A Medical Mystery by D T Max. I learned about prion disease (the underlying cause of FFI) and its affect on the brain, concluding that total sleep deprivation eventually equals death.

That is, until I was contacted by a man named John Alan Jordan, who claims he has not slept a wink for the past three years following a severe fever. Jordan believes he was the victim of molecular poisoning, which caused prolonged fever and subsequently total sleep deprivation. There is no name for his condition - he calls it total insomnia - and his sleeplessness is yet to be explained by science, which is why he wants to raise awareness of his condition today.

This is Jordan's story.

As a teenager, John Alan Jordan was a high achiever. He had excellent grades in Biology, Physics and Electronics. He went on to work as a laboratory assistant at a leading dairy company in England.

A few months into his new job, Jordan lost his temper in the lab and abandoned normal safety procedures. He decided to retrieve the plastic milk bottle samples without wearing any protective gloves. By doing so, Jordan exposed himself to broponol kathon (used for dyeing cows' milk cells), ammonia, hydrochloric acid and industrial strength detergent (used to clean the sample bottles).

Jordan continued to work like this for several weeks. But soon, he began to feel more tired than usual. "It would seem to me the detergent molecules passed the blood-brain barrier and contaminated my cerebral spinal fluid, leading to an effect on the temperature control mechanism of the hypothalamus," Jordan explained. "It made me gravely ill for two years with a very high temperature."

When he finally recovered, he found that his memory had deteriorated significantly. Jordan went to see a neurologist but the brain scans showed everything was normal. He then asked to be referred to a psychiatrist, who diagnosed him with schizoaffective disorder (which presents itself with mood swings and psychosis). Jordan rejected this diagnosis, on the basis that his memory still hadn't recovered. Neither did it explain his fever.

Jordan's mental and physical symptoms grew worse. "From around Easter 2006 I stopped sleeping altogether. Sleeping pills and all the usual things any human being might try do not work on me at all... So I just meditate and get lost in my own thoughts when I feel the need to rest." This enables Jordan to slow his brainwaves and relax his body, but is no substitution for real sleep.

Today, Jordan feels largely alone in his condition. He acknowledges that it is exceptionally rare for humans to go for extended periods with total insomnia - much less survive and be able to function normally. However, at just 40 years old, he now suffers from premature dementia and memory problems. Seeing the deadly effects of Fatal Familial Insomnia, and knowing that readers would be incredulous about his condition, Jordan points to the famous Vietnamese farmer, Ngoc Thai, who has not slept for 33 years - also after a severe fever.

Born in 1942, Ngoc Thai is well known for being "the man who never slept." At the age of 31 he came down with a severe fever and has suffered from total insomnia ever since. Amazingly, Thai insists that his sleep deprivation gives him no physical symptoms; now in his sixties, he is still able to carry two 110-lb sacks of rice more than 2 miles to his house every day.

Over the years, Thai has tried many medications and traditional folk remedies to cure his insomnia. Nothing worked. Doctors who have examined him say he is in good health, albeit with a slightly weakened liver function. This could be related to his sleep deprivation, or linked with his diet or even the number of sleeping pills he's taken over the years into order to lose consciousness. In 2006, Thai told Thanh Nein News, "I don't know if the insomnia has impacted on my health or not, but I'm still healthy and I can do the farm work normally like others."

Scientists are yet to study Ngoc Thai in any detail. However one specialist, Dr Wadhwa, says the explanation could be in perception. Wadhwa believes that some insomniacs just can't tell the difference between sleep and wakefulness: "The subject may feel they are merely resting when in actuality they are sleeping," he says. "They may also be having micro naps - very short naps lasting minutes." Whether this is accurate or not is still to be decided. The only way we'll know whether total insomnia exists (beyond Fatal Familial Insomnia) is if further study is done on total sleep deprivation sufferers like Ngoc Thai.

How about the woman who never slept? Back in the 1970s, it was reported that a Spanish woman named Ines Fernandez had not slept for more than 30 years. Incidentally, despite suffering from total sleep deprivation, Fernandez did not suffer from Fatal Familial Insomnia.

Her story began in the summer of 1943. Fernandez was standing at the door of her cottage near Caceres in southwest Spain, watching a religious procession pass by. "I suddenly yawned and a searing pain went through my head," she said, "and since then I have never slept. I have taken thousands of pills and medicines and consulted many doctors, but nothing has been of any use."

"There were long, agonizing nights sitting in my armchair next to the bed watching my husband sleep soundly. Now he's gone and I can't stand the terrifying loneliness of the night." At 57, Fernandez lost her husband and became increasingly nervous and frustrated. It prompted specialists in London and New York to help find a cure for her total insomnia.

In her 30 years without sleep, Fernandez was treated by a neurosurgeon, Dr Padios Abril, who said, "I have never known a case like this. I now think an operation would be useful, but it would have to be in England or America, where such specialist clinics exist." The doctor described her condition as chronic cholecystitis (inflammation of the gall bladder) and total insomnia, adding that the sleep section of the brain appeared to permanently impaired.

Whether total sleep deprivation is caused by fever, illness, genetic mutation or psychological disorder, it remains an exceptionally rare condition.

However, if you feel you are suffering from some form of transient, acute or chronic insomnia, my advice is to see a doctor and get diagnosed because there may be an underlying cause. Only then can you understand the best way to treat your condition and start enjoying better quality sleep once again.

Sleep deprivation is a lack of sleep that is needed to function normally. It can be caused by working night shifts; traveling through multiple time zones; sleep disorders like insomnia; stress; depression; the menopause; scientific studies into sleep and dreaming; or interrogation and torture.

However, the main cause is at the root of our busy modern society. We just don't have enough time to get everything done.

This problem causes American businesses to lose $100 billion in lost productivity each year. Worse, tired workers are thought to be responsible for many major disasters - ranging from the giant oil spillage of the Exxon Valdez, to the nuclear meltdowns of Three Mile Island and Chernobyl.

However, in the realm of science, staying awake for lengthy periods is useful for sleep experiments. Scientists can learn a lot by looking at a person's behavior, as they encounter confusion, hallucinations, cognitive problems and micro sleep.

If you've never gone for more than 24 hours without sleep, you won't be familiar with the effects of long term sleep loss. But sufferers of insomnia will tell you: it is definitely not a pleasant experience.

Whereas insomnia describes chronic sleeplessness, anyone can experience short term sleep loss as a side effect of some other problem. The physical effects of sleep deprivation affect the whole body, including:

aching musclesblurred visiondepressioncolor blindnessdrowsinessloss of concentrationweak immune systemdizzinessdark circles of the eyesfaintingconfusionhallucinationssymptoms of drunkennesstremorsheadachesherniahyperactivityimpatienceirritabilitymemory lossnauseapsychosisslow reaction timesslurred speechweight loss or gainconstant yawning "There is no hope for a civilization which starts each day to the sound of an alarm clock"

Author unknown

Recent studies also show a link between sleep deprivation and obesity. People who are deprived of sleep find it harder to break down sugar, increasing the risk of diabetes and obesity in the long term.

Interestingly, when they finally manage to sleep, sufferers of insomnia are more likely to have lucid dreams. Perhaps this is because the normal sleep cycles are thrown out of balance and conscious dreams are more easily triggered.

Needless to say, the physical effects of sleep deprivation are wide-ranging and severe. In fact, if you go for long enough without any sleep, the result can be deadly. This is the case for sufferers of Fatal Familial Insomnia, a rare but incurable sleep disorder that causes total sleeplessness and ultimately death.

Scientists use sleep deprivation studies to isolate the functions of sleep. By looking at how our minds and bodies are impaired after little or no sleep, we can see exactly why sleep is vital to us all.

The most famous sleep deprivation studies involve attempts to break the Guinness World Record. In these experiments, volunteers went for many days and nights without any sleep at all. They allowed researchers to monitor them to see the mental and physical effects of sleep deprivation. Here are two of the more prominent world records:

The New York DJ, Peter Tripp, set a world record for sleep deprivation in 1959. He went for 201 hours (8.4 days) without sleep. He spent most of the time in a glass booth in Times Square, and the rest in a hotel room across the street, set up as a laboratory to monitor his reactions.

The stunt produced strange results. After three days, Tripp began to find things hilarious that weren't funny at all. At other times, he became upset for no reason. He was also confused, asking why there were bolts in the window frames.

By day four, he was suffering from hallucinations and paranoia. At first they were simple patterns - like cobwebs on the doctors' faces, or imagining that paint specks on the table were insects.

But soon his hallucinations became 3D. Tripp imagined mice and kittens scurrying around the room...

Eventually, Peter Tripp became psychotic. He rummaged through draws looking for non-existent money. He accused a technician of trying to harm him. He then claimed he was not Peter Tripp but an imposter. Nothing made sense to him.

On reaching his 200-hour target, Tripp was made to stay awake for one final hour while doctors did more tests. They left the EEG in place as he finally closed his bloodshot eyes and entered a deep 13-hour slumber.

He may have been physically restored, but Tripp's family soon noticed a difference in his personality. His wife said he was moody and depressed. He fought with his boss, became involved in the payola scandal, and was fired from his high profile job as a radio DJ. He went on to have four divorces. Some would say the sleep stunt changed Peter Tripp forever.

Randy Gardner beat the world record for sleep deprivation at the age of 17. A typical high school student from California, Gardner stayed awake for 264 hours (11 days) without using any stimulants. His stunt was part of a school science project on sleep patterns.

The effects of sleep deprivation on Randy Gardner included moodiness, problems with concentration and memory, paranoia and hallucinations. After four days, he had the delusion that he was a famous American football player winning the Rose Bowl. He also mistook a street sign for a person.

On the 11th day, he was asked to subtract seven repeatedly, starting from 100. He stopped when he got to 65... and said he had forgotten what he was doing.

Yet later that day, Randy Gardner held a press conference where he spoke without slurring his words and appeared to be in excellent health.

After his marathon, Gardner slept for nearly 15 hours and returned to a normal sleeping pattern within days. Unlike Peter Tripp (who incidentally used stimulants to stay awake) there were no reports of any long term personality changes.

Peter Tripp and Randy Gardner are known as the most famous sleep deprivation studies, because they involved rigorous scientific testing. They are the most widely cited examples of sleep deprivation today. However, a few other Guinness World Record attempts are worth mentioning.

Less than a month after Randy Gardner's feat in 1964, Toimi Soini of Finland stayed awake for 276 hours (11.5 days). In 1977, Maureen Weston of the UK went without sleep for 449 hours (18.7 days). She began to hallucinate towards the end but reported no lasting effects from her rocking chair marathon.

However, if you are thinking about doing a sleep deprivation stunt of your own - forget it. Guinness World Records no longer recognizes this category because long term sleep deprivation is thought to pose serious health risks, both physically and mentally. It could even trigger other sleep disorders.

What's more, sufferers of chronic insomnia could be staying awake for far longer than these record attempts, which would be unfair to them.

What a shame that the UK's Tony Wright didn't know this when he stayed awake for 266 hours in 2007. He thought he was outdoing Randy Gardner, and hadn't even heard of Toimi Soini. A spokesman for Guinness World Records simply said: "People who attempt records should make sure their research is accurate or they may be very disappointed."

To learn more about sleep deprivation, check out End Your Sleep Deprivation - a website created by Dr Dement, the father of sleep medicine, and the students of Stanford Sleep and Dreams. They share their expert knowledge on the science of sleep so you can sleep healthily and live alertly.