Dreamland: Adventures in the Strange Science of Sleep

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Dreamland: Adventures in the Strange Science of Sleep Page 13

by David K. Randall


  Although the reasons are unclear, about one in five people will sleepwalk at least once in their lifetime, though most outgrow it by the time they are in middle school. Sleepwalking children are relatively mellow and lethargic, whereas adults who wander around at night tend to make quick movements, as if they are in a hurry to do something. Scientists can’t yet account for the difference.

  Sleepwalking isn’t the only complex behavior that can happen in your sleep. People with parasomnias can do pretty much every basic human activity while sleeping, including talking, eating, driving, masturbating, and having sex. (Some people with sexsomnia, as it’s called, are better lovers while they are asleep than when they are awake. As one doctor told me, “This condition is only a problem if the person sleeping next to you doesn’t like it. No harm, no foul.” The same doctor also said he believed a better term for the disorder would be snore-gasm.) The only difference is that they have no conscious awareness of what they are doing. It’s as if their bodies have rebelled and decided to go about their business without the brain’s input.

  In the early 1980s, two doctors at the Minnesota Regional Sleep Disorders Center in Minneapolis began cataloging the number of patients who complained of injuring themselves or their bed partners in their sleep. As part of their investigation, Mark Mahowald and Carlos Schenck videotaped each patient sleeping at least one night in the hospital’s lab. What they found was a window into a bizarre world. Older men with sweet dispositions turned into angry sailors in the middle of the night, repeatedly swearing and punching the wall next to them. Other patients suddenly sat up, stared intensely at the wall, and then dove headfirst into the nightstand. And at least one man sat at the foot of the bed, bellowing show tunes while fast asleep.

  Parasomnias seemed to be a particularly male trait. The wives of some patients came in complaining that their sleeping husbands had put them in a headlock the night before or had tried to strangle them. Not surprisingly, these couples would often end up sleeping in different rooms. In a series of interviews conducted by the doctors, one woman said that her otherwise mellow husband would get out of bed during the middle of the night and crouch in the corner of the room and snarl like a wild animal. Another said that her sleeping husband repeatedly destroyed the furniture. “He broke so many lamps in our bedroom,” she said. “You don’t want to spend any money on lamps because you know they’ll be flung across the room.” Other patients with parasomnias said that they had flung themselves out of second-story windows while sleeping. This usually happened only once: after the first time, patients took to tying themselves to their beds at night out of fear that they might inadvertently commit suicide. Patients told the doctors tales of getting into a car and driving more than ten miles to a family member’s home, of running down the street with dogs nipping at their heels, and of almost snapping someone’s neck in their hands—all while sleeping. Out of these and other cases, Mahowald and Schenck were the first to identify and classify what are now known as violent parasomnias. As with sleepwalking, almost all are caused by partial arousals in the brain.

  Like blond hair or high arches, parasomnias run in certain families. My own habit of sleepwalking, for instance, may be something I inherited. It wasn’t until after I began working on this book that my father told me stories of his sleepwalking on the farm where he grew up, in Kansas. More than once, he told me, he woke up in his pajamas in the middle of a cornfield.

  The Parks family tree was not the place to look for normal sleep patterns. Or dry sheets. The Parks men shared the embarrassing habit of wetting the bed, a condition that scientists tactfully call enuresis, well into their teens and twenties. Doctors blamed it on staying in deep sleep for too long. All would later sleepwalk as adults. In a bizarre variation of the midnight snack, Ken’s grandfather would often sleepwalk into the kitchen and start frying eggs and onions on the stove, only to go to bed without eating. The family traits didn’t skip Ken. When he was eleven, his grandmother caught him trying to climb out of a sixth-story window while he was sleepwalking.

  Parasomnias, and sleepwalking especially, can be triggered by sleep deprivation. As the brain struggles to make up for its lost sleep, it stays in the deeper stages of sleep for a prolonged time and doesn’t always make a smooth transition to the next stage. Those rough handoffs lead to weird behavior. Ken, after spending two sleepless nights worrying about his marriage and the money he owed, was perfectly primed for a sleepwalking episode.

  There was no question that Parks killed his mother-in-law. The only real question was whether he was sane on the night of the murder. The British, Canadian, and American legal systems all come from English Common Law and have wide areas of overlap. In each country, criminal law is based on the idea that in order to be found responsible for a crime, a person needs not only to have committed an act but also to demonstrate mens rea, or a guilty mind. This is how we separate accidents from crimes. If your brakes go out suddenly while you are driving on a busy street and you hit and kill a person, you won’t be charged for murder, even though you were responsible for another’s death (whether you should have known that your brakes were on the fritz is another matter). But if you purposely used your car as a weapon, then deadly action was paired with deadly intent.

  The precedent of considering the mental state of the wrongdoer goes as far back as ancient Babylonia, where people who knowingly broke the law were put to death in much more gruesome ways than those who simply made a very bad mistake. In Greek mythology, Hercules was forgiven for killing his children during a rampage because he was put under a spell of madness by Hera, who was both Zeus’s wife and sister and clearly dealing with some of her own issues. In 1843, the notion that a mental disorder nullifies criminal responsibility was codified in what became known as the M’Naghten rule, named after a case in which Daniel M’Naghten, a schizophrenic, shot and killed the secretary to the British prime minister while in the midst of a paranoid delusion. After he was found not guilty, public outcry that stretched as far up as Queen Victoria led the House of Lords to pass the first laws establishing the limits of the defense of insanity. Though it has been tweaked and modernized, the basic gist of the law still applies as written: “to establish a defense on the ground of insanity, it must be clearly proved that, at the time of the committing of the act, the party accused was laboring under such a defect of reason, from disease of mind, and not to know the nature and quality of the act he was doing; or if he did know it, that he did not know he was doing what was wrong.”

  Observers in the Parks trial thought that if Ken was indeed sleepwalking, he had a chance at acquittal under the definition of insanity. But simply pleading insanity doesn’t mean that an accused person is given a free ticket home. Instead, many are sent to mental institutions for the rest of their lives and given no chance of parole. It can be just as bad as prison. Parks refused to claim that he was insane because he thought it meant he wouldn’t see his daughter again.

  His attorney was left to develop a novel defense. Sleepwalking, she said, wasn’t a defect of the mind. It was simply a normal condition in which the body acted without any conscious input from the brain. Therefore, she reasoned, Parks couldn’t be held responsible for something he never chose to do, and couldn’t be deemed insane for a common and temporary state. In effect, she was asking for the jury to agree that Parks’s mind was both not guilty and fully rational, even though his body committed a crime. It was the first time in Canadian history that a defendant claimed to be asleep when he was killing someone.

  During the trial, Parks’s attorney called Roger J. Broughton, an assistant professor of neurology at elite McGill University, to the stand. A few years earlier, Broughton had published an influential article in Science magazine in which he argued that contrary to Freudian reasoning, which viewed moving during sleep as an acting out of blocked emotional pain, disorders like sleepwalking or sleep talking were not a result of a person’s mental state. The idea that sleepwalking reflected emotional turmoil was ac
tually much older than Freud’s theory. In a theatrical device that reflected the understanding of the time, Shakespeare implies that the guilt of murdering her husband’s rival is what pushes Lady Macbeth into sleepwalking.

  Broughton told the jury that Parks was most likely in deep sleep from the time he got off his couch to the time he walked into the police station. That would account for his lack of memory and for his apparent lack of motive. Broughton’s theory was that Parks drove to his in-laws’ house while acting out a dream, and that his series of movements would have been suppressed by hormones in a normally functioning brain if it wasn’t for his genetic predisposition toward sleepwalking. Once there, his mother-in-law tried to wake him up, and that was when he went into a violent rage. No one knows why, Broughton told the jury, but sleepwalkers often react aggressively when confronted.

  On cross-examination, the prosecutor asked how Parks was able to safely drive all fourteen miles of a route that included three stoplights if he truly was sleepwalking. Because his eyes were open, Broughton answered. Just as sleepwalking children can perform complex maneuvers such as walking down a flight of stairs without falling and hurting themselves, he argued, Parks was able to drive that night on a very familiar route without getting into an accident because he was essentially on autopilot.

  Perhaps swayed by Broughton, or the fact that Karen testified in Ken’s defense, the jury acquitted Parks of all charges after only a few hours of deliberation. Though it was obvious he had killed one person and came very close to killing another, the jury found that he did not do so voluntarily. Instead, Parks’s deeds were classified under a new category—officially called a non-insane automatism—that allowed him to walk outside of the courtroom a free man.

  After the verdict, frustrated prosecutors filed an appeal in hopes of preventing a surge of defendants claiming that they, too, had been asleep at the time of a crime. During the hearing, justices on the court puzzled over whether Parks’s sleepwalking was so extreme that it could be termed a disease, like schizophrenia, and thus fit within the definition of insanity. But without any scientific evidence to support different degrees of sleepwalking, this argument fizzled away. Next, they discussed whether Parks was a ticking bomb, primed to kill again in his sleep. But again, there was nothing in the medical records to suggest that a person who has one extreme sleepwalking episode is likely to have another. In a somewhat exasperated decision, the court finally ruled, “This case is extremely troubling. The facts are so extreme that it stretches credulity to think that a person could perform all of those apparently deliberate acts over such an extended period of time without volition or consciousness. But the wisdom of the jury’s verdict cannot be the subject of review in this court.” It continued: “When asleep, no one reasons, remembers or understands. Medical experts do not understand exactly why those faculties do not function during sleep but it is accepted that they do not . . . If the respondent’s acts were not proved to be voluntary, he was not guilty.”

  Nearly twenty years after Parks left the courtroom a free man, Michel Cramer Bornemann steps behind a lectern in a hotel banquet hall in central New Jersey. With a black shirt, red tie, pale skin, and black hair, he looks like he would be equally at home in a room full of Johnny Cash impersonators. A few hundred physicians and medical researchers have gathered here on a cold October morning to listen to him give the keynote address at the New Jersey Sleep Society’s Annual Educational Symposium. Cramer Bornemann is an assistant professor of neurology at the University of Minnesota and has published several influential research studies, but that’s only part of the reason why he is attracting a crowd. It is his side job that leads to calls from lawyers and law enforcement officials from around the world, to numerous requests to write articles for scientific journals, and to a recent symposium given in his honor at Cambridge University.

  All of the attention comes from the fact that he is perhaps the world’s only doctor devoted to investigating the strange habit of humans to commit crimes while they are asleep. In a way, he is the personification of the legal and medical worlds that Ken Parks created. Cramer Bornemann’s life is spent looking at cases of sleepwalking, sleep driving, and sleep sex, all because he sees it as the next step toward reaching a full understanding of what it means to be conscious. He is a detective of the human mind, living in a world in which what Parks did was odd only by degrees. “What in essence we’re doing is developing and defining a new field of sleep forensics,” he tells the crowd.

  It is a field with a greater demand than you might expect. Even before Ken Parks, a stream of defendants accused of violent crimes claimed to be sleepwalking, including at least two unrelated cases involving some unlucky person receiving an axe to the head. Few of them were successful. Albert Tirrell, the son of a wealthy shoe manufacturer in Boston, is thought to be the first person to cite sleepwalking as a defense and win. That came in 1846, well before science had any understanding of the nature of sleep or sleep disorders. Tirrell’s attorney was able to convince the jury that his client slit the throat of a prostitute and burned down her brothel while in the throes of a nightmare. He wasn’t so skilled at getting him out of the charge of adultery, however, and Tirrell ended up spending three years doing hard labor at a state penitentiary. Thirty years later, a Scottish man was acquitted of killing his young son while asleep, but he was freed only after he agreed to never sleep in the same room as someone else again. Sleepwalking cases popped up here and there in the following decades.

  Then came the Ken Parks ruling. Within seven years after his acquittal, there were in Canada alone five well-known cases of defendants claiming to be sleepwalking when committing a crime. Around the world, cases of sleep violence were increasingly put before juries. In 2009, a fifty-nine-year old Welsh man was acquitted of murder after he claimed that he was sleeping when he strangled his wife of forty years in their motor home while they were on vacation. Like Parks, his attorney argued that he was not insane and thus did not belong in a mental institution. The judge and jury agreed. “You are a decent man and a devoted husband,” the judge told him from the bench. “I strongly suspect that you may well be feeling a sense of guilt about what happened that night. In the eyes of the law, you bear no responsibility.”

  Surely some people who use sleepwalking as a defense are lying. But some are not. Those are the cases that Cramer Bornemann looks for. While he likes to help district attorneys identify liars who attempt to weasel out of their crimes by claiming to be asleep, he is most interested in the truth-tellers who give him a chance to document the strange capabilities of the sleeping body.

  No one really knows how often a night’s sleep leads to a crime scene, in part because of the nature of the things that sleepwalkers do. The brain isn’t able to formulate a plan while awake and then carry it out while asleep, which means that there are no Bernie Madoffs or John Dillingers in the annals of sleep crime. Sleepwalking incidents that result in causing someone else pain tend to fall between two extremes, neither of them pleasant. In most cases, a person who acts violently in his sleep is a threat to whomever he or she shares a bed with. If a woman throws an elbow and breaks her boyfriend’s nose while they are both asleep, the only authority involved will most likely be the doctor who bandages him up. Because there are no police reports or any other official records, there is no way to know how often these incidents of nocturnal violence happen unless they find their way to a courtroom. One study in the Journal of Trauma: Injury, Infection, and Critical Care cited twenty-nine cases of sleepwalking that resulted in an injury either to the sleepwalker or to those nearby. “There is a large tolerance from the family and even the medical community to episodes of somnambulism [sleepwalking], and it seems that the potential life-threatening risks associated with nocturnal wandering are not well understood,” its authors noted, with a tone of bewilderment. This is often the case with REM sleep behavior disorder, a rare condition that mostly affects older men in which the brain doesn’t paralyze the body during REM s
leep like it is supposed to. The result is that patients act out their dreams. The wives of patients with this disorder often tell the sleep doctor stories of their husbands hitting them, and worse, while still asleep.

  Cramer Bornemann investigates the other extreme of sleepwalking. Determining whether someone was asleep while committing violent acts ranging from child molestation to murder could mean the difference between freedom and the death penalty. That’s not all. In a study published by the Journal of Forensic Science in 2003, Cramer Bornemann detailed cases of people falling from hotel rooftops, getting hit by cars after marching into traffic, and picking up loaded guns and shooting themselves—all while sleepwalking. The official term for this is parasomnia pseudo-suicide. Determining that these were accidents, and not intentional, can have profound emotional effects on the victim’s surviving family members. Identifying sleepwalking as the cause can also trigger life insurance policies that don’t cover suicide.

  Cramer Bornemann didn’t set out to be the Columbo of sleep crime. Not long after medical school, he was studying patients with amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease, at the University of Minnesota as part of an investigation commissioned by the National Institutes of Health. In a clinical trial, his team found that one of the first signs of respiratory problems associated with the disease surfaced during the later stages of non-REM sleep. Patients essentially had to work harder to breathe when they entered the deepest stages of sleep. Armed with this early clue, doctors could offer patients respiratory support before any larger symptoms arose. “From that, I became so enamored with sleep that I transitioned my career to focus solely on it,” he told me.

 

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