The Difference Between Sleep and Anesthesia

Prof. Emery Brown of MIT on the rapid eye movement stage of sleep, electroencephalogram patterns, and the role of GABA receptors

videos | June 26, 2014

Which diagnostic methods can help us distinguish different stages of sleep? Was Michael Jackson given the right treatment for sleep deprivation? Professor of Computational Neuroscience at Massachusetts Institute of Technology Emery Brown explains why we use anesthesia in certain conditions.

If sleep were anesthesia or if anesthesia were sleep, I should say, then taking care of patients and surgery would be very easy — we’ll just wait till they fell off to sleep and then just roll them down to the operating room and operate on them. And we certainly don’t do that. What anesthesia really is – is a coma, it’s a drug-induced reversible coma that has these four components: you’re unconscious, you don’t feel pain, you’re not moving, and you form no memory about what’s going on during the time that you’re under the anesthesia, and we keep you physiologically stable.

We think that what sleep does it allows us to reconstitute, it allows us to help form memories, to help consolidate memories that we formed during the day and it helps us to learn, and it might be very important for maybe even reconstituting our immune system so we can fight off infections. So that’s a physiologic condition. Anesthesia is entirely different. Based on the type of surgery that you need we actually give you a series of drugs that actually holds you in a fixed drug-induced state for as long as necessary for the surgeon to complete the surgical procedure that he or she is undertaking.

Having explained the difference between sleep and anesthesia, let’s think about the Michael Jackson case. What we know is that Michael Jackson was administered propofol supposedly in order to help him sleep. Well, if you think about what I just said that at best all he was getting is some type of sedation, and it’s very likely that having gotten sedation and not being able to go through the normal cycling between the REM and non-REM states he most likely deprived himself of sleep during the time that he was actually taking propofol or he was being administered propofol as opposed to getting real sleep or getting restful sleep.

Warren M. Zapol Professor of Anaesthesia, Harvard Medical School, Department of Anesthesia and Critical Care, Massachusetts General Hospital; Professor of Computational Neuroscience, Department of Brain and Cognitive Sciences, MIT; Professor of Health Sciences and Technology, Harvard/MIT Division of Health Sciences and Technology, MIT
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