A Farewell to REMs

For $600 and a stack of TV dinners, I surrended my sleep cycle to the Walter Reed dream police.

BY WARREN COHEN

May 4, 1990 (2042 words)

The man in the white lab coat shook me awake. "Don't drop out on us," he coached. "You can do it. Stay alert."

Eyes half-opened, I scanned the room for solace. My three companions remained hypnotized by the television, viewing an encore screening of Weekend at Bernie's. more lab-coated researchers stood behind a row of computers-watching us watch TV. The walls were painted orange, except for a bucolic forest scene wallpapered to the back wall: gazing at it, I began to dream of past vacations.

A loose wire brushed my face. Damn! One of my electrodes had come undone again. Electrodes? What were we all doing wired up like lab monkeys? The horror came back to me, and I sought escape to the oblivion of sleep. But my lab-coated sentry banished the sandman. "'You can do it. Stay alert."

I had been awake for hours...days...months...eons, living this horrible nightmare. But unlike most nightmares, this one actually happened. In fact, I volunteered for it by enlisting in a sleep study at the Walter Reed Institute for Behavior Biology.

Housed in a horseshoe-shaped one-story complex in Silver Spring, the institute is one of the nation's leading sleep research centers. An offshoot of the military hospital, it was founded in 1952 to study the biological workings of sleep, alertness, and fatigue to help the military build a better soldier. Today, the institute shares its secrets of sleep with universities across the country.

Animal rights activists fear not-the institute's sleep experiments use only the real McCoy. To this end, volunteers are asked to forego sleep for between 24 and 72 hours. Depending upon the experiment, institute researchers may pump subjects with a battery of drugs-including deprenyl, nicotine, and high-octane stimulants-to disturb the sleep cycle. All the while, a vigilant team of psychiatrists and researchers observes and records the subjects' behavior.

The institute's brass insists the studies are worth losing sleep over. "Sleep research is interesting because no one knows why we sleep," says chief physician Una McCann. "It's the major unanswered question of human behavior."

Like my three fellow guinea pigs, I had responded to one of the institute's advertisements in local college newspapers seeking healthy, non-smoking males. Sam was a fundraiser for a non-profit group; James, a phys-ed major; and Victor, a community college student from Baltimore. A co-ed group would have increased the appeal of five days in an isolation chamber, but the military bias against women extends to sleep studies. The institute's doctors say that women's hormonal fluctuations make them poor sleep study subjects.

The pre-experiment screening consisted of a comprehensive physical exam, 23 bloods tests (including a test for HIV), and repeated oaths that I was sane and drug-free. I made the cut.

My ambition wasn't to advance the science of sleep. Nor was I lured by the promise of an "altered states"-type sensory experience in the isolation chamber. I had been told that Walter Reed was the Hay Adams of sleep studies and that its human subjects are handsomely compensated-$600 and all the Lean Cuisine you can eat. I envisioned a pleasant weekend retreat occupied with reading, letter-writing, and movie-watching. It sounded like a painless way to make some fast cash.

They called the experiment I participated in "Catecholaminergic Modulation of Sustained Performance in Rested and Sleep Deprived Humans." Catecholamines are neurotransmitters believed to restore alertness as humans sleep. Hence the study. "We want to know what goes on during sleep that makes you feel better when you wake up," the institute's Dr. David Penetar told us.

The hypertension drug AMPT (alpha-methyl-para-tyrosine) stops the production of catecholamines. The goal of the study was to gauge AMPT's effect on alertness by subjecting drugged and non-drugged volunteers to a variety of performance tests while screwing up their sleep cycles.

The subjects were divided into four categories. Given the luck of the draw, the weekend stay could be a breeze if I was a part of the "control group" that was sent to sleep at bedtime and received a blue sugar-pill placebo instead of a blue capsule containing AMPT. The other three possibilities: no sleep, no AMPT; sleep, but AMPT; and the dreaded double whammy-no sleep, plenty of AMPT.

My foursome, like the other foursomes that the institute recruited for other weekends, had no way of knowing exactly what fate awaited us-nor did the researchers. They, too, were "blinded" as to who got the capsules of AMPT and who got the sugar placebos, and they wouldn't be let in on the secret until the experiment was over. If the doctors knew who got what during the study, they might have treated the drugged subjects with excessive sympathy and ''contaminated the data" as scientists put it.

I feared the double whammy: The doctors said three nights with no sleep were easier to endure than one sleepless night on AMPT. But how bad could it be? I had a long history of pulling all-nighters. And so what if drooling, jaw-clenching, and diarrhea were potential side-effects of AMPT? "The highest dose we give is 20 milligrams, which is in a clinical range," Penetar assured. "We're not here to blow peoples' heads off."

We acclimated ourselves to the test surroundings by sleeping at the institute on Thursday night and returned Friday evening to begin the study in earnest, bidding the outside world good-bye until Tuesday morning.

The staff spent an hour gluing 11 electrodes to my scalp and chest until I looked more android than human. The wires ran through a Velcro collar and dumped our mental output into "medilogs," Walkmanlike contraptions that recorded the data on cassettes. A fisherman's vest held the machinery in place.

Friday night was uneventful. We played cards, dined on TV dinners prepared in the isolation chamber's kitchenette, and were introduced to the computer tests that would measure our cognitive performance throughout the weekend. A 15-minute session, with tests ranging from arithmetic to intricate logic games, measured our alertness. There was also "number zapping," a scientist's idea of a video game in which you press a key to shoot a number when it appears on the screen. The researchers' hypothesis was that our scores would gradually decline if we were drugged and/or sleep-deprived.

Upon our 7 a.m. Saturday reveille, we received the single whammy: Our group would all be kept awake for 40.5 hours until 11:30 p.m. Sunday. My new friends and I (insomnia loves company) resolved to reserve our strength for the wee hours of the morning, when the effects of sleep deprivation are most acute.

At noon, we swallowed the first of our seven doses of "the drug." We watched each other closely for evidence of AMPT. It wasn't until midafternoon that I realized I had drawn the double whammy. One moment I was relaxed; the next, I felt as drained as if I had just completed a triathalon. I lost all interest in TV, always a sure sign of affliction. I tried to write a letter but I could barely address the envelope. I sat in a drowsy stupor, eyes at half-mast, while the doctors constantly prodded me awake.

The computer tests became an ordeal. Simple addition problems seemed like Boolean algebra. I stumbled on the logic tests. My number-zapping scores plummeted as I could no longer distinguish digits from Rorschach inkblots. I created my own academic challenge: how to sneak quick dozes without being caught by the researchers. At this I inevitably failed, being jolted awake with my hands sprawled across the keyboard.

Then there were the 17 sleep latency tests to measure our escalating sleepiness. One by one, we were led to a blissful paradise- a dark, sound-insulated room with a full-sized bed. The researchers asked us to fall asleep, then left the room. Our only connection to the outside was a wire that ran from our medilogs under the door to our watchers. The moment our brain waves revealed that we had dozed off, the researchers rushed into the room and woke us. Dr. McCann said that most people enjoyed this test because it gave them time for a catnap.

Right, Dr. McCann. The sleep latency tests were brutal teases-clearly derived from the Old Gulag torture techniques used to extract confessions from discredited revolutionaries. I, too, buckled, and meekly begged for sympathy and five more minutes of sleep. The doctors stood firm.

I soon realized that my comrades, though tired, were faring much better than I. Their conversations revolved around me: "Is he awake?" "Boy, he looks horrible." "I'm glad I didn't get drugged." While they were enjoying a sugar buzz, I was fast losing the will to live.

Round midnight, I pleaded to be released from the study. I feared my sleeping patterns would be irrevocably ruined by the ordeal, and that I might never sleep again. Let me drop out, I implored. The researchers reminded me that they couldn't turn me loose until Tuesday even if they stopped drugging me and let me sleep. Besides, if I quit, I'd forfeit most of the $600 payment. All smiles and pep talks, the doctors laughed off my anxieties. I stayed awake through the night.

Sunday's sunrise brought my nadir. Human beings' circadian rhythms-our internal activity cycles-reach their low point in the early morning hours. My companions and I were more mummies than men, wrapped in wires and showing few signs of life. The researchers rousted us for a hike around the complex. To passing cars, we must have resembled those government-protected, institutionalized mentally ill patients I'd read about in too many science-fiction novels. My faith in humanity was shaken when no one called the police to rescue us.

By midmorning, the double whammy had KOed my sociability. Dr. Penetar had warned that mood deteriorates as people become sleepier. (Duh!) We'd been logging our moods each hour on a "behavioral analysis questionnaire," and mine deteriorated from affability to antagonism. The free meals now seemed a nauseating mix of gruel. The doctors were meddlesome dream police. And I ceased taking the computer tests seriously, not bothering to read the question before I pushed a button. During the sleep latency tests, I fell asleep as soon as the light went out. The dream police barely had a chance to record my brain waves.

My body finally surrendered Sunday afternoon. During a routine blood test, I began to hallucinate, losing 3-D perspective as the room spun and throbbed. For the first time, the doctors lay me down and ignored my snoring for a few minutes. I didn't regain consciousness until they pulled the needle from my arm. Then it was out into the freezing weather for another forced march.

I don't have any solid recollections of Sunday evening. I knew I spent it glued to the television, but I can't remember what was shown. My friends told me later that I was written up in the log book for being "uncooperative" because I demanded the doctors fix me a tuna fish sandwich. I ate the bread, tuna, and mayonnaise separately with my fingers.

Relief finally arrived at 11:30 p.m. Sunday, as the doctors eased us into bed. My last waking thought-floating like a comic strip bubble above my head-was that I had done this experiment on my own volition.

Monday was supposed to be our recovery day. We weren't given any more blue pills, but I still felt woozy from the AMPT. My computer test scores picked up a little and I could hold a conversation without slurring my words. We went to bed early that night.

As my friends and I departed the isolation chamber on Tuesday morning, I wondered what kind of data I had been able to provide after I lost my ability to think-much less add or subtract. The doctors said I had done fine. "Our hypothesis is that AMPT blocks catecholamines that are necessary for normal alertness," Dr. Penetar briefed us. "And although we haven't completed the study, it appears that the people who had the drug get sleepier faster.

And in science, once again, the obvious was proven.

Copyright 1990 by Washington City Paper. All rights reserved.


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