Observations Heads Up

We need to wake up to the value of sleep medicine

BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g6099 (Published 15 October 2014) Cite this as: BMJ 2014;349:g6099
  1. Krishna Chinthapalli, associate editor, The BMJ
  1. [email protected]

More UK medical schools teach complementary medicine than sleep medicine

The first known victim was an anonymous middle aged doctor from Venice. He had suffered from an inability to sleep for over a year before he experienced complete paralysis and died in 1765. Over the centuries half of his descendants succumbed to the same fate; they initially found it difficult to sleep at night and after a few months were only able to drift off into a daydreaming state for a few minutes (now known as stage 1 sleep) before waking. Eventually they developed a permanent confusional stupor, with pinpoint pupils, sweating, tachycardia, ataxia, myoclonic seizures, and akinetic mutism.1 Another doctor, Ignazio Roiter, married into this family and discovered the hereditary nature of the illness in 1979. Sadly the disease still lives up to its name: fatal familial insomnia. It is caused by deposits of misshaped prion protein in the thalamus, which destroy neurones essential for deep “slow wave” sleep (stages 3-4).

Sleep is important for learning and consolidating memories. In one study participants either slept or stayed awake for three hours …

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