LETTER TO/FROM (DELETED) WITH ENCLOSURE TITLED "REM ELECTRO-THERAPY" RE SLEEP THERAPY AND SLEEP MACHINE

• Document Type: SPECIALCOLLECTION
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): 00173701
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 16
• Document Creation Date: January 21, 2025
• Document Release Date: January 15, 1983
• Publication Date: October 22, 1969

1
7-7
.
Dear i4r.
se"
,
Oct. 22, 1969 .
I thought of you when the author of the attached report came in to see
me the other day. As you see, he has iay.ented a better sleep machine.
The_machine is being used by co-author
i I know enouch about sleep physiology to detect some flagrant
mist57es in the text, but am sending you a copy in hopes you may be
able to giy6 me a:: confidential evaluation. The reason I am asking yo.
to go to the trouble is that is giving a reoort on use of the
machine in San Francisoo
( Do you think the machine is a lot of hookum or may he
have something?
ilectr-onirengineer.
Thanks for any help you can give.
Sincerel.
/P"
cifit4
0
Ito
G- v17-11111-
M ;13
P'''
4*0
�A,441
6('
.14
(He sayg-he is an
�
1�����
REM ELECTRO-THERAPY
THE .RUSSIANS PIONEERED "S.LEEI! THERAPY" OVER
THIRTY YEARS AGO, AND HAVE TREATED MORE THAN 500,000
PERSONS IN SOME 300 SLEEP CLINICS LOCATED IN VARIOUS
PARTS OF THEIR COUNTRY. AMERICAN SCIENTISTS HAVE BEEN
SKEPTICAL OF ELECTROSLEEP BECAUSE OF THE WIDE RANGE or
CONDITIONS WHICH THE RUSSIANS CLAIM TO BENEFIT. LIKE-
WISE, THE RUSSIAN CHOICE OF THE NAME "ELECTROSLEEP" CRE-
ATED THE IMPRESSION THAT IT WAS A MACHINE TO INDUCE NATU-
RAL SLEEP BY ELECTRICAL STIMULATION, AND THAT AN EXTRA
HOUR OR TWO OF NATURAL SLEEP WAS RESPONSIBLE FOR ITS SUC-
CESS. HOWEVER, THE RUSSIANS DIDN'T KNOW HOW OR WHY IT
WORKED ON SUCH AN APPARENTLY UNRELATED GROUP OF AILMENTS,
BUT SINCE IT WAS FOUND THAT MANY OF THE OBSERVABLE AND
MEASURABLE CHANGES THAT OCCUR WHEN AN INDIVIDUAL GOES
FROM WAKEFULNESS TO SLEEP TOOK PLACE DURING STIMULATION,
THE NAME "ELECTROSLEEP" PROBABLY SEEMED TO THEM AS A
LOGICAL CHOICE. UNFORTUNATELY, WHEN AMERICAN INVESTIGA-
TORS TESTED THE ELECTROSON:SOLELY AS A SLEEP-INDUCING
MACHINE RATHER THAN A MODALITY FOR TREATING VARIOUS AIL-
-- MENTS AND FOUND THAT ONLY A PORTION OF rHE SUBJECTS ACT-
UALLY FELL ASLEEP, THEY CONSIDERED THAT THE RUSSIAN CLAIMS
WERE GREATLY EXAGGERATED.
HOWEVER, AT LONG LAST, AMERICAN DOCTORS ARE SHOWING
INTEREST IN ELECTROSLEEP THERAPY BECAUSE OF THE LARGE AMOUNT
OF AMERICAN RESEARCH ON SLEEP StkCE ABOUT 1955. THIS
-1--
-
EL-
�
INTEREST STEMMED FROM THE DISCOVERY OF A NEW KIND OF SLEEP.
. .
AND FROM A NUMBER OF INVESTIGATIONS OF THE EFFECTS OF
SLEEP DEPRIVATION. THIS NEW KIND OF SLEEP IS MOST COMMONLY
CALLED REM, DREAM, OR DEEP SLEEP BECAUSE ITS MOST SALIENT
FEATURES ARE RAPID EYE MOVEMENTS, DREAMING, AND EXTREME
MUSCLE RELAXATION. QUIET, OR SLOW-WAVE, SLEEP IS SO NAMED
BECAUSE OF THE ABSENCE OF THE OCCASIONAL BODY MOVEMENTS OF
REM SLEEP AND THE FACT THAT THE BRAIN WAVES HAVE MUCH LOWER
FREQUENCIES.
MODERN THEORIES ON SLEEP ARE DERIVED FROM A
CONSIDERABLE AMOUNT OF RESEARCH USING THE ADVANCED TECHNIQUES
OF ELECTRONIC INSTRUMENTATION, AND THIS RESEARCH DISCLOSES
THAT THE ONSET OF SLEEP IS A VERY COMPLEX INTEGRATION OF
MANY FACTORS WHICH INVOLVE BOTH EXCITATORY AND INHIBITORY
PROCESSES. THESE THEORIES ARE FAR FROM BEING COMPLETE, BUT,
FOR THE PURPOSE OF THIS PAPER, AN ELEMENTARY DESCRIPTION OF.
PHENOMENA WHICH ARE PERTtNENT TO AN EXPLANATION OF ELECTRI-
CAL STIMULATION ARE PRESENTED HERE.
THE STATE OF WAKEFULNESS IS MAINTAINED BY TWO
ENTIRELY DIFFERENT TYPES OF ACTiVATORY PROCESSES WHICH
ARE CALLED SENSORY STIMULATION AND TONIC FACILITATION.
IN SENSORY STIMULATION, THERE IS A FLOW OF INFORMATION
FROM THE SENSE ORGANS WHICH ARE LOCATED BOTH PERIPHERALLY
AND INTERNALLY THROUGH THE THALAMIC NUCLEjS IN THE BRAiNSTEm
TO VARIOUS REGIONS IN THE BRAIN WHICH ARE SPECIFIC TO EACH
TYPE OF INFORMATION. THE FLOW IS.CONTROLLED OR MODULATED
BY THE SENSORY RECEPTORS, VARIOUS SYNAPSES, AND BY THE
BRAINSTEm CONTROL.,CENTER. THESE STIMULI UNDER_CERTAIN
*CONDITIONS ALSO MAY INDUCE A REVERSE FLOW FROM THE CEREBRAL
CORTEX TO THE BRAiNSTEm CAUSING FuRTHER AROUSAL ACTIVATION.
THE ONSET OF SLEEP MECHANISM STARTS WITH INHIBITION IN THIS
SYSTEM. VISUAL AND AUDITORY STIMULI, MUSCLE TENSION, AND
MOTOR ACTIVITY ALL HAVE STRONG AROUSAL ACTION WHICH ARE
NORMALLY INHIBITED WHEN WE LIE DOWN AND RELAX IN A QUIET,
DARK ROOM. ARTIFICIAL INHIBITION OF. AUDITORY AND VISUAL
STIMULATION IS MOST EFFECTIVELY ACCOMPLISHED BY HABITUATION
OF SPECIFIC MONOTONOUS AUDITORY STIMULI AFTER SOME MINIMUM
NUMBER OF CLICKS ARE HEARD, OR BY A FLASHING LIGHT. REPEATED
FOR A PERIOD OF 300 TO 500 SECONDS. A FAR SuPER1OR VISUAL
STIMULUS, HOWEVER, IS THE INDUCTION OF VISUAL IMAGES BY
ELECTRICAL STIMULATION OF THE OPTIC SYSTEM, SINCE THE
FREQUENCY OF THE FLICKER CAN.BE.INCREASED BY A FACTOR
OF ABOUT THREE BEFORE THE FLICKER DISAPPEARS BY FUSION.
A BY-PRODUCT OF THE HABITUATION OF THE AUDITORY AND VISUAL
SYSTEMS IS THE DEACTIVATION OF MUSCLE TENSION INDUCING A
GENERAL RELAXATION. THIS RESULT IS CONFIRMED NOT ONLY BY .
THE OBSERVED MUSCLE FLACiDiTY BUT BY THE BRAIN-WAVE
PATTERN AS PORTRAYED BY THEENCEPHALOGRAPH WHICH SHOWS
A CHANGE FROM THE ACTIVATORY PATTERN OF WAKEFULNESS TO
THE ALPHA FORM OF THE RELAXED STATE. THE 'SENSORY SYSTEM
IS INACTIVE DURING SLEEP AND IF NO STIMULATION IS PRESENT,
SLEEP WILL FOLLOW. THIS PHENOMENON IS EXEMPLIFIED BY .THE
CASE OF A SUBJECT WHO, THROUGH INJURY, LOST THE SIGHT IN
ONE EYE AND THE HEARING IN ONE EAR, WHO WOULD FALL ASLEEP
EVENTUALLY WHENEVER THE GOOD EYE AND EAR WERE COVERED AND
PLUGGED RESPECTIVELY.
IN ORDER TO PREVENT UNWANTED SLEEP THE BRAIN AS
PROVIDED WITH A CONTINUOUS STIMULATION WHItH ORIGINATES
IN THE MESENCEPHALiC HEMISPHERE OF_ THE. B-RAINSTEm. THIS
TONIC FACILITATION WHICH KEEPS THE BRAIN AWAKE HAS A MAXI -
muM.1NTENSITY AFTER AWAKENING AND IT IS CONTINUOUSLY SUP-
PRESSED DuRIN:G-T-M'E -DAY WITH A MINIMUM mAGNITuDE-AT BED-TIME..
THE ORIGIN OF THIS SUPPRESSION OF TONIC FACILITATION IS
RELATED TO THE NEED FOR RECOVERY WHICH PROGRESSES DURING
THE DAY AND TERMINATES IN SLEEP. THE TIME FOR RECOVERY
RANGES FROM MAGNITUDES MEASURED IN MILLISECONDS, SUCH AS
THE NERVES, TO HOURS IN THE CASE OF THE HIGHEST LEVEL CF
CEREBRAL ACTIVITY. THIS HIGHEST LEVEL IS FOUND TO OCCUR
IN LEARNING AND CONDITIONING WHICH IS THE REASON FOR THE
LARGE AMOUNT OF TIME SPENT BY A BABY IN SLEEP.
THIS
ACTIVITY IS BELIEVED TO 'PRODUCE CHANGES IN THE LARGE GLIAL
CELLS AND SYNAPSES IN THIS LEVEL, AND THESE CHANGES ARE
CONSIDERED TO PROGRESSIVELY SUPPRESS THE TONIC FACILITA-
TION OF THE MESENCEPHALON DURING THE DAY,' SO THAT WHEN
THE SENSORY STIMULI ARE CUT OFF, SLEEP WILL FOLLOW.
SOME PROCEDURES USED BY SCIENTISTS FOR FINDING
A CORRELATION BETWEEN A SPECIFIC REGION AND ITS FUNCTIONS
'ARE TO STIMULATE TUC REGION WITH VARIOUS CHEMICALS OR
ELECTRICAL CURRENTS OF VARIOUS CHARACTERISTICS, ANO OBSERVE
THE PHENOMENA PRODUCED; AND TO CUT OR REMOVE A SPECIFIC
REGION AND OBSERVE THE CHANGE IN PHENOMENA BEFORE AND �
AFTER RE-STIMULATION, SOMETIMES SUPPLEMENTED BY'APPROPIATE
ELECTRONIC INSTRUMENTATION.
WHEN THE mESENCEPHALON IS REMOVED IN ANIMALS A
SLEEP-LIKE STATE CHARACTERIZED BY EYE CLOSURE, MUSCLE
RELAxATtON, LOWERED PULSE AND RESPIRATION RATES, AND
INSENSIBILITY TO TACTILE PRESSURE HAS BEEN PRODuCED. THE
SAME SLEEP-LIKE STATE HAS BEEN INDUCED BY INSERTING AICRO.
ELECTRODES AND PASSING A LOW FREQUENTY CURRENT THROUGH THE
mESENCEPHALON.
IN REVIEW, IT HAS BEEN ESTABLISHED THAT THREE
STIMULI CAN PROVIDE 'THE CONDITIONS FOR THE ONSET- OF SLEEP,
NAMELY, AN AUDITORY MONOTONE FOR HABITUATING THE AUDITORY
CORTEX1.AN ELECTRICAL FLICKER FOR HABITUATING THE VISUAL
CORTEX - EITHER ONE OF WHICH WILL INDUCE A RELAXED MUSCULATURE
AND A LOW FREQUENCY ELECTRICAL CURRENT WHICH MUST PASS
THROUGH THE BRA1NSTEM IN ORDER TO DEACTIVATE THE MESEN�
CEPHALON. HOWEVER, A NEW PROBLEM EXISTS BECAUSE TWO
DIFFERENT ELECTRIC CURRENTS FLOWING IN THE SAtfE REGION
WILL INTERFERE WITH EACH OTHER. THIS PROBLEM WAS SOLVED
BY SYNCHRONIZING THE TWO ELECTRICAL CURRENTS. THIS
.SYNCHRONIZATION PROOuCED AN AMAZING RESULT � THE ELECTRI�
CAL FLICKER WAS TWICE AS BRIGHT IF THE LOW FREQUENCY CUR-
RENT THROUGH THE ESRAiNSTEM WAS THE SAME AS THE ALPHA
RHYTHM, AND IF THE FLICKER CURRENT FREQUENCY WAS FOUR
TIMES THE ALPHA FREQUENCY. THE RESULTS WERE OPTINum WHEN
THE MONOTONE WAS ALSO SYNCHRONIZED WITH THE TwO ELECTRICAL
STIMULI. THE THREE SYNCHRONIZED STIMULI � AUDITORY MONO�
TONE, ALPHA DRIVE, AND ELECTRICAL FLICKER � INDUCE A STATE
OF RELAXATION, A SLEEP�LIKE STATE, OR SLEEP.
CONCERN OVER LOSS OF SLEEP BY THE ARMED FORCES
DURING WAR RESULTED IN NUMEROUS STUDIES ON THE EFFECTS OF
SLEEP DEPRIVATION SINCE IT HAD BEEN KNOWN FOR A LONG TIME
THAT SLEEP DEPRIVATION LEADS TO MAL�FUNCTION, PERMANENT.
DAMAGE, AND FINALLY DEATH; AND ALSO THAT TEMPORARY SLEEP
LOSS IS MADE UP BY INCREASED SLEEPING TIME DURING THE
RECOVERY PERIOD. THE MENTAL SYMPTOMS OF SLEEP LOSS FOLLOW
A SLOW AND PREDICTABLE PATTERN, AND THE CHANGES ACCELERATE
AS TIME PASSES. SOME OF THE CHANGES FOLLOWING SLEEP
DEPRIVATION ARE: INATTENTION, WEARINESS, LACK OF CONCEN�
TRATION, LOSS OF MEMORY, SLURRED AND FAUCTY SPEECH, LIST�
LESS BEHAVIOR, REDUCED MUSCULAR EXERTION, ANXIETY, SKIN
SENSATIONS, WITHDRAWAL FROM REALITY, TIME DISORIENTATION,
VISUAL DISTORTIONS, ILLUSIONS, HALLUCINATIONS, SEVERE
PERSONALITY CHANGES, AND FINALLY A PSYCHOTIC STATE. THE
EEG's OF BRAIN WAVES SHOWED AN ALTERNATION BETWEEN THE
ALPHA FORM AND THE SLOW SLEEP�LIKE WAVES, AND THESE AL�
TERNATIONS ARE CALLED "miCROSLEEPS".
�
�
SLEEP IS PRECEDED BY A DECLINE IN ACTIVITIES
OR PERFORMANCE AND BY SUBJECTIVE FEELINGS OF TIREDNESS,
WHICH HAVE BEEN CONSIDERED TO BE DUE TO AN ACCUMULATION
DURING WAKEFULNESS OF WASTE PRODUCTS WHICH ARE DISPOSED
OF DURING SLEEP OR OF A DEPLETION DURING WAKFEULNESS OF
^ITAL CHEMICALS WHICH ARE REPLENISHED DURING SLEEP. WHEN
CEREBROSPINAL FLUID FROM FATIGUED DOGS IS INJECTED INTO
NON-FATIGUED DOGS, THE LATTER SHOWED SIGNS OF DROWSINESS
AND SLEEP, THUS INDICATING THAT A HYPNOGENIC SUBSTANCE
ACCUMULATED DURING WAKEFULNESS. SEROTONtN, WHICH IS A
HORMONE"-LIKE SUBSTANCE EXHIBITING A WIDE RANGE OF
POWERFUL EFFECTS ON THE BRAIN AND OTHER ORGANS OF THE.
BODY, IS FOUND IN CEREBROSPINAL FLUID. SIMILAR EXPERIMENTS
WITH WATER-SOLUBLE EXTRACTS FROM THE BRAINS OF SLEEPING
ANIMALS PRODUCED SLEEP IN THE RECIPIENT ANIMALS. THE
MEDULLA AT THE BASE OF THE BRAINSTEm CONTAINS THE RAPHE
NUCLEI WHICH ARE NOTED FOR THEIR PRODUCTION .OF SEROTONIN.
WHEN 80% OF THE CELLS OF THESE NUCLEI ARE DESTROYED THE
EXPERIMENTAL ANIMALS SLEPT LESS THAN 10% OF THEIR NORMAL
PE.R100. SIMILARLY, THERE IS A LOCUS COERULEuS NUCLEUS
�
JUST BELOW THE RAPHE NUCLEI WHICH CONTAINS THE SYSTEM FOR
PRODUCING REM SLEEP, AND .THIS NUCLEUS USES NORADRENALiN
FOR ITS ACTIVATING AGENT.
e
IT HAS BEEN LONG SUSPECTED THAT THERE AS A STRONG
LthK BETWEEN INSOMNIA AND MENTAL ILLNESS: IN ONE'TWO-
YEAR SURVEY OF SEVERAL HUNDRED MENTAL PAT'I'ENTS .(WITH
PSYCHOSES, DEPRESSIONS, AND OTHER AILMENTS), IT WAS FOUND
THAT 81% OF THEM HAD BEEN SUFFERING FROM SLEEP DISORDERS,
AND-mANY OF THEM WERE COGNIZANT THAT SLEEP LOSS' WAS.THE
CAUSE OF THEIR.AILmENT. IN ANOTHER STUDY OF A 1:7..RGE NUMBER
OF PATIENTS HAvINC HEART SURGERY, IT WAS FOUND THAT A HOSPITAL
IS NO PLACE TO FIND REST. PATIENTS'� COMPLAINED BITTERLY OF
LACK OF SLEEP IN 4 BUSY WARD WITH HOuRCY.mEDICAL CHECKS AND
.-6-
EXTENDED NURSING CARE. THIS STUDY, oiscuosEp THE FACT THAT
IN A THREE TO FIVE DAY POST�OPERATIVE PERCOD� OVER onc�
Tiltuo or TUE- PATILNTN HAD DIVCLOPED PADANOID
DLI INtDM, DI:i0IIILNIAIION, AND HALLUCINATIONS WHICH VANISHED
ArTIN LIM l'ATIENr WA IPLACLO IN A QUICT HOOM WITH A
MINIMUM NUMDCH or INTEDNUPTIONG. Tlicsc AND OTHER STuOICS
Lo:; or SLLEP INTO rocus AS AN IMI'DRTANT FACTO( IN
MEDICAL PRACTICE SINCE IRE SLEEP DEPRIVATION STUDIES .
SHOWED TRAT THE SYMPTOMS APPEARING WERE ESSENTIALLY THE
SAME AS FOUND IN THE MENTALLY ILL. ' THE IMPORTANT QUESTION
IS, THEREFORE, WHICH KIND OF SLEEP LOSS IS THE CULPRIT.
SEVERAL STUDIES OF REM SLEEP DEPRIVATION WERE MADE
AFTER OVERCOMING THE DIFFICULTIES OF DETERMINING THE EXACT
TIME THAT REM DREAMING STARTED AND ENDED. WHEN AN
INDIViDuAL'GOES TO SLEEP, HIS INITIAL QUIET SLOW�WAVE
SLEEP LASTS FOR A PERIOD OF 60 TO 90 MINUTES AFTER WHICH
HE STARTS DREAMING. THERE ARE NORMALLY FOUR OR FIVE OF
THESE REM PERIODS, IN WHICH THE FIRST ONE IS THE SHORTEST
ANO THE LAST ONE IS THE LONGEST, AND ONLY THE DREAMS OF
THE LAST ONE ARE REMEMBERED. THE TOTAL REM SLEEPING TIME
IS, ON THE AVERAGE, 20% OF THE TOTAL PERIOD. THESE STUDIES
DISCLOSED. THE AmAilAG FACT THAT THE LOSS OF REM SLEEP
PRODUCED ESSENTIALLY THE SAME MAL�FUNCTIONING THAT OCCURRED
WITH TOTAL SLEEP DEPRIVATION. THE SUBJECTS ACTUALLY SLEPT
MUCH LONGER THAN USUAL IN THE QUIET SLOW�WAVE PHASES AND
THEY WERE EXTREMELY DIFFICULT TO AWAKEN. 'THE DISCOVERY
OF THIS BASIC PHENOMENON PROVIDES THE SCIENTIST WITH A NEW
TOOL FOR ATTACKING SLEEP DISORDERS AND THEIR DERIVATIVE.
AILMENTS. THiS THIRD STATE OF CONSCIOUSNESS CAN BE '
IDENTIFIED BY ITS SALIENT CHARACTERISTICS SUCH AS AN EEG
PATTERN RESEMBLING THAT OF WAKEFULNESS, RAPID EYE MOVEMENTS,
OFTEN JERKING OF THE LIMBS, MARKED FLACiDiTY OF NECK MUSCLES,
AND ALMOST ALWAYS A REPORT OF DREAMING WHEN AWAKENED.
ANOTHER IMPORTANT FACET OF TOTAL SLEEP DEPRIVATION IS THAT
THERE IS A CHANGE IN QUALITY OF SLEEP, AND THIS CHANGE .
IS FOR THE WORST SINCE THERE IS A LARGER PERCENTAGE LOSS
OF THE REM STATE.
SLEEPING PILLS AND TRANQUILIZERS ARE USED IN
LARGE QUANTITIES FOR THEIR HYPNOGENIC EFFECTS, AND, SINCE
THERE' ARE TWO KINDS OF SLEEP, INVESTIGATIONS WERE CONDUCTED
ON THE KIND OF SLEEP WHICH THEY INDUCED. THE SURPRISING'
RESULTS WERE THAT BARBITURATES, TRANQUILIZERS, AMPHETAMINES
AND ALCOHOL SUPPRESS THE REMHSTATE.WHEN TAKEN REGULARLY.
WHEN REM SLEEP DEPRIVATION IS TERMINATED THERE IS
A REBOUND IN THE RECOVERY PERIOD- IN WHICH THE SUBJECT
SLEEPS FROM II TO 14 HOURS AFTER SEVERAL NIGHTS OF SLEEP .
LOSS WITH A MUCH HIGHER THAN NORMAL PROPORTION OF REM SLEEP.
WITH LONGER PERIODS OF DEPRIVATION THE PROPORTION OF REM IN�
CREASED. ANIMAL STUDIES DETERMINED THAT AFTER REM SLEEP
DEPRIVATION THEY SEEMED
ONCAm PLUIOW:. FUNTUCH
itt.100 PuLNOMLNON
TO RECOVER ABOUT 60% Or THEIR LOST
sTuoiEs WIRE MADE ON THL UCCOVERY
TWO CitOUPS' or RATS UCRRivCr) 01 LCCp
FOR rOuk OR rivt: DAYS WHERE ONE GROUP WAS GIVEN A SLIGHT
ELECTRIC� SHOCK BY TOUCHING THE ELECTRODE TO THE EAR. � THE
uNSHOCKED CONTROL GROUP SHOWED THE USUAL INCRemENTAL COMPEN-
SATORY PERIOD OF REM SLEEP BUT THE SHOCKED GROUP SPENT AMUCH
SMALLER PERIOD IN REM SLEEP. THIS KEY aPtRIMENT PROVIDES A
NEW METHOD CF QUICKLY REMOVING REM SLEEP DEPRIVATION EFFECTS
IN THE RAT WHICH WAS SUBSEQUENTLY VERIFIED IN THE CAT� NAMELY,
B-Y PASSING AN ELECTRICAL CURRENT THROUGH THE-HEADS OF THESE
'ANIMALS. THIS EXPERImENT
CURRENT CAUSES THE RELEASE
THE FLOW OF THE ACTIVATING
SUGGESTS THAT THE ELECTRIC
OF A.COMPOUND .THAT COULD BLOCK
AGENT 'FOR REM SLEEP, WHICH AS
BEEN IDENTIFIED AS NORADRENALIN. IT HAS SEEN KNOWN FOR
-8-
SOMETIME THAT THE PONTINE RETICULAR FORMATION CONTAINS
A TIMING DEVICE WHICH PRODUCES REM SLEEP AT REGULAR.
INTERVALS BUT WHICH IS INTERRUPTED DURING WAKEFULNESS.
IT HAS SEEN DETERMINED EXPERIMENTALLY THAT A SPECIFIC
DOSE OF RESERPINE IN CATS LEADS TO A COMPLETE ELIMINATION'
OF REM SLEEP FOR AS LONG AS FOUR DAYS. A POSSIBLE
HYPOTHESIS IS, THEREFORE, THAT THE ELECTRIC CURRENT
COuNTERAuTED.THE BLOCKING EFFECT OF A RESERPINE�LIKE
SUBSTANCE OF EITHER THE TIMING DEVICE OR OF THE EXCRE�
TION OF NORADRENALIN
FROM THE LOCUS COERuLEuS
REGION.
IF THE CAUDAL PONTiNE
RETICULAR FORMATION IS
CUT
OR
REMOVED, REM SLEEP IS
COMPLETELY ELIMINATED,
CUT
IF
THIS REGION IS STIMULATED ELECTRICALLY WHILE
MAN
IS
IN A SLOW SLEEP�LIKE STATE, REM SLEEP WILL FOLLOW. IT
IS POSSIBLE FOR STRONG AROUSAL STIMULI OR DRUGS, SUCH
AS AMPHETAMINE, TO COUNTERACT THIS ELECTRICAL STIMULA�
TION. THUS, WE FIND THAT ELECTRICAL STIMULATION OF THE
BRAINSTEm AFTER SENSORY HABITUATION LEADS TO A QUIET .
SLEEP�STATE FOLLOWED BY THE REM STATE IN WHICH SYMPTOMS
OF REM SLEEP DEPRIVATION ARE REVERSED. THESE CHANGES
ARE DRAMATIC IN A LARGE NUMBER OF.CASES.FOR IN MANY
INSTANCES A SINGLE ONE�R,OuR STIMULATION COMPLETELY
REVERSES THE SYMTOLOGY OF DEPRESSION AND OTHER SIMILAR
MENTAL DISORDERS INDUCING A STATE OF CALMNESS AND WELL�
/
BEING.
Tuc CLINICAL APPLICATION or.cLcciuscAL STIMuLATION
TO MAN iNTROOUCES THE PROBLEM OF PASSING AN ELECTRICAL CUR�
RENT THROUGH THE HEAD, BY MEANS OF EXTERNALLY ATTACHED: .
ECECTRODES_y4STEAD,OF THE USE OF INTRA-SKuLL MICRO-
-. -
ELECTRODES PLACED IN A SPECIFIC REGION OF THE BRAINSTF:m.
THE SIZE OF THE RETICULAR FORMATION OF THE BRAiNSTEm 15 NO
BIGGER THAN THE LITTLE FINGER, SO IT IS OBVIOUS THAT AN
ELECTRICAL CURRENT FROM EXTERNAL ELECTRODES WOULD PASS
_o_
THROUGH ALL REGIONS OF THE RETICULAR FORMATION IF IT
PASSED THROUGH THE BRAINSTEM AT ALL.
ACCORDING TO OSCILLATOR
TO CURRENT FLOW IS A MINIMUM FOR
THE SPONTANEOUS RHYTHMS, AND THE
IN THE REGIONS IMPLICATED IN THE
THEORY, THE IMPEDANCE
FREQUENCIES APPROXIMATING
RHYTHMS WHICH ARE FOUND
INDUCTION OF SLEEP HAVE
FREQUENCIES WHICH RANGE FROM LESS THAN 1 CYCLE/SEC. TO
ABOUT 14 C'YCLES/SEC. Fon EXAmPLE, THE WAVES IN THE
PoNTINC RETICULAR FORMATION DURING REM SLEEP ARE 6 TO 8
CYCLES/SEC., AND THE WAVES.FOR DROWSINESS ARE 8 TO 12
CYCLES/SEC. WHICH ARE ESSENTIALLY THE ALPHA RHYTHM.
HOwCVER, THE MOST EFFECTIVE ELECTRICAL FL icKERA FREQUeNCY
IS 32 TO 40 CYCLES/SEC. WHICH IS. THE THIRD HARMONIC OF
THE ALPHA RHYTHM, AND THEREFORE WILL PROVIDE MINIMAL
STIMULATION OF STRUCTURES WITH SPONTANEOUS FREQUENCIES OF
8 TO 10 CYCLES/SEC. THUS, WE FIND THAT FOR OPTIMUM STIMU-
LATION OF THE OPTIC NERVE AND THE BRAINSTEM RETICULAR FOR-
MATION TWO OSCILLATORS ARE REQUIRED WITH A 4:1 FREQUENCY
RATIO.
THERE ARE THREE LOW IMPEDANCE PATHS IN THE
HEAD; JUST UNDER THE SCALP, THROUGH THE SURFACE AT THE
BASE OF THE BRAIN, AND ALONG THE OPTIC NERVE WHICH EX-
TENDS FROM THE EYES TO THE V4SUAL CORTEX. ELECTRICAL
�
FLICKER CAN BE INDUCED WITH MINIMAL CURRENT iNTENSITY
WITH ELECTRODES ON THE mASTOiDS BEHIND THE EARS, WITH
CORRESPONDING
mENT PRODUCES
ELECTRODES OVER THE EYES, BUT THIS ARRANGE-
PSYCHOLOGICAL EFFECTS, SUCH A; ANXIETY AS
WELL AS THE SIDE EFFECTS. OF BLURRED VISION
IN SOME PAT4ENT.S,....INFREQuENT LARYNGEAL SPASMS,,JH ADDITION:
TO MINIMAL CURRENT IN THE BRAINSTEM. FOR MAXIMUM
CURRENT IN THE BRAINSTEM, THE CURRENT SHOULD FLOW
EITHER BETWEEN THE TWO MASTOIDS OR FROM AN ELECTRODE AT
-10-
THE BACK OF THE HEAD AT THE SASE OF THE OCCIPITAL LOBE
TO FOREHEAD' OR TEMPLE ELECTRODES. THE LATTER ARRANGEMENT
IS SUPERIOR BUT IT INTRODUCED 4 NEED FOR THE DEVELOPMENT
OF A NEW TYPE OF ELECTRODE FOR CARRYING CURRENT FROM THE.
SURFACE OF THE HAIR, WHICH IS PARTICULARLY THICK ON.wOmEN
AND HIPPIES, TO THE SCALP.' THE IDEAL FLICKER ELECTRODE
ARRANGEMENT IS EITHER WITH .TEMPLE OR FOREHEAD ELECTRODES,
JUST OVER THE EYES.
SUMMARIZING THE PHENOMENOLOGY, WE FIND THAT,
SLEEP DISORDERS ARE THE GENESIS FOR A MAJOR PORTION OF
MENTAL ILLNESS AND THAT REM-STATE SUPPRESSION IS THE
ACTIVATING AGENT, AND THAT MOST OF THE DRUGS FOR TREATING
MENTAL ILLNESS NOT ONLY DO NOT HAVE MUCH CURATIVE VALUE
BUT ARE THEMSELVES A PARTIAL CAUSE OF THE CONDtTiONS WHICH
THEY ARE SUPPOSED TO TREAT. APPR-OPRVATE-ELECTRiCAL
STIMULATION APPEARS TO PROVIDE THE BEST SOLUTION BECAUSE
IT HAS NO SIDE EFFECTS, SUPPRESSES DRUG WITHDRAWAL REBOUND,
AND PRODUCES IMMEDIATE RELI.EF OF SYMPTOMS IN A SUSSTANTiAL
PROPORTION OF THE MENTALLY ILL.
LOOKING AT THE CLINICAL APPLICATIONS OF REM
ELECTRO-THERAPY, A GUIDING PRINCIPLE FOR PROGNOSTICATING.
ITS PROBABLE EFFICACY IN TREATING VARIOUS AILMENTS WOULD
BE.TO LOOK FOR CORRELATIONS BETWEEN THE REM DEPRIVATION
PHENOMENA AND THE SYMPTOLOGY OF VARIOUS AILMENTS TEMPERED
BY THE KNOWLEDGE THAT THE mOOLIS OPERANDS OF REM ELECTRO-
THERAPY INCLUDES: RAPID DISSIPATION OF REM HYPNOTOXINS,
REHABILITATION DURING REM SLEEP, AND THE SUGGESTIBILITY
OF THE APPARATUS PER SE. THIS SUGGESTIBILITY KAY BE EITHER
FACtLiTATIVE OR COUNTERACTIVE DEPENDING ON THE THOUGHTS
WHICH WILL BE BROUGHT INTO CONSCICAISNESS BY ASSOCIATION
WITH THE STORED mEmORiES OF PAST EXPERIENCE. FOR EXAMPLE,
THE PATIENT REACTION TO THE APPARATUS HAS BEEN ICO%
COUNTERACTIVE IN ALL CASES OF PATIENTS WHO HAVE PRE�
VIOUSLY BEEN GIVEN ELECTRO�CONVULSIVE SHOCK TREATMENTS.
ANOTHER EXAMPLE WHICH PROVIDES A QUANTITATIVE RESULT IS,
OBTAINED FROM A CLINICAL PRACTICE ANALYSIS OF ONE THOU�
SAND PATIENTS IN JAPAN TREATED BY AN ELECTROSLEEP MACH�
INE WHICH USED EYE ELECTRODES' THE APPARATUS PROVED TO
�
BE COUNTERACTIVE TO ALMOST ONE�FOURTH OF THE PATIENTS .
SINCE IT WAS FOUND THAT 26.7% OF THEM SHOWED NO CHANGE
OR RESPONSE DURING OR AFTER TREATMENT, BUT NEARLY ALL
BECAME DROWSY OR SLEPT AFTER RESTIMULATION WHICH FOL�
LOWED THE ADMINISTRATION or A MILD SLEEPING DRUG WHICH
WAS INEFFECTIVE BY ITSELF. THE FACILITATIVE EFFECTS �
�
OF THE APPARATUS WERE DEMONSTRATED BY THE FACT THAT
AFTER FOUR OR FIVE TREATMENTS, A SUBSTANTIAL NUMBER
OF THE PATIENTS WENT INTO FIRST�STAGE SLEEP AFTER THE
ELECTROOES WERE ATTACHED BUT BEFORE THE CURRENT WAS TURNED'
ON.
AN EXAMINATION OF ELECTROSLEEP CASE HISTORIES
REVEALS THE.CONCLUSION_THAT THE MAJORITY OF THE AILMENTS
TREATED COULD BE DIVIDED INTO TWO DOMAINS � THE REM STATE
AND THE NEUROGENIC DOMAINS, WHEREIN THE FIRST INCLUDES
ALL CASES IN WHICH THE SYmPTOLOGY IS RELATED TO REM DE�
PRIVATION PHENOMENA, AND THCSECOND INCLUDES THOSE ILL�.
.NESSES WHERE IN REM ELECTRO�THERAPY WOULD 6.NLY CONTRIBUTE
�NEuRoGENICALLY TO THE RELIEF OF SYMPTOMS 'RESPECTIVELY.
THE REM STATE DOMAIN WOULD OBVIOUSLY INCLUDE INSOMNIA,
DEPRESSION, SCHIZOPHRENIA, ETC., WHEREAS THE NEUROGENIC
DOMAIN WOULD INCLUDE DERMATITIS, ULCERS, HYPERTENSION, ETC.,
WHEREIN PHYSIOL-OGrCAL CHANGES MIGHT ALSO BE IMP-ORTANT
CAUSAL FACTORS. A QUANTITATIVE EXAMPLE OF THE NEUROGEN1C
DOMAIN IS GIVEN BY THE RUSSIAN STu.DY OF 376 PATIENTS
SUFFERING FROM ARTERIAL CONGESTION !N WHICH ELECTRoSL.EEP
TREATMENTS PROVIDED sYmPTOLOGICAL IMPROVEMENTS IN 52% OF
THE CASES AND SLIGHT IMPROVEMENT IN 38%.
BRAIN TISSuE IS CAPAOLE OF TOLERATtNC SOmE
TYPES OF STIMULATION OVER LONG PERIODS OF TIME. TIGSuE
DAMAGE CAN OCCUR IN TWO WAYS, VIZ., ELECTROLYTICALLY AND
THERMALLY. ELECTROLYTIC DAMAGE OCCURS WITH ANY DIRECT
CURRENT STIMULUS AT ANY CURRENT .0ENSITY, RESULTING IN
DECOMPOSITION OF ELECTROLYTES AND DIFFUSION OF METAL
INTO TISSUES. UNIDIRECTIONAL CURRENT PULSES CAUSE THE
SAME DAMAGE BECAUSE SINGLE PULSES ARE CUMULATIVE OVER
SHORT INTERVALS OF TIME. THE HISTORY OF ELECTRICAL
STIMULATION OF THE BRAIN DISCLOSES THAT SEVERAL FORMS
OF ELECTRICAL CURRENT HAVE BEEN .USED INCLUDING DIRECT,
ALTERNATING, AND .UNIDIRECTIONAL PULSES. TODA.Y, THERE
ARC THREE BASIC TYPES OF CURRENT IN USE - BALANCED,
UN3ALANCED RECTANGULAR PULSES, AND THE LATTER PULSES
SUPERIMPOSED ON DIRECT CURRENT. A BALANCED RECTANGULAR
PULSE HAS A FORWARD CURRENT EQUAL TO THE BACKWARD CURRENT
WHICH WOULD BECOME AN UNBALANCED PULSE IF THE FORWARD AND
BACKWARD FLOWS ARE UNEQUAL. AN UNBALANCED PULSE HAS A
UNIDIRECTIONAL COMPONENT. TISSUE TOLERANCE STUDIES HAVE
_DETERMINED THAT BALANCED RECTANGULAR PULSES CAN PASS
THROUGH TISSUE FOR AN INDEFINITE PERIOD. OF TIME, SUCH
AS WOULD BE REQUIRED OF A PERMANENT IMPLANT PROVIDING
THAT THE AMOUNT OF ELECTRICAL CHARGE .1N EACH PULSE 010
NOT EXCEED 200 MICRO COULOMBS. OBVIOUSLY, MUCH LARGER
CHARGES COULD SE USED FOR INFREQUENT STIMULATION.
HOWEVER, IF THE PULSES ARE UNIDIRECTIONAL, THE CHARGE
.PER PULSE FOR EQUAL TOLERANCE IS LESS THAN 20 MICRO
COULOMBS. DATA ON DIRECT CURRENT BIAS T'OLERANCE IS NOT
AVAILAULL OUT or cousc.;E THE CORRESPONDING CuRRENT MAGNIJUDE
WOULD BE MUCH LOWER. THE LATEST PRIOR ART ELECTROSLEEP
GENERATORS USE AN UNBALANCED PULSE WITH .4 DIRECT CURRENT
BIAS AND THEREFOiiE WILL CAUSE ELECTROLYTIC OUSSOCIATtON
AND DEPOSITION OF METALLIC IONS IN THE BRAIN TISSUE. THE
NATURE OF THE EFFECTS OF THIS DEID.OSITiON IS SUGGESTED BY.
CONVULSIVE ELECTRO�SHOCK TREATMENTS IN WHICH MEMORIES OF
CONTEMPORARY EXPERIENCE ARE DESTROYED. THE REASONS FCR
II A.
A .111
HABITUATED TO A SPECIFIC MONOTONOUS AUDITORY STIMULUS,
SUCH AS A SOUND OF CONSTANT AMPLITUDE AND PITCH, AND IF
THE MARGINAL BRA1NSTEm STtmuLATION OBTAINED WITH THESE
GENERATORS ARE THAT THE EYES CAN ONLY TOLERATE A VERY
SMALL CURRENT AND THAT ONLY SMALL CURRENTS SHOULD SE
USED FOR MINIMAL IRREVERSIBLE BRAIN TISSUE
CHANCES.
THERE ARE TWO KINDS OF BALANCED PULSES - SYMMETRIC
AND ASYMMETRIC WHEREIN THE CHARGE IN ONE-HALF OF THE
ASYMMETRIC PULSE MAY BE OBTAINED BY A LARGER CURRENT
FLOWING FOR A SHORTER TIME, AND VICE VERSA IN THE OTHER
HALF OF THE PULSE. THE SITUATION IN THE SYMMETRIC
PULSE IS SELF-EVIDENT. THE EFFICACITY OF THE ALPHA
DRIVE OSCILLATOR IN THE INDUCTION OF SYNERGISTIC
EFFECTS WHEN SYNCHRONIZED WITH THE SENSORY STIMuLAT.ORS
IS A MAXIMUM WHEN THE RECTANGULAR PULSES ARE BOTH
BALANCED AND SYMMETRIC. THUS IT IS ESTABLISHED THAT
THE CHOICE OF BOTH THE FORM OF THE CURRENT AND THE
_TYPE AND POSITION OF THE ELECTRODES ARE OF PARAMOUNT
IMPORTANCE IN DETERMINING THE PERFORMANCE OF THE STIMU-
LATOR.
CLINICAL PRACTICE WITH ELECTROSLEEP
STIMULATORS UNCOVERED A RECURRING PROBLEM, NAMELY, THE
AROUSAL ACTION OF AN UNEXPECTED OR UNUSUAL SOUND. IT
HAS SEEN FOUND EXPERIMENTALLY THAT WHEN A:SUBJECT IS
I/
THE PITCH OF THE SOUND IS DISCREETLY CHANGED BY A LARGE
ENOUGH INCREMENT, THE AUDITORY CORTEX WILL SE.DEHASiTuATEO
CAUSING THE AWAKENING OF THE SUBjECT, PARTICULARLY IF
IN THE REM STATE. THE PROBLEM WAS SOLVED BY PLACING
THE MONOTONE TRANSMITTER IN THE STIMULATOR CABINET AND
TRANSMITTING THE �S'OUND THROUGH TUBES TO SOUND-:TSOLATING
PLASTIC CUPS HELD. IN PLACE OVER THE EARS. BY THIS MEANS
ANY EXTERNAL SOUNDS WOULD BE ATTENUATED TO A LEVEL AFTER
FILTERING THROUGH THE CUP WALLS WHICH IS FAR BELOW THE
THRESHOLD OF AUDIBILITY CREATED BY THE MONOTONE ENTERING
a.
�a.
�
THE CAVITIES VIA RuBBER TuOES. THE MONOTONE' APPLICATOR
EXTENDS THE USE OF THE STIMULATOR BEYOND THE QUIET
PRIVATE ROOM TO THE NOISY OFFICE ROOM OR HOSPITAL WARD.
IN CONCLUSION, AN ELECTROPHYStOLOGICAL
STIMULATOR PROVIDING THREE BALANCED, SYMMETRIC AND
SYNCHRONIZED STIMULI - AUDITORY MONOTONE, ELECTRICAL
FLICKER, AND ALPHA DRIVE - APPLIED TO THE HEAD VIA
MONOTONE EAR CAVITIES, FLICKER TEMPLE OR FOREHEAD
ELECTRODES, AND ALPHA DRIVE OCCIPITAL ELECTRODES RE-
SPECTIVELY, CAN BRING A NEW ORDER OF EFFECTIVENESS TO
REM ELECTRO-THERAPY.
-