According to Dr. Charles Czeisler, a Harvard Medical School sleep expert, testifying on Friday at the trial of concert promoter AEG Live, the 60 nights of propofol infusion that Dr. Conrad Murray used to fight Michael Jackson's chronic insomnia may be unique because it is possible that no other person has undergone such extended treatment with the drug.
Czeisler said he was not aware of any other person having gone 60 days without REM sleep.
reports that Czeisler, a sleep consultant to NASA and the CIA, said "The symptoms that Mr. Jackson was exhibiting were consistent with what someone might expect to see of someone suffering from total sleep deprivation over a chronic period."
Jackson's personal staff, including and his choreographer, had testified that the symptoms he suffered before his death included inability to do regular dance routines, memory lapses such as forgetting songs he had known for a long time, paranoia, hearing voices and extreme weight loss.
Czeisler said: "I believe that that constellation of symptoms was more probably than not induced by total sleep deprivation over a chronic period."
The expert listed the effects of REM sleep deprivation as paranoia, anxiety, depression, learning impairment, exaggerated emotional responses, loss of appetite and physical reflexes, which get 10 times slower.
Jackson died while preparing for a comeback concert run.
Czeisler was testifying in a trial following a suit brought by Michael Jackson's mother Katherine and Michael Jackson's children against concert promoter AEG Live, claiming that the organization was liable in the performer's death because although it hired and retained Murray, it failed in its responsibility to monitor him properly and did not pay attention to early warning signs that Jackson's health was failing.
The late popstar's family also alleged that the company placed Murray under pressure to ensure that Jackson attended rehearsals while refusing to acknowledge the warning signs.
AEG Live's lawyers, however, said that Jackson hired Murray himself and that the company's executives did not have sufficient access to know that Jackson was undergoing propofol infusions in the privacy of his home.
Czeisler explained that propofol disrupts the normal sleep cycle. The "coma" it induces gives a patient a misleading feeling of having had a good night's sleep, but in fact, because it deprives the user of REM sleep, it does not allow the brain opportunity to undergo normal self-repair and maintenance.
Czeisler, describing the effect of REM sleep deprivation, said: "It would be like eating some sort of cellulose pellets instead of dinner. Your stomach would be full, and you would not be hungry, but it would be zero calories and not fulfill any of your nutrition needs."
He told the jury that the adult brain needs seven to eight hours of sleep for proper self-maintenance function. Explaining the effects of REM sleep deprivation and the functions of the body's internal clock, the circadian rhythm that controls hormonal activities associated with the cycle of night and day alternation between sleep and wakefulness, Czeisler, said: "That's why we sleep at night and are awake in the day. Your brain needs sleep to repair and maintain its neurons every night. Blood cells cycle out every few weeks, but brain cells are for a lifetime. Like a computer, the brain has to go offline to maintain cells that we keep for life, since we don't make more. Sleep is the repair and maintenance of the brain cells."
According to CNN
, he said that during REM sleep "... we are integrating memories that we have stored during slow-eyed sleep, integrating memories with previous life experiences. We are able to make sense of things that we may not have understood while awake."
Czeisler said that had Jackson not died on June 25, 2009 of an overdose of propofol, he would likely have died before eighty days of propofol infusions. He said research experiments showed that rats deprived of REM sleep died after about five weeks, and that experiments had never been tried on humans before Jackson's doctor unwittingly tried it on his patient.
The Daily Mail
reports the trial, which has been running for eight weeks, is expected to end in August.
The pop superstar Michael Jackson, died on June, 25, 2009, after his personal doctor Conrad Murray, administered an overdose of the drug propofol, an anesthetic.
Murray was later convicted of involuntary manslaughter and is serving a four-year prison sentence.