Did Michael Jackson Have a Primary Sleep Disorder?

Sleep disorders can be discounted by the public and even by physicians, but they can indeed be very tragic according to experts. People will seek all sorts of remedies to help them sleep. Michael Jackson’s nurse told ABC that he pleaded for a dangerous sedative to help him sleep. Cherilyn Lee, a registered nurse and nutritionist, said she refused to help the famous entertainer get Diprivan, which is a sedative used mostly at hospitals. Lee tearfully reported Jackson she had heard Jackson beg,”Find me an anesthesiologist, I don't care how much money they want, find me an anesthesiologist to be with me here overnight and give me this IV.'" Jackson, Lee went ont to say Jackson “was in extreme discomfort, was desperate for sleep and said that one side of his body was hot and the other side was cold. The nurse described Lee said Jackson had often complained of not being able to sleep more than a few hours at a time and really struggling to get to sleep, sometimes watching television for hours at a time in order to sleep. Sleep problems can accompany certain health conditions including restless leg syndrome, diabetes and certain lung problems. When they are primary, however, they can create serious health issues and can lead to drug addiction. According to the DSMIV, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, the characteristics of primary insomnia are these:

• The predominant symptom is difficulty initiating or maintaining sleep, or nonrestorative sleep, for at least 1 month.

• The sleep disturbance (or associated daytime fatigue) causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

• The sleep disturbance does not occur exclusively during the course of narcolepsy, breathing-related sleep disorder, circadian rhythm sleep disorder, or a parasomnia.

• The disturbance does not occur exclusively during the course of another mental disorder (eg, major depressive disorder, generalized anxiety disorder, a delirium).

• The disturbance is not due to the direct physiological effects of a substance (eg, drug abuse, medication) or a general medical condition.

Even if Jackson had a secondary condition, that is sleep deprivation caused by long-term anxiety or depression, sleep disorders can cause cyclical problems. The less one sleeps, the more anxious one becomes, thereby sleeping less. This is called persistent psycho-physiological insomnia. Then there is the type of primary sleep problem that is idiopathic, that has existed since early childhood or even infancy. According to experts, primary insomnia is estimated to occur in 25% of all patients with chronic insomnia. These are the problems chronic sleeplessness can create:

• Increased risk of mortality is associated with short sleep lengths.

• Insomnia is the best predictor of the future development of depression.

• Catastrophic worry about the consequences of not sleeping is common among patients with chronic insomnia and serves to maintain the sleep disturbance.

• Increased risk exists of developing anxiety, alcohol and drug use disorders, and nicotine dependence.

• Poor health and decreased activity occur.

• Onset of insomnia in older patients is related to decreased survival.

The problems both diagnostically and in terms of treatment can be very complex, experts say. The diagnostic problems can be particularly difficult because certain types of substance-related or medical conditions can be part of what underlies the sleep difficulty. In addition withdrawal from certain substances such is extremely complex because of the very large number of substance-related or medical conditions that can underlie sleep disorders. Sleep problems can occur during the intoxication phase of alcohol, amphetamine and other stimulants, anxiolytics, caffeine, cocaine, hypnotics, nicotine, opiods, and sedatives. Many sleep medications can be habit-forming and given only for short durations as well. Sleep problems can cause havoc with a person’s life. Before Michael Jackson’s death, he complained about problems sleeping. If he indeed had insomnia for any significant length of time, his mental and physical health may have been compromised, as this is what medical authorities maintain happens with sleep problems of long duration. Only Jackson's doctors can answer the questions about Jackson's sleep problems, but the fact is his complaints caused his personal nurse consternation enough to be concerned.