[b]Can Sleep Deprivation be Fatal?[/b]

Posted by: SwampDonkey

[b]Can Sleep Deprivation be Fatal?[/b] - 01/15/08 05:06 PM

Hi,

Last night I taught a very basic Wilderness Survival class to the new members of our local youth group (ages 12 to 14).

The class involved a discussion on what is a survival situation, what to do when you find yourself in one (e.g. S.T.O.P.), what are the priorities of survival, what equipment assists survival and it ended with the teens assembling there own small personal survival kit. (See this previous post for the kit contents http://forums.equipped.org/ubbthreads.php?ubb=showflat&Main=9218&Number=100560#Post100560 )

When discussing Survival Priorities I use the "Rule of 3's" to help the kids understand what is the most important element at anytime in a survival situation. I list; 3 seconds, 3 minutes, 3 hours, 3 days, 3 weeks, 3 months and 3 years on the blackboard and have the students suggest (on average) what aspect of life a person requires within that timeframe (e.g. 3 minutes without air, 3 weeks without food).

I find this discussion really helps the kids focus on what is important for survival (although I often get answers like "my MP3 player" or "a shower"). One bright student last evening suggested that sleep was required by the body within 3 days; I had to both agree and disagree with him. I know people have gone much longer that 3 days without sleep but that the frequency of accidents is greatly increased.

So wanting to improve my future presentations I Googled "Sleep Deprivation" today to find out if a person can actually die from not sleeping. I found that sleep deprivation has been linked to many health concerns; obesity, diabeties, infection, depression, accidents, memory loss, poor learning,..., but only found one brief reference where mammals (lab mice after 3 weeks) actually died.

I know many members of this forum are/have been in the military or worked in professions where sleep deprivation is common (e.g. emergency services, shift work) and I would appreciate hearing about your sleepless experiences so hopefully I can include the "need for sleep in a survival situation" into my presentations.

Thanks,

Mike
Posted by: Arney

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/15/08 05:15 PM

I have never heard of any instance where a person died simply from being kept from sleeping, e.g. in a POW or interrogation situation. However, sleep is definitely required to maintain mental alertness, so in a survival situation, as you mentioned, there's a much higher chance of an accident or making a dumb decision if you're severely sleep deprived.

I remember watching a TV show about a sleep deprivation experiment. The test subjects were able to function physically just fine for a long time. It was the mental functioning that rapidly deteriorated, and which seemed to require sleep. However, note that there are people who do not sleep at all. I'm not sure how their brains cope with the lack of sleep, though.

I'm not sure that sleep really fits into the rule of 3's analogy. Strictly speaking, it's absence is not deadly the same way that lack of oxygen or water is deadly.
Posted by: BrianTexas

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/15/08 06:03 PM

My understanding is that sleep deprivation significantly impacts mental alertness. It could be considered fatal in that one is more likely to die in an accident related to their mind failing to function properly.

IIRC, some law enforcement groups theorized that many accidents were caused not just by drugs/alcohol but rather by the decline in attention, alertness and functioning of the brain due to lack of sleep.

Speaking of which, my productivity in the classroom seems to be heavily influenced by sleep or lack thereof. sleep
Posted by: LumpyJaw

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/15/08 06:40 PM

I remember reading about this recently. He even took quick naps, but exhaustion got the best of him.

http://www.cbc.ca/story/world/national/2005/08/09/video-games050809.html
Posted by: justin2006

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/15/08 09:07 PM

Hmm.. do a search on "fatal familial insomnia".

Here is one:

http://en.wikipedia.org/wiki/Fatal_familial_insomnia

"The disease's genesis and the patient's progression into complete sleeplessness is untreatable, and ultimately fatal."

Of course this is a medical condition and not exactly related to your question... crazy
Posted by: OldBaldGuy

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/15/08 10:22 PM

"... some law enforcement groups theorized that many accidents were caused not just by drugs/alcohol but rather by the decline in attention, alertness and functioning of the brain due to lack of sleep..."

Yup. I have worked more solo rolo fall asleep at the wheel crashes on I-5 in Central CA (very boring road anyway) than I care to remember...
Posted by: OldBaldGuy

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/15/08 10:25 PM

Do some research about "Hell Week" in Navy SEAL training, it will give you a pretty good idea about what happens when people get really tired. They don't die, but by the end of the week, the instructors mainly keep them awake, and make sure that they don't hurt themselves or others. They are pretty much out of it...
Posted by: Arney

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/15/08 10:55 PM

I think Morvan's syndrome is what I had read about a long time ago. Extremely rare. One case went without sleep without 4 months. But still, you're pretty screwed up in various ways from this condition, so I'd rather not have Morvan's syndrome. eek

Posted by: MtnRescue

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/16/08 06:44 PM

Sleep deprivation in itself might not be fatal, but its consequence is too often fatal. We lost a SAR team member a number of years ago for this very reason due to lack of sleep at a search. As she drove home, without the benefit of a nap, fell asleep at the wheel and struck a tree. Following that the team instituted new dispatch policies to prevent this in the future.

We always stress following a long field exercise or mission, to rest and/or sleep before driving home. The drive home can be the most dangerous phase of a mission. Once the adrenaline wears off during the return trip, it's quite easy to fall asleep.
Posted by: SwampDonkey

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/18/08 02:34 PM

Thank you for the replies concerning death from sleep deprivation.

Other than persons with specific sleep diseases or conditions, I do not think a lack of sleep alone would be fatal in a survival situation. Eventually the survivor will become so tired that they will sleep, thereby reducing mental/physical fatigue but perhaps succumbing to death from outside forces which require alertness (e.g. accident, attack, enviromental exposure, etc).

Take care,

Mike
Posted by: raydarkhorse

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/26/08 10:27 PM

While in the Navy I was once required to be awake for 172 hours. I don't know about sleep deprivation being fatal but I do know that without supervision your actions can cause your death or the death of others. Most people can go 24hrs without to much problem, and allot can go 48 without to many problems, but after that your mind will start to wonder and it's almost impossible to keep you mind on all but the most demanding situations. After 3-4 days without lots of outside stimulus you will sleep sitting standing doesn’t matter, but never fear when you fall it usually wakes you up. I would like to tell you what it was like after the 4th day but I honestly can't, I remember small bits like you remember a half forgotten dream from the last few days. People yelling for me to wake up, banging my knees and other body parts as I passed out and fell. Trying to perform do complex jobs and not understanding what the tool in my hand was for. From my experience in a survival situation an untrained person can stay awake and still be able to perform reasonably well for about 3 days maybe 4 max. after that your mind can't be trusted. You may in a life or death situation be able to go longer but if there is any time at all even a short 10 min nap will help.
Posted by: SwampDonkey

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/26/08 11:19 PM

Hi Raydarkhorse,

Thank you for your detailed discription of your experience with sleep deprivation, I will work it into my basic survival lecture if it is O.K. with you?

If I can ask (e.g. not classified) why did the Navy make you stay awake for a week?

Thanks,

Mike
Posted by: raydarkhorse

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/27/08 02:32 AM

If my experience can help by all means use it. The reason I was awake is not classified, I was one of three people that was qualified to make certain emergency repairs to the main engines. We were dead in the water in a bad place and none of us slept until the repairs were made. Except for the times we literlly fell asleep on our feet, which is how I know you will wake up when you fall down.
Posted by: Art_in_FL

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/27/08 02:56 AM

Under serious sleep deprivation your short-term memory goes all to hell. During one exercise I remember being unable to follow simple verbal instructions because I couldn't remember the complete instruction.

Faced with three different colored balls and three different colored boxes and told to: 'Pick up the red ball and put it into the yellow box' I would pick up the red ball and have no idea what I was supposed to do with it. Or if I picked it up and walked to the yellow box I might not remember what I was supposed to do. It is a strange sensation finding a ball in your hand and that your standing in front of a yellow box. Remembering your supposed to do something but not knowing what it is.

The trick was to write instructions and messages down in simple steps and to check off the steps as each is completed. Written instructions can be reviewed so if you forget the first part you can look back at it. It works better if you work in pairs. One person reading and checking and the other doing the work.

Ironically long-term memory seems less effected. Told to repeat a thirteen digit number many times over a twenty minute period the person can recite this number a day later even when the learning and recitation was during a deeply sleep deprived period.

Also previously learned skills that have made it into muscle memory and routine, like field stripping and reassembling a weapon and sometimes driving, are also relatively unaffected. You might be unaware you are doing the job. Effectively sleeping with your eyes open while you do it. It has been noted that chronic drunks often drive home in a similar autopilot state of mind. As long as the task is free of variations from the trained routine it gets done in the normal manner. If something is changed the person is often completely unable to cope.

It is also interesting to see how people can stand up, march and complete simple jobs while being, for all practical purposes, asleep. It is fascinating to see the degree with which the primitive brain still prevent a person from doing things that would directly harm themselves or violate ethical norms. Although completely unaware of the situation it is next to impossible to get someone to put their hand into a fire or march off an obvious cliff. Told to do so they simply stop. If questioned they have no understanding of the situation, what they were told to do or stopping.

It is pretty funny to watch this sort of 'march of the zombies' behavior. Very strange to be playing the part of the zombie. I remember it as if it were a series of disconnected snap-shots of something done by someone else.

It is pretty hard to keep a person from getting any sleep after a couple of days. It becomes a full-time job just to keep one person awake all the time. As soon as they are not actively engage they catch a series of tiny cat naps. Often less than a minute each. People can sleep a few minutes at a time while hiking and standing up. These add up to significant amounts of sleep over a 24 hour period. Actively kept from getting any sleep at all people become delusional in just a few days. If people can slip in a few minutes of light sleep every few hours they can go much longer.

But inevitably everyone goes a bit nuts and becomes subject to hallucinations and delusions if kept from sleep long enough. In extreme cases people who have tried to break the sleep deprivation record have become dangerously insane. One guy jumped through of a second-floor picture window thinking the building was on fire. A few apparently became at least semi-permanently deranged. This is supposed to be why the Guinness Book of Records no longer lists the record for going without sleep. It isn't clear if they weren't deranged before they went for the record. Anyone who would voluntarily try to stay awake for over a week has to be a bit strange to begin with.

Most people recover completely as long as they get some sleep before they become delusional. Most people don't get that far. Unless someone is actively preventing them from getting sleep most people find it impossible to get to that stage. The body just shuts down and they doze off for at least a short time.
Posted by: SwampDonkey

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/27/08 03:19 AM

Thanks Art and Raydarkhorse, I appreciate the first hand information.

I remember staying up all night in my youth which usually involved road trips, fishing and chasing girls, sometimes all three!

Later,

Mike
Posted by: NeighborBill

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/27/08 01:31 PM

Once upon a time as a young soldier in a far away land, I spent roughly 170 hours awake. I do not remember anything after the third day. I woke up in a hospital after (this comes from friends, like I said, I don't remember) being lured into a tracked vehicle, locked inside, and administered a sedative.

This happened because I was the only available electronics tech when there was supposed to be five of us--we were transitioning to the M1 Abrams (from the M60--sheesh, I just dated myself), and on a combat alert (one nice captain in operations sold his soul to the dark side). I can remember the first three days or so repairing problems with the radio/intercom system because of design flaws with the NBC (nuke/bio/chem) overpressure/filter system. By all accounts I was fine until day six; the morning of day seven I started (apparently) to disassemble a thermal imager with my SAK, while muttering about 1.5 volts--the voltage required to set off a 120mm round. After that they pretty much figured out I was bonkers smile Especially since we were all carrying live rounds....
Posted by: clearwater

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/27/08 06:43 PM

Sleep deprivation can bring on seizures in those with a predisposition for them. Seizures can be fatal.
Posted by: MoBOB

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/27/08 06:54 PM

Originally Posted By: clearwater
Sleep deprivation can bring on seizures in those with a predisposition for them. Seizures can be fatal.


That's me (myoclonic epilepsy)...That's why have to be very careful. My mind is as stable as anyone else's; so I think. It's just that the synapses are a little froggy. Meds are a good thing. My condition is very mild so I would have to limit my awake time w/o meds to about 36-48 hours.
Posted by: OldBaldGuy

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/28/08 02:15 PM

That is probably why, in the period I was in the service, they said that you were not responsible for your actions after being on duty for more than 36 hours straight...
Posted by: unimogbert

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/28/08 02:29 PM

Originally Posted By: OldBaldGuy
That is probably why, in the period I was in the service, they said that you were not responsible for your actions after being on duty for more than 36 hours straight...


But Navy regs said that if you were allowed 1 hr sleep in 24 then you were good to go (i.e. could be court-martialled for mistakes). Yes, this has no basis in physiology. But it does have a basis in case law.....

I went a week on 4 hrs sleep at least twice in my Navy time. I learned that I personally degrade fairly gracefully (I just get slower and slower and slower). Others learned that they hallucinate.

This sleep deprivation thing is one reason why your mother doesn't want you to go into the Service. She knows you need a good night's sleep :-)



Posted by: raydarkhorse

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/28/08 06:34 PM

long periods without sleep was pretty common in the Navy. The case I talked about was by no means the only time I was up for more than 48 hrs it was just my longest time awake. My next two longest times were just short of 4 days but with one of those I did managed to get one 30 minute nap which make a lot of difference in how you feel but not so much how you act and react.
Posted by: benjammin

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/28/08 07:17 PM

Yep, 60+ hours at General Quarters seemed to be about the limit for the commanding officer on our can. Like he thought our performance would improve with time. Lord help the poor slob who nodded off in front of him or the xo. If they could've gotten away with flogging us they would've. You'd be surprised how close we came to mutiny; it was discussed seriously more than once.

Anyone see the movie "The Bedford Incident"? Many a time I felt like Wally Cox sitting at the NTDS chasing tracks. There are two movies I always recommend to prospective recruits wanting to go to sea, that one, and "Mr. Roberts". It'll either be one way or the other 90% of the time. Then there was the Saturday Night Live spoof on the Navy recruiting commercials: "Navy, it's not just a job, it's $79.62 a week". The best one though was Garrett Morris as a Marine recruiter out looking for "a few good men". That was classic laugh

Posted by: Dan_McI

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/28/08 07:41 PM

The last place I would ever want to be trying to work while going for any length of time without sleep is at sea. The office did not appreciate that I knew there were legal limits on how long I was allowed to be at the helm, and I did say "That's it. I'm going to bed."

Spending 12 hours or more at the helm was actually kind of normal, at times, and that was the legal limit. But when you got above 15 hours, your skills and thinking dropped. There were a few times I went a little too long and found myself heading into trouble. I can recall images of the bow of a container ship looming. Brain functioned kicked in for a while, and then, adrenaline got me through until I got to my bunk.

I know had I stayed awake the took the helm or conn after being for 48+ hours, my crew and myself would have been at risk. If I was in trouble and needed to do it to get out, well, I would, but that's the only excuse.

A very skilled and experienced harbor pilot once told me you needed two things to do that job: "Some common sense and a set of balls." Working on too little rest is not enough of the first and perhaps too much of the second. Keeping my crew awake and working for extended periods would have been a lack of common sense, in almost all circumstances.
Posted by: OldBaldGuy

Re: [b]Can Sleep Deprivation be Fatal?[/b] - 01/29/08 01:58 PM

One of the reasons I went into the Air Force (they were drafting into the Army, Navy, and Marines at that time, and I figured that four years in the AF beat two in any of the others)...