Dreamland: Adventures in the Strange Science of Sleep (12 page)

Military disasters can take many forms. As the nature of war changes—the epic battles between sophisticated national military forces in World War II have now been replaced by door-to-door searches for rogue enemy combatants in the mountains of Afghanistan—the decisions that each soldier makes resonate far beyond the battlefield.

In the first few months of 2007, the United States had a precarious hold on Baghdad. One March evening, a band of American soldiers from the 172nd Infantry came under attack while driving through the streets of the capital. They returned fire and eventually chased four men into a warehouse. There, they found a weapons stash that included several machine guns, grenades, and a sniper rifle. The four men were handcuffed, and the convoy turned and headed toward a makeshift jail under American control. A few minutes later, their superior’s voice crackled on the radio. There wasn’t enough evidence to keep their new prisoners locked up, he told them, and then ordered the men released.

The order was never followed. A few days before, a roadside bomb had killed two of the unit’s men. The soldiers resented the fact that they had risked their lives apprehending four men they believed to be insurgents, only to be told to let them go. Three officers—including the unit’s medic—decided to take their prisoners to a canal that snaked its way through an industrial area in a remote part of town. There, they ordered the men, blindfolded and with their hands tied behind their backs, to line up against the back of their vehicle. The Americans pulled out their nine-millimeter pistols and shot each in the back of the head. They dumped the bodies into the canal and drove away.

At a court-martial in Germany two years later, the Americans who were on patrol that night stood trial for murder. Each had admitted to shooting the captives. They pled not guilty, however. Their lawyers said that they were so sleep deprived they could not make a rational decision. In calling the men’s actions a regrettable but common part of war, one of the attorneys said that “good soldiers who freaked out in the field of battle largely as a result of sleep deprivation and a lack of battlefield backup are spending a lot of time in jail.” A military psychologist, too, testified that sleep deprivation could have played a role in the shootings. It was not enough. All four soldiers were found guilty and sentenced to twenty-year terms at military prisons in the United States.

In one way, the shootings can be seen as a failure of the prefrontal cortex. As with the sleep-deprived men who seemed to turn into drunks in the army study, the soldiers’ emotions and impulses were no longer being held in check by a rational force. What should have been suppressed by a normally functioning brain bubbled to the surface and manifested itself into a terrible action. Unable to accept the fact that the men the soldiers thought were the enemy would be released, the soldiers killed them on the spot. The rational decision-making prowess that separates us from animals had collapsed into rage. In a war that depended on winning over the hearts and minds of the locals, a few sleep-deprived soldiers made the Americans appear like warlords who administered justice in the streets. Something had to change.

On the type of hot, humid day in Washington, D.C., that reminds residents that the city was built on a swamp, I picked up a small red Toyota from the airport and headed out on the highway. I was on my way to the Walter Reed Army Institute of Research, the Department of Defense’s main facility dedicated to testing the limits of the human body. I inched along the Beltway and soon found myself driving down a small street in Silver Spring, Maryland, lined with strip malls and a kitchen supply store called Counter Intelligence. The red brick wall surrounding the military base soon popped into view. With gleaming glass towers, it looked more like the campus of a major corporation than a collection of barracks.

I was there to meet Thomas Balkin, a civilian scientist who has spent the last twenty-five years working for the military and who was now the chief of Walter Reed’s Department of Behavioral Biology. A few weeks before I met with him, Balkin had traveled to Europe and made a presentation to top NATO brass on how to prepare soldiers for warfare in the twenty-first century. Through this presentation and others, Balkin was in the midst of a campaign to convince war planners that the success of future missions depended on recognizing the innate weaknesses of the human body that can impact the abilities of soldiers to make smart choices. The management of sleep and fatigue topped his list.

“A sleep lab isn’t the most exciting thing to see in the world,” Balkin said as he took me on a tour of the rooms where he has ushered in hundreds of participants of sleep deprivation studies. With government-issued blue couches, a small TV, and a shelf full of video games, the rooms looked like a suite in a college dorm. We made our way into an office so small that it couldn’t hold more than four people at once. Balkin sat down behind his desk, and with a couple of clicks of his mouse, he opened a graph on his computer that showed a red line plummeting. “See this line?” he asked me, pointing with his left hand. “This represents the number of reported incidents between a soldier and a civilian in Iraq. Twenty percent of the men who are sleeping less than four hours a night have reported an altercation with a civilian. Follow it all the way across, and you’ll see that only 4 percent of the men who are sleeping eight hours a night have.”

Lack of sleep was an underlying cause of an exhausting and depressing cycle, Balkin explained. Grumpy, tired soldiers have less control over their emotions and are therefore more likely to get into a fight with civilians. Those civilians, in turn, are more likely to have a negative view of American forces and their presence in the country. Some vent by harassing U.S. forces, which of course leads to additional sleep-deprived soldiers. It was a cycle that captured the dual sins of being self-inflicted and preventable. Instead of helping to secure an area, pushing soldiers past the line of sleep deprivation was undermining the success of the mission.

Sleeplessness has always been a part of combat, but its effects are greater now because the military asks more of its soldiers than it did a generation ago. On the surface, this seems silly. Technology has allowed many of the jobs that were once performed by humans to be automated. But automation works only when the human operators—the men and women sitting in the chairs directing the show—make smart decisions again and again. Instead of overtaxing each soldier’s body, the military now overworks a soldier’s mind. Take, for instance, a new class of navy destroyers that reduces the number of sailors needed aboard from three hundred to less than one hundred. With only one third of the personnel, the new ships are able to execute a wider range of functions. Technology increases the human responsibility when measured in terms of the decisions each sailor has to make in order for the destroyer to perform. That means that the errors of one sleep-deprived sailor will reverberate throughout the whole ship because there is little in the way of backup. In places like Iraq and Afghanistan, meanwhile, troops have to make countless choices when trying to distinguish between civilians and potential terrorists. “Guys who are patrolling are constantly surveying the environment looking for signs of potential danger,” Balkin says. “With sleep loss you are less likely to notice these things or notice them relatively slowly.”

To solve the problem, Balkin realized that the military needed a way to measure and prepare for sleep as accurately as it does everything else. This is made more difficult by the fact that, unlike with alcohol in the bloodstream acting as a measure of drunkenness, there is no absolute biological marker of fatigue. Humans are notoriously bad at accurately estimating how many hours they slept the night before, making most sleep data collected from soldiers unreliable. Moreover, peer pressure and demands from their commanders would likely push troops into overreporting the number of hours they slept and working without taking a break, even if their mental performance was severely restricted. “If we could discover a marker for it, it would revolutionize our ability to manage sleepiness,” he told me. “You can’t manage what you can’t measure.”

Balkin turned to the next best thing: a program first developed by the air force for pilots, one of the few professions in the military that come with hard restrictions on the number of hours a person can work in one week. The premise of the sleep-tracking model was simple: the longer a person stays awake, the less competent he or she will be. Through research studies, the military knew that cognitive performance declines by about one-fourth for every twenty-four hours of time spent awake. Pilots who haven’t met their mandated hours of rest are considered not competent to fly, a policy meant to prevent exhausted pilots from making decisions that endanger themselves or their aircraft. Balkin realized that he could take the scheduling tool used for pilots and apply it to every soldier in the field. After all, soldiers who weren’t sleeping enough were picking fights with civilians in Iraq, which was endangering the success of the military’s top mission. For it to work, each soldier would need to wear a wristwatch-sized sleep monitor, called a wrist activograph, at all times. The monitor recorded the body’s movements each minute to determine whether the person wearing it was asleep or awake.

Balkin decided to test his theory that hours of sleep alone could predict a soldier’s performance. He went to an officer-training school and asked a number of cadets to wear the sleep monitors for several days. Periodically, he would assemble them in a room and give them an exam. He then compared their test scores to the estimated amount of sleep recorded from the sleep-monitoring system. “Soldiers that consistently averaged the highest amounts of sleep obtained consistently high exam scores, whereas those that averaged low levels of sleep obtained inconsistent performances on the exams, with some doing quite well and others receiving failing or only marginally passing grades,” he summarized in a research report. In the classroom, inconsistent test scores were nothing more than annoying and a sign that a cadet needed to hit the books. But in the field, inconsistent or poor decisions could cost lives.

The monitor, which is expected to become a standard part of a soldier’s gear by the end of 2020, opens up a flood of data to military planners that can be used to predict performance. Suddenly, with a few clicks of a mouse, a commander will know how many hours each person in the unit has slept—and, by extension, what kind of decisions he or she will likely make. Performance on tasks that range from maintaining friendly relations with civilians to changing strategy in the middle of a battle can be modeled based on sleep time, a system allowing operations to be more efficient and soldiers less likely to make a mistake that can have far-reaching effects.

Balkin imagines a scenario where a commander, through the data obtained from each soldier’s wrist, realizes that a unit’s decision-making abilities will start to decline in a few hours because of a lack of sleep. Depending on the demands of the battlefield, the commander can order the unit either to take a nap before it leaves on patrol or to ingest a stimulant such as caffeinated gum. Fatigue, long the overlooked nemesis of military efficiency, can soon be regulated and quantified as easily as food rations or bullets. In one report, Balkin estimated that in future conflicts, the number of friendly-fire accidents will plunge toward zero, all on account of the increased decision-making abilities made possible by sleep.

The ability to track sleep allows the military to hone its most vital asset—each soldier’s intellect. Rather than trying to run its enemies into the ground with exhaustion, the military will harness sleep to mount an organization that has the ability to make smart decisions consistently, a battlefield edge that can trump advances in technology. Friendly fire may become a thing of the past, as confusion and exhaustion no longer give the enemy unearned advantages or lead to unnecessary deaths. “Sleep has always been a weapon,” Balkin said to me in his office. Now, he said, the U.S. military will be able to control it unlike any other organization in history.

Sometimes, however, sleep can transform your body into a weapon in ways that you didn’t intend. That’s what happened to a man named Ken Parks, at least. On one night in the suburbs of Toronto, he unintentionally revolutionized our understanding of deep sleep and the brain’s ability to transition between previously unknown stages of consciousness. And his actions led to one of the most perplexing questions popping up in courts across the world: Does accidentally killing someone while you are sleepwalking make you a murderer, or a bystander to a terrible mistake over which you had no control?

8

Bumps in the Night

I
t was not a good night to be Ken Parks. As he tried to wedge all six feet five inches of his frame onto his living room couch, Parks couldn’t have known that he was about to upend our understanding of what the brain can do. At that moment, all he could think of was how he was screwed. He was broke, out on bail, and sorely in need of a time machine that could undo the last twelve months of his life. His wife wouldn’t even let him into their bedroom.

It wasn’t always like this. Though he was a high school dropout, he had convinced his wife, Karen, the daughter of an engineer, to marry him, and together they had fashioned a normal middle-class lifestyle. They owned a home in the suburbs of Toronto and had a five-month-old daughter. Then he discovered horse racing. All it took was watching a five-dollar bet turn into forty-five dollars and he was hooked, convinced he had a supernatural ability to pick winners. That reality proved otherwise didn’t matter.

With his large size, Parks was easy to spot at the track, making bet after bet and quickly draining the family’s bank account. Once he ran out of money, he reasoned that the only way to get it back was to double down. After loan sharks refused to extend him any more credit, Parks created fake purchase orders at his job and deposited the money into his own account. He embezzled thirty thousand dollars before someone caught onto him. Stuck in jail and charged with fraud, Parks called Karen and told her that not only had he lost his job but that the family was penniless, and all he had to show for it was a mound of worthless racing slips.

Learning that your husband promised your refrigerator to a loan shark so that he could bet on horses would be enough to send any woman to a divorce attorney, but Karen was resilient. She told him that unless he promised to stop gambling, she would leave and take their daughter with her. She also demanded that Ken go to her parent’s house and ask for their help in sorting out the financial mess he had made. Without much support from his own parents, Parks worshipped Karen’s family. Now, they would know that he was nothing more than a screwup. With that unpleasant conversation scheduled for the next day, Parks lay in the house that he could no longer afford and watched
Saturday Night Live
in an effort to relax enough to fall asleep after two restless days without it.

That was the last normal moment in Ken Parks’s life. Sometime during the night, he got off of the couch, walked out the front door, and got into his car. He then drove fourteen miles on a busy highway and pulled up to his in-laws’ townhouse. He parked, got a tire iron out of the trunk, and let himself into the house with his key.

A couple of hours earlier, Ken’s father-in-law, Dennis, had laid down next to his wife, Barbara, and fallen asleep. He was suddenly woken up by the disturbing realization that a very heavy man had his strong hands around his throat. “Help me, Bobbie! Someone’s trying to strangle me!” he choked out. He kicked his legs in panic and soon lost consciousness. When he came to, he had no idea what time it was, why he was lying face down on the bed in a pool of blood, or why there was a police officer in his bedroom. His wife’s body lay in the bathroom a few feet away. She had been stabbed five times and beaten over the head with a tire iron.

Around the same time, a large blond man with a dazed look in his eyes and blood covering his body walked into a police station a few blocks away from the home. As soon as she saw him, the patrol sergeant at the desk called for immediate backup. The man didn’t notice that his hands were cut so deeply that a pool of blood was collecting under him with every step he took. “I’ve just killed two people. My God, I’ve just killed two people,” he told the officer. He looked down and, as if registering his mutilated body for the first time, screamed, “My hands!”

It was only after the officers hastily bandaged the man’s hands and put him into an ambulance that they learned his name. He calmly told them that he was Ken Parks. When asked whom he had killed, Parks replied, “My mother- and father-in-law,” not realizing that Dennis had survived. An officer then asked him how he had done it. Had he shot them? Stabbed them? Ken’s head jumped at the word. “The knife’s in my car,” he gasped.

A bloody man had walked into a police station and confessed to killing two people and, for good measure, told investigators where to find the murder weapon. Few cases have seemed so easy to solve. But as the detectives started unraveling what happened that night, something didn’t quite add up. Aside from the embarrassment at disclosing his gambling debts, Parks had no motive to kill his in-laws. He knew that neither he nor Karen were in line to collect payments from her parents’ life insurance policy, so their deaths wouldn’t solve his financial troubles. There were no signs that he had lost his temper in an argument after he asked for a loan. If he had gone over to their house intending to kill them, then why would he grab a tire iron from his trunk when an axe lay right next to it? Why would a killer plan an attack and then drive directly from the scene of the crime to a police station? And, most bothersome of all, why couldn’t Parks remember anything? In one unnerving moment of the investigation, a detective walked into Parks’s hospital room a few hours after he was admitted and began to interview him. Parks asked if his in-laws were dead. The detective said that one of them was. “Did I have anything to do with it?” Parks asked. The officer couldn’t tell if Parks was delusional or the best actor he had ever seen.

Later, at the trial, one of the most esteemed doctors in his field would give a simple explanation for why a man would go out and murder one of his in-laws and nearly kill the other on an otherwise boring Saturday night: he was sleepwalking.

A checklist to determine whether someone is asleep would seem to be pretty short. Eyes closed, check. Slow rate of breathing, check. Little reaction to the surroundings, check. Maybe some light talking or kicking could be involved, but definitely not driving, and certainly not murdering. However, as Ken Parks unintentionally discovered, it is possible to break all of these rules and still be asleep. The brain, as we now know, never really shuts down during the night. Instead, parts that are responsible for different functions turn on and off at various points throughout the sleep cycle. It is a little like a car factory that runs twenty-four hours a day, with workers responsible for painting coming in at noon and the crew that puts in seats arriving to work at six. When something happens to alter those delicately timed cycles, strange things happen.

Sleepwalking is the best-known condition of what are called parasomnias, a broad group of problems that arise when one part of the brain shows up for work when it is not supposed to or misses its shift entirely. In most cases, the result is a person who is literally half asleep. When someone is sleepwalking, the parts of the brain that control movement and spatial awareness are awake, while the parts of the brain responsible for consciousness are still asleep. That means that sleepwalkers can have their eyes open and react to the events going on around them, but have no conscious thought or memory. Though parasomnias weren’t fully understood as a class of disorders until the early 1980s, Shakespeare was eerily correct in his description of the sleepwalking Lady Macbeth. In one scene, she sleepwalks into the room where two men are talking. “You see, her eyes are open,” one says when Lady Macbeth walks by. “Aye, but their sense is shut,” the other replies.

Although the reasons are unclear, about one in five people will sleepwalk at least once in their lifetime, though most outgrow it by the time they are in middle school. Sleepwalking children are relatively mellow and lethargic, whereas adults who wander around at night tend to make quick movements, as if they are in a hurry to do something. Scientists can’t yet account for the difference.

Sleepwalking isn’t the only complex behavior that can happen in your sleep. People with parasomnias can do pretty much every basic human activity while sleeping, including talking, eating, driving, masturbating, and having sex. (Some people with sexsomnia, as it’s called, are better lovers while they are asleep than when they are awake. As one doctor told me, “This condition is only a problem if the person sleeping next to you doesn’t like it. No harm, no foul.” The same doctor also said he believed a better term for the disorder would be
snore-gasm
.) The only difference is that they have no conscious awareness of what they are doing. It’s as if their bodies have rebelled and decided to go about their business without the brain’s input.

In the early 1980s, two doctors at the Minnesota Regional Sleep Disorders Center in Minneapolis began cataloging the number of patients who complained of injuring themselves or their bed partners in their sleep. As part of their investigation, Mark Mahowald and Carlos Schenck videotaped each patient sleeping at least one night in the hospital’s lab. What they found was a window into a bizarre world. Older men with sweet dispositions turned into angry sailors in the middle of the night, repeatedly swearing and punching the wall next to them. Other patients suddenly sat up, stared intensely at the wall, and then dove headfirst into the nightstand. And at least one man sat at the foot of the bed, bellowing show tunes while fast asleep.

Parasomnias seemed to be a particularly male trait. The wives of some patients came in complaining that their sleeping husbands had put them in a headlock the night before or had tried to strangle them. Not surprisingly, these couples would often end up sleeping in different rooms. In a series of interviews conducted by the doctors, one woman said that her otherwise mellow husband would get out of bed during the middle of the night and crouch in the corner of the room and snarl like a wild animal. Another said that her sleeping husband repeatedly destroyed the furniture. “He broke so many lamps in our bedroom,” she said. “You don’t want to spend any money on lamps because you know they’ll be flung across the room.” Other patients with parasomnias said that they had flung themselves out of second-story windows while sleeping. This usually happened only once: after the first time, patients took to tying themselves to their beds at night out of fear that they might inadvertently commit suicide. Patients told the doctors tales of getting into a car and driving more than ten miles to a family member’s home, of running down the street with dogs nipping at their heels, and of almost snapping someone’s neck in their hands—all while sleeping. Out of these and other cases, Mahowald and Schenck were the first to identify and classify what are now known as violent parasomnias. As with sleepwalking, almost all are caused by partial arousals in the brain.

Like blond hair or high arches, parasomnias run in certain families. My own habit of sleepwalking, for instance, may be something I inherited. It wasn’t until after I began working on this book that my father told me stories of his sleepwalking on the farm where he grew up, in Kansas. More than once, he told me, he woke up in his pajamas in the middle of a cornfield.

The Parks family tree was not the place to look for normal sleep patterns. Or dry sheets. The Parks men shared the embarrassing habit of wetting the bed, a condition that scientists tactfully call enuresis, well into their teens and twenties. Doctors blamed it on staying in deep sleep for too long. All would later sleepwalk as adults. In a bizarre variation of the midnight snack, Ken’s grandfather would often sleepwalk into the kitchen and start frying eggs and onions on the stove, only to go to bed without eating. The family traits didn’t skip Ken. When he was eleven, his grandmother caught him trying to climb out of a sixth-story window while he was sleepwalking.

Parasomnias, and sleepwalking especially, can be triggered by sleep deprivation. As the brain struggles to make up for its lost sleep, it stays in the deeper stages of sleep for a prolonged time and doesn’t always make a smooth transition to the next stage. Those rough handoffs lead to weird behavior. Ken, after spending two sleepless nights worrying about his marriage and the money he owed, was perfectly primed for a sleepwalking episode.

There was no question that Parks killed his mother-in-law. The only real question was whether he was sane on the night of the murder. The British, Canadian, and American legal systems all come from English Common Law and have wide areas of overlap. In each country, criminal law is based on the idea that in order to be found responsible for a crime, a person needs not only to have committed an act but also to demonstrate
mens rea
, or a guilty mind. This is how we separate accidents from crimes. If your brakes go out suddenly while you are driving on a busy street and you hit and kill a person, you won’t be charged for murder, even though you were responsible for another’s death (whether you should have known that your brakes were on the fritz is another matter). But if you purposely used your car as a weapon, then deadly action was paired with deadly intent.