Sleep Talkin' Man (13 page)

A Word from our Friendly Neighborhood

Sleep talking, or to give it its scientific name, somniloquy, is something of an enigma in the already enigmatic world of sleep disorders. Given the huge response that Sleep Talkin' Man generated when it went viral on the Web, you would imagine there would be similar enthusiasm for the topic among sleep experts. But, oddly, that's not the case. Some sleep textbooks don't mention sleep talking at all. Kryger's
Principles and Practice of Sleep Medicine
is a hefty tome found on the desks of most sleep doctors and researchers around the world. It weighs in at 1,552 pages and yet sleep talking only manages to command a paltry thirty-six lines (scattered across five different chapters) and a couple of passing mentions. That's not to say that there hasn't been a fair bit of research into the field, but we know very little more about it now than we did thirty years ago. Perhaps this is because it is common, and is seen more as a source of amusement or mild annoyance than as a serious problem. Indeed, there seems to be growing doubt in the sleep science community about whether to consider it a disorder at all, as evidenced by its status in The International Classification of Sleep Disorders. In the first edition, sleep talking made the grade as a disorder and was
listed under “Sleep Wake Transition Disorders.” But by the time the second edition came out people weren't so sure. It has now been relegated to “Isolated Symptoms, Apparently Normal Variants and Unresolved Issues.”

So what is sleep talking, what causes it, and what does Sleep Talkin' Man tell us about Adam's unconscious? To really get to grips with this we need to take a closer look at sleep.

For thousands of years we assumed that sleep was a single thing. You were either awake or asleep. But with the invention of the EEG we discovered that sleep was much more complicated and researchers have spent the last sixty years trying to understand what is really going on, with only partial success.

Sleep is actually made up of several different types of sleep, or sleep stages, which alternate through the night in ninety-minute cycles. Stage One sleep is very light sleep and is usually a brief transitional stage we pass through between being awake and being “properly” asleep. That twilight, half-asleep, half-awake sensation you get just as you're drifting off to sleep is probably a sign that you are in Stage One sleep.

Stage Two sleep is also pretty light, but this is unequivocally sleep and you spend about half the night in Stage Two. What may surprise you is that you don't stop thinking throughout this stage. There appears to be mental activity of one type or another for much of the time
you are in Stage Two of sleep, and there have even been dreams reported in Stage Two. So it is not unexpected that where sleep talking occurs it often comes out of this stage of sleep.

Stages Three and Four are lumped together and referred to as Slow Wave Sleep. Slow Wave Sleep is the deepest stage of sleep; in fact it is the most unconscious you will ever be without being under anaesthetic or knocked out by a blow to the head. Yet even in this deeply sedated state there is evidence that your brain doesn't turn off completely. Counterintuitively, in some people this can be a very active time, because Slow Wave Sleep is when sleepwalking occurs! We don't know for sure why people sleepwalk, but the really deep sleep of Slow Wave Sleep is vital to this process. What seems to happen is that the somnambulist (sleepwalker) somehow partially wakes up from Slow Wave Sleep. Those parts of the brain that allow them to see, move, eat, unlock doors, drive cars, dance, or have sex wake up. But those parts of the brain that control purposeful behavior, exercise sound judgement, strive for goals or restrain the person from doing inappropriate things remain deeply asleep, blissfully unaware of what the rest of the brain is getting the body to do. Thus the somnambulist may eat very skilfully with a knife and fork, but what they eat may be a box of Kleenex. If you can sleep dance then you can sleep sing and so some sleep talkers do their talking when in Slow Wave Sleep.

The final sleep stage is Rapid Eye Movement Sleep or REM, and this is the strangest sleep stage of all. REM is where you do most of your vivid dreaming. You spend a quarter of the night in this state of intricate, intense, and often bizarre hallucinations. But it gets even stranger. In REM Sleep, we temporarily become cold blooded. As mammals, we keep much the same body temperature no matter what the outside temperature is. But in REM we lose this ability—if the room temperature goes up, so does our body temperature; if the room temperature goes down, our body temperature drops too.

But what is most relevant to sleep talking is another odd feature of REM Sleep. When you dream that you are running down the road, that part of your brain that makes your legs run is actually firing. Now, clearly running in bed is not a great idea, so a group of nerves at the base of your brain set up a sort of road block that stops those nerve impulses reaching your muscles. As a result, when you are in REM Sleep you are literally paralyzed. Only your diaphragm, your eye muscles, and middle ear muscles are able to move. For this reason, sleep talking is not as common during the dreams of REM Sleep as one might have expected. Some sleep talking does come out of REM Sleep, but if it weren't for the sleep paralysis it would happen almost every time we dreamed.

So which stage of sleep does Sleep Talkin' Man dwell in? The biggest clue is in the timing. Although the various
sleep stages alternate in cycles, these cycles change gradually across the night. The first couple of cycles have lots of Slow Wave Sleep but very little REM and Stage Two, while the later cycles are almost entirely REM and Stage Two Sleep. Sleep Talkin' Man appears far more frequently in the second half of the night, between 4:30 and 6:30 a.m., so this pretty much rules out Slow Wave Sleep. Also, Sleep Talkin' Man does sometimes respond to external stimuli, like sounds. This is unlikely in deep Slow Wave Sleep, but quite common in the lighter Stage Two and REM stages.

From here on we are relying on a bit of educated guesswork. As Adam doesn't recall having dreams if he wakes up at the tail end of a Sleep Talkin' Man utterance, it seems unlikely that Sleep Talkin' Man is in REM Sleep. So on balance, Sleep Talkin' Man seems to be a product of Adam's Stage Two Sleep.

We now have an idea where STM comes from, but haven't yet worked out what it all means. Is this normal or should Adam and Karen be really worried?

The first thing to say is that sleep talking is very common, especially in children. In fact, sleep talking has been reported in up to half of young children! It is actually quite possible that the vast majority of us sleep talk at some point in our lives with varying levels of comprehensibility, emotion, and frequency. This creates a problem for scientists. When they want to compare people who
sleep talk and people who don't, they have quite a time finding people who have never sleep talked. Some people who swear blind that they never sleep talk can turn out to be quite prolific sleep talkers when they are recorded at night.

Adam's story is a bit different. Other than the odd mumble at college, he seems to have been a pretty silent sleeper until the age of thirty-four. Adult onset sleep talking is much rarer, though by no means unheard of. Nor is Sleep Talkin' Man's impressive canon of work unprecedented. Sleep talking several times a night, most nights has been reported in numerous scientific studies of prolific sleep talkers. Why some people sleep talk more than others isn't known for sure but there is often a genetic component to sleep talking so it is quite possible that we may one day have Son of Sleep Talkin' Man!

So sleep talking is probably normal and Adam's case is not as unusual as one might imagine. But, the big question everyone is asking about Sleep Talkin' Man is what he says about Adam. Does the content of Sleep Talkin' Man's remarks reveal something dark and sinister about Adam's character?

The first point to consider is whether Sleep Talkin' Man is simply accurately reporting what Adam is thinking. Unfortunately we can never know for sure, because Adam rarely remembers what he was thinking when he wakes from a Sleep Talkin' Man episode. Sometimes sleeptalkers
say exactly what they are thinking, sometimes they say things that are related to what they are thinking, and sometimes what they say has no relationship to what was actually going on in their heads. Adam and Karen have been able to identify numerous times when Sleep Talkin' Man appears to be referring to something that has been going on in their lives. For example, elephants appeared prominently in Sleep Talkin' Man's musings when they were on honeymoon in an elephant sanctuary. It stands to reason that Adam would have been thinking or dreaming about elephants in his sleep and that this came out in his sleep talking. But whether what Adam was thinking about the elephants and what Sleep Talkin' Man was saying about them is the same thing we may never know.

It seems that when Sleep Talkin' Man appears, some parts of Adam's brain are fully functioning while others are not. His speech and language generating circuits are clearly working, but perhaps those parts of the brain that exercise judgement and tact, or govern logic are still fast asleep. Thus Sleep Talkin' Man speaks with perfect grammar but what he talks about is irreverent, uninhibited, and full of bizarre connections that the waking mind, constrained by the need to be orderly and logical, could never generate.

Some people worry that Sleep Talkin' Man may be an indication of insanity. It is true that psychiatric disorders are about twice as common in adults who are frequent
sleep talkers as compared to non–sleep talkers. Nevertheless, the vast majority of adult frequent sleep talkers have no psychiatric problems whatsoever. Remember, even the sanest people in the world have crazy dreams on a nightly basis and we probably all have bizarre and disjointed thoughts when we sleep. It's just that most of us aren't generous enough to share these thoughts with the world.

Sleep is a strange and mysterious state. It is almost inevitable that it will sometimes create something as strange and mysterious as Sleep Talkin' Man.

Dr. Hugh Selsick is a psychiatrist with a special interest in
sleep disorders. He is Chair of the Sleep Group in the Royal
College of Psychiatrists, and is Lead Clinician of the Insomnia
Clinic at the Royal London Hospital for Integrated Medicine/
University College London Hospitals

Legs time!

Everybody get your legs!

Adam made it through thirty-six years of life without the company of his alter ego. So, why did Sleep Talkin' Man suddenly emerge out of Adam's subconscious depths that cold February night, and what purpose does he serve?

Many sleep specialists hypothesize that sleep talking is linked to stress. Thinking back to when STM first showed his face (or mouth, as the case may be), that theory sounds about right to me. Back in February 2009, Adam and I were under a number of tremendous stresses. Allow me to paint you a picture:

A year earlier (as soon as we got engaged), we had applied for a visa for Adam to come live in the States with me. His immigrant visa had been rejected in May (that story is another whole book right there), and we had appealed. By February, we had already spent over EIGHT MONTHS waiting to hear the results of our
appeal. During that entire time, our life was in limbo, waiting for the U.S. government to determine on what continent we would settle down together. Because Adam could not enter the States while his appeal was in process, our only option to be together was for me to come to London. However, I had an apartment and Molly the little beagle in New York. So all that time, I commuted back and forth between my two lives—six weeks in London, three in New York. It was painful to spend so much time separated, when we already felt like we had lost so many years together. And it is difficult to communicate how nerve-racking it is to live that way for so long, waiting on a faceless agency to decide something so major in your life, losing control over something as fundamental as on what continent you can choose to make your life. It sucked.

Of course, in order to be able to spend two-thirds of my time with my fiancé in the United Kingdom, I had to quit my job. During this whole time my status in the United Kingdom was that of a visitor, so I was unable to do any
work except for bits of freelance that I picked up from the States. Meanwhile, Adam had been looking desperately, but without success, for a job in his industry for most of a year. The economy had tanked, and advertising agencies were on a hiring freeze. Although it was wonderful that we got to spend so many of our days together whenever I was in London—and I would happily do that for the rest of my life—it wasn't a situation that was very good for our bank accounts, or for Adam's self-esteem. It really sucked.

With no real income, and no notion of when we would get an answer and where we would end up, signing a lease on an apartment was out of the question. We spent those months moving back and forth between Adam's parents' home and a tiny little studio apartment we could sublet for a few weeks at a time in the East End, with the occasional heavenly stint house-sitting whenever Adam's brother's family was on vacation. As lovely and generous and wonderful as Adam's parents were, and as kind as his brother was to lend us his home, we felt like nomads. We simply had no place to settle in and make our home. It royally sucked.