William Dement, The Man Who Founded Sleep Medicine

William Dement may have been one of the greatest scientists nobody ever heard of.

In 1953, as a young medical student, he helped change the way the world thought of sleep.

Dement performed some of the first in depth studies using the electroencephalogram (EEG) to measure brain waves during sleep. Through a painstaking series of countless observations, he established the fundamental difference between REM and non-REM sleep and identified the basic stages of sleep which occur in predictable cycles throughout the night.

He showed that sleep was not just a period when the body and brain shut down. It was a vital biological process that was “actively generated by the brain.”

Later at Stanford University, he did groundbreaking research on narcolepsy and sleep apnea and established the world’s first sleep lab to treat patients with sleep disorders.

One of his main missions was to see to it that all the scientific knowledge that was won through lab research would make it out to the doctors in primary care where it could actually help people – something he often found to be an uphill battle.

He also became a kind of public advocate for the importance of sleep in our daily lives. He diagnosed what he called a “sleep-sick society” where sleep was given a low priority in modern life and serious sleep disorders went untreated. The result, he warned, was a chronically sleep-deprived population leading to more workplace injuries, traffic fatalities, health problems and a lower quality of life.

Dement, who died last month, June 17, just shy of turning 92, will go down as “the father of sleep medicine”, and it’s no exaggeration. If you haven’t quite heard of him, here’s a thumbnail of his story.

He was born in 1928 and grew up in Walla Walla, Washington. After serving in the Army in Japan just after the war, Dement earned his degree from the University of Washington, where he made extra tuition money playing bass in a jazz band. He was good enough to play on occasion with legends like Quincy Jones, Ray Charles and Stan Getz.

He entered medical school at the University of Chicago in 1951 intending to become a psychiatrist. At that point, he later wrote, “I had little curiosity about the nature of sleep and would never have dreamed that I would study it at all, let alone as a career.”

In 1952, he heard a lecture by Nathaniel Kleitman who in those days was virtually alone in the world as a scientist researching sleep. Meanwhile, the rest of science couldn’t have cared less. After all, you’ve got someone just lying there doing nothing but snoozing for eight hours – what’s to study?

Dement’s education in psychology had led him into heavy philosophy of mind questions, namely, what is consciousness and how does it work. When he heard Kieitman’s lecture, he was struck with the insight that consciousness and sleep were just two sides of the same coin – that you could understand consciousness by looking at what happened in its absence.

He immediately signed on to work in Kleitman’s lab. This turned out to be one of those moments of fate/chance. Because just a few months before, Kleitman and one of his graduate students, Gene Aserinski, had observed what they called “rapid eye movements,” in sleeping test subjects. But they weren’t sure what they had or if there was even any significance to them.

As a student of Freudian psychoanalysis, Dement at that time was invested in ideas about dream interpretation as a way of unlocking the mysteries of the psyche (this was 1952 after all). So when Aserinski told him that they thought the rapid eye movements might have something to do with dreaming, Dement was enthralled.

He threw himself into the job of observing and documenting the eye movements in sleeping test subjects and with his colleagues confirmed that they were indeed correlated with periods of dreaming. But even bigger revelations were to come.

Dement took the lead in doing continuous, all-night recordings of eye movements and brain activity in sleepers using EEG machines. Electroencephalographs work kind of like a polygraph test, with needles scribbling out the brain waves on long sheets of moving paper. (Now, of course, it’s all done electronically, but back then a night’s recordings could amount to ½ a mile of paper.)

The observations revealed that REM-sleep, as Dement now called it, was not just a phase of sleep – it was a radically different state of existence when the brain was more active than during wakefulness.

For all of human history, this had been locked away from observation behind the appearance of a motionless, sleeping person. Dement’s EEG studies allowed for the first time a look inside the black box to see how the brain generated sleep. It overturned our very idea of what sleep was. And made the field of sleep research not just an area of speculation but a hard science.

“It is hard to convey how exciting it was to be doing this work” he recalled later. “Here I was, a mere medical student, holed up in a nearly deserted building, making one surprising discovery after another. And knowing that I was the only one in the whole world who was looking at this aspect of human existence only added to the thrill of discovery.”

Dement went on to get his medical degree and a Ph.D. in neurophysiology from the University of Chicago. After six years at Mount Sinai Hospital in New York, he moved on to Stanford where he spent the rest of his career

As his sleep research continued, his focus moved beyond questions of how sleep works and on to what happens when it doesn’t. Back then, sleep disorders like narcolepsy, sleep apnea, and insomnia were not well understood and doctors often had no way to treat or even diagnose them.

Dement was on the vanguard of research in this area. But to bring treatment to patients on a wide scale would take nothing less that the creation of an entirely new field of medicine. Dement spent decades leading the effort to train sleep specialists, create professional organizations, establish standards, secure funding for research, and educate the medical community and the public about sleep.

He wrote the first university textbook on sleep, started the American Academy of Sleep Medicine, serving as president for its first twelve years, and was a founding editor of the academic journal Sleep.

Dement’s accomplishments in sleep research made him a great scientist. But his warmth as a human being and his sense of fun also made him a great teacher and mentor, a caring physician, and a compelling voice for the importance of sleep.

He described sleep as part of a “triumvirate of health” equal in importance to diet and exercise. And warned of what happened when people neglected it. He used to say, “Drowsiness is red alert,” to remind about the life-and-death dangers of sleep deprivation and its link to countless traffic deaths and on-the-job injuries. Even catastrophic accidents like Chernobyl and the Exxon Valdez disaster.

At Stanford in 1971, he created an undergraduate course called Sleep and Dreams which became unexpectedly popular. He continued to teach it, even after his 2003 retirement, well into his eighties. It was reputed that if you fell asleep during his class, he would squirt you with a water pistol!

In 1990, congress formed the National Commission on Sleep Disorder Research and tapped Dement to be chairman. Their 1993 final report put sleep on the map as a public health issue and inspired the creation of the National Center on Sleep Disorders Research which operates under the National Institutes of Health.

Dement’s 1999 bestselling book The Promise of Sleep is an essential for anyone who wants to get a grounding in the science of sleep. And considering how information-packed it is, it’s a darn good read.