U.S. patent number 3,762,396 [Application Number 05/085,586] was granted by the patent office on 1973-10-02 for method and apparatus for inducing sleep by applying electrical pulses to plural portions of the head.
Invention is credited to Earle W. Ballentine, Bernard C. Gindes.
United States Patent |
3,762,396 |
Ballentine , et al. |
October 2, 1973 |
METHOD AND APPARATUS FOR INDUCING SLEEP BY APPLYING ELECTRICAL
PULSES TO PLURAL PORTIONS OF THE HEAD
Abstract
A method and apparatus for inducing sleep, treating
psychosomatic disorders, and aiding the induction of hypnosis in a
patient is disclosed in which electric current pulses are passed
through the brainstem via electrodes attached to the back of the
head and forehead. The electric current pulses have a frequency of
8 to 10 cycles per second. A second stimulus of electric current
pulses having a frequency of four times the first stimulus is
passed through the optic nerve via electrodes attached to the
temples and forehead. A third auditory stimulus produced by the
first electrical stimulus is applied to the ears via sound
attenuating chambers in order to acoustically isolate the patient
from a noisy environment. The three stimuli are preferably
synchronized with each other. A novel electrode is disclosed which
is attached to the back of the head protuberance where the hair
would normally electrically insulate the electrode from the scalp.
Means for filling the hair between the scalp and the electrode with
a viscous hygroscopic electrolyte is described.
Inventors: |
Ballentine; Earle W. (Palos
Verdes Estate, CA), Gindes; Bernard C. (Los Angeles,
CA) |
Family
ID: |
22192619 |
Appl.
No.: |
05/085,586 |
Filed: |
October 30, 1970 |
Current U.S.
Class: |
600/26;
600/28 |
Current CPC
Class: |
A61M
21/02 (20130101); A61N 1/36034 (20170801); A61N
1/0526 (20130101); A61M 2021/0072 (20130101) |
Current International
Class: |
A61N
1/32 (20060101); A61N 1/34 (20060101); A61n
001/34 () |
Field of
Search: |
;128/1C,1R,410,417,420,421,422 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Kamm; William E.
Claims
We claim:
1. A method of inducing sleep in a patient comprising the steps
of:
developing a first train of rhythmical fluctuating electrical
currents with a particular fluctuation rate above the alpha rhythm
frequency;
applying the fluctuations to the head for stimulating the optic
nerve via electrodes to be attached to the head near the ocular
region;
developing a second train of rhythmical fluctuating electrical
currents with a particular fluctuation rate approximately similar
to or lower than the alpha rhythm frequency whereby the duration of
each fluctuation is about 40 to 60 percent of the period of the
rhythmic fluctuations of the second train; and
applying the second train to the back of the head for stimulating
the brainstem region via electrodes attached to the back of the
head.
2. The method as set forth in claim 1, placing the electrodes at
diametrically opposed locations of the patients head so that the
brainstem current flows through the brainstem region along a
diametric path between the electrodes.
3. The method as set forth in claim 1, synchronizing the first and
second trains so that the optic nerve current is synchronized with
the brainstem current.
4. The method as set forth in claim 3, the fluctuation rate of the
optic nerve current is four times the fluctuation rate of the
brainstem current.
5. The method as set forth in claim 1, including the steps of:
attaching a pair of sound attenuating chambers to the head over the
ears of a patient in a noisy environment;
developing a monotone stimulus of variable intensity;
introducing the monotone stimulus into the ear chamber whereby the
intensity of the monotone is higher than the attenuated noise
intensity after transmission through the ear chamber walls thereby
isolating the patient from the noisy environment.
6. The method as set forth in claim 5, the monotone stimulus having
a pulse repetition rate approximately similar to the alpha rhythm
frequency.
7. The method as set forth in claim 6, synchronizing the first and
second train with each other and synchronizing the monotone
stimulus with said trains so that the optic nerve current, the
brainstem current and the monotone stimulus are synchronized with
each other.
8. The method as set forth in claim 1, including the step of:
providing a viscous, hygroscopic solution and filling rhe
interstices of the hair between the scalp at the back of the head
of a patient and the electrode placed in the back of the head
whereby the electrical conductivity of the path from electrode to
scalp does not change appreciably during treatment due to viscous
flow or evaporation of the solution.
9. Method as set forth in claim 1, including the step of providing
electrically conductive path from back of head electrode to scalp
comprising:
providing a plate with aperture, and
forcing a viscous electrolyte through plate aperture into hair
between plate and scalp of patient.
10. Method as set forth in claim 9, including:
using a plate having a concave surface as inner face, and
using an electrolyte which is hygroscopic.
11. Apparatus for inducing sleep in a patient comprising:
first means providing a first train of rhythmical fluctuating
electrical currents with a particular fluctuation rate above the
alpha rhythm frequency; electrode means for attachment to the head
of the patient near the ocular region, and connected to the first
means for receiving the currents and applying the currents to the
head for stimulating the optic nerve;
second means providing a second train of rhythmical fluctuating
electrical currents with a particular fluctuation rate
approximately similar to or lower than the alpha rhythm; and
frequency electrode means to be attached to the head and connected
to receive the currents of the second train for applying the
currents to the head for stimulating the brainstem region.
12. Apparatus for treating psychosomatic disorders of a patient
comprising:
first generator means for producing a train of rhythmical
fluctuating electrical potentials with a particular fluctuation
rate above 25 per second,
electrode means to be attached to temples or forehead and connected
to first generator means for forcing a flow of current trhough the
ocular region;
second generator means for producing a train of rhythmical
fluctuating electrical potentials with a fluctuation rate below 20
per second;
electrode means to be attached to back of head or nape of neck with
indifferent electrode attached to forehead or temple and connected
to second generator means for forcing a flow of pulsating current
through the brainstem region, whereby the duration of each pulse is
about 40 to 60 percent of the duration of a current pulse and the
pause following the pulse.
13. Apparatus as set forth in claim 12, the ocular region electrode
means comprising two temple electrodes and an indifferent electrode
for placement at center of the forehead.
14. Apparatus as set forth in claim 12, the fluctuation rate of
first generator means is four times the fluctuation rate of second
generator means.
15. Apparatus as set forth in claim 14, transducer means is
connected to second generator means for producing a monotone
stimulus consisting of a train of sound quanta.
16. Apparatus as set forth in claim 15, the first generator means
being connected to the second generator means for being
synchronized with second generator means.
17. Apparatus as set forth in claim 15, including:
conduit means connected to transducer means for air transmission of
sound;
ear chamber means with sound attenuating walls connected to conduit
means for attaching to head of patient in noisy environment;
and means for adjusting the intensity of the monotone transmitted
from transducer means through conduit means into ear chamber means
to a value greater than environmental noise after transmission
through sound attenuating ear chamber walls thereby isolating the
patient from the noisy environment.
18. Apparatus as set forth in claim 12, including:
the fluctuation rate of the second generator means being adjusted
to be 8 to 10 pulses per second;
the fluctuation rate of the first generator means adjusted to be
four times the fluctuation rate of second generator means;
the second generator means connected to run in synchronism with
first generator means.
Description
The present invention relates to a method for treating various
psychosomatic ailments by electro-physiological stimulation -- to
induce relaxation, a sleep-like state, or sleep -- and to aid the
induction of hypnosis.
The novel method consists of the application of a plurality of
synchronized energetic stimuli characterized by distinctive
waveform, repetition rate, and the manner of applying the waves to
a patient's head.
The invention provides apparatus for generating an electrical
current consisting of symmetric square-wave pulses occurring at
certain frequency rates which are applied to the head via
electrodes in order to induce flicker images in the optic system. A
second electrical current of symmetric pulses having a frequency
rate the same as the alpha rhythm is applied via a different set of
electrodes whereby the current will pass through the brainstem
control center. Further, a means is provided for synchronizing the
two currents entering the electrodes. A third stimulus consisting
of pulses of groups of sound wave harmonics produced by a
transducer connected to the above-mentioned alpha frequency
generator is transmitted to chambers enclosing the ears for
purposes to be explained later.
Further, the application of these stimuli to a patient will usually
induce a paradoxical state which can lead to hypnosis when
accompanied by the suggestive verbalization of an operator.
Electrosleep originated in 1902 when Leduc was able to produce
sleep and general anesthesia in rabbits by applying transcerebrally
an interrupted low intensity direct current. Contemporary prior art
devices use high amplitude (up to 50 Volts) and short duration
(10-20 percent of the period) pulses which are superimposed on a DC
bias. The pulse frequencies are usually in the electrical flicker
range. The current is applied to the head via eye-lid
electrodes.
These devices which were developed without a knowledge of
electrosleep modus operandi, have several disadvantages. Electrodes
over the eyes produce patient apprehension, limit the area of the
electrode and, therefore, the current intensity due to eye-lid
sensitivity, and prevent the doctor from observing the rapid eye
movements which signal the so called REM state required for
electrosleep therapy; "REM" standing for "rapid eye movement". The
flicker repetition frequencies of 30 to 40, which are most
effective for habituating the visual cortex, are least effective
for activating the brainstem sleep center where the natural
frequencies are the alpha rhythm or lower. The narrow spike-like
pulses used are known to be efficient in activating a peripheral
nerve but the brainstem system with spontaneous waves which are
nearly sinusoidal is most efficiently driven with symmetric square
waves. The most important disadvantage of prior art devices is the
basic limitation that a single current must provide, functions
requiring different locale, current intensities, and waveforms.
There are large differences in physiological characteristics
between patients so that the settings vary from person to person,
and are limited by the eyelid sensititivity. In some patients, the
setting may be too low for brainstem activation. Finally, direct
currents produce irreversible changes in brain tissue and,
therefore, can be used only at a fraction of the intensity of
alternating currents. If the devices are used in a noisy room,
unconditioned sounds may cause frequent arousal.
The present invention provides an apparatus which obviates all of
the foregoing disadvantages while providing the highest performance
due to an integrated selection of the most appropriate stimulus and
applicator for each necessary function, and at the same time
minimizing patient apprehension and arousal where treatments are
given in a noisy environment. The apparatus is portable, battery
operated for maximum safety, and inexpensive to manufacture using a
hybrid of standard integrated transistorized assemblies. All
external equipment have pluggable connections to the cabinet panel.
The electrodes are mounted on a single elastic band which encircles
the head and provides electrode contact pressure. Electrical
conductive paste placed between electrodes and forehead, temples,
or scalp, as the case may be, provide a low resistance contact. A
light-weight, washable, molded plastic headset using air for sound
transmission, fits over the ears and delivers the monotone. The
flicker currents flow in a local path in the forehead. The
brainstem currents flow from the back of the head through the
brainstem to the forehead.
In the method of practicing the invention, electrical and
acoustical energy is applied to the patent as described. A first
electrical energy source preferably consists of a balanced,
symmetric square wave potential pulse train with a median
repetition rate of 38 cycles/sec. with a median pulse width of
approximately 13 milli/seconds. The second electrical energy source
has a similar waveform but a frequency which is 9.5 cycles/sec. The
4:1 frequency ratio is preferable to other integral ratios.
(Spontaneous alpha rhythms of approximately this frequency are know
to contain the maximum power found in such waves.) Thus, a
preferred flicker stimulus of 38 cycles/sec. is synchronized with a
9.5 cycles/sec. alpha frequency stimulus which also produces an
acoustic monotone of 9.5 clicks/sec. The currents are adjusted
until a tingling sensation is felt at the electrodes which is
slightly uncomfortable. The sensation is evanescent by adaptation
if without pain. The acoustic monotone is adjusted to a comfortable
level.
During treatment the patient becomes relaxed, enters a sleep-like
state or sleep and finally artificially induced REM state wherein
normal sleep patterns are reinstated, tensioned-provoking stresses
are relieved, and emotional and psychosomatic disorders are
cured.
Further objectives and advantages of the invention will be apparent
to those skilled in the art from a reading of the following
detailed description thereof, when viewed in the light of the
accompanying drawings.
FIG. 1 is illustrated an overall view of the system used for
electrosleep and electrohypnosis in accordance with the preferred
practice of the invention. For electrosleep, the microphone and the
voice control knob on the panel would not appear in this view;
FIG. 2 illustrates an electrode supporting band for attachment to
the head of a patient;
FIGS. 3 and 4 illustrate, respectively, views taken from planes
3--3 and 4--4 of FIG. 2;
FIG. 5 illustrates a perspective view of a head-phone used in the
system shown in FIG. 1;
FIG. 6 illustrates a block diagram of the circuit used in the
electrosleep apparatus;
FIG. 7 illustrates the electrical waveforms generated by the
apparatus; and
FIG. 8 illustrates a block diagram of the circuit used in the
electrohypnosis apparatus.
Proceeding now to a detailed description of the drawings in FIG. 1,
there is illustrated a bed as couch B on which rests the patient P
for electrosleep treatment or hypnosis. The principal components of
the system providing the electrical and auditory stimuli are
contained in cabinet C. The doctor D does not speak to the patient
P during electrosleep therapy. For electrohypnosis, however, the
doctor D speaks directly into microphone M providing suggestive
verbalization concurrently with the stimuli to patient P via
headphone 30.
A headband 10 is placed on the head of the patient P as illustrated
in FIG. I, and carries either three or four electrodes and
insulates them from each other. The headband is made of a suitable
insulating material which is preferably elastic. FIG. 1 shows the
three electrode arrangement wherein electrodes 11 and 12 placed on
the forehead over the eyes or electrode 11 can be placed on the
forehead over one eye with electrode 12 placed on the temple
adjacent the other eye. The position of the ground or indifferent
electrode is such that the mainstem intersects a straight line
between electrodes 11 and 13. FIG. 2 exhibits the four electrode
arrangement which is preferred. The electrodes 12 and 12a are
placed on the temples with the ground or indifferent electrode
centered on the forehead. The fourth electrode 13 is centered on
the protuberance at the back of the head adjacent to the base of
the occipital lobe. Electrically conductive paste is forced from
the snout 16 of a squeeze bottle which is inserted into an aperture
14 in electrode 13. The paste aided by groove 15 in face of
electrode 13 fills the space between electrode 13 and the scalp and
provides a low resistance path for the electrical current.
Each of these electrodes 11, 12, 12a, and 13 connects individually
to an insulated wire, respectively denoted 21, 11 and 23 and joined
in a cable 20 for insertion in a suitable jack in cabinet C. The
electrical potentials applied to wires 21, 22 and 23 are developed
by the electrical components contained in cabinet C; the circuit
diagrams FIGS. 6 and 8 illustrate the circuits which develop the
stimuli potentials.
A second type of connection between the components in cabinet C and
the patient P is established by an audio channel which includes a
hollow tube 33 and a headset element 30 for defining two ear
cavities. Soft rubber pieces, such as 31 form ear cavities proper
to fit snugly against the skin around the ears.
An acoustic stimulus is developed inside cabinet C and transmitted
through tube 33 into the hollow headset 30. Apertures 32
acoustically connect the air passages with the cavities defined by
caps 31 which enclose the ears. The element 30 is made of a light
plastic and is washable.
The panel of cabinet C is provided with a plurality of control
knobs for adjusting the intensities of the various stimuli. The
cabinet C panel also includes two milliammeters for measuring the
electrical currents passing through the patient's head in addition
to the usual switch, indicator light and jacks.
Turning to a detailed description of FIG. 6 which is a block
diagram of a typical circuit for the electrosleep apparatus in
accordance with the invention:
The astable multivibrator 40 is a relaxation oscillator in which
two capacitors are alternately charged and discharged through
respective resistors. The applied potential and the sum of the two
time constants determine the frequency of oscillation, and a
specific ratio of these time constants determines the
duration-period ratio. If the time constants are unequal, the
multivibrator is asymmetric, and if no coupling capacitors are
employed, the output current will have a DC component. The prior
art multivibrators are of this latter type. However, if this
multivibrator is AC coupled by connecting a capacitor in series
with the load, the current becomes balanced in that at the end of
each cycle there will be not net charge displacement but the
waveform will remain unsymmetrical.
The subject invention preferably employs a nearly symmetric
multivibrator with AC coupling in order to obtain maximum tissue
tolerance and the most effective waveform for brainstem
stimulation.
Brain tissue is capable of tolerating some types of stimulation
over long periods of time. Tissue damage can occur two ways, viz.,
electrolytically and thermally. Electrolytic damage occurs with any
direct current stimulus at any current density, resulting in
decomposition of electrolytes and diffusion of metal into tissues.
Thermal damage occurs if current density is too high. Tissue
tolerance studies have determined that balanced currents can pass
through tissue for an indefinite period of time, such as would be
required of a permanent implant providing that the amount of
electrical charge in each pulse did not exceed 200 micro coulombs.
Obviously, much larger charges could be used for infrequent
stimulation. Electrosleep devices which use a DC bias can cause
electrolytic dissociation and deposition of metallic ions in brain
tissue.
Extensive clinical studies with variable duty ratios established
that the performance was far superior when the pulse duration was
.4 to .6 of the period. This unexpected result was consistent with
the fact that spontaneous waves in the brainstem during the sleep
cycle more nearly resembled the sinusoidal form than the spike-like
pulses of short duration used by prior art stimulators.
At the core of the present invention is the fact that during the
sleep cycle the internal impedance of a brainstem oscillator
coupled to its load impedance defines oscillation frequencies of
the order of the alpha rhythm or lower, and therefore such a
frequency should be optimum for the alpha drives.
Referring again to FIG. 6, the output of astable multivibrator 40
with preferred flicker frequencies of 32 to 40 cycles/sec., is
connected to amplifier 45 which is connected to the temple
electrodes 12 and 12a. Likewise, multivibrator 40 is coupled to
astable multivibrator 41 which is set at a frequency slightly lower
than multivibrator 40 so that it can pull multivibrator 41 into
synchronism. Multivibrator 41 is connected to amplifier 55 which
supplies current to protuberance electrode 13. The forehead
indifferent electrode 11 is at amplifier ground potential.
Transducer 60 converts the audio electrical currents into sound
waves which are then transmitted through air passages 30 and 33 to
ear chambers 31.
The application of sound energy to the ears via ear chambers
introduces the consideration of ear tolerance to sounds of various
intensities. Long continued sound of any frequency is known to
cause hair-cell deafness, which is often called nerve deafness. In
hair-cell deafness, the major loss of hearing is found to be in the
frequencies above 2000-3000 cps. White noise in particular is much
more dangerous since the sound energy is distributed uniformly over
the entire audible range and therefore stimulates all areas of the
basilar membrane of the ear. For these reasons, a low cut-off
frequency of 4 to 5 kilocycles is preferred. In the case of
ordinary sound, it has been found that continued stimulation of the
ear with a sound intensity of 100 db or higher will cause ear
damage in many people. The maximum monotone intensity should be
substantially less than 100 db's. Thus, the monotone consists of a
series of clicks with the alpha drive repetition rate wherein each
click consists of the harmonics of the square-wave up to the
cut-off frequency of the transducer.
A feature of the present invention is to use the monotone as a
means for isolating the patient P from the auditory environment. It
is well known that an ambient noise field provides a threshold of
audibility which completely masks sounds of lower intensity and
that it is difficult to attenuate sound solely by sound absorption
materials. The monotone establishes a threshold in the ear cavity
which can easily exceed the attenuated sounds filtering into the
cavity through a relatively small amount of absorption material.
Thus, the dual purpose monotone provides a simple inexpensive means
for isolating the patient P in a noisy hospital ward during
treatment as well as inducing habituation in the auditory
system.
FIG. 7 displays graphically the synchronized waveforms of the
currents which pass through the patient's head. The flicker current
I.sub.f has a freqyency which is four times the alpha drive current
I.sub.a. The square waves are symmetric but the amplitudes are
individually adjusted to patient tolerance. The horizontal time
axis shows the pulse duration .DELTA. t.sub.f and .DELTA. t.sub.a
and the dotted axes O.sub.f and O.sub.a result from capacitor
coupling and display graphically the fact that the currents
alternate in direction.
FIG. 8 is a block diagram of a typical circuit for electrohypnosis
apparatus in accordance with the invention, which also discloses an
alternate method for generating the synchronized electrical
stimuli.
There is illustrated an astable multivibrator 40 preferably
generating a nearly symmetric square-wave voltage train with means
for varying the frequency.
Two bistable multivibrators 50 and 51 are connected in frequency
divider configuration to multivibrator 40 whereby multivibrator 50
provides a 2:1 reduction of the output frequency of multivibrator
40, and multivibrator 51 provides a 2:1 reduction of the output
frequency of multivibrator 50.
Amplifiers 45 and 55 which are preferably of the constant potential
type, are connected to the outputs of multivibrators 40 and 51
respectively. The currents delivered to electrodes 12 and 13 from
amplifiers 45 and 55 are adjustable. Indifferent electrode 11 is at
amplifier ground potential.
Operational amplifier 61 receives voice currents from microphone M
and alpha frequency currents from multivibrator 51 concurrently.
The intensities of the amplified outputs of these two audio
frequency currents are independently adjustable. This is
accomplished by a constant potential junction which prevents
inter-action between the voice and monotone currents.
Prior art electrosleep devices employ a combination of DC and AC
currents. A nerve will be activated by an AC current and will
habituate after sufficient stimulation. However, a nerve will be
fatigued without activation by DC currents. The previously
mentioned disadvantages of using a DC component are obviated in the
present invention. FIG. 9 illustrates a diagram of the circuit for
electrosleep after providing for a DC component in the alpha drive
current. The adjustable DC potential is obtained from the
combination of battery 80 and potentiometer 81. The DC current has
a maximum value which is determined by resistor 82 and is added to
the square-wave current appearing at junction with coupling
capacitor 83. This coupling capacitor is included in amplifier 55
in FIGS. 6 and 7 but is not included in amplifier 55a. If the
capacitor is electrolytic, it is necessary to use diode 84 to
prevent reverse flow in the event that the AC potential is less
than the DC potential. FIG. 10 displays graphically the DC
component i.sub.d of the alpha drive current i.alpha..
Electrosleep therapy has become a subject of considerable interest
to American scientists because of the large amount of American
research on sleep since about 1955. This interest stemmed from the
discovery of a new kind of sleep and from a number of
investigations of the effects of sleep deprivation. This new kind
of sleep is most commonly called REM, dream, or deep sleep because
its most salient features are rapid eye movements, dreaming, and
extreme muscle relaxation. Quiet, or slow-wave, sleep is so named
because of the absence of the occasional body movements of REM
sleep and the fact that the brain waves have much lower
frequencies.
The state of wakefulness is maintained by two entirely different
types of activatory processes which are called sensory stimulation
and tonic facilitation. In sensory stimulation, there is a flow of
information from the sense organs which are located both
peripherally and internally through the thalamic nucleus in the
brainstem to various regions in the brain which are specific to
each type of information. The flow is controlled or modulated by
the sensory receptors, various synapses, and by the brainstem
control center. These stimuli under certain conditions also may
induce a reverse flow from the cerebral cortex to the brainstem
causing further arousal activation. The onset of sleep mechanism
starts with inhibition in this system. Visual and auditory stimuli,
muscle tension, and motor activity all have strong arousal action
which are normally inhibited when we lie down and relax in a quiet,
dark room. Artificial inhibition of auditory and visual stimulation
is most effectively accomplished by habituation of specific
monotonous auditory stimuli after some minimum number of clicks are
heard, or by a flashing light repeated for a period of 200 to 300
seconds. A far superior visual stimulus, however, is the induction
of visual images by electrical stimulation of the optic system,
since the frequency of the flicker can be increased by a factor of
about three before the flicker disappears by fusion. A by-product
of the habituation of the auditory and visual systems is the
deactivation of muscle tension inducing a general relaxation. This
result is confirmed not only by the observed muscle flaccidity but
by the brain-wave pattern as portrayed by the encephalograph which
shows a change from the activatory pattern of wakefulness to the
alpha form of the relaxed state. The sensory system is inactive
during sleep and if no stimulation is present, sleep will follow.
This phenomenon is exemplified by the case of a subject who,
through injury, lost the sight in one eye and the hearing in one
ear, who would fall asleep eventually whenever the good eye and ear
were covered and plugged respectively.
In order to prevent unwanted sleep the brain is provided with a
continuous stimulation which originates in the mesencephalic
hemisphere of the brainstem. This tonic facilitation which keeps
the brain awake has a maximum intensity after awakening and it is
continuously suppressed during the day with a minimum magnitude at
bed-time. The origin of this suppression of tonic facilitation is
related to the need for recovery which progresses during the day
and terminates in sleep. The time for recovery ranges from
magnitudes measured in milliseconds, such as the nerves, to hours
in the case of the highest level of cerebral activity. This highest
level is found to occur in learning and conditioning which is the
reason for the large amount of time spent by a baby in sleep. This
activity is believed to produce changes in the large glial cells
and synapses in this level, and these changes are considered to
progressively suppress the tonic facilitation of the mesencephalon
during the day, so that when the sensory stimuli are cut off, sleep
will follow.
When the mesencephalon is removed in animals, a sleep-like state
characterized by eye closure, muscle relaxation, lowered pulse and
respiration rates, and insensibility to tactile pressure has been
produced. The same sleep-like state has been induced by inserting
micro electrodes and passing a low frequency current through the
mesencephalon.
In review, it has been established that three stimuli can provide
the conditions for the onset of sleep, namely, an auditory monotone
for habituating the auditory cortex, an electrical flicker for
habituating the visual cortex -- either one of which will induce a
relaxed musculature -- and a low frequency electrical current which
must pass through the brainstem in order to deactivate the
mesencephalon. If the frequency of the brainstem current is chosen
to be the same as the alpha rhythms, and if this current is
synchronized with the current inducing the electrical flicker, the
intensity of the visual images is about twice as bright when the
flicker frequency is four times the alpha frequency. The results
were optimum when the auditory monotone was also synchronized with
the two electrical stimuli. This synergistic phenomenon provides a
method of integrating two electrical stimuli without interference.
The three synchronized stimuli -- auditory monotone, alpha drive,
and electrical flicker -- induce a state of relaxation, a
sleep-like state, or sleep.
Concern over loss of sleep by the Armed Forces during war resulted
in numerous studies on the effects of sleep deprivation since it
had been known for a long time that sleep deprivation leads to
malfunction, permanent damage, and finally death; and also, that
temporary sleep loss is made up by increased sleeping time during
the recovery period. The mental symptoms of sleep loss follow a
slow and predictable pattern, and the changes accelerate as time
passes. Some of the changes following sleep deprivation are:
inattention, weariness, lack of concentration, loss of memory,
slurred and faulty speech, listless behavior, reduced muscular
exertion, anxiety, skin sensations, withdrawal from reality, time
disorientation, visual distortions, illusions, hallucinations,
severe personality changes, and finally a psychotic state. The
EEG's of the brain waves showed an alternation between the alpha
form and the slow sleep-like waves and these alternations are
called "microsleeps."
Sleep is preceded by a decline in activities or performance and by
subjective feelings of tiredness, which have been considered to be
due to an accumulation during wakefulness of waste products which
are disposed of during sleep, or of a depletion during wakefulness
of vital chemicals which are replenished during sleep. When
cerebrospinal fluid from fatigued dogs is injected into
non-fatigued dogs, the latter showed signs of drowsiness and sleep,
thus indicating that a hypnogenic substance accumulated during
wakefulness. Serotonin, which is a hormone-like substance
exhibiting a wide range of powerful effects on the brain and other
organs of the body, is found in cerebrospinal fluid. Similar
experiments with water-soluble extracts from the brains of sleeping
animals produced sleep in the recipient animals. The medulla at the
base of the brainstem contains the raphe nuclei which are noted for
their production of serotonin. When 80 percent of the cells of
these nuclei are destroyed, the experimental animals slept less
than 10 percent of their normal period. Similarly, there is a locus
coeruleus nucleus just below the raphe nuclei which contains the
system for producing REM sleep, and this nucleus uses noradrenalin
for its activating agent.
Several studies on REM sleep deprivation were made after overcoming
the difficulties of determining the exact time that REM dreaming
started and ended. When an individual goes to sleep, his initial
quiet slow-wave sleep lasts for a period of 60 to 90 minutes after
which he starts dreaming. There are normally four or five of these
REM periods, in which the first one is the shortest and the last
one is the longest, and only the dreams of the last one are
remembered. The total REM sleeping time is, on the average, 20
percent of the total period. These studies disclosed the amazing
fact that the loss of REM sleep produced essentially the same
malfunctioning that occurred with total sleep deprivation. The
subjects actually slept much longer than usual in the quiet
slow-wave phases and they were extremely difficult to awaken. The
discovery of this basic phenomenon provides the scientist with a
new tool for attacking sleep disorders and their derivative
ailments. This third state of consciousness can be identified by
its salient characteristics such as an EEG pattern resembling that
of wakefulness, rapid eye movements, often jerking of the limbs,
marked flaccidity of neck muscles, and almost always a report of
dreaming when awakened. Another important facet of total sleep
deprivation is that there is a change in quality of sleep, and this
change is for the worst since there is a larger percentage loss of
the REM state.
When REM sleep deprivation is terminated there is a rebound in the
recovery period in which the subject sleeps from 11 to 14 hours
after several nights of sleep loss with a much higher than normal
proportion of REM sleep. With longer periods of deprivation the
proportion of REM increased. Animal studies determined that after
REM sleep deprivation they seemed to recover about 60 percent of
their lost dream periods. Further studies were made on the recovery
period phenomenon using two groups of rats deprived of sleep for
four or five days where one group was given a slight electric shock
by touching the electrode to the ear. The unshocked control group
showed the usual incremental compensatory period of REM sleep but
the shocked group spent a much smaller period in REM sleep. This
key experiment provides a new method of quickly removing REM sleep
deprivation effects in the rat which was subsequently verified in
the cat -- namely, by passing an electrical current through the
heads of these animals. This experiment suggests that the electric
current causes the release of a compound that could block the flow
of the activating agent for REM sleep, which has been identified as
noradrenalin. It has been known for some time that the pontine
reticular formation contains a timing device which produces REM
sleep at regular intervals but which is interrupted during
wakefulness. It has been determined experimentally that a specific
dose of resperine in cats leads to a complete elimination of REM
sleep for as long as four days. A possible hypothesis is,
therefore, that the electric current counteracted the blocking
effect of a resperine-like substance of either the timing device or
of the excretion of noradrenalin from the locus coeruleus region.
If the caudal pontine reticular formation is cut or removed, REM
sleep is completely eliminated, but if this region is stimulated
electrically while man is in a slow sleep-like state, REM sleep
will follow.
Thus, we find that electrical stimulation of the brainstem after
sensory habituation leads to a quiet sleep-state followed by the
REM state in which symptoms of REM sleep deprivation are reversed.
These changes are dramatic in a large number of cases for in many
instances a single one-hour stimulation completely reverses the
symptology of depression and other similar mental disorders
inducing a state of calmness and well-being.
Volumes have been written on the powers of suggestion, but
unfortunately, only a select group of people are able to use this
powerful phenomenon for their own benefit. The great value of
hypnosis lies in the fact that it can transform the potentiality of
suggestion into reality. The mechanism is extremely simple. In a
state of deep hypnosis, it is only necessary to make a suggestion
and post-hypnotically there will be a tremendous compulsion to
carry out the suggestion. Deep-seated habits which are difficult to
change with ordinary suggestion are easily erased by the force of
hypnotic suggestions, e.g., smoking, obesity, phobias of various
kinds, and many others. Hypnotic suggestion has a much wider
application, however, in its ability to inhibit the sensations of
pain. For example, prior to a tooth extraction or childbirth fear,
apprehension and pain will be inhibited post-hypnotically. If
post-hypnotic suggestion is so effective, why hasn't it been in
regular use? The answer is that past methods of inducing hypnosis
have failed in two ways. In the first instance, only a small
portion of the population can be hypnotized in a practical length
of time. Also, only a minor percentage of this group will reach the
depth of hypnosis required for analgesia.
The primary goal of hypnosis is to induce a state in which the mind
will accept the suggestions of an operator without question,
analysis or qualifications of any kind. In the normal state, the
mind is receiving a stream of bits of information from the sense
organs which are integrated in the mind to produce thoughts. These
thoughts will bring into consciousness by association related
information or memories of past experiences which are stored in the
brain. This combination of transient and associated stored
information generates a host of thoughts which will compete with
the suggestion of an operator for the attention of the mind. The
mechanism of the induction of hypnosis involves a substantial
reduction or elimination of these competing thoughts. The hypnoidal
state which might be called conscious sleep is preceded by a
transitory "paradoxical" state in which the goal is the exclusion
of the unwanted thoughts which are competing with the suggestions
of the operator. This exclusion process requires a maximal
inhibition or shut-off or sensory stimuli and particularly those
arising from sound, motion, tension, and light. The "paradoxical"
state is thus seen to be similar to the "sleep syndrome" with the
exception that the degree of extinction or attenuation of auditory
stimuli must not reach a level which would prevent communication
with the subject.
Suggestive verbalization is the fundamental catalytic ingredient
which can transform the paradoxical state into hypnosis. However,
the early attempts to give a subject suggestions after inducing the
paradoxical state were unsuccessful for the following reasons. The
habituated monotone and other familiar sounds have a mean amplitude
during REM sleep of about 15 percent of that of wakefulness, i.e.,
a very low sound level. In sharp contrast, is the fact that when a
subject is in REM sleep, any new sound (unhabituated) will evoke a
much larger response in REM sleep than in any other state,
resulting in a maximum startle reaction. Consequently, when the
operator speaks to a subject in the paradoxical state, the EEG
instantly changes to the activatory form, arousal ensues and the
state disappears. If instead, the operator gives the suggestive
verbalization concurrent with the other stimuli, the induction
process is under his complete control and the subject will neither
be aroused nor inattentive. An alternative method of induction is
for the operator to give suggestions to the effect that when he
speaks to the subject later, he will hear the operator's voice,
even though asleep, and will not be startled thereby. This method
is effective if the suggestions are strong enough to survive the
elapsed time interval.
Thus, it has been developed that electrosleep therapy and
electrohypnosis have a modus operandi evolved from a varied
phenomenology which is briefly summarized herewith.
Relaxation is established in the absence of motor activity by
artificial monotonous stimulation of the visual system by an
electrical flicker stimulus as evidenced by the EEG wave pattern of
the alpha rhythm. This result has also been obtained by stimulating
the auditory system with a monotone. The combination of these two
sensory stimuli has been most effective due in large part to the
masking of external sounds by the monotone when introduced within
sound attenuating chambers placed around the ears.
The application of these sensory stimuli to the head of a patient
will induce a sleep-like state or sleep but the best results were
obtained when the patient was mentally tired. (Tiredness is known
to suppress mesencephalic activation which induces wakefulness.)
Thus, a first purpose of the concurrent alpha drive stimulus is the
deactivation of the mesencephalon, providing a performance which is
independent of previous cerebration activity.
Hypnosis can be induced any time after a state of relaxation is
obtained by suggestive verbalization if concurrent with the stimuli
from the start.
The sleep-like state is defined by many physical changes from the
normal state which include: reduced blood pressure, lower pulse
rate, flaccid muscles, EEG patterns, etc., and these changes are a
maximum when normal sleep is attained.
The genesis of REM sleep is controlled by a clock in the pontine
reticular formation but its cyclic activity must be preceded by the
slow sleep-like state which is a prerequisite for its activation.
REM sleep normally follows slow sleep provided that the excretion
of noradrenalin from the locus coeruleus region is not blocked by
hypnotoxins derived from REM deprivation process. In any case, the
alpha drive stimulus will activate the caudal pontine reticular
formation thereby inducing the REM state and hypothetically
dissipating the hypnotoxins subsequently.
Men of medicine know that the majority of illnesses, whether they
be physical or emotional, have their dominant anxiety components.
Tensions and anxieties are normally relieved in the one-fifth of
total sleep which constitutes the REM state but the sleep patterns
of the emotionally ill are significantly affected with the result
that a considerable portion of the anxiety relieving states are
excluded. By artificially inducing the REM state and by reinstating
normal sleep patterns and relieving tension provoking stress, a
cure of emotional and psychosomatic disorders are effected.
This invention provides the most effective method and apparatus for
inducing the REM state by finding experimentally a unique set of
stimuli in combination whose characteristics individually give
optimum performance of the functions of each facet involved in the
activation of sleep and the REM state.
The invention is not limited to the embodiments described above but
all changes and modifications thereof not constituting departures
from the spirit and scope of the invention are inteded to be
included.
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