Sleep Cure: What It Is, How It Was Used, And Why It Is Not Recommended
Sleeping well is essential to having a healthy life. For this reason, it is not surprising that when psychological problems appear, such as stress, depression or serious psychiatric disorders, there are problems falling asleep.
Since the birth of psychology and psychiatry, it has been considered that a good way to help a person regain their mental stability is, precisely, to make them sleep.
The sleep cure is a treatment that has been applied to people with diverse psychopathologies, and is not exempt from controversy Below we will look in more depth at this practice, called “intensive therapy” in the psychiatric field.
In psychiatry, the procedure by which the patient is induced to sleep for a long period of time, several days normally being between 6 to 7 days, although there have been cases of up to 3 weeks.
To get the person to sleep for so long various types of psychotropic drugs are administered, specifically hypnotics, inducers and perpetuators of the dream state. The patient is only woken up to relieve herself and feed.
Although the idea that sleep is “a cure against madness” had already been related since ancient times, it was not until the end of the 19th century and the beginning of the 20th century that it was incorporated as a treatment for psychological disorders and associated problems. The sleep cure It has its origins in the works of Jakob Klaesi (also spelled Kläsi) who, from the famous Burghölzli Clinic in Switzerland, spread the “prolonged sleep cure” or “prolonged narcosis” (dauernarkose in German), used for the treatment of schizophrenia starting in the 1920s. Today It is no longer used, as we will see.
Normally, the person to whom the treatment was applied had some psychological problem that made them very upset, especially if they had experienced a traumatic situation or had an anxiety, mood or psychotic disorder. The objective of the treatment was to get the patient’s autonomic nervous system to normalize, causing his symptoms to decrease in intensity.
When a system is healthy, everything is kept in order, ensuring that the person has an adequate state of health and can cope with the demands of their environment. However, when the alteration occurs, the autonomic system is overloaded, activating and manifesting stress, given that the body is in a constant state of alarm. This is because your body releases too high levels of adrenaline and norepinephrine, perpetuating overexcitement.
It is for all this that, throughout the history of psychology and psychiatry, The sleep cure has been proposed as an alternative treatment for various types of disorders, since it would help the patient regain some control of his life. By making him sleep for a long period of time, his body would relax, making it possible to work on the cognitive part of his problems once he had woken up from his long lethargy, such as his beliefs and opinions or the direction of his life.
Types of disorders in which it is applied
The sleep cure has been applied to many psychological problems since it was conceptualized. Among them we can highlight traumatic experiences, suicide attempts, patients with psychosis delusions, depression and anxiety disorders.
The application in people who have experienced a traumatic situation is based on the overactivated autonomic system hypothesis When a very disturbing situation has been experienced, especially caused by the action of another person such as robberies, crimes, terrorist attacks or a plane crash, a high activation occurs in the nervous system, generating problems sleeping and having an adequate way of relating. with the world, as happens in Post-Traumatic Stress Disorder (PTSD).
Benefits of the sleep cure
The main benefit of the sleep cure is that makes the body return to normal, calming down The person obtains the necessary rest to be able to functionally face the demands of daily life, thanks to having been immersed in a deep sleep with restorative effects.
The biological hypothesis that supports the application of the sleep cure is that the patients to whom it is applied present an overactivation of adrenaline and norepinephrine, along with dopamine, a substance that passes through the mesolimbic pathway. That is why the drugs used in the sleep cure can be, among them, the classic medications that produce sleep, especially tranquilizers such as benzodiazepines, including diazepam, alprazolam and clonazepam.
In the case of psychotic patients, antipsychotic medications are also added, which are used while the individual sleeps. The antipsychotics currently used are atypical, such as quetiapine and olanzapine, which also cause drowsiness. In this way, dopamine is modulated, which at high levels is related to suffering from delusions and hallucinations. When the individual wakes up after six or seven days, his or her autonomic system is moderated, and the psychotic symptoms that disturb him have subsided, making way for the application of other therapies.
It is interesting to understand that in sleep cures for patients with psychotic conditions, the application of the sleep cure is not done with the aim of sleeping for sleep’s sake. Antipsychotic and hypnotic medications are applied to these psychiatric patients, which work best during sleep. The patient’s family could make the mistake of thinking that nothing is being done to his relative, but, in reality, the patient is in a kind of “psychiatric intensive care.”
Sleep Cure Precautions
The sleep cure requires supervision It is not a permanent or continuous sleep for several days, as if it were hibernation. The individual has moments in which he is between sleep and wakefulness, and that is when he gets up to relieve himself and feed himself. In addition, he is supplied with the vitamins he needs throughout the process, especially the B complex.
As we have already mentioned, the treatment usually lasts between six and seven days, since it is that period of time in which the autonomic nervous system is supposed to have stabilized. Once the individual has awakened, it is assumed that he has achieved greater control of his activation. It is from this point on that, if your problem has been a traumatic experience, you will begin to see it as part of your past, making it easier to apply psychotherapy without you being altered.
It is important to understand that several types of drugs are administered during induced sleep, which may vary depending on the psychopathology being tried to treat. If necessary, antidepressants and antipsychotics will also be given, always monitoring their interactions with drugs that induce sleep. This therapy has been combined with electroconvulsive therapy.
The most recommended thing is to do the sleep cure in a specialized center, because, depending on the patient’s age and health condition, it will require continuous monitoring by the nursing staff and the doctor who is treating them. You must check on the patient at least once or twice a day and this can only be done in a clinic. In addition, any health problems that the patient may have will be taken into account, such as heart, respiratory, kidney or any other type of problems.
In case the patient does not suffer from any physical health problem, the possibility of being cared for at home can be considered However, it is very important to understand that you will need a very efficient nurse at your side and that your doctor is constantly aware of the situation. In any case, this scenario is unlikely, given that in order to carry out a safe sleep cure at home it is necessary for the patient to be very healthy, something that, taking into account what this procedure is used for, is already It seems strange.
The Sleep Cure Application It is not a treatment widely recommended by the psychiatric community In fact, throughout its history several deaths have been recorded due to drugs administered during sleep. Although it is true that since Klaesi devised this therapy until today, different psychotropic drugs have been used and there has been greater knowledge of the interactions between them, it is not considered completely safe.
In fact, Klaesi himself indicated this, given that of the 26 patients he treated with his method, which was novel at that time, he recorded 3 deaths. It should be said, however, that the cause of these deaths appears to be medical problems prior to the application of the treatment.
Throughout the 20th century, new forms of sleep cures were devised, which were supposedly safer. In the 1930s, Cloettal was created to replace Somnifen which was attributed to less serious side effects on the cardiovascular system. Even so, a skilled clinician should always be nearby since it was considered a treatment with great dangers.
The sleep cure had its ups and downs, with its worst decade being the 1960s in Australia. There, specifically at the Chelmsford Private Hospital, between 1963 and 1979, 1,115 patients were treated with sleep cures. The treatment consisted of a cocktail of barbiturates, benzodiazepines and neuroleptics and was administered, discreetly, by nurses. This procedure is related to the death of 25 patients which is why in 1980 the Royal College of Psychiatrists of Australia and New Zealand considered that the use of the sleep cure with psychopathology was not justifiable.
Despite its history, the sleep cure is still present in popular and professional ideology, with more than one patient coming to consultations who, suffering from emotional disturbances or who want to calm down, request to be treated with this method. Nevertheless, This treatment is not within the official clinical practice guidelines Those who continue to apply it consider it an intensive therapy of psychiatry.
