LOS ANGELES (CNN) — Michael Jackson died while preparing to set a world record for the most successful concert run ever, but he unknowingly set another record that led to his death.
Jackson may be the only human ever to go two months without REM — Rapid Eye Movement — sleep, which is vital to keep the brain and body alive. The 60 nights of propofol infusions Dr. Conrad Murray said he gave Jackson to treat his insomnia is something a sleep expert says no one had ever undergone.
Propofol disrupts the normal sleep cycle and offers no REM sleep, yet it leaves a patient feeling refreshed as if they had experienced genuine sleep, according to Dr. Charles Czeisler, a Harvard Medical School sleep expert testifying at the wrongful death trial of concert promoter AEG LIve.
If the singer had not died on June 25, 2009, of an overdose of the surgical anesthetic, the lack of REM sleep may have soon taken his life anyway, according to an opinion by Czeisler.
Lab rats die after five weeks of getting no REM sleep, he said. It was never tried on a human until Dr. Murray gave Michael Jackson nightly propofol infusions for two months.
Czeisler — who serves as a sleep consultant to NASA, the CIA and the Rolling Stones — testified Thursday that the “drug induced coma” induced by propofol leaves a patient with the same refreshed feeling of a good sleep, but without the benefits that genuine sleep delivers in repairing brain cells and the body.
“It would be like eating some sort of cellulose pellets instead of dinner,” he said. “Your stomach would be full and you would not be hungry, but it would be zero calories and not fulfill any of your nutrition needs.”
Depriving someone of REM sleep for a long period of time makes them paranoid, anxiety-filled, depressed, unable to learn, distracted, and sloppy, Czeisler testified. They lose their balance and appetite, while their physical reflexes get 10 times slower and their emotional responses 10 times stronger, he said.
Those symptoms are strikingly similar to descriptions of Jackson in his last weeks as described in e-mails from show producers and testimony by witnesses in the trial.
Jackson’s mother and children are suing AEG Live, contending the company is liable in his death because it hired, retained or supervised Dr. Murray, who was convicted of involuntary manslaughter. They argue the promoter pressured Dr. Murray to get Jackson to rehearsals, while failing to get Jackson help despite numerous red flags warning that he was in trouble.
AEG Live lawyers contend it was Jackson who chose, hired and supervised Murray and their executives had no way of knowing about the dangerous propofol treatments administered in the privacy of Jackson’s rented mansion.
A very long question
Czeisler is back on the witness stand Friday to answer a question that was asked just as court ended Thursday. Jackson lawyer Michael Koskoff asked his expert what may also be a record breaker in a trial — a 15-minute-long hypothetical question.
He was asked to render an opinion based on a long list of circumstances presented so far in the trial about Jackson’s condition and behavior, including:
— That Murray administered propofol to Jackson 60 consecutive nights before June 22, 2009.
— That Murray began to wean Jackson from propofol on June 22, 2009, and gave him none of the drug on June 23.
— That a paramedic who tried to revive him the day he died initially assumed he was a hospice patient.
— That show producers reported Jackson became progressively thinner, paranoid and was talking to himself in his final weeks.
— That the production manager warned Jackson had deteriorated over eight weeks, was “a basket case” who he feared might hurt himself on stage and could not do the multiple 360 spins that he was known for.
— That show director Kenny Ortega wrote Jackson was having trouble “grasping the work” at rehearsals” and needed psychiatric help.
— That Jackson needed a teleprompter to remember the words to songs he had sung many times before over several decades.
— That show workers reported the singer was talking to himself and repeatedly saying that “God is talking to me.”
— That Jackson was suffering severe chills on a summer day in Los Angeles and his skin was cold as ice to the touch.
AEG Live lawyers objected to the question because the information about Murray’s nightly propofol treatments was derived only from the doctor’s statement to police after Jackson’s death. The judge previously ruled that statement was inadmissible. It was a ruling made earlier in the trial when Jackson lawyers objected to AEG’s use of Murray’s statement that he believed he was Jackson’s employee, not AEG Live’s.
The statement could be used if Murray, who is serving a prison term, is brought into testify. But that is unlikely since the doctor has said he would impose his constitutional protections against self-incrimination as long as the appeal of his conviction is pending.
Jackson lawyers could clear the way for use of the statement by withdrawing their objection, something they are now considering.
Koskoff told the judge that his expert would testify that Jackson’s symptoms perfectly matched what he would expect from someone who had been given long-term propofol treatments.
The jury is likely to hear his answer Friday.
A lecture on sleep
Jurors appeared quite interested as Czeisler lectured them Thursday on his sleep research, including an explanation of circadian rhythm — the internal clock in the brain that controls the timing of when we sleep and wake and the timing of the release of hormones
“That’s why we sleep at night and are awake in the day,” he said.
Your brain needs sleep to repair and maintain its neurons every night, he said.
Blood cells cycle out every few weeks, but brain cells are for a lifetime, he said.
“Like a computer, the brain has to go offline to maintain cells that we keep for life, since we don’t make more,” he said. “Sleep is the repair and maintenance of the brain cells.”
An adult should get 7-8 hours of sleep each night to allow for enough sleep cycles, he said.
You “prune out” unimportant neuron connections and consolidate important ones during your “slow eyed sleep” each night, he said. Those connections — which is the information you have acquired during the day — are consolidated by the REM sleep cycle. Your eyes actually dart back and forth rapidly during REM sleep.
“In REM, we are integrating the memories that we have stored during slow eyed sleep, integrating memories with previous life experiences.” he said. “We are able to make sense of things that we may not have understood while awake.
Learning and memory happen when you are asleep, he said. A laboratory mouse rehearses a path through a maze to get to a piece of cheese while asleep.
A basketball player’s area of the brain that is used to shoot a ball will have much greater slow eyed sleep period since there is more for it to store, he said. They shoot better after sleep.
The Portland Trailblazers consulted with him after they lost a series of East Coast basketball games, he said. He was able to give their players strategies for being sharper when traveling across time zones.
He’s worked with the Rolling Stones on their sleep problems, he said. Musicians are vulnerable since they are traveling across time zones and usually “all keyed up” to perform at night, he said.
Czeisler developed a program for NASA to help astronauts deal with sleep issues in orbit, where they have a sunrise and sunset every 90 minutes.
Other clients include major industries that are concerned about night shift workers falling asleep on the job, the CIA, Secret Service and the U.S. Air Force, he said.
Jackson lawyers argue that AEG Live should have consulted a sleep expert like Czeisler for Jackson instead of hiring Murray — a cardiologist — for $150,000 to treat the artist.
The trial ends its eighth week in a Los Angeles courtroom Friday. Lawyers estimate the case will conclude in early August.