If they are unable to sleep and rest until they die from exhaustion, wouldn’t they just forcibly fall asleep through the power of general anesthesia?
In: 1975
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Unconsciousness and sleep are vastly different. Sleep is a process that your brain needs to go through in stages in order for your body to receive the rest it needs. Sedating someone is simply brute forcing unconsciousness.
Not a doctor here. But the fatal insomnia has my interest.
As others have commented. The brain never reaches its resting state.
Anesthesia, very simply put is turning off the monitor and leaving the computer running instead of putting the whole thing in to sleep mode.
The brain never gets to do its routine of flushing waste out and “defragmenting” its harddrive.
Thus the brain tissue slowly degrades and dies
If we are talking about Fatal Familial Insomnia or it’s rare Sporadic version, it’s not the insomnia which kills. The insomnia is just a symptom of the patient’s central nervous system being destroyed by prions. Therefore even medically induced coma would not save the patient, prions gonna keep prioning.
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Imagine a big button in your brain. To go to sleep you turn off the lights, close the curtains, tell the body to get into rest mode and once ready press the button.
Anesthesia is someone sprinting in, and slamming the button down without turning off the lights or any of that. Just shuts off consciousness.
In Fatal Insomnia the button isn’t connected to anything anymore. As the disease gets worse the button basically melts too. Theres nothing to hijack.
Thats because fatal insomnia is a very rare prion disease. This means a very important protein in the nervous system misfolds. Misfolded proteins do not function correctly if at all, and build up in the brain.
Its like CJD another prion disease. The nervous system just goes bad and we can’t do anything.
So how could this inevitably fatal disease (and similar like rabies) best be managed to minimise suffering? Is there any medical consensus?
Anaesthesia is nothing like sleep – when you’re asleep, you can still react to external stimuli to defend yourself. Being put under requires going deeper than that. One person on here described it as ‘killing you just enough that you’re still alive’ and that’s kinda stuck with me. It’s about forcing your body into an unnatural state where all your awareness is disabled and the body focuses on survival. It’s been argued that the most difficult job in the operating theatre is the anaesthetist because they have to walk an extremely fine line with the patient and continuously monitor their state.
Sleep consists of 2 states – REM sleep (dreaming) and restful sleep, which alternate in cycles through the night. Anaesthesia skips both of those. The brain does not rest or dream but goes into a deeper state of unawareness – it’s just a skip between being knocked out and waking up. In fact, many patients wake up exhausted after surgery and want to sleep because they haven’t rested at all even if the op took most of a day.
Anaesthesia is brutal on the body and not a substitute for sleep. The only thing that will allow the body to rest is natural sleep, and that’s what most sleep aids do – they try to trigger the brain’s natural sleep functions.
Fatal insomnia is terrifying.
They do, and it doesn’t change the outcome. Probably still is the second kindest thing to do though. The first would probably be to allow them to choose the moment of their death.
“General anesthesia” involves paralyzing your muscles including the ones that cause you to breath. Therefore, it is a poor and resource intensive treatment modality.
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