jackson v aeglive- transcripts - june 20th dr. charles czeisler. sleep medicine, harvard medical...

7/28/2019 Jackson V AEGLive- Transcripts - June 20th Dr. Charles Czeisler. Sleep Medicine, Harvard Medical School

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JACKSON V AEGLIVE June 20th Dr. Charles Czeisler

Dr. Charles Czeisler

Sleep Mediine! "ar#ard Medial Sh$$l

%lainti&&s E'pert (itness

(Hearing prior to jury entering)

Judge:(ant t$ )a*e +$ur appearanes,

Mr. Panish:-es. G$$d )$rnin! +$ur h$n$r. /rian %anish &$r %lainti&&s.

Mr. Kosko:G$$d )$rnin! +$ur h$n$r. Mihael K$s*$&& &$r %lainti&&s.

Mr. !oyle:Ke#in /$+le &$r %lainti&&s.

Ms. "ahan:Kathr+n Cahan &$r the De&endants.

Mr. Putna#:Mar#in %utna) &$r the De&endants.
http://teammichaeljackson.com/archives/8530https://sleep.med.harvard.edu/people/faculty/210https://sleep.med.harvard.edu/people/faculty/210http://teammichaeljackson.com/archives/8530


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Ms. $te%%ins:Jessia Steins Steins &$r the De&endants.

Judge:S$)e$d+ 1anted t$ tal* t$ )e,

Ms. "ahan:-es! +$ur h$n$r. (e 1ere ust handed a de)$nstrati#e and a dis 1ith p$1erp$int*ind $& slides $n it that 1e thin* are $in t$ e pr$le)ati &$r puttin in $ur li#e $nneti$n.And l$$*ed at the)! and I elie#e %lainti&&s3 $unsel th$uht it 1as ad#isale t$ address the)1ith +$ur h$n$r e&$re the 1itness ta*es the stand and the ur+ is r$uht in.

Judge:O*a+. (hih 1itness are 1e tal*in a$ut,

Mr. Panish:Dr. Czeisler.

Judge:O*a+. Dr. Czeisler.

Mr. Putna#:Dr. Czeisler.

Judge:"e3s an e'pert4 riht,

Mr. Kosko:"e3s a sleep e'pert! +es.

Judge:And he has a slide presentati$n,

Mr. Kosko:(ell! there are su))ar+ slides. (e an i#e the) t$ +$ur h$n$r. And the+3re ust

$in t$ 55 1e thin* the+3ll help )$#e the testi)$n+ al$n.

Mr. Panish:All riht. (h+ d$n3t +$u i#e the) t$ the ler*,

Judge:(ell! is there s$)e reas$n 1h+ it 1asn3t i#en t$ the de&ense earlier,

Mr. Panish:-es. /eause it3s a de)$nstrati#e! and ude3s $rder 1as &$r an+ de)$nstrati#ee'hiit! t$ sh$1 it t$ the) e&$re the 1itness! s$ 1e3re $)pl+in 1ith that. C$ntrar+ t$+esterda+! Ms. Steins didn3t sh$1 us the de)$nstrati#e e&$re she used it. (e &$ll$1ed the$rder and a#e itt$ the).

Judge:O*a+. Is it an issue $& needin ti)e t$ re#ie1 it! $r are there $eti$ns! $r +$u ust d$n3t*n$1 +et,

Ms. "ahan:(ell! I3) l$$*in at the) n$1! and I ha#e $eti$ns t$ the). 6he &irst 55 1e anl$$* at the %$1erp$int! 1hih 1as! I thin*! ust printed &$r +$u! a nu)er $& these 55 I thin* shehas t1$ per pae.

Mr. Panish: I thin* 1e sh$uld identi&+ it 1ith the nu)er s$ 1e an *n$1 1hat 1e3re tal*in


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a$ut spei&iall+.

Ms. "ahan: 6he &irst $ne I ha#e sa+s! 7Sleep! the eha#i$ral state enerated + the rain.7

Mr. Panish:O*a+.

Ms. "ahan:I d$n3t *n$1 1hat nu)er +$u 1ant t$ i#e the).

Judge:6he+3re painated at the $tt$)! 7pae 8.7

Ms. "ahan:%ae 8 has 55

Mr. Kosko: E'use )e. -$ur h$n$r )a+ ha#e t1$ $n a pae! and Ms. Cahan has $ne. 6he &irst$ne is laeled! 7Sleep!7 and it3s a su))ar+ slide $& 1hat sleep is.

Ms. "ahan:I& he3s $in t$ la+ the &$undati$n &$r this $ne in his testi)$n+! that3s O*a+. Itd$esn3t see) t$ e 55 it d$esn3t see) t$ e ited t$ an+thin!ut i& he3s $in t$ testi&+ ased $nhis e'periene! that3s &ine. 6hat3s n$t s$)ethin he testi&ied t$ at his dep$siti$n! ut I thin* it3spr$al+ &air a*r$und.

Judge:O*a+. It see)s t$ e a*r$und! +$u an aree $n! it see)s.

Ms. "ahan:6hat3s &ine.Judge: Desripti$n $& i$l$ial needs $& sleep.

Ms. "ahan:6he &$ll$1in t1$! pitures $& diara)s $& the rain! I thin*! are &ine. 6he&$ll$1in $ne that sa+s 7(a*e!7 and then sa+s 7stae 9:;!7 that3s n$t s$)ethin that 1asaddressed at all at his dep$siti$n. I d$n3t *n$1 1hat the+ plan $n usin this &$r.

Judge:(hat is that,

Ms. "ahan:I d$n3t reall+ *n$1.

Mr. Kosko:6h$se are sh$1in the rain 1a#es durin sleep. (hat 1e3re $in t$ e sh$1in!+$ur h$n$r! is 55 this is all in $nneti$n 1ith his testi)$n+ that he has i#en! and his $pini$ns hehas i#en at his dep$siti$n a$ut 1hat sleep depri#ati$n )eans! and h$1 55 and this is

a*r$und &$r sh$1in 1hat happens 1hen +$u3re a1a*e4 1hat happens 1hen +$u3re asleep41hat the staes $& sleep are! and 1h+ pr$p$&$l inter&erers 1ith sleep! 1hih is the 1h$le thrust 55that3s 1h+ he3s here! t$ tal* a$ut 1hat the e&&ets $& pr$p$&$l is $n natural sleep. 6he &at thatthe+ didn3t as* the riht


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Mr. Kosko:-eah.

Judge:D$es this ha#e an+thin t$ d$ 1ith pr$p$&$l! $r is this ust sh$1in 1a#es durin sleep

$r 55

Mr. Kosko:-es. It3s sh$1in 1a#es durin n$r)al sleep! and then he is $in t$ disuss 1hatthe di&&erent parts $& the 1a#es are4 1hat the+ )ean in ter)s $& eha#i$r! 1h+ 1e need th$separts. And then he3s $in t$ sa+ 55

Judge:I thin* +$u3re l$$*in at a di&&erent 55

Mr. Kosko: And then he3s $in t$ sa+ 1hat pr$p$&$l d$es t$ that. And then he3s $in t$ sa+55

Mr. Panish:"$ld $n a se$nd. I d$n3t thin* +$u3re $n the sa)e slide.

Judge:"$ld $n. I3) l$$*in at this =indiatin>.

Ms. "ahan:6his $ne =indiatin>.

Mr. Kosko: -$ur h$n$r! are +$u l$$*in at the $ne 1ith the rain 1a#es! $r the $ne 1ith the7Sleep+ rain7,

Judge:6his $ne ust sa+s! 7(a*e.7

Mr. Kosko:-es. 6hat3s ust sh$1in the rain 1a#es in the 1a*e state! a1a*ened state! and therain 1a#es in the di&&erent staes $& sleep. And 1hat is $in t$ e sh$1n is 55 I )ean! he andesrie it! ut it s$unds *ind $& sill+ &$r hi) t$ desrie it 1hen he an sh$1 it! h$1 pr$p$&$linter&eres 1ith the staes $& sleep. It sa+s under the 7Opini$ns!7 1e had n$. ?@ 7Dr. Murra+3snihtl+ ad)inistrati$n $& pr$p$&$l t$ anesthetize MJ ad#ersel+ a&&eted his ailit+ t$ per&$r) andhis ailit+ t$ learn his danes in rehearsals.7 and this is $in t$ supp$rt that.

Judge: O*a+. I d$n3t thin* there d$esn3t see) t$ e a dispute as t$ 1hether it a&&ets it $r n$t. Ithin* the dispute has t$ d$ 1ith this partiular desripti$n 55

Ms. "ahan:Biht. And! +$ur h$n$r 55

Judge:55 $& 55 55 the issue is that there 1as n$ testi)$n+ 1hats$ 55 I a#e Dr. Czeisler the &l$$rt$ tell )e e#er+thin a$ut his $pini$ns at his dep$siti$n. "e $&&ered n$ testi)$n+ 1hats$e#era$ut the di&&erent staes $& sleep. "e did $&&er an $pini$n that Dr. C$nrad Murra+3s nihtl+ad)inistrati$n $& pr$p$&$l t$ anesthetize Mr. Ja*s$n ad#ersel+ a&&eted his ailit+ t$ per&$r)and learn his danes in rehearsals durin that inter#al! ut he said n$thin a$ut h$1 pr$p$&$la&&ets the rain! h$1 pr$p$&$l a&&ets sleep. 6hat 1as atuall+ 1hat Dr. /r$1n testi&ied a$ut!and I understand the+3#e eleted n$t t$ all hi). /ut that d$esn3t )ean the+ an ha#e Dr. Czeisler$)e in and sa+ thins he3s ne#er testi&ied a$ut.


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Mr. Kosko:"e said it. "e said at n$. ?! he said that Dr. Murra+3s nihtl+ ad)inistrati$n $&pr$p$&$l t$ MJ a&&eted it. And then he sa+s later $n! $ne $& the $ther $pini$ns 55 1hih is als$

related t$ this 55 and he als$ said in 55 in &at! he spei&iall+ said! 7pr$p$&$l ad#ersel+ a&&etsB.E.M. sleep.7 and h$1 an 55 &irst $& all! there 1as a i rep$rt that he a#e t$ +$u! and +$u ust55 this is +$ur s+n$psis $& his rep$rt that +$u3re allin his $pini$ns.

Judge:S$ a rep$rt 1as pr$#ided,

Mr. Kosko:a #er+ #$lu)in$us rep$rt.

Judge:O*a+. All riht. 6his has 55

The clerk:-$ur h$n$r! I3) s$rr+. I thin* the 1itness is in the $urtr$$). Is that O*a+,

Judge:Ma+e he sh$uld step $ut.

Mr. Panish:"e an step $ut.

Judge:-es. -$u an step $ut.(&r. "'eisler eited the courtroo#)

Mr. Kosko:I an i#e +$ur h$n$r a $p+ $& his rep$rt. It3s reall+ their s+n$psis $& his $pini$ns.

Judge:(ell! 1hat d$es the rep$rt $n sleep in spae ha#e t$ d$ 1ith this, I uess I3) u)pin the

un! ut 55

Mr. !oyle:-$ur h$n$r! +$u ha#e the 55 als$! the rep$rt 1as attahed t$ his dep$siti$n! 1hih isl$ded 1ith +$ur h$n$r.

Judge:O*a+.

Ms. "ahan:And! +$ur h$n$r! t$ e lear! the rep$rt is 90 paes. 6he &indins relatin t$ Mr.Ja*s$n! there3s t1$ seti$ns@ seti$n starts $n pae 2! and it sa+s! 7preli)inar+ &indinreardin Mr. Mihael Ja*s$n74 and seti$n ! 1hih starts $n pae 2! sa+s! 7preli)inar+$pini$ns.7 and there3s n$ disussi$n in there 1hats$e#er $& the e&&ets $& pr$p$&$l $n $ne3s ailit+

t$ sleep! 1hat it d$es t$ the rain 1a#es. Si)pl+ n$t a suet that 1as tee3d up + the rep$rt as itrelates t$ Mr. Ja*s$n $r an+thin addressed 1ith hi) at the dep$siti$n.

Mr. Panish:It is. (e 55

Mr. Kosko:(e ust read that4 that the nihtl+ ad)inistrati$n $& pr$p$&$l a&&eted 55

Judge:O*a+. Ms. Cahan! i& that3s in the dep$siti$n! h$1 is that n$t s$)ethin that he $pined t$


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in the dep$siti$n,

Ms. "ahan:/eause he said the asis &$r that $pini$n is@ 7Generall+ spea*in! 1hen pe$ple

aren3t ettin en$uh sleep! it a&&ets their ailit+ t$ en$de e'perienes int$ )e)$ries and uild$n their )e)$ries.7

Judge:O*a+.

Ms. "ahan:N$thin a$ut pr$p$&$l a&&etin that! n$thin a$ut the staes $& sleep! n$ne $&that detail. 6hat is 1hat Dr. /r$1n did! and I uess the+ eleted n$t t$ all hi). /ut this is n$ts$)ethin Dr. Czeisler 1as testi&+in t$ $r addressed in his rep$rt 1ith respet t$ Mr. Ja*s$n.S$ the+3re ta*in an $pini$n and i#in it a Ne1 &$undati$n that 1asn3t disussed at hisdep$siti$n.

Mr. Kosko:(ell! the+ an r$ss5e'a)ine hi)! i& that3s the ase. /ut 1e ha#e the $pini$ns! allthe $pini$ns! and this is all a*r$und t$ the $pini$ns. Let the) 55

Judge:O*a+. S$unds li*e he has the $pini$n! it ust d$esn3t ha#e the 55

Ms. "ahan:/rand5ne1 &$undati$n.

Judge:In the dep$siti$n! )uh $& the &$undati$n! 1asn3t that e'pl$red durin the dep$siti$n,

Ms. "ahan:I as*ed hi) the &$undati$n! and 55

Judge:O*a+. And 1hat did he sa+,

Ms. "ahan: 6he &$undati$n! he said! 1as 1athin the 6his Is It #ide$! he th$uht! and readinthr$uh testi)$n+ 1here it said Mr. Ja*s$n 1as sl$1 55 I elie#e it 1as Mr. %a+ne $r Mr.Ortea! he 1as a little it sl$1 t$ pi* up the dane )$#es.

Judge: And n$1 he3s $in t$ sa+ s$)ethin else. And s$ +$u an i)peah hi) t$ the &at thathe ne#er )enti$ned it in his dep$siti$n4 riht,

Ms. "ahan:-es! +$ur h$n$r! ut the la1 is 55

Mr. Kosko:+es. As e#er+ $ther 1itness has een i)peahed 1hen the+ didn3t sa+ s$)ethinIn their dep$siti$n. And Mr. %hillips! 1h$ didn3t sa+ an+thin at all in his dep$siti$n andsuddenl+ had re&reshed )e)$r+ 1as i)peahed! li*e! ?0 ti)es. "e an3t e pre#ented &r$)testi&+in 1hen he has the sa)e $pini$n. All 1e3re d$in is the &$undati$n 55

Ms. "ahan:And! +$ur h$n$r! I as*ed the &$undati$n &$r his $pini$n at his dep$siti$n! and it 1ass$)ethin entirel+ di&&erent. Apparentl+! n$1 the+ 1ant hi) t$ tal* a$ut 1hat Dr. /r$1n 1astal*in a$ut. /ut the pr$le) is! this is n$t the appr$priate 1itness. 6his is n$t n$r)al


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i)peah)ent. 6his is an e'pert. And under the rules! the purp$se &$r an e'pert dep$siti$n is t$a#$id un&air surprise at trial. "e3s a sleep e'pert. "e3s een d$in this &$r ;0 +ears. I3#e studiedup $n it! ut I3) n$t at his le#el! and it3s n$t &air t$ )e t$ ha#e a rand5ne1 &$undati$n &$r an

$pini$n rand&athered in &$r the &irst ti)e 1hen he ta*es the stand.

Mr. Panish:-$ur h$n$r! he a#e an $pini$n. nder the ase la1 he a#e his $pini$ns indep$siti$n. "e3s n$t i#in a ne1 $pini$n. 6hat3s as lear as da+.

Jude@ I3) $in t$ den+ +$ur )$ti$n. I d$n3t *n$1 e'atl+ 1hat +$ur )$ti$n 1as. It started $&&1ith the slide sh$1! ut it3s *ind $& turned int$! an I e'lude his $pini$ns alt$ether. And )+understandin 55 i& that3s +$ur )$ti$n! that3s denied.

Ms. "ahan: And that3s n$t )+ )$ti$n! +$ur h$n$r. I3) n$t see*in t$ e'lude the $pini$ns he$&&ered at the dep$siti$n. I had a


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Mr. Panish: /ut it3s illustrati#e $& the $pini$ns that he a#e at his dep$siti$n.

Judge:O*a+.

Mr. Panish:It3s a de)$nstrati#e e'hiit t$ illustrate the $pini$ns + the e'pert. And pursuant t$+$ur rule! it 1as t$ e +$ur rule! the+ re


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e'pert. "e3s an anesthesi$l$ist. And eause the anesthesia is n$1 part $& the ase! and itsee)ed t$ e $neded + the $ther side! there 1as n$ need t$ rin Dr. /r$1n in. 6his is thesleep e'pert! and he is $in t$ in &at sa+ he didn3t et sleep. And he3s $in t$ 55 that3s e'atl+

1hat he3s $in t$ sa+. "e3s $in t$ sa+ the reas$n he didn3t et sleep is eause the pr$p$&$l1as n$t i#in hi) sleep. It 1as i#in hi) the illusi$n $& sleep and that he didn3t et sleep! andthat3s e'atl+ 1hat he3s $in t$ sa+.

Judge:Beread the $pini$n that +$u read earlier,

Ms. "ahan:7Based upon the findings summarized above, and the other materials that Ireviewed in connection with my evaluation of this matter and relevant scientific information,

it is my medical and scientific opinion that Dr. Conrad Murray's nightly administration of

propofol to anesthetize Mr. ac!son adversely affected his ability to perform and his ability to

learn dances in rehearsals that occurred during that interval.7 And 1hen 1e as*ed hi) a$ut

that in his dep$siti$n! he said that3s eause he 1asn3t sleepin! n$t eause he 1as 55 s$)ethin1ith 55 the pr$p$&$l a&&eted hi).

Mr. Panish:6hat3s the sa)e thin.

Judge:All riht. (ell! this is 1hat I3) $in t$ d$. D$ +$u ha#e $eti$ns t$ all this $ther asi&$undati$n $nernin sleep,

Ms. "ahan:I d$n3t *n$1 55

Judge:It see)s t$ )e i& he disussed that in the dep$siti$n! this sh$uldn3t e a pr$le). At least

e#er+thin up t$ the last pae.

Ms. "ahan:6he $ne that 1e ha#e 55 that3s all ne1! ut I didn3t reall+ ha#e an issue 1ith it. 6he$nes 1e ha#e a real pr$le) 1ith is 7Sleep #ersus pr$p$&$l anesthesia7 55

Judge: O*a+.

Ms. "ahan:55 as 1ell as the last $ne 55

Judge:O*a+.

Ms. "ahan: 55 that &$ll$1s it! and the separate de)$nstrati#e. /eause these appear t$ e ased$n Dr. Murra+3s p$lie inter#ie1! 1hih is n$t in e#idene. And as +$ur h$n$r *n$1s 1ell! ane'pert an &$r) $pini$ns ased $n hearsa+ ut an3t rand&ather in spei&i in&$r)ati$n that3shearsa+ thr$uh their testi)$n+. S$ it3s this $ne =indiatin>! and I d$n3t *n$1 i& the+ pr$#ided+$u 1ith 55

Judge:6his is 1hat I3) $in t$ d$@ I3) $in t$ stri*e the last pae. 6he rest $& it is all&$undati$nal he testi&ied t$ 1ith his e'pertise. -$u an use that. I d$n3t thin* there is an+thin


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pre#entin hi) &r$) $in t$ the $ard and 1ritin n$tes as t$ 1hat his testi)$n+ is.

Mr. Kosko:D$ 1e ha#e a $ard,

Ms. "ahan:S$! +$ur h$n$r! ust s$ the re$rd is lear 55 eause s$)e $& us ha#e $ne slide perpae! and the $ther ha#e t1$ slides per pae 55

Judge: -es.

Ms. "ahan:55 1hat +$u3re e'ludin at this ti)e is the slide headed! 7Sleep #ersus pr$p$&$lanesthesia7,

Judge:-es.

Ms. "ahan:And the $ne that has the headin $& 7M$nda+! June 22nd! and 6uesda+! June 29rd7,

Judge: Biht.

Ms. "ahan:And 1e 1$uld ta*e 55 d$ +$u ha#e a C$p+ $& this e'hiit 9?58, I3) happ+ t$ handup )ine.

Judge:N$. And in &at! I3) $in t$ )a*e sure this ets t$ the &ile s$ it3s lear 55

Mr. Putna#:6han* +$u! +$ur h$n$r.

Judge:55 1hat 1e3re all tal*in a$ut.

Mr. Panish:Are 1e all read+,

Ms. "ahan:-$ur h$n$r! 9?58 appears t$ e a ti)eline $& the ad)inistrati$n $& the pr$p$&$l and$ther drus ased $n June 2?th $r June 2;th.

Mr. Kosko:I3) $in t$ as* 55

Ms. "ahan:%lease let )e &inish.

Mr. Kosko:I ap$l$ize.

Ms. "ahan:/ased $n Dr. Murra+3s p$lie inter#ie1. And! aain! that3s ased $n hearsa+ andthat3s n$t appr$priate.

Mr. Kosko:I3) $in t$ use it as a h+p$thetial.

Ms. "ahan:It3s still n$t appr$priate.


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Mr. Kosko:I3) $in t$ sa+! 7D$ +$u ha#e an understandin!7 sa)e


12/103

. D$t$r! 1here d$ +$u li#e at the urrent ti)e,

A. I li#e in the /$st$n area in Massahusetts.

. And 1here are +$u &r$) $riinall+,

A. I re1 up in Chia$.

. (here in Chia$,

A. On the s$uth side $& Chia$.

. And did +$u $ thr$uh +$ur asi sh$$lin in Chia$,

A. -es. I did asi sh$$lin in Chia$. (ent t$ rade sh$$l in Chia$ and then 1ent t$ hihsh$$l in $ne $& the suurs $& Chia$.

. And then a&ter hih sh$$l! did +$u $ t$ $llee,

A. I did.

. (here did +$u $,

A. I 1ent t$ "ar#ard C$llee in Ca)ride! Massahusetts.

. And did +$u ha#e sh$larships,

A. I had an h$n$rar+ &resh)an sh$larship.

. An h$n$rar+ &resh)an sh$larship,

A. -es. And as I re$llet! there 1as a J$hn "ar#ard sh$larship.

. -$u3re $in t$ ha#e t$ *eep +$ur #$ie up. 6he a$ustis in here are 55

A. I3ll $ a little l$ser t$ the )ir$ph$ne.

. 6hat3s reat.

A. I3) 1$nderin i& 55

Judge: t #oves. *o. +ike this, %ack and orth (indicating).


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The -itness: kay.

. O*a+. And did +$u raduate &r$) "ar#ard C$llee,

A. -es! I did.

. N$1 +$u3re li*e a tal* sh$1 h$st.

A. 6here +$u $. It3s a little t$$ sh$rt! $ther1ise.

. And +$u raduated &r$) "ar#ard,

A. -es. I raduated &r$) "ar#ard C$llee in 8F;.

. And +$u raduated 1ith h$n$rs,

A. -es! I did. Mana Cu) Laude.

. Mana Cu) Laude, And &$ll$1in +$ur raduati$n &r$) "ar#ard! 1hat did +$u d$, Did +$u$ntinue +$ur eduati$n,

A. -es! I did.

. (here did +$u $,

A. Stan&$rd Medial Sh$$l.

. Stan&$rd. 6hat3s riht up the r$ad here.

A. -es! it is.

. And +$u 1ent t$ )edial sh$$l. Did +$u raduate &r$) )edial sh$$l,

A. -es! I did.

. Get a deree in )ediine,

A. -es. I $t an M.D.

. And then a&ter +$u raduated &r$) )edial sh$$l! did +$u $ntinue +$ur eduati$n,

A. -es. (ell! I atuall+ 55 s$ it 1as a $nurrent pr$ra) I 1as in alled )edial sientisttrainin pr$ra)! 1hih is an M.D. and %h.D. %r$ra). And I reei#ed a %h.D. in the neur$ andi$eha#i$ral sienes! and then I reei#ed )+ M.D.


14/103

. S$ +$u $t t1$ derees@ an M.D. deree 55 that3s a D$t$r $& Mediine,

A. 6hat is $rret.

. And a %h.D. Deree! 1hih is a55

A. D$t$r $& %hil$s$ph+.

. 55 D$t$r $& %hil$s$ph+, And the D$t$r $& %hil$s$ph+ deree 1as in 1hat &ield,

A. Neur$ and i$eha#i$ral sienes.

. Neur$ and i$eha#i$ral sienes. 7neur$!7 d$es that ha#e t$ d$ 1ith the rain,

A. -es.

. And the $ther part 1as,

A. /i$eha#i$ral sienes.

. /i$eha#i$ral sienes, (hat are i$eha#i$ral sienes,

A. 6hat is the siene related t$ h$1 i$l$+! in this ase! the neur$sienes! $r the rain! a&&ets$ur eha#i$r.

. And s$ that 1as +$ur %h.D.! in that &ield,

A. -es.

. And then a&ter +$u 55 +$u $)pleted that pr$ra)! 1as that in 88,

A. -es. I $)pleted the pr$ra) in 88.

. And then did +$u ta*e a p$siti$n as a Seni$r Hell$1,

A. -es! I did.

. And 1here 1as that p$siti$n as a Seni$r Hell$1,

A. 6hat 1as at "ar#ard uni#ersit+ at the J$hn H. Kenned+ Sh$$l $& G$#ern)ent. 6he )edialsh$$l. It 1as a $int pr$ra).

. -$u *n$1! &$r s$)e reas$n! the )ir$ph$ne is s$undin a little )u&&led t$ )e.


15/103

Mr. Kosko: does it sound that -ay to the jury/ t sounds a little #uled to all o us.

don0t kno- -hat -e can do.

. Ma+e i& +$u put it a* in the 55

A. O*a+. I3ll tr+ puttin it a* in.

. I *n$1 part $& the pr$le) is! it3s n$t tall en$uh.

A. "$1 a$ut this, D$es that 1$r*,

. 6hat3s a little etter.

A. Is that etter, 6here. G$$d.

. O*a+. G$$d. S$ 1e ha#e +$u at the J$hn H. Kenned+ sh$$l $& $#ern)ent as a Seni$rHell$1. And is that a&&iliated 1ith "ar#ard,

A. -es. 6hat3s the 55 at "ar#ard ni#ersit+! and there3s a pr$ra) et1een the "ar#ard MedialSh$$l 55 the Kenned+ Sh$$l $& G$#ern)ent! and the "ar#ard Sh$$l $& %uli "ealth andpr$ra) in health p$li+.

. In health p$li+, And then did +$u $ntinue and e$)e a pr$&ess$r at "ar#ard,

A. -es.

. Di&&erent staes@ Assistant pr$&ess$r! da5da5da! and then +$u &inall+ ea)e a pr$&ess$r at"ar#ard,

A. -es! that3s aurate.

. And that 1as in 8. In 200;! I see in +$ur resu)e that there3s s$)ethin alled a /aldin$pr$&ess$r $& sleep )ediine. Hirst $& all! 1hat is this p$siti$n! a /aldin$pr$&ess$r, Is that a Chair in this area,

A. -es. S$ that3s a pr$&ess$rship. As a pr$&ess$r $& )ediine! the )edial sh$$l! 1hen itreei#es a Gi&t &r$) a D$n$r! it s$)eti)es estalishes a li&eti)e p$siti$n in a partiular &ield! ina partiular disipline. And 1e 1ere &$rtunate t$ reei#e d$nati$ns that estalished the &irst threepr$&ess$rships in sleep )ediine in the 1$rld in 200; in the "ar#ard )edial sh$$l in thedi#isi$n $& sleep )ediine. And I 1as na)ed + the Dean $& the )edial sh$$l t$ e theinu)ent $& $ne $& th$se end$1ed pr$&ess$rships.

. And d$ +$u still h$ld that p$siti$n,


16/103

A. I d$.

. N$1! the 55 durin the $urse $& +$ur areer! 1hen 1as it that +$u reall+ started t$ stud+ sleep)ediine,

A. (hen I 1as an underraduate 1hen I &irst ean t$ l$$* at $ne $& the *e+ &at$rs thatreulates it! 1hih is the ti)in $& $ur end$en$us iradian rh+th).

. O*a+! sir. End$en$us iradian rh+th).

A. 6he internal l$* in the rain.

. (hat is it,

A. 6he internal l$* in the rain that $ntr$ls the ti)in $& 1hen 1e sleep and 1a*e! and theti)in $& the release $& h$r)$nes. 6hat3s 1h+ 1e sleep at niht and 1e are a1a*e durin the da+.

. S$ that i$l$ial l$* is s$)ethin that3s alled the iradian rh+th),

A. 6hat3s riht. 6he i$l$ial l$* dri#es the iradian rh+th)s.

. And +$u started stud+in that 1hen +$u ea)e 55 1hen +$u 1ere an underrad,

A. 6hat3s riht.

. Did +$u $ntinue +$ur stud+ $& that thr$uh the #ari$us )edial sh$$l:%h.D. pr$ra)! etetera,

A. -es. I ean 1$r*in $n the dail+ +le $& $rtis$l as a dail+ pr$et! &$r 1hih I reei#ed aSu))a Cu) Laude e#aluati$n. And then I did )+ d$t$ral dissertati$n at Stan&$rd $n theiradian rh+th)s $& $d+ te)perature! the ther)al reulati$ns! the ti)in! aain! $& the release$& $rtis$l! and als$ $ther h$r)$nes.

. O*a+. And 55

A. And the ti)in $& sleep and 1a*e.

. And alth$uh +$u are a )edial d$t$r! d$ +$u treat patients,

A. N$! I d$ n$t.

. And +$u3re n$t in the pratie $& )ediine,


17/103

A. I d$n3t pratie )ediine.

. N$1! in )$#in thr$uh +$ur urriulu) #itae! I see that there are the 1$rds 55 7iradian7

sh$1s up a l$t. And that3s 1hat +$u desried as the $d+ l$*. "$1 d$es the $d+ l$* a&&etsleep,

A. It reulates the ti)in $& 1hen 1e sleep and 1a*e. It reulates the ti)in $& 1hen 1e aree#en sleepin! and it reulates the ailit+ t$ )aintain the $ns$lidati$n $& sleepin at niht. S$this internal l$*! ir$niall+! sends $ut the str$nest dri#e &$r 1a*in near the end $& $ur 1a*inda+ in the e#enin. It pr$#ides us a se$nd 1ind that all$1s us t$ sta+ a1a*e &$r 1hat is a)arath$n in the ani)al *ind$)! 1hih is 8 h$urs. S$)e pe$ple push it &urther! ut )$stani)als ta*e little atnaps e#er+ &e1 )inutes. -$u 1al* +$ur d$! and as s$$n as +$u et a*!+$ur d$ $es t$ sleep! and +$u $ t$ 1$r*. /ut 1e ha#e this )arath$n $& 1a*e&ulness! and the1a+ the hu)an rain is ale t$ ahie#e that and 1e dis$#ered this in )+ la$rat$r+ 55 is that

1e is that in the late e#enin! it sends $ut this dri#e! s$rt $& a&ter the lunh! a&ter lunhti)e! thedri#e &r$) the internal l$* t$ sta+ a1a*e e$)es str$ner and str$ner. N$1! s$)eti)esthr$uh liht e'p$sure! 1e push that e#en later and later! eause liht is the p$1er&uls+nhr$nizer $& +$ur internal l$*. It sends a )essae t$ the internal l$*! this is da+ti)e! +$ush$uld e a1a*e4 and dar*ness sends an$ther )essae t$ the internal l$* that this is nihtti)e!and it is the ti)e t$ sleep.

. N$1! d$es that ause pr$le)s &$r pe$ple 1$r*in 1h$ are 1$r*in pe$ple! 1h$ ha#e niht$s! &$r e'a)ple,

A. It d$es. (hen edis$n )ade it p$ssile &$r us t$ ha#e arti&iial liht! suh as 1e ha#e here in

the $urtr$$)! 1e an n$1 &lip $n and $&& a S1ith! 1hih is 55 sends a p$1er&ul sinal t$ therain! shi&tin $ur iradian rh+th)s. And i& 1e turn $n that s1ith and ha#e liht e'p$sure atniht! that sends a $n&usin sinal t$ the rain. It suppresses the release $& the natural h$r)$ne)elat$nin that n$r)all+ all$1s us t$ &ailitate sleep at niht and atuall+ shi&ts the iradianrh+th)! )a*in it harder &$r us t$ $ t$ sleep at the ti)e 1e 1ant.

. N$1! in additi$n t$ pe$ple 1h$ 1$r* the niht shi&t 1h$ an e a&&eted + this! is thiss$)ethin that a&&ets! &$r e'a)ple! sp$rts tea)s,

A. -es! it d$es.

. And ha#e +$u! durin the $urse $& +$ur areer! had $asi$n t$ $nsult &$r sp$rts tea)s1h$se pla+ers are $thered + this hane in iradian rh+th)s,

A. -es. 6he &irst sp$rts tea) that as*ed )e t$ 1$r* 1ith the) 1as the p$rtland traillazers!1hih is a pr$&essi$nal as*etall tea). And the+ had ust l$st a series $& a)es in 1hih the+had tra#eled t$ the east $ast! and $ntated )e and as*ed i& I $uld help the) deal 1ith thattra#el shedule.


18/103

. And ha#e +$u dealt 1ith $ther sp$rts tea)s t$ deal 1ith that pr$le) $& the shi&tin $& ti)ez$nes! and the li*e,

Ms. "ahan: %jection, your honor. 1elevance.

Judge: verruled.

A. -es! I ha#e. I3#e helped the Minnes$ta 6i)er1$l#es and the /$st$n Celtis! 1$r*in 1ithd$ ri#ers. And als$ ha#e d$ne s$)e 1$r* 1ith the /ruins! and n$1 e)ar*in 1ith 1$r*in1ith the Bed S$'.

. -$u ha#e n$t said a l$t $& #er+ p$pular thins in this $urtr$$) s$ &ar.

A. It is 55 I didn3t sa+ the la*ers! &$r e'a)ple.

. N$t +et. And I d$n3t 1ant t$ 55 I3#e een as*ed t$ as* this


19/103

. Is that a $))$n e'periene &$r these r$ups,

A. 6hat 1$uld e a $))$n e'periene.

. "a#e +$u $nsulted &$r an+ )usial r$ups 1ith reard t$ their pr$le)s in dealin 1ithsleep issues,

A. -es! I ha#e.

. (hat r$ups ha#e +$u $nsulted &$r,

A. (ell! )$st n$tal+! the B$llin St$nes! and their lead siner.

. And! + the 1a+! ha#e +$u atuall+ 55 and I *n$1 +$u ha#e per)issi$n t$ sa+ this! ut 55

eause 55 ut d$ +$u atuall+ 55 +$u 1$r*ed 1ith Sha


20/103

A. -es. (e trained the astr$nauts in h$1 t$ set up the re$rdins! and instru)ent the). (ere$rded the sleep $& senat$r $hn lenn 1hen he 1as in spae! and a Nu)er $& $ther astr$nauts

$n #ari$us )issi$ns. It 1as *ind $& $$l 1athin the data $)e d$1n &r$) spae and see EAGre$rdins! and see the di&&erent staes $& sleep the+ 1ere in 1hile the+ 1ere in spae.

. N$1! in additi$n t$ +$ur $nsultin! teahin! +$u3re enaed in $n$in researh! I ta*e it4 isthat riht,

A. 6hat3s riht.

. And d$ +$u et rants! as the head $& the sleep pr$ra) at "ar#ard! &r$) #ari$us instituti$nsreardin 55 1h$ are stud+in sleep,

A. -es. (e 55 the 1a+ it usuall+ 1$r*s is that! as in#estiat$r! as a researh sientist! I 1$uldsu)it a pr$p$sal! pr$p$sed researh rant t$ the $#ern)ent. And it ta*es t$ 82 )$nths &$r itt$ e re#ie1ed. And then i& 1e3re lu*+ en$uh t$ e seleted a)$n the rant pr$p$sals that1ere su)itted! 1e 1$uld e a1arded t$ arr+ $ut the researh pr$p$sed.

. And ha#e +$u een in#$l#ed in $n$in researh,

A. I3#e een $ntinu$usl+ supp$rted thr$uh the rant pr$ra) &$r a$ut 2? +ears.

. D$t$r! 1hat is the institute $& )ediine,

A. 6he institute $& )ediine is an $ranizati$n that 1as estalished 55

. Spea* a little sl$1er! please.

A. 6he Institute $& Mediine is an $ranizati$n that 1as estalished + the $#ern)ent! ut it3s aseparate! independent $ranizati$n! t$ pr$#ide p$li+ ad#ie t$ the nited States $#ern)ent andt$ $thers $n )atters $& health $& the nati$n.

. Are +$u a55 1hat3s in#$l#ed in ettin app$inted t$ the Institute $& Mediine,

A. 6here is a seleti$n pr$ess.

. "$1 )an+ appliants are there, Or h$1 )an+ ph+siians are there,

A. 6here are a$ut 00!000 ph+siians in the nited States.

. "$1 )an+ et app$inted eah +ear,

A. ?.


21/103

. And are +$u a )e)er $& the Institute $& Mediine,

A. -es. I 1as eleted t$ the institute $& )ediine.

. In 1hat &ield d$ +$u ad#ise the $#ern)ent thr$uh the Institute $& Mediine, (hat is +$ur&ield $& speialt+ there,

A. 6he 1a+ it 1$r*s at the institute $& )ediine! +$u3re n$t di#ided int$ speial &ields $&speialt+! ut I 1as ad)itted as a Me)er and ha#e ser#ed $n #ari$us panels in the institute $&)ediine a$ut speial issues that ha#e 55 are a )atter $& 55 1here p$liies are ein de#el$ped.

. O*a+. N$1! is the 55 durin the $urse $& all $& this 1$r* that +$u d$! teahin! andresearhin and e#er+thin! ha#e +$u als$ had an $pp$rtunit+ t$ 55 1ell! l$$*in at 55 t$ e a

)e)er $& #ari$us s$ieties! pr$&essi$nal s$ieties! in the &ield $& )ediine,

A. -es! I ha#e.

. And are +$u 55 ha#e +$u held $&&ie in )an+ $& these pr$&essi$nal s$ieties,

A. I ha#e ser#ed as the president $& the sleep researh s$iet+! and I3#e een a )e)er $& thesleep researh s$iet+.

. 6he sleep researh s$iet+,

A. 6he sleep researh s$iet+ and the A)erian Aade)+ $& Sleep Mediine &$r )an+ +ears. Iha#e ser#ed as a )e)er $& the $ard $& the Nati$nal Sleep H$undati$n! and I a) n$1Chair)an5elet $& the Nati$nal Sleep H$undati$n $ard $& diret$rs. And I ha#e ser#ed $n anu)er $& di&&erent panels. I3) a Me)er $& the A)erian Aade)+ &$r the Ad#ane)ent $&Siene and S$iet+ &$r 55

. At the Institute $& Mediine! 1hat *inds $& panels d$ +$u ser#e $n,

A. I ser#ed $n panels e#aluatin 55 $ne 1as a panel $n the $#ern)ent that 55 the ar)+ had uilta tan* that pe$ple $uld sur#i#e in &$r F2 h$urs! ut the+ had n$ plae &$r the) t$ sleep in thispartiular tan*. And the+ as*ed )e t$ ser#e $n a panel e#aluatin h$1 this 1$uld e depl$+ed!

and 1hat *ind $& issues and hazards 1$uld e ass$iated 1ith this. And there 1as a panel $n1$r*l$ad transiti$n. I als$ ser#ed $n! &$r the S C$nress! the $&&ie $& tehn$l$+ assess)ent! apanel $n ha#in t$ d$ 1ith shi&t 1$r* in $ur s$iet+. I testi&ied e&$re $nress $n 55 &$r the panele#aluatin shi&t 1$r* pr$duti#it+ and health in $ur s$iet+. I d$n3t ha#e a $p+ $& )+ CV in&r$nt $& )e.

. 6hat3s O*a+.


22/103

A. Vari$us $ther panels I3#e ser#ed $n.

. I thin* 1e et the piture. In additi$n t$ that! sir! and t$ all $& that 1$r* +$u3re d$in and

$nsultin! and 1ith the #ari$us $ranizati$ns and ser#in $n panels! ha#e +$u als$pulished artiles in learned $urnals in the &ield $& sleep,

A. -es! I ha#e.

. And d$ +$u ha#e $#er 820 $riinal rep$rts in peer5re#ie1ed $urnals,

A. -es! I d$.

. And 7peer5re#ie1ed $urnals!7 ust s$ 1e an understand 1hat the+ are! are the+ 55 1ell! theseare $urnals that d$t$rs and $ther sientists pulish in4 is that $rret,

A. 6hat3s $rret. S$ 55

. "$1 d$ +$u et int$ a peer5re#ie1ed $urnal, (hat has t$ e d$ne t$ et an artilepulished,

A. A 1ritten rep$rt is a &indin that 55 n$t a Be#ie1 $& the literature. It )eans +$u ha#e d$ne$riinal researh t+piall+ supp$rted + $ne $& th$se rants I desried. -$u d$ researh &$r &$ur$r &i#e +ears4 +$u $)e up 1ith a &indin! and +$u rep$rt the results $& the researh. /eause i&+$u d$n3t rep$rt the results $& the researh! then n$ $ne *n$1s 1hat +$u3#e spent the &unds $n&r$) the $#ern)ent t$ d$ this ati#it+. S$ 1hat I al1a+s li*e t$ tell the students is! i& +$u d$n3t

pulish it! n$ $ne 1ill *n$1 that it happened. S$ it is an $liati$n t$ pulish the results $& theresearh that the puli has supp$rted.

. And then 55

A. -$u su)it the results! and then a panel the edit$r $& the $urnal in#ites pe$ple 1h$ aree'perts in that &ield t$ e#aluate 1hat +$u3#e su)itted t$ &ind $ut i& it3s een 55 i& it has eenri$r$usl+ arried $ut and )erits puliati$n in the sienti&i literature.

. And these panel $& e'perts! are the+ alled ad h$ $))ittees,

A. 6he+ 1$uld e alled peer re#ie1ers.

. And are +$u $n the edit$rial $ard $& an+ $urnal,

A. I3) $n the edit$rial $ard $& the $urnal $& sleep. /elie#e it $r n$t! there is a $urnal.

. 6here is a J$urnal $& Sleep. D$es it put +$u t$ sleep,


23/103

A. It sh$uldn3t. 6he artiles are atuall+ #er+ e'itin.

. And in additi$n 55 and s$ +$u desried t$ us 1hat the $riinal rep$rts are. In additi$n t$ that!

ha#e +$u d$ne re#ie1 artiles,

A. -es! I3#e 55

. And 1hat3s the di&&erene et1een 55 +$u said the $riinal rep$rt! +$u desried 1hat that is."a#e +$u d$ne )$re than F? re#ie1 artiles,

A. -es. S$ re#ie1 artiles is 1here +$u tr+ t$ s+nthesize. S$ there are )an+ rep$rts@ 6his ausesthis4 this d$es this. I& 1e shi&t the iradian s+ste) 1ith liht $r 55 n$1! +$u ha#e t$ tr+ t$s+nthesize th$se t1$ t$ether. And the re#ie1 artiles are 1ritten t+piall+ &$r pe$ple 1h$ 55 s$the r$up $& sientists 1h$ are deepl+ in#$l#ed in $ne partiular area 1ill e readin eah $ther3s

$riinal rep$rts all the ti)e. /ut then there )a+ e s$)e$ne slihtl+ $utside the area 1h$ still1ants t$ understand 1hat that 55 1hat3s $in $n. And s$ +$u 1ill 1rite a re#ie1 artile! 1hihs+nthesizes the 1$r* that3s een arried $ut! let3s sa+! in the past ? $r 80 +ears! and puts itt$ether either &$r $ther sientists $r liniians.

. And that3s 1hat a re#ie1 artile is,

A. 6hat3s a re5 55

. -$u re#ie1 literature,

A. E'atl+.

. And + the 1a+! in these peer5re#ie1ed $urnals! 1hat r$le! i& an+! d$es )edial ethis pla+ inthe puliati$n in a peer5re#ie1ed $urnal,

A. (ell! &irst $& all! there is the ethis $& h$1 +$u $ndut the researh. S$ e#er+ 55

. 6hat3s $ne part.

A. E#er+ $ne in a (hile +$u 1ill read a$ut a Sientist 1h$ has &uded data $r )ade up stu&& t$et it pulished! $r it )iht n$t et pulished. And then it 1ill ha#e t$ e 1ithdra1n &r$) the

literature! and there is then &$re#er attahed t$ that artile a state)ent that 76his has eenresinded $r 1ithdra1n eause $& the


24/103

A. -eah. -$u3re n$t $in t$ et an$ther rant 55

. And are there ethis in#$l#ed! als$! in h$1 +$u use hu)an suets,

A. -es. 6here are ethis 55 e#er+ hu)an e'peri)ent 1e d$! 1e ha#e t$ $ e&$re an ethis panel.(e present 1hat 1e pr$p$se t$ d$! and then a panel! 1hih inludes researh d$t$rs in #ari$usareas! linial ph+siians 1h$ understand 1hat the ris*s )iht e in#$l#ed in 1hat $ur pr$edureis $in t$ e atte)pted! and then pe$ple &r$) the eneral puli 1h$ 55 an ethiist! ands$)eti)es ler+! and s$ $n! 1h$ sit $n a panel. And the+ sa+! is this a reas$nale thin, D$esthe ris* $& the indi#iduals 1h$ are $in t$ e part $& this researh )erit 55 ased $n 1hat $ne)iht learn &r$) the researh! is the ris* 1$rth it! and are +$u pa+in the pe$ple a reas$nalea)$unt! ut n$t an e'essi#e a)$unt that 1$uld $ere the) e$n$)iall+ t$ partiipate,

. And it3s als$ 55 O*a+. And the+ als$ ha#e t$ e ad#ised $& the ris*s! I ta*e it,

A. -es. 6he+ ha#e a $nsent &$r) that 55

. Let )e as* +$u an$ther


25/103

Mr. !oyle: Has to do -ith pu%lishing journals ethics.

Mr. Kosko: This only has to do -ith pu%lishing journals ethics at this point so -e can

understand -hat the i#port is o a pu%lication 7 -hat it #eans to %e ethical in apu%lication, and -hat -ould %e considered unethical in a pu%lication.

Judge: kay.

Ms. "ahan: 4nd, your honor 22

Mr. Kosko: $o -e kno- -hat to rely upon, and the jury has to decide i a pu%lication is

ethical or 22

Ms. "ahan: 8our honor, that is outside the scope o the opinions that he0s %een allo-ed to

oer, so -e0d ask or a side%ar i -e pursue this issue.

Mr. Kosko: 8ou kno- -hat/ don0t -ant to interrupt this. -ant to keep going. $o -ill

ta%le that or no-, and 22 so -e can #ove on.

Judge: 4ll right.

. I3#e $ne thr$uh a L$t $& +$ur redentials! sir! and I *n$1 I $uld $ $n &$r )an+ )$re h$urs$n this! ut ha#e +$u als$ $nsulted &$r #ari$us industries in the &ield $& sleep )ediine,

A. -es! I ha#e.

. And ha#e +$u 55 1hat *inds $& industries ha#e +$u $nsulted &$r,

A. 6+piall+! industries that in#$l#e r$und5the5l$* $perati$ns. S$ the &irst $ne I ea)ein#$l#ed in 1as $utside $& Salt La*e Cit+. Sand+! tah. It 1as a he)ial )inin $perati$n thathar#ested )aterial &r$) the reat Salt La*e! put it int$ e#ap$rati$n p$nds.

. (e d$n3t ha#e t$ *n$1 the details.

A. /ut the+ 1$r*ed ar$und the l$* 55

. Just the industr+.

A. 55 and the+ needed help 1ith the 1$r*ers 1h$ 1ere ha#in pr$le)s sleepin in the da+ti)e1hen the+ 1$r*ed at niht! and ha#in pr$le)s sta+in a1a*e at niht 1hen the+ needed t$ esheduled t$ 1$r* at niht. And s$ I spent )$re than a deade tra#elin 55 eause 1e hadp$siti#e results 1hen 1e 55

. 6$$ )uh in&$r)ati$n.


26/103

A. S$rr+.

. Just 1ant t$ *n$1 1hat the industries are at this p$int.

A. E#er+thin &r$) the eletri p$1er enerati$n utilities! nulear p$1er plants! )anu&aturintires! )anu&aturin paper! dealin 1ith p$lie &$res. I3#e 1$r*ed 1ith p$lie)en! &ire&ihters!&ederal air )arshals.

. Air tra&&i $ntr$llers! $r n$t, H.A.A.,

A. I3#e een


27/103

. And are +$u ein paid &$r +$ur ti)e,

A. -es.

. And appr$'i)atel+ h$1 )uh per h$ur are +$u ein paid,

A. ?0.

. H$r h$1 l$n ha#e +$u een harin that,

A. I thin* a$ut 80 +ears.

. 80 +ears. And at ?0 an h$ur! an +$u please *eep +$ur ans1ers sh$rt,

A. -es.

. 6han* +$u. And 1hat did +$u re#ie1 in preparati$n &$r 55 1ell!


28/103

. N$1! +$u see it $n +$ur sreen 55

A. I d$.

. 55 and I3) $in t$ as* +$u i& 55 ust the t$p sa+s! 7/eha#i$ral state enerated + the rain t$&ul&ill asi i$l$ial needs haraterized +.7 And 1hat is 55 &irst $& all! I 1ant t$ as* +$u! itsaid! 7eha#i$ral state7,

A. 6hat3s $rret.

. And is that asiall+ 1hat it s$unds li*e,

A. It is 1hat it s$unds li*e. S$ sleep is )+steri$us t$ a l$t $& pe$ple! ut 1hen 1e stud+ it

sienti&iall+! 1e tr+ t$ rea* it d$1n and understand 1hat3s in#$l#ed 1ith sleep. Sleep isatuall+ 55 a l$t $& pe$ple thin* it3s li*e turnin an appliane $&&! s$rt $& turnin the $d+ $&&! utsleep is a #er+ ati#e pr$ess.

. (e3re $in t$ et int$ it a little it )$re! ut 55

A. /ut it3s haraterized +! and it &ul&ills asi i$l$ial needs. It3s i)p$rtant t$ re$nize it3senerated atuall+ + the rain! n$t a passi#e resp$nse! and it &ul&ills asi i$l$ial needs andis haraterized +@ redued ati#it+. S$ +$u an tell i& s$)e$ne is runnin ar$und! the+3re n$tsleepin. I))$ile p$sture. 6+piall+ +$ur e+es are l$sed! alth$uh it is p$ssile t$ sleep 1ith+$ur e+es $pen. It3s readil+ re#ersile. S$ i& s$)e$ne is asleep! +$u an 1a*e the) up 1ith s$)e

sti)ulati$n. 6here3s a reduti$n in sensiti#it+ t$ e'ternal sti)uli! ut it is n$t a $)plete l$ss $&sensiti#it+. S$! &$r e'a)ple! the )$ther $& a ne1$rn! i& she hears the hild 1hi)per! she 1ill 55e#en i& she is asleep! e#en i& she is deepl+ asleep! she 1ill e ale t$ et up and attend t$ thehild. And a re#ersile l$ss $& $nsi$us a1areness that is readil+ re#ersile.

. (h+ d$ +$u ha#e this thin 1here it sa+s! 7re#ersile7 and 7readil+ re#ersile7, (h+ d$ +$usa+ that, (hat3s 55

A. /eause +$u an ta*e a Sleepin pers$n and ar$use the)! 1a*e the) up


29/103

Mr. K$s*$&&@ Can +$u sh$1 us slide 2! please,

. 6hat sa+s! 7n$r)al 1a*e&ulness.7 And 1hat are th$se little 55 I see there3s l$ts $& little tennis

alls.

A. 6he tennis alls are r$ups $& ells 55

. O*a+.

A. 55 sientists all nulei! and it3s a Cluster $& ells that t+piall+ ha#e a spei&i $. And thereare a 1h$le set $& ell lusters 55

. I3) $in t$ interrupt +$u a Se$nd. S$ there are these little lusters $& rain ells and this is

the part $& the rain that 1e use t$ thin* =indiatin>4 O*a+, S$ this is the part that3s neessar+&$r $nsi$us a1areness and alled the ereral $rte'. And a L$t $& the h$use*eepin in#$l#edin the rain is d$ne in this $ther area S$ this area $& the rain! &$r e'a)ple =indiatin>! alane!is in the ereellu).

. -$u said alane is in the ereellu),

A. -es. S$! an+1a+! these lusters that are in the h+p$thala)us! and s$)e in 1hat3s alled therain ste) here =indiatin>! the+ send $ut )essaes that help supp$rt 1a*e&ulness $& these areas$& the rain that are resp$nsile &$r thin*in and $nsi$us a1areness.

. N$1! +$u 1ant t$ sh$1 the ne't slide,

A. -es! I 1$uld.

Mr. Kosko: kay. "ould you go to the net slide, please/

A. And this is a luster $& ells =indiatin> 55 the &unti$n $& 1hih 1as dis$#ered + $ne $& )+$lleaues at "ar#ard 55 and this r$up $& ells atuall+ ati#el+ turn $&& all $& these $therlusters and helps t$ pr$)$te sleep. S$ 1hen this area 55 1hen the ells in this area $& the rain

&ire $r inite! the+ send a sinal t$ turn $&& these $ther areas. And s$ 55 the anal$+ that3s eenused t$ understand this is *ind $& a see5sa1 $r a &lip5&l$p s1ith. S$ +$u d$n3t 1ant t$ e hal&1a+a1a*e and hal&1a+ asleep. 6hat 1$uld e ad. -$u 1ant t$ e either a1a*e $r asleep. And s$ the1a+ this area $& the 55 the 1a+ this area $& the rain 1$r*s! is that it sends $ut a sinal that helpst$ )a*e sure that all these areas are n$t 55 s$ that 1e d$n3t ha#e s$)e $n&usi$n that part $& thearea is sa+in! 7/e a1a*e!7 and part $& the rain issa+in! 7/e asleep.7


30/103

. S$ that3s 55 n$1! $in $n! this )a*es it l$$* li*e 55 1hen +$u l$$* at this slide! it )a*es itl$$* li*e asiall+ n$thin is $in $n 1hen +$u sleep. And I3) $in t$ as* +$u i& that3s true.And I alread+ *n$1 the ans1er.

A. It3s n$t true.

. O*a+.

A. It3s n$t true.

. Is there stu&& $in $n 1hile 1e3re asleep,

A. As$lutel+. 6here3s a l$t $in $n 1hen 1e3re asleep! and it in#$l#es the repair and)aintenane $& the neur$ns in the rain that supp$rt 1a*e&ulness.

. And I *n$1 that there3s a Slide n$1 1hih sh$1s the staes $& sleep.

A. -es.

. And are there di&&erent staes $& sleep,

A. 6here are di&&erent staes $& sleep.

Mr. Kosko: kay. 4nd sho- slide no. =, please.

A. s$ a L$t $& pe$ple thin* $& sleep as +$u3re either asleep $r a1a*e. /ut! atuall+! there are t1$)a$r di&&erent *inds $& sleep! and $ne *ind $& sleep is alled rapid e+e )$#e)ent sleep.

. -$u ha#e t$ $ sl$1l+ $n this part! eause &$r )$st $& us! this is reall+ rand5ne1.

A. O*a+.

. And 1e3re n$t "ar#ard raduate students.

A. I understand. S$ there are di&&erent t+pes $& sleep. 6here are t1$ )a$r ate$ries@ $ne is1hat3s alled rapid e+e )$#e)ent sleep! 1here +$ur e+es are dartin a* and &$rth in their

s$*ets 1hile +$ur asleep.

. O*a+. I3) ust $in t$ interrupt +$u. S$ the &irst )a$r di#isi$n is 1hat is alled rapid e+e)$#e)ent sleep. Is that are#iated,

A. B.E.M. sleep.

. B.E.M. sleep, And in B.E.M. sleep! are +$u sa+in that the e+es )$#e a* and &$rth inside


31/103

underneath the e+elids,

A. 6he+ d$.

. "$1


32/103

re$rdin l$$*s al)$st the sa)e as up here

. -es! it d$es.

A. S$ $riinall+ 1hen E.E.G. re$rdins 1ere &irst )ade! the sientists th$uht the+ 1ere a1a*ehere. 6he+ l$$*ed asleep! ut the+ 1ere a1a*e! eause the+ didn3t realize the+ 1ere asleep.

. And 1hat is an E.E.G.,

A. An E.E.G. is a rain 1a#e re$rdin 1here +$u put eletr$des! and +$u3re )easurin illi$ns$& $lts $& p$tential eletrial hanes in the salp.

. S$ +$u3re )easurin eletrial 1a#es,

A. -eah. S$ 1hen +$u send 55

. And the na)e $& it is alled,

A. 6he tehnial na)e 55

. Sl$1 d$1n. Is an eletr$enephal$ra),

A. 6hat3s $rret.

. O*a+. And that3s an E.E.G. And are these dra1ins that 1e3re seein the pr$dut $& E.E.G.S,

A. It is. And s$ 1hen s$)e$ne has an epilepti seizure 55

. -es.

A. 55 +$u )iht see a i 1a#e $n the salp! eause all the ells are &irin at $ne eausethe+3re ha#in a seizure.

. I see.

A. S$ in rapid e+e )$#e)ent sleep! the rain l$$*s li*e it3s a1a*e. And ulti)atel+! 1hen it 1as

dis$#ered that sleepin 55 &irst $& all! parad$'iall+! eause pe$ple 1ere pr$&$undl+ asleep! utthe rain 1a#es l$$*ed li*e the+ 1ere a1a*e.

. E#er+ n$1 and then! I $ li*e this =indiatin>. I3) n$t tellin +$u n$t t$ sa+ an+thin! ust)$#e it al$n.

A. O*a+. -$u did sa+ +$u 1anted )e t$ spea*


33/103

. -es.

A. S$ here 1hen +$u e$)e dr$1s+! +$u ein t$ see s$)e inrease in the size $& the rain

1a#es. And 1hen +$u et int$ stae 8 sleep! n$1 +$u see s$)e #er+ s)all $sillati$ns here that1ere n$t present either in rapid e+e )$#e)ent sleep $r in 1a*e&ulness.

. And 1hen 55

A. And then these ein t$ 55 n$1! this is 1hat3s alled a sleep spindle! 1hih is an$ther$ranized set $& rain 1a#es. And i& 1e e'panded this re$rdin $ut! +$u 1$uld see that a L$t1as $in $n there. And then 1e see 1hat are these i 1a#es here! 1hih are alled *5$)ple'es. And the+ represent s+nhr$nized &irin $& s$)e $& the ells in the $rte'.

. O*a+. N$1! 1e3re $in t$ ha#e t$ $ $#er this $ne little it at a ti)e and sl$1l+. Hirst! +$u

sa1 the dr$1s+ state. S$ n$1! in a n$r)al pers$n $in t$ sleep! h$1 l$n d$es it n$r)all+ ta*et$ $ &r$) dr$1s+ t$ 55 1hat is that stae, I an3t read it.

A. 6his is stae 8. 6he na)es $& the staes are


34/103

A. At the sa)e ti)e.

. O*a+.

A. S$ that )eans a l$t $& the ells in the rain are &irin at the sa)e ti)e! and there 55 it3s as i& the$ndut$r $& the $rhestra is sa+in! 7O*a+! n$1.7 s$ n$1 it3s ein enerated internall+! n$t inresp$nse t$ e'ternal sti)uli! ut ein enerated internall+. And then 1hen +$u et 55

. I 1ant t$ sta+ $n that stae &$r $ne se$nd.

A. -eah.

. S$ +$u sa+ all these ells are s$rt $& urstin at the sa)e ti)e,

A. -es. O& a partiular lass $& ells.

. Certain lass. And that3s 1hile +$u3re asleep,

A. -es. 6hat 55

. /ut d$es that happen 1hile +$u3re a1a*e,

A. N$.

. I& it happened 1hile +$u3re a1a*e! 1hat 1$uld happen t$ +$ur eha#i$r,

A. (ell 55

. -$u3d e asleep,

A. -eah. -$u3d e asleep! +es.

. 6hat 1$uld )ean +$u3re asleep,

A. Biht.

. S$ that the 1a#es 55 the ells are all urstin at the sa)e ti)e. And then the ne't $ne! +$usaid! is,

A. Is 55 +$u ha#e a series $& these eletrial p$tential $sillati$ns that an e re$rded at thesur&ae $& the salp that sh$1 that there is reurrent s+nhr$n$us &irin. And this is ta*in plaethree $r &$ur +les per se$nd. 6hat )eans! +$u *n$1! +$u an see that the 1a#es are sl$1ind$1n. S$ +$u ha#e t$ 82! 9 t$ F! 82 t$ 8;. N$1 a "al& +le per se$nd! )eanin it ta*es $ne


35/103

se$nd! I )iht ha#e t1$ $& these 1a#es t$ t1$ +les per se$nd. And these are delta 1a#es=indiatin>! and +$u an see the) #er+ pr$)inentl+ here in this re$rdin.

. And then the last $ne is the 55 1hat +$u alled the B.E.M. sleep,

A. Biht.

. Bapid e+e )$#e)ent sleep,

A. E'atl+.

. N$1! 1e3#e tal*ed a$ut 55 +$u3#e tal*ed a$ut these staes. Is there an+ eneral 55 &irst $& all!is there an+ eneral peri$d $& ti)e that3s $nsidered a n$r)al niht3s sleep! let3s sa+,

A. 6he a#erae pers$n 55

Ms. "ahan: %jection. >ague.

Judge: verruled.

A. 6he a#erae pers$n sh$uld $tain a$ut F t$ h$urs $& sleep at niht.

. And is there s$)e s$rt $& a 55 is this pattern 8 thr$uh ;! are the+ 55 is that the $rder in 1hihthese staes $ur,

A. -es! t+piall+.

. S$ that 55 and h$1 )uh 55 1ell! $ne $ther thin I didn3t as* +$u. -$u tal*ed a$ut rapid e+e)$#e)ent sleep at the end! ut is there als$ a part $& this 1here there is sl$1 e+e )$#e)ent! apart $& 55

A. -es. 6hat t+piall+ ta*es plae in stae 8 sleep.

. O*a+. S$ 55

A. In this transiti$nal state.

. 55 is there an understandin as t$ a$ut the lenth $& ti)e eah $& these staes ha#e! $r d$es it#ar+ dra)atiall+,

A. (e $ thr$uh 1hat is alled a sleep +le! 1hih enerall+ ta*es a$ut an h$ur and a "al&! $ra little l$ner! t1$ h$urs. And durin a Sleep +le! +$u $ thr$uh a pr$ressi$n 1here +$u3re$in t$ stae 8! 2! 9! ;! and then +$u $ int$ rapid e+e )$#e)ent sleep! and +$u ha#e a L$t $&


36/103

rapid e+e )$#e)ent sleep. And then +$u $ a* and start $in thr$uh these staes aain int$the deep! sl$1 1a#e sleep. And that $urs thr$uh$ut the niht. S$ sleep has an arhiteture t$it. -$u see! all $& the 55 )$st $& the $ther ells in the $d+! s*in ells! and $ur l$$d ells and

)$st $& the)! 1e $nl+ *eep $ur l$$d ells! &$r e'a)ple! &$r three t$ si' 1ee*s! and then 1e)a*e ne1 $nes. /ut the rain ells 1e *eep &$r $ur entire li&eti)e. S$ there has t$ e a peri$d $&ti)e! ust li*e s$)eti)es +$u3ll et a )essae &r$) the an* $r 1hate#er sa+in the $)puters+ste) is $in $&&line &$r )aintenane. And the rain has t$ $ $&&line s$ that 1e an )aintainth$se ells that 1e are $in t$ *eep &$r li&e! eause 1e d$n3t )a*e ne1 $nes.

. S$ durin that 55

A. Durin that peri$d $& $&&line! repair and )aintenane is the thin 1e all sleep.

. S$ 1hile 1e3re asleep! there are thins $in $n in $ur rains,

A. Biht. L$ts $& thins $in $n in ter)s $& repair. Means! in essene! replae)ent $& ener+st$res and 55 eause 1e dissipate $ur ener+ durin 1a*e&ulness. 6he rain uses 20 perent $&the lu$se 1e 55

. 20 perent. (hen +$u sa+! 7the lu$se!7 is that the ener+ that 1e use,

A. 6he ener+ that 1e use.

. 6he rain uses 20 perent,

A. -es. And $ne $& the )$st hih de)ands! ati$ns! is the &irin $& these neur$ns that happen1hen 1e thin*.

. And! n$1! +$u tal*ed a$ut the *ind $& repair that $es $n 1hen 1e sleep. And ust i#e )e a$uple $& sentenes $n that. (hat *ind $& repair,

A. (ell! $ne $& the thins 55 e#er+ ti)e 1e all $& $ur e'perienes 1e ha#e in the da+ti)e! 1henthat happens! the 1a+ the rain en$des that )e)$r+ is )a*in an$ther $nneti$n 1ith n$tneur$ns. S$ 1e )a*e all these ne1 $nneti$ns durin the da+ that re&let all 1e ha#ee'periened durin the da+ti)e. At niht! $ne $& the thins is that 1e prune $ut a l$t $& th$se thatare n$t i)p$rtant! and 1e $ns$lidate th$se )e)$ries 1hih are. And that pr$ess is happenin

durin the! in partiular! the sl$1 1a#e sleep and the n$n5B.E.M. sleep.

. N$1! 1hat happens durin B.E.M. sleep 1hen +$u ha#e that rapid e+e )$#e)ent, And Ithin* 55 + the 1a+! 1e )a+ ha#e a slide that an help us! slide that +$u3#e prepared.

The -itness: "an -e go to the net slide/


37/103

. Oh! atuall+! d$es this sh$1 atuall+ re$rdins $& the rain 1a#es,

A. -es. 6his sh$1s the re$rdin $& n$t ust the rain 1a#es! ut als$ the e+e )$#e)ents! and

s$)e )usle t$ne =indiatin>. And here +$u an see the rain 1a#es at the transiti$n &r$)1a*e&ulness t$ sleep =indiatin>. 6his is the sleep ha)er that 1e used =indiatin>. And theseare the eletr$des that are re$rdin the rain 1a#e ati#ities and e+e )$#e)ents =indiatin>. S$+$u an see 55 and these are 90 se$nds $& re$rdin. And +$u an see! as this partiular astr$nauteins t$ &all asleep! +$u an see his e+es r$llin ar$und in their s$*ets! and these are thesl$1in r$llin )$#e)ents that are happenin. Ne't slide.

. 6hat3s stae 8. And that slide $ntains an $#erla+ t$ it as 1ell,

A. -es! it d$es. And n$1 +$u an see the transiti$n t$ stae 2 sleep =indiatin>. -$u an see $ne

$& th$se s+nhr$n$us &irin! $ne $& th$se *5$)ple'es here =indiatin>. N$1! the sl$1 e+e)$#e)ents are $ne! and 1e3re atuall+ pi*in up rain 1a#e re$rdins $& the eletr$de riht$#er the te)ple. And this represents stae 2 =indiatin>. S$ n$1 the pers$n is de&initi#el+asleep. And then the ne't slide! +$u 1ill see staes 9:; sleep! and 55 ein ea)ed d$1n &r$)spae. And +$u see the $sillati$n here in the rain 1a#e ati#it+. S$ sleep has an arhiteture t$it. As the rain is $in thr$uh this repair pr$ess e#er+ niht! that arhiteture is ritial as 1e$ &r$) eause B.E.M. sleep! 1hih is in the ne't side 55

. -eah. Let3s see the B.E.M. sleep.

A. 55 is as di&&erent a state $& $nsi$usness et1een rapid e+e )$#e)ent sleep and n$n5rapide+e )$#e)ent sleep as the di&&erene et1een 1a*e&ulness and sleep.

. O*a+. Just $ $#er that $ne )$re ti)e. Are +$u sa+in that the rapid e+e )$#e)ent sleep is asdi&&erent &r$) the rest $& it as ein a1a*e is di&&erent &r$) sleep,

A. -es.

. And h$1 is it di&&erent &r$) 55

A. 6here are three )a$r states $& $nsi$usness 55

Judge: 4sk you, don0t talk over each other, %ecause our court reporter is having a hard

ti#e, and the rest o us are having a hard ti#e 22

Mr. Kosko: apologi'e, your honor. t0s #y ault.

A. S$ there are three staes $& $nsi$usness@ $ne is 1a*e&ulness4 the $ther is n$n B. E.M. sleep!


38/103

and the third is the rapid e+e )$#e)ent sleep. S$ in rapid e+e )$#e)ent sleep! +$u see the rain1a#es are l$$*in li*e the pers$n 55 the+3re #er+ si)ilar as t$ 1hat 55 i& the pers$n 1ere a1a*e.And n$1 +$u see the e+es are dartin ar$und in their s$*ets. I& the pers$n 1ere 1athin a

tennis )ath! +$u 1$uld see the e+es $in a* and &$rth and a* and &$rth! and it is atuall+in realti)e. S$ it is n$t sped up! as )an+ pe$ple thin*. And there are s$)e $nditi$ns in 1hih there is an area $& the rain that paral+zes the )usles 1hile 1e3re in rapid e+e )$#e)ent sleep55

. %aral+zes 1hat )usles,

A. 6he )usles that 1e 1$uld $rdinaril+ the s*eletal )usles that 1e 1$uld use t$ 1al* and t$run and t$ )$#e $ur ar)s. And i& that area is da)aed! then pe$ple 1ill atuall+ at $ut theirdrea)s. And s$ a at 1ill e hasin )ie in their rapid e+e )$#e)ent sleep! and s$ $n.

. S$ in this rapid e+e )$#e)ent sleep! is the rain re#ie1in the e#ents $& the da+,

A. In the rapid e+e )$#e)ent sleep! the rain is atuall+ interatin! s$ a l$t $& the )e)$riesthat 1ere st$red in the deep! sl$1 1a#e sleep 55

. O*a+. S$ that3s 55

A. 55 and then the rapid e+e )$#e)ent sleep! 1e3re interatin the )e)$ries.

. O*a+. Keep 55 I3) s$rr+. I interrupted +$u.

A. In the rapid e+e )$#e)ent sleep! 1e3re interatin the )e)$ries that 1e had st$red 1ith sl$11a#e sleep 1ith all the $ther )e)$ries 1e had learned pre#i$usl+. S$ 1e ha#e the ne1 da+3s)e)$ries $)e in and are $ns$lidated! and 1e laid the) d$1n in sl$1 1a#e sleep! and allthese ne1 )e)$ries $)e in! and 1e ha#e t$ interate the) 1ith 1hat 1e alread+ ne1. And thatsee)s t$ happen durin rapid e+e )$#e)ent sleep. 6hat3s 1here 1e interate all this in&$r)ati$n1e ust learned t$da+ 1ith all $ur pre#i$us li&e e'perienes. And 1e! atuall+! als$! durin rapide+e )$#e)ent sleep! 1e are ale t$ atuall+ )a*e sense $& thins that )iht ha#e een 55 that 1e)iht n$t ha#e re$nized durin the da+ti)e. H$r e'a)ple 55

. Can I interrupt +$u,

A. -es. As$lutel+.

. I 1ant +$u 55 i#e an e'a)ple. Supp$se there3s a as*etall pla+er 1h$ durin the da+ ispratiin &$ul sh$ts 55

A. -es.


39/103

. 55 &r$) the &ree5thr$1 line. And he d$es it &$r t1$ h$urs durin the da+! and he3s $in! li*e!0 perent &r$) the &ree5thr$1 line. (hat happens t$ the rain durin that peri$d $& ti)e 55

A. 6he area $& the rain 55

. 55 at niht 1hen he3s sleepin,

A. 6he area $& the rain that he is usin t$ thr$1 that as*etall! that niht! that 55 let3s sa+ he3sriht5handed. 6he area $& the riht 55 that $ntr$ls the )$#e)ent $& the riht hand! the area $nthe le&t side $& the rain that $ntr$ls the riht hand )$#e)ent! 1ill ha#e )uh deeper sl$11a#e sleep l$all+ riht in that spei&i area On the $ther hand! i& +$ur ar) 1ere in a Slin! thenthe area that $ntr$ls that area $& the ar) has )uh less sl$1 1a#e sleep! eause there3s )uhless t$ re$rd 1hat happened. Si)ilarl+! i& +$u learn a Set $& n$tes $n a pian$ $r 1hate#er! i&+$u3re d$in 55 learnin h$1 t$ $perate a isa1! 1hate#er! that niht +$u3ll ha#e )uh deeper

sl$1 1a#e sleep in the area $& the rain that $ntr$ls the )$#e)ent $& that part $& +$ur $d+! as+$u are learnin that. And then +$u 1ill atuall+ d$ the tas* )uh etter the ne't da+ 1hen +$ua1a*en. S$! &$r e'a)ple! studies that ha#e een d$ne in ani)als. 6here are spei&i ells in therain! i& an ani)al is in a )aze! these are alled 7plae ells.7 -$u an tell 1hat plae in the )azethe ani)al is standin + 1hih ell is &irin. Kind $& $$l. And s$ the ani)al &iures $ut the+3reall dead ends in the )aze! ut i& it &$ll$1s a ertain path! it ets a %iee $& heese in the end.6hen 1hen the ani)al is sleepin! a)azinl+ en$uh! the+ an l$$* at 1here the ani)al isstandin durin sleep! and +$u an see that the ani)al is re)e)erin the path $#er and $#eraain! hundreds $& ti)es! rehearsin the path 1here it ets the heese. And 1hen the ani)al isa1a*e! it an run thr$uh that )aze )uh )$re


40/103

+$u3re in stae ; sleep! that 1$uld e a hih ener+! deep sl$1 1a#e sleep $ns$lidatin a l$t $&)e)$r+.

. (hat are th$se red areas $n the upper 55

A. 6hese are illustratin 1hether the indi#idual is in rapid e+e )$#e)ent sleep. 6his is thatdi&&erent state $& $nsi$usness I 1as tal*in a$ut. (e spend a$ut 2? perent $& the niht inrapid e+e )$#e)ent sleep! ut it3s n$t all at $ne. And ritial t$ the $ranizati$n $& sleep! it hast$ $ur in these e#er+ h$ur and a "al& t$ t1$ h$urs.

. S$ that3s the +le,

A. 6hat3s the +le.

. (ell! O*a+.

Mr. Kosko: 4nd the net slide, please/ kay. 3hy does the %rain need sleep/

A. 6he rain needs sleep in $rder t$ &ul&ill a Series $& asi i$l$ial needs. As I )enti$ned! 1e*eep $ur rain ells &$r li&e. And s$ 1e need t$ repair and )aintain th$se $nneti$ns t$ deide1hih $nneti$ns are i)p$rtant! and shed the $nes! prune the $nes that are less i)p$rtant!eause 1e d$n3t ha#e en$uh r$$) in $ur s*ull t$ )a*e eah $ne $& the $nneti$ns ta*e spae!n$r d$ 1e ha#e en$uh ener+. (e $ns$lidate )e)$r+ durin sleep4 1e interate dail+ learnin1ith pri$r e'perienes! and 1e re&ill the &uel tan* $& all these ner#e ells + rest$rin the ener+

st$res $& the ells re


41/103

A. (e ha#e t$ release ertain h$r)$nes! partiularl+ the h$r)$ne insulin + the panreas! andthe release that pre#ents us &r$) ettin diaetes re


42/103

dishe#eled! the+3re unale t$ )aintain their $d+ te)perature! s$ their ther)$reulat$r+ s+ste)ets $&& *ilter. And 1hen the+3re depri#ed $& all sleep! the+ die in an a#erae $& a$ut three1ee*s. And i& the+3re seleti#el+ depri#ed $& rapid e+e )$#e)ent sleep! the+ last a little l$ner4

ut + a$ut &i#e 1ee*s! the+ die. S$ it is sleep turns $ut t$ e neessar+ &$r li&e.

. O*a+. S$ &irst! +$u used a 1$rd there! 1hih is the 7ther)$reulat$r+ s+ste).7 1hat is thether)$reulat$r+ s+ste),

A. 6hat3s the s+ste) in the $d+ that helps us t$ )aintain $ur $d+ te)perature. S$ 1e3re )a))als are n$t li*e $ld s$ alled $ld5l$$ded ani)als! li*e a &r$! 1hih 1hate#er thete)perature it is in the $utside 1$rld! that3s the te)perature $& the ani)al. (e ha#e ather)$reulat$r+ s+ste) that *eeps $ur $d+ te)perature at a$ut as e#er+$ne *n$1s! a$ut. derees! and it h$lds it stead+ there. 6here is atuall+ a dail+ +le! s$ it3s l$1er at niht andhiher durin the da+ti)e. /ut the $d+ de&ends the te)perature t$ e at 1hate#er set p$int is

appr$priate &$r that ti)e $& da+.

. And 1hat happens i& an indi#idual is t$tall+ depri#ed $& sleep! t$ the ther)$reulat$r+s+ste),

A. 6he ani)al eins t$ n$ l$ner e ale t$ )aintain the appr$priate te)perature! and the $d+te)perature atuall+ dereases.

. N$1 and that3s n$1! +$u als$ ha#e in +$ur slide that there ha#e een studies 1hih sh$11hat happens 1hen the BEM sleep! the rapid e+e )$#e)ent sleep! is pr$hiited,

A. -es. S$

. And 1hat happens 1hat happens i& +$u ust eli)inate the rapid e+e )$#e)ent sleep ut therest $& the sleep +le re)ains intat,

A. I& +$u eli)inate ust the rapid e+e )$#e)ent sleep! the ani)als 1ill als$ die. It ta*es a littlel$ner. It ta*es $n a#erae a$ut &i#e 1ee*s instead $& a$ut three 1ee*s. /ut e#en i& the+3reall$1ed t$ $ int$ all the $ther staes $& sleep ut n$t rapid e+e )$#e)ent sleep! the+ an3tsur#i#e 1ith$ut that stae $& sleep! s$ it3s neessar+ &$r li&e.

. N$1! d$es sleep als$ it s$rt $& )a*es sense aid in per&$r)ane, (hen there is a 1hen apers$n is depri#ed $& sleep! d$es that a&&et per&$r)ane,

A. -es! it d$es. In &at! in these in these in indi#iduals 1h$ are depri#ed $& sleep! it a&&ets their$niti#e &unti$n and their ailit+ t$ $ns$lidate )e)$r+. Man+ $& the thins that 1e tal*eda$ut in ter)s $& the &unti$ns $& sleep are i)paired i& the pers$n d$esn3t et the sleep that the+need.


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. And $niti#e I3) s$rr+.

A. And $niti#e per&$r)anes! and s$ $n. One $& the thins I didn3t )enti$n in this slide is that

i& ani)als are depri#ed $& sleep and the+ are! let3s sa+! l$se t$ the three51ee* )ar*! and the+3resh$1in all the sins! the+3re sra1n+! the+3re dishe#eled! the+3re l$sin 1eiht! their $d+te)perature is n$t ale t$ sta+ at the n$r)al te)perature and then i& at the last )$)ent the+atuall+ all$1 the ani)als t$ sleep aain $& $urse! s$)eti)es! the+ d$n3t st$p the e'peri)ents$$n en$uh and the+ still die. /ut in th$se 1h$ d$ n$t die! 1ithin $ne t$ three da+s! the+ ha#e$)pletel+ re$#ered. And s$ the lettin the) sleep! aain! an resue the) s$ that the+ anre#erse the deteri$rati$n that the+3#e een su&&erin thr$uh t$tal sleep depri#ati$n.

. N$1! +$u ha#e a slide that sh$1s s$)e $& the areas in 1hih sleep depri#ati$n a&&etsper&$r)ane. Ne't slide! please,

A. -es. (hen +$u3re depri#ed $& sleep! let3s sa+ i& +$u pull an all5nihter and +$u3re a1a*e &$r)$re than 2; h$urs. I))ediatel+ 1e an ein t$ detet hanes in per&$r)ane. S$ $ne $& the&irst thins that hanes is +$ur reati$n ti)e. And s$ 1hat 1$uld n$r)all+ ta*e +$u! let3s sa+! a


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d$n3t resp$nd appr$priatel+ t$ +$ur en#ir$n)ent. O#i$usl+! sleep depri#ati$n inreases the ris*$& &allin asleep4 and alth$uh that )a+ see) $#i$us! )$st pe$ple thin* 1hen the+3re eausethere are a )illi$n dr$1s+ dri#in rashes e#er+ +ear. A$ut 2?0!000 pe$ple a da+ n$d $&& and

&all asleep at the 1heel! and the+3re surprised + it eause the+ d$n3t realize that 1hen +$u ettired en$uh! the rain )a+ seize $ntr$l and +$u )a+ in#$luntaril+ )a*e the transiti$n &r$)1a*e&ulness t$ sleep. And an$ther thin that happens is pe$ple e$)e &ast and sl$pp+. S$ the+1ill atuall+ instead $& n$r)all+ pe$ple 1ill sl$1 d$1n t$ )aintain their aura+ i& a tas* ets)$re di&&iult4 ut a sleep5depri#ed pers$n 1ill ust 1ant t$ et it $#er 1ithAnd speed thr$uh it.

. I 1anted t$ as* +$u a$ut the sl$pp+. ($uld a pers$n 1h$ is sleep depri#ed 1h$ is n$r)all+ arather &astidi$us pers$n 1$uld the+ s$)eti)es ha#e s$)e sl$pp+ eha#i$r! &$r e'a)ple! in theirpers$nal e&&ets $r their edr$$)s $r the li*e,

A. -es! de&initel+! eause 1hen a pers$n is e'hausted! the+ d$n3t tend t$ tend t$ the sa)eissues! the+ 1ill +$u *n$1! it3s interestin. As I )enti$ned in the last slide! e#en the rats e$)edishe#eled 1hen the+3re depri#ed $& sleep. 6he+ st$p r$$)in the)sel#es appr$priatel+! and s$$n.

. And the ne't slide! please. I thin* it sh$1s $ne $& the thins +$u 1ere ust +$u 1ere tal*ina$ut! the ad#erse

A. /+ the 1a+! e#en i& +$u lean s$)e$d+ up and ha#e the)! +$u *n$1! put $n their )a*eup

and d$ e#er+thin else! the a#erae pers$n an re$nize i& s$)e$d+ has een sleep depri#ed $rn$t ust 1ith a in t1$ $r three se$nds + a ph$t$raph $& the)! e#en i& the+3#e ta*en a sh$1erand leaned up and s$ $n! eause 1e an tell ust &r$) the appearane! ust + l$$*in ats$)e$ne.

. N$1! the +$u ha#en3t tried that $n )e +et! ha#e +$u,

A. N$ $))ent.

. Is there an ad#erse e&&et $& sleep de&iien+ $n )$$d,

A. -es. -$u *n$1! 1e all re$nize in little *ids i& the+ ha#en3t $tten en$uh sleep! )$thers 1ill$&ten sa+! +$u *n$1! that the+3re irritale! 7J$hnn+ hasn3t slept 1ell last niht!7 and that3s 1h+the+3re r+in. (hat 1e d$n3t realize is that this pr$pert+ $& sleep l$ss $ntinues e#en int$adulth$$d! and s$ pe$ple e$)e inreasinl+ #$latile in ter)s $& their e)$ti$n. 6he+ )a+ &l+$&& the handle! the+ )a+ e$)e the+ ha#e di&&iult+ &$usin and sustainin their attenti$n. I&the+3re presented 1ith the sa)e i& the+3re presented 1ith the sa)e! let3s sa+! disturin i)ae!rain sans ha#e een d$ne t$ sh$1 that the e)$ti$nal part $& the rain! 1hih has a tehnialna)e alled an eni)a =ph$neti> that little luster $& rain ells 1ill reat 1ith ten ti)es the


45/103

resp$nse i& +$u d$ rain i)ain $n s$)e$d+ 1h$ is sleep depri#ed than s$)e$ne 1h$ is 1ellrested.

And this is 1h+ I tr+ t$ tell the pr$&essi$nal sp$rts pla+er i& +$u ha#en3t $tten +$ur sleep! then i&the re&eree alls +$u &$r a &$ul! 1hate#er! at as*etall! then +$u )a+ et a tehnial &$ul and ethr$1n $ut $& the a)e eause +$u )a+ n$t e ale t$ h$ld +$ur e)$ti$ns in he* and n$thallene the re&eree. %e$ple als$ interestinl+ en$uh! the+ 1hen it $es $n hr$niall+! the+are at ris* $& urn $ut! depressi$n! and e#en suiidal ideati$n. And all th$se! +$u *n$1! an leadt$ depressed )$$d! 1hih is *ind $& parad$'ial eause at the einnin 1hen +$u3re &irst sleepdepri#ed! s$)e pe$ple! +$u *n$1! a&ter the+3#e sta+ed up all niht! the+ s$)eti)es &eel a &eelin$& euph$ria! and the+ e$)e s$rt $& slap5happ+ and punh+! as s$)e pe$ple all it! 7I 1as up allniht! I3) a little punh+.7 the+3ll i#e an inappr$priate resp$nses. E#entuall+ 1hen it3s hr$ni itleads t$ a depressed )$$d. %e$ple ha#e )$re $d+ $)plaints! their suseptiilit+ the+ are )$resensiti#e t$ pain 1hen the+ are sleep depri#ed! the+ tend t$ e'periene )$re s+)pt$)s $&

an'iet+ and e#en paran$ia and distured th$uht.

. And then the ne't slide! please. D$es this sh$1 e'plain 1hat 1e3re seein in this slide. Hirst$& all! 1hat *ind $& an i)ae is this,

A. 6his is this is an i)ae $& a rain san4 and in this partiular there are all s$rts $& di&&erentt+pes $& rain sans. 6his partiular rain san is l$$*in at the utilizati$n $& lu$se in the rain!1hih is the )ain ener+ s$ure $& the rain. And in this slide! +$u an see in the areas that areillustrated in lue! the lu$se is n$t ein used #er+ e&&eti#el+. And this is a $)paris$n $& arested rain 1ith a rain that has n$t $tten en$uh sleep! that has een a1a*e all niht. 6his is

1$r* that 1as d$ne at the (alter Beed ar)+ h$spital! )+ $lleaues there. And +$u an see thatthe areas that are ettin that are ettin that are turnin lue! 1hih is t$ sa+ that the+3re n$tutilizin lu$se #er+ 1ell! the+3re n$t utilizin the ener+ s$ure and the &uel 1ell! th$se are thepre&r$ntal $rte'! the area I said 1as ehind the &$rehead resp$nsile &$r ud)ent and $ntr$l.S$ th$se areas! it3s *ind $& li*e! +$u *n$1! in the in the n$rtheast! i& the ar enine is $ld! it3sn$t $in t$ 1$r* #er+ 1ell. It d$esn3t happen here in LA! ut s$ that3s $in st$ne $ld. 6heinteri$r parietal $rte'! 1hih is the area $& the rain that interates sens$r+ in&$r)ati$n $)in&r$) the e+es and ears and t$uh! is als$ n$t utilizin ener+ #er+ 1ell. And then in a #er+i)p$rtant part $& the rain! the thala)us! 1hih rela+s sens$r+ in&$r)ati$n &r$) the in&$r)ati$nthat 1e3re ettin &r$) $ur senses t$ the area $& the rain that $ntr$ls )$#e)ent is #er+seri$usl+ deraded 1hen 1e ha#e een a1a*e all niht.

. O*a+. S$ n$1 I 1ant t$ $ thr$uh a $uple $& th$se seti$ns 1ith +$u t$ ust see 1hat it)eans in pratial ter)s. 6he area 1a+ $#er $n the riht! 1hih +$u sa+ is the pre&r$ntal $rte'!that $ntr$ls ud)ent and $ntr$l,

A. -es.


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. And d$es the lue! the #er+ dar* lue )ean it3s n$t

A. -es! an+thin that3s

. n$t ettin &uel $r urnin &uel,

A. An+thin that3s lue is n$t urnin &uel as 1ell as it sh$uld e. S$ +$u an see and that3s usedas a an indiati$n that that area $& the rain is i)paired.

. And h$1 d$es that $n#ert t$ the &unti$n $& that area, In $ther 1$rds! h$1 1$uld h$11$uld that )ani&est itsel&,

A. S$ that 1$uld )ean and 1e thin* that these *inds $& rain i)ae supp$rt the e'peri)entalresults that ud)ent is i)paired 1hen pe$ple are sleep depri#ed. S$ that has een $ser#ed

e'peri)entall+! and it is $nsistent 1ith the rain i)ain studies.

. N$1! is there s$)ethin alled 7e'euti#e &unti$nin7 1hih tal*s a$ut a pers$n3s ailitiest$ $ranize thins,

A. -es! that is it is the pre&r$ntal $rte' that is ritial &$r e'euti#e &unti$n.

. ($uld that e i)paired in a pers$n 1h$ is sleep depri#ed,

A. -es! de&initel+.

. (hat is e'euti#e &unti$n,

A. S$ e'euti#e &unti$n is h$1 1e )a*e the deisi$ns as t$ 1hat 1e3re $in t$ d$ as a hu)anein! h$1 1e resp$nd 1hen 1e ha#e t$ deide 1hether s$)ethin is appr$priate $rinappr$priate! riht $r 1r$n! 1hether 1e ha#e t$ )anae a situati$n. And the ailit+ t$ d$ thatis $in t$ e deraded.

. -$u3re sh$1in a rain here. "$1 )uh h$1 )uh la* $& sleep did the pers$n in this sanha#e,

A. Just $ne niht.

. Just $ne niht. O*a+. N$1! the in&eri$r parietal $rte'! 1hatD$es that d$,

A. 6hat3s an area $& the rain that is resp$nsile &$r interatin in&$r)ati$n &r$) all all $& $urdi&&erent senses. S$ the sense $& t$uh4 the sense $& taste4 the sense $& s)ell4 the sense $& hearin4and! $& $urse! the sense $& #isi$n. All $& these di&&erent senses! that in&$r)ati$n is interated inthat area $& the rain! 1hih is als$ i)paired! s$ $ur ailit+ t$ ta*e in 1hat3s $in $n in $ur


47/103

e'ternal en#ir$n)ent is $in t$ e i)paired.

. And that

A. S$! &$r e'a)ple I3) s$rr+ t$ interrupt +$u.

. I 1as interruptin +$u all )$rnin.

A. S$! &$r e'a)ple! i& +$u present $n a $)puter sreen i)aes t$ si)ulate a pers$n ein alet$ see $ets in their #isual &ield! and t$ re$nize the)! and t$ resp$nd t$ the)! the+ 1ill )a*eten ti)es as )an+ )ista*es a&ter ein up all niht and )issin i)aes in the #isual &ield as1hen the+3re 1hen the+3#e slept. And! $& $urse! that3s #er+ i)p$rtant &$r )an+ $upati$ns.

. And $ipital,

A. 6he $ipital $rte' is 1here 1e interate in&$r)ati$n $n #isi$n $)in in &r$) the &r$) the&r$) the $pti ner#es and the &r$) the e+eall! asiall+.

. O*a+. And s$ that3s i)paired s$)e1hat &r$)

A. -es.

. a niht3s sleep l$st, And that #er+! #er+ dar* lue seti$n in the enter 1hih sa+s 7thala)usrela+s sens$r+ in&$r)ati$n!7 1hat is aain! the thala)us,

A. Be)e)er! that 1as in the enter $& the rain! and it 1as at$p the rain ste). And that isritial &$r rela+in sens$r+ in&$r)ati$n t$ the )$t$r $rte'. S$ 1e3#e n$1 interated all $& $ursenses! and n$1 1e3re $in t$ send the )essaes up t$ the t$ the thin*in part $& the rain1here 1e reulate $ur )$#e)ents! and s$ that3s $in t$ e ritial &$r! +$u *n$1! seein 1herethe step is and then )$#in t$1ard it and n$t &allin d$1n.

. N$1 +$u ha#e an$ther slide 1hih sh$1s 1hat happens t$ the #isual disri)inati$n 1hen in 1ith reard t$ sleep,

A. -es! ne't slide.

. Ne't slide! please.

A. S$ this is this is a$ut learnin. S$ this )$rnin I tal*ed a$ut the i)pat $& sleep l$ss $nlearnin! and this the e'peri)ent that is illustrated here 1hih 1as $nduted + )+ $lleaue%r$&ess$r Sti*$ld at the "ar#ard )edial sh$$l! pulished in the $urnal $& natureneur$siene a$ut 89 +ears a$! 1as a pi$neerin e'peri)ent in 1hih he sh$1ed thei)p$rtane $& sleep t$ learnin. S$ in this e'peri)ent! $n da+ zer$ and I3) s$rr+ it d$esn3tsh$1 1hat the a'es are $n the h$riz$ntal a'is4 ut that3s da+ 0! 8! 2! 9! ;! and a 1ee* later $n da+


48/103

F.

. S$ that3s se#en da+s as sh$1n + that 0 thr$uh F,

A. E'atl+.

. And the

A. And $n the #ertial a'is is i)pr$#e)ent in the speed at 1hih the+3re d$in a #isualdisri)inati$n tas*.

. (hat3s that,

A. S$ the #isual disri)inati$n tas* is a tas* that the+ ha#e t$ the+ ha#e t$ re$nize di&&erent

letters $n a sreen! $r learn h$1 t$ d$ a tas*. And in this partiular ase! the+ 1ere trained in thetas*! +$u *n$1! identi&+ the e3s that are $n their side! $r s$)e unusual tas*. 6he+3re trained in thetas* $n da+ 0! and then the+ et n$ &urther trainin &$r the &$ll$1in 1ee*. And 1hat pr$&ess$rSti*$ld $ser#ed 1as that a&ter sleepin $ne niht! the+ sp$ntane$usl+ et etter $n the test ina 1a+ that d$es n$t $ur i& he trains the) )$re durin the sa)e da+. In &at! he did e'peri)entsand he sh$1ed that i& +$u trained the) in the )$rnin and test the) in the e#enin and the+didn3t sleep in the inter#al! the+ d$n3t et etter. /ut i& the+ sleep riht a&ter1ards! the+ et etter4and then i& the+ sleep the ne't niht! the+ et etter4 and eah suse


49/103

. And 1hat3s

A. E#en a 1ee* later! the+3re n$t d$in adl+! e#en th$uh the+ ha#en3t pratied it &$r a 1ee*.

. S$ 1hat is that attriuted t$,

A. As I )enti$ned this )$rnin! 1hen 1e are sleepin! 1e are $in thr$uh and repla+in thee#ents! and 1e3re als$ $ns$lidatin th$se )e)$ries! s$ 1e3re atuall+ pratiin 1hat 1elearned durin sleep.

. And i& +$u d$n3t et sleep! is there a slide that sh$1s 1hat happened,

A. -es. Ne't slide. S$ i& +$u didn3t sleep that niht! then e#en i& +$u sleep! the ne't niht a&terthe s$ +$u )issed a sleep a&ter da+ 0! then +$u slept a&ter da+ 8! slept a&ter da+ 2! ut +$u ne#er

et the sleep5related i)pr$#e)ent.

. S$ that sh$1s 1hen d$ +$u ha#e t$ sleep t$ start ettin the i)pr$#e)ent,

A. -$u ha#e t$ sleep $n the niht a&ter learnin.

. S$ i& +$u3re learnin a tas*! and +$u d$n3t et a niht3s sleep a&ter +$u learn the tas*! that1h$le thin +$u sh$1ed us earlier a$ut i)pr$#in! i)pr$#in! i)pr$#in d$esn3t happen,

A. E'atl+.

. And 1hat a$ut 1hat3s sh$1n $n da+ 9 there,

A. 6hat3s e#en a&ter t1$ suse


50/103

. Is sleep used as a &$r) $& t$rture s$)eti)es,

A. It is.

. Can +$u i#e e'a)ples $& that &r$) +$ur e'periene and a*r$und and in&$r)ati$n,

A. It is $ne $& the it3s een used as a )eth$d $& t$rture &$r )an+! )an+ +ears4 and it3s it 1ase#en! un&$rtunatel+! used t$ t$rture pe$ple in the )iddle east in an e&&$rt t$ et the) t$ $n&ess t$thins and un&$rtunatel+! it3s n$t a $$d )eth$d. -$u an et pe$ple t$ $n&ess t$ thins! utthe+ )a+ n$t ha#e d$ne the)! ut the+3re s$ e'hausted and it is s$ pain&ul t$ e sleep depri#edthat it3s een &$und that pe$ple 1ill $n&ess t$ thins that the+ didn3t d$ ust t$ e ale t$ ets$)e sleep. In &at! Menahe) ein! 1h$ used t$ e 1h$ 1as t$rtured 1ith sleep depri#ati$nhe 1as t$rtured 1ith )an+ di&&erent thins in the ula in the S$#iet ni$n. And he said! 1hen

he 1r$te his )e)$irs! that sleep depri#ati$n 1as + &ar the 1$rst &$r) $& t$rture! 1$rse than an+ph+sial thins the+ $uld ha#e d$ne.

. S$ the pe$ple 1h$ ha#e su&&ered &r$) sleep depri#ati$n! d$ the+ l$$* &$r 1a+s t$ et sleep,

A. -es.

. And is there s$)ethin alled 1hat is sleep5related an'iet+, Is there suh a thin.

A. 6here is. It is! it3s part $& a t+pe $& ins$)nia. It3s related t$ pri)ar+ ins$)nia in 1hih pe$ple1ith ps+h$ph+si$l$ial ins$)nia an atuall+ ha#e 1hat $uld e desried as an $#er5

$nern &$r l$sin sleep eause the+ d$n3t 1ant t$ su&&er the $nse


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A. S$ pri)ar+ ins$)nia is there are a nu)er $& di&&erent t+pes4 ut! &$r e'a)ple! it an eps+h$ph+si$l$ial ins$)nia! )eanin that the indi#idual t+piall+ it3s hr$ni in nature! s$

pri)ar+ ins$)nia 1$uld n$t e s$)ethin 1here! +$u *n$1! +$u the air $nditi$ner 1as t$$$ld $ne niht and +$u had tr$ule sleepin. -$u )a+ ha#e had ins$)nia! ut +$u d$n3t ha#epri)ar+ ins$)nia. S$ pri)ar+ ins$)nia i)plies that it is hr$ni4 and that it has een $in $n&$r at least a )$nth! three )$nths! si' )$nths! dependin $n 1hih de&initi$n +$u 1ant t$ read./ut it is hr$ni.

. D$es 7hr$ni7 )ean that the+ al1a+s ha#e ins$)nia,

A. N$4 ut it )eans that the+ ha#e it &$r a sustained inter#al $& ti)e. It3s n$t ust that it 1as t$$$ld in the r$$) last niht! $r the ed 1as un$)&$rtale.

. /ut +$u3re tal*in a$ut pri)ar+,

A. -es.

. And then +$u said there3s s$)ethin alled se$ndar+ ins$)nia,

A. (ell! )a+ I &inish 1hat I 1as sa+in a$ut pri)ar+,

. -es.

A. I3) s$rr+. S$ 1ith the pri)ar+ ins$)nia! 1ith the ps+h$ph+si$l$ial ins$)nia! pe$ple 1ith

that are $&ten h+per ar$used! e#en durin the da+ti)e! and the+ ha#e the+ ha#e an $#er5$nerna$ut the inailit+ t$ sleep! and the+ )a+ ha#e learned the+ )a+ ha#e ass$iati$ns 1ith theedr$$) $r 1ith sleep that are atuall+ neati#e ass$iati$ns &$r the) t$ et the sleep that the+need. 6hen there is an$ther $nditi$n alled parad$'ial ins$)nia in 1hih the rep$rt $& theins$)nia +$u *n$1! pe$ple sa+! 7I didn3t sleep at all niht!7 ut i& +$u d$ an atual re$rdin!+$u )a+ &ind that the+ sleep &i#e $r si' h$urs. S$ the $)plaint the a)$unt $& sleep that the+thin* that the+3re ettin is less than the+3re atuall+ ettin. N$1! at least )easurin their sleep1ith an E.E.G. Mahine ut it )a+ e that the+3re ale t$ their sens$r+ s+ste) )a+ n$t eturned $&&! and the+3re the researh is n$1 sh$1in that the+ )a+ atuall+ e )$re disturedthan it see)s. An+1a+! there is parad$'ial ins$)nia. 6hen there3s a phen$)en$n alled7adust)ent sleep dis$rder.7 and that an e an ins$)nia ass$iated 1ith a spei&i stress$r $r a

spei&i situati$n 1here the pers$n an3t sleep 1hen the+ are at their in5la1s! $r the+ an3t sleep1hen the+ are at their +$u *n$1! in ass$iati$n 1ith a ti)e that the+ ha#e t$ prepare &$r e'a)si& the+3re in sh$$l! $r s$ and that3s alled adust)ent sleep dis$rder. And then there3s ins$)niaass$iated 1ith sleep h+iene. N$1! 7sleep h+iene7 s$unds it3s n$t a$ut rushin +$ur teeth.Sleep h+iene is li*e i& +$u ha#e an irreular sleep:1a*e shedule! $r i& +$u ha#e alertin i& +$ud$ a l$t $& alertin ati#ities e&$re edti)e! +$u3re $n a #ide$ a)e 1ith +$ur udd+ and +$u3repla+in riht up until and then +$u 1ant t$ shut the lihts $&&.


52/103

. D$ *ids su&&er &r$) that a l$t,

A. -es! the+ d$.

. %la+in #ide$ a)es &$r *ids! is that a $$d thin &$r the) t$ e d$in at niht,

A. N$4 and it happens a$ut 9 illi$n h$urs a 1ee* $lleti#el+ in $ur hildren. 6he industr+ $alis t$ et it up t$ 20 illi$n h$urs a 1ee* + the end $& this deade! ut that3s an$ther st$r+. It ane a p$$r sleep en#ir$n)ent! s$ lihts $n in a edr$$). F0 perent $& parents put a 6V. In their*id3s edr$$) t$ tr+ t$ help the) t$ sleep! n$t realizin that it atuall+ inter&eres 1ith sleep andthe+ 1ill spend three )$re h$urs a da+ $n rereati$nal )edia i& the+ ha#e a 6V. In the edr$$).E'essi#e a&&eine usae. Man+ pe$ple d$n3t realize that a&&eine has

A. Si'5 t$ nine5h$ur hal& li&e! and the+3re s1iin d$1n these &i#e5h$ur ener+ drin*s and! +$u

*n$1! an+ a&&eine ta*en a&ter lunhti)e is $in t$ a&&et +$ur ailit+ t$ sleep at niht. S$ that3sthe sleep h+iene area. And then there are a $uple $& $thers. One is idi$pathi and $ne related t$eha#i$ral ins$)nia $& hildh$$d. 6h$se are the pri)ar+ ins$)nias.

. N$1! the se$ndar+ ins$)nias! 1hat are the+,

A. 6he+ an e se$ndar+ related t$ a )edial $nditi$n! as I )enti$ned. %ain! &$r e'a)ple. Or i&+$u ha#e it an e the treat)ent! als$! $& a )edial $nditi$n! s$ +$u )a+ ha#e asth)a and +$uha#e t$ ta*e an inhaler. 6hat inhaler )a+ ha#e )ediati$n in it that )a*es +$ur heart rae and)a*es it di&&iult &$r +$u t$ &all asleep. S$ it an e it is se$ndar+ t$ s$)ethin else. It an ese$ndar+ t$ sustane ause4 s$! +$u *n$1! i& +$u3re ta*in $aine e&$re +$u $ t$ ed! that3s

n$t $in t$ help +$u sleep. It3s $in t$ inter&ere 1ith +$ur sleep! and +$u )a+ de#el$p anins$)nia ass$iated 1ith sustane ause. Or e#en a presripti$n dru that )a+ inter&ere 1ith+$ur sleep. And then ins$)nia an als$ e ass$iated 1ith an'iet+ $r depressi$n. -$u an e#enha#e re$und ins$)nia &r$) ha#in ta*en sleepin pills. S$ )an+ sleepin pills! $ne +$u areta*in the) &$r a series $& nihts! then i&

jackson v aeglive- transcripts - june 20th dr. charles czeisler. sleep medicine, harvard medical...

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