Balm of hurt minds

The main character of Haruki Murakami's brilliant and terrifying short story "Sleep" is a perfectly normal middle-class woman living in Tokyo.  Her husband is a dentist, and they've got a lively, cheerful five-year-old son.  Everything about her life is so ordinary that it's hard even to describe.

Then, in one instant, all that changes.

One night, she awakens -- or thinks she has -- to a terrifying vision that even afterward, she's not certain was real or a hallucination during sleep paralysis.  A dark shape is huddled by the foot of her bed, and unfolds itself to reveal the figure of an elderly man, dressed in black, staring at her with an undisguised malevolence.  She attempts to scream, and can't.  After a moment, she forces herself to close her eyes, and when she opens them, the man is gone.  She's drenched with sweat, so she gets up, showers, pours herself a brandy, and waits for morning.

But after that moment, she is completely unable to go to sleep.  Ever.

The remainder of the story could be a teaching text in a fiction writing course lesson about how to create a believable Unreliable Narrator.  She returns to her ordinary life, but everything starts seeming... off.  Some senses are amplified, others dulled into nonexistence.  Everyday objects appear surreal, as if they've changed subtly, but she can't quite tell how.  One evening, she watches her husband as he's sleeping, and realizes that his face suddenly looks ugly to her.  She takes to going out driving at night (once her husband and son are asleep) and meets people who may or may not be real.  Her progressive slide into insanity reaches its apogee in the wee hours of one night, after seventeen days with no sleep, when she drives farther than she has ever driven, and ends up in an empty parking lot overlooking the ocean.  Dark figures raise themselves on either side of her little car, grab it by the handles, and begin to rock it back and forth, harder and harder.  She's thrown around by the motion, slamming against the door and steering wheel, and her last panicked thought is, "It's going to flip over, and there's nothing I can do to stop it."

An apt, if disturbing, summation of what is happening to her mind.

Sleep is an absolutely critical part of human health, but even after decades of research, it is unclear why.  Just about every animal studied sleeps, and many of them seem to dream -- or at least undergo REM sleep -- the same as we do.  (I know my dogs do; both of them bark and twitch in their sleep, and our sweet, gentle little dog Rosie sometimes growls as if she was the biggest meanest Rottweiler on the planet.)

Now, a team at the Binzhou Medical University's Shandong Technology Innovation Center has found one reason why sleep is so critical.  Sleep-deprived mice stop producing a protein called pleiotrophin, which apparently has a protective effect on the cells of the hippocampus.  Reduced pleiotrophin levels lead to cell death -- impairing both memory and spatial awareness.  Pleiotrophin decline has also been implicated in neurodegenerative diseases like Alzheimer's.

[Image licensed under the Creative Commons Sasha Kargaltsev, Sleeping (10765632993), CC BY 2.0]

What's unclear, though, is what direction the causation points.  Does the decline in pleiotrophin from sleeplessness cause the neurodegeneration, or does the neurodegeneration lead to insomnia and a drop in pleiotrophin levels?  The current research suggests the former, as the mice in the study had been genetically engineered to experience sleep disturbances, and the pleiotrophin loss seems to have followed as a consequence of the sleep deprivation.  Then, the question is, if pleiotrophin decline does trigger neurodegeneration, could the damage from Alzheimer's be prevented by increasing the production of the protein?

Uncertain at this point, but it's intriguing to find one piece of a puzzle that has intrigued us for centuries.  It seems fitting to end this musing on the power of sleep with the famous quote from Macbeth:

Methought I heard a voice cry ‘Sleep no more!
Macbeth does murder sleep,’ the innocent sleep,
Sleep that knits up the ravell’d sleave of care,
The death of each day’s life, sore labour’s bath,
Balm of hurt minds, great nature’s second course,
Chief nourisher in life’s feast.

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A win for the good guys

I find it discouraging, sometimes, how often the hucksters win.  We still have homeopathic "remedies" on pharmacy shelves.  Selling supplements of dubious benefit and largely unknown side effects is still a multi-million dollar business.  Throw in all of the purveyors of woo who every year bilk thousands of people out of their hard-earned cash, and it all adds up to a pretty dismal picture.

But still, every once in a while, the good guys come out on top.

This  happened just this week with the announcement that the creators and marketers of the "Lumosity" brain-training games are being ordered to pay $2 million in reparations to customers who fell for their "unfounded claims that Lumosity games can help users perform better at work and in school, and reduce or delay cognitive impairment associated with age and other serious health conditions."

The selling points were attractive, with the aging population becoming increasingly (and justifiably) spooked by the specter of Alzheimer's and other age-related dementias.  I can understand the fear; I watched my aunt, my mother's older sister, outlive both of her siblings, finally dying at the age of 90 after spending the last ten years of her life essentially unresponsive and needing 24-hour care due to the ravages of Alzheimer's.  It's my worst nightmare, really.  The idea of having my body go on long after my mind is gone is absolutely terrifying.

So the claim that you could stave off dementia by playing some computer games was appealing.  So, too, were there other claims -- that you would improve your performance at work, at school, and on the sports field, feel more alert, perform cognitive tasks more quickly and accurately.  A direct quote from their advertisements said that playing their games three or four times a week would help users to reach "their full potential in every aspect of life."  With that kind of claim, it's understandable why people fell for their sales pitch.

[image courtesy of the Wikimedia Commons]

The problem was, it had no basis in fact, and the Federal Trade Commission is requiring Lumos Labs, the company which created and marketed Lumosity, to refund money to their customers because they were participating in "misleading health advertising."

"Lumosity preyed on consumers’ fears about age-related cognitive decline, suggesting their games could stave off memory loss, dementia, and even Alzheimer’s disease," said Jessica Rich, Director of the Federal Trade Commission’s Bureau of Consumer Protection.  "But Lumosity simply did not have the science to back up its ads."

In fact, it wasn't simply a lack of evidence; there is significant evidence against their claims.  A 2014 joint statement from Stanford University and the Max Planck Institute said that "The strong consensus of this group is that the scientific literature does not support claims that the use of software-based 'brain games' alters neural functioning in ways that improve general cognitive performance in everyday life, or prevent cognitive slowing and brain disease."

But flying in the face of scientific evidence wasn't the only problem.  The FTC found that "...the defendants [failed] to disclose that some consumer testimonials featured on the website had been solicited through contests that promised significant prizes, including a free iPad, a lifetime Lumosity subscription, and a round-trip to San Francisco."

So promoting falsehoods for profit + paying people to give you good reviews = a $2 million penalty.  Which is exactly as it should be.

It's high time that the FTC crack down on these spurious claims.  You have to wonder how long it'll take before they can get the supplement-and-remedies cadre to stop hiding behind "This product is not intended to diagnose, treat, or cure any human illness" as a catch-all disclaimer and general Get Out of Jail Free card.

In any case, I find the whole thing heartening.  I do believe in the principle of caveat emptor, but we sure as hell wouldn't have to invoke it quite so often if the powers-that-be would pull back the reins on the false advertisers.