Herbie Murray
Deep sleep therapy (DST), also known as prolonged sleep treatment or continuous narcosis, is a controversial psychiatric treatment where patients are kept unconscious for days or weeks using drugs. The treatment was first introduced in Shanghai in 1900 and later popularised in the 1920s by Swiss psychiatrist Jakob Klaesi. DST was practised by Dr Harry Bailey from 1962 to 1979 at the Chelmsford Private Hospital in New South Wales, where it led to 25 deaths. This controversial practice has since been discredited and is no longer used. However, the question of whether deep sleep therapy is effective in treating sleep disorders remains. Today, sleep therapy typically involves working with a trained therapist to develop specific skills and habits to improve sleep quality. Cognitive behavioural therapy for insomnia (CBT-i) is a recommended treatment for insomnia that helps individuals identify and address thoughts and behaviours that disrupt their sleep.
| Characteristics | Values |
|---|---|
| What is Deep Sleep Therapy | A discredited form of psychiatric treatment in which drugs are used to keep patients unconscious for days or weeks |
| Synonyms | Prolonged sleep treatment, continuous narcosis |
| History | First tried by Scottish psychiatrist Neil Macleod in 1900 using sodium bromide to induce sleep. The method was soon abandoned as it was considered toxic and reckless. In 1915, Giuseppe Epifanio tried barbiturate-induced sleep therapy in Italy. In the 1920s, Swiss psychiatrist Jakob Klaesi popularised deep sleep therapy using a combination of two barbiturates marketed as Somnifen by Roche. |
| Impact | The treatment led to the death of 25 patients in Chelmsford Private Hospital in New South Wales, Australia, from the early 1960s to the late 1970s. |
| Current Status | Deep Sleep Therapy was rescinded in June 2023 |
| What is Sleep Therapy | Any method designed to help people overcome sleep challenges or improve sleep quality |
| Types | Electro-sleep therapy, CBT-I, SRT, SHE |
| Techniques | Relaxation techniques such as deep breathing and visualization, exercise, listening to relaxing music, practicing gentle stretching, mindfulness techniques, CBT |
| Effectiveness | Research from 2020 suggests CBT for insomnia works, particularly for people living with depression. A 2018 analysis of studies on the efficacy of SHE found it can improve insomnia symptoms. |
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What You'll Learn
Deep sleep therapy's history
Deep sleep therapy was popularised in the early 1920s by Swiss psychiatrist Jakob Klaesi, who used a combination of two barbiturates marketed as Somnifen by the pharmaceutical company Roche. The treatment was first used in the Devon County Mental Hospital in 1934. Patients received an injection of 2cc of Somnifen and slept for about five consecutive hours. Two to three injections were given to patients on several consecutive days. The method became widely known and was used in some mental hospitals in the 1930s and 1940s. It was adopted and promoted by some leading psychiatrists in the 1950s and 1960s, such as William Sargant in the United Kingdom and Donald Ewen Cameron in North America.
Deep sleep therapy was also practiced (in combination with electroconvulsive therapy (ECT) and other therapies) by Dr Harry Bailey between 1962 and 1979 at the Chelmsford Private Hospital in New South Wales, Australia. Twenty-five patients died at Chelmsford during the 1960s and 1970s. After the failure of the agencies of medical and criminal investigation to tackle complaints about Chelmsford, a series of articles in the early 1980s in the Sydney Morning Herald and television coverage on 60 Minutes exposed the abuses at the hospital, including 24 deaths from the treatment. This forced the authorities to take action, and the Chelmsford Royal Commission was appointed in 1988. The commission found that there was a long history of death certificates being altered and files on patients lost. Bailey signed 17 death certificates that were probably false. Only four of the 24 deaths were investigated by a coroner.
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Deep sleep therapy's effectiveness
Deep sleep therapy (DST), also known as prolonged sleep treatment or continuous narcosis, is a controversial and discredited form of psychiatric treatment. It involves keeping patients unconscious for days or weeks using drugs. DST was first introduced in Shanghai in 1900 by Macleod, who used bromides to induce sleep in patients with mania. In 1915, barbiturate-induced sleep therapy was tried by Giuseppe Epifanio in Italy, and later by Swiss psychiatrist Jakob Klaesi for the treatment of schizophrenia.
The method became widely known and was used in some mental hospitals in the 1930s and 1940s. Leading psychiatrists in the 1950s and 1960s, such as William Sargant and Donald Ewen Cameron, also adopted and promoted the technique. DST was practiced by Dr Harry Bailey between 1962 and 1979 at the Chelmsford Private Hospital in New South Wales. However, the treatment led to the deaths of 25 patients, and legal action was pursued on behalf of former patients.
The effectiveness of DST is questionable and controversial. While it was used for the treatment of psychiatric disorders such as schizophrenia, the method was also associated with memory loss and an increasing dread of further treatments. The combination of DST with other therapies, such as electroconvulsive therapy (ECT), was thought to be a promising new beginning in psychiatry by some. However, DST has since been discredited and is no longer used.
Today, sleep therapy refers to a range of techniques designed to help individuals improve their sleep quality and overcome sleep challenges. This includes cognitive behavioural therapy for insomnia (CBT-i), which is the American College of Physicians' first recommended treatment for insomnia. CBT-i combines teaching and review components to address sleep anxiety and perceptions about insomnia. Research from 2020 suggests that CBT-i is particularly effective for people living with depression. Other approaches to sleep therapy include sleep restriction, relaxation techniques, stress reduction, and the exploration of mental health barriers to good sleep. Sleep therapy is typically a short-term treatment, and it aims to treat the root causes of sleep challenges to restore natural sleep drive and maintain long-term results.
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Deep sleep therapy's safety
Deep sleep therapy (DST), also called prolonged sleep treatment or continuous narcosis, is a discredited form of psychiatric treatment. It involves keeping patients unconscious for days or weeks using drugs, particularly barbiturates. DST was popularised in the early 1920s by Swiss psychiatrist Jakob Klaesi, who used it to treat patients with schizophrenia. It was later adopted and promoted by leading psychiatrists such as William Sargant and Donald Ewen Cameron in the 1950s and 1960s.
The safety of DST has been a significant concern, with a history of patient deaths and abuse associated with the practice. Between the early 1960s and late 1970s, 25 patients died at the Chelmsford Private Hospital in New South Wales, Australia, where DST was practised by Dr Harry Bailey in combination with electroconvulsive therapy (ECT) and other therapies. This led to legal action by former patients and the exposure of abuses at the hospital, ultimately forcing authorities to take action and appoint the Chelmsford Royal Commission.
The combination of DST with other treatments, such as ECT, contributed to the controversy and safety concerns. Patients were often unaware of the length of their unconsciousness or the specific treatments administered during that time. The use of barbiturates to induce prolonged sleep also carries risks, as seen in the early attempts by Scottish psychiatrist Neil Macleod, where one patient died.
The lack of support for DST within the medical community is evident. In 1978, Sydney psychiatrist Brian Boettcher convened a meeting of doctors at Chelmsford, finding little support for the practice. Despite this, DST continued to be used into 1979. DST has since been discredited and is no longer recommended or practised. Position Statement 34 on Deep Sleep Therapy was rescinded in June 2023.
Today, insomnia and other sleep disorders are typically treated with a combination of sleep medications and behavioural techniques, such as cognitive behavioural therapy (CBT). While DST aimed to address sleep challenges, its safety record and ethical concerns have led to its discontinuation. The focus is now on evidence-based treatments that improve sleep quality without compromising patient safety.
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Deep sleep therapy's alternatives
Deep sleep therapy, which involves long periods of barbiturate-induced unconsciousness, has been used to treat various conditions, including schizophrenia, depression, and insomnia. However, there are now concerns over the safety of this approach, with patients at risk of falls, memory issues, and confusion. As a result, alternative treatments that do not involve medication are being sought.
One such alternative is cognitive behavioural therapy for insomnia (CBT-I), a non-pharmaceutical approach that can help patients fall asleep naturally. CBT-I helps patients recognize and change old thoughts, behaviours, and emotions that perpetuate insomnia. It involves keeping sleep diaries, learning relaxation exercises, practising good sleep hygiene, and managing anxious thoughts. Clinical trial data suggest that CBT-I is highly effective, with up to 80% of patients seeing improvements in their sleep.
Another natural remedy for insomnia is exercise. Moderate aerobic exercise increases the amount of nourishing slow wave (deep) sleep, although it is important to avoid working out within two hours of bedtime. Other recommendations include reducing exposure to light before bed, especially from smartphones and other electronic devices, and drinking melatonin supplements or natural sleep aids such as warm milk, chamomile tea, or tart cherry juice.
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Deep sleep therapy's combination with other treatments
Deep sleep therapy (DST), also known as prolonged sleep treatment or continuous narcosis, is a controversial and discredited form of psychiatric treatment. It involves keeping patients unconscious for days or weeks using various drug combinations, including barbiturates. DST was popularised in the early 1920s by Swiss psychiatrist Jakob Klaesi for treating schizophrenia.
Deep Sleep Therapy in Combination with Other Treatments
Deep sleep therapy has been combined with other treatments, such as electroconvulsive therapy (ECT), as practiced by Dr Harry Bailey between 1962 and 1979 at Chelmsford Private Hospital in New South Wales. The combination of DST with ECT aimed to alleviate patient anxiety and improve tolerance to ECT, but it also induced considerable memory loss.
Sleep therapy, in general, is often used in conjunction with other treatments, such as cognitive behavioural therapy (CBT), to address underlying mental health issues that may contribute to sleep disturbances. CBT for insomnia (CBT-I) is recommended by the American College of Physicians as the first-line treatment for insomnia. CBT techniques involve identifying and changing negative beliefs and attitudes about sleep, as well as behavioural interventions like stimulus control therapy, sleep restriction, and relaxation techniques.
Additionally, sleep therapy can be combined with other approaches such as sleep hygiene counselling, which focuses on improving sleep habits and routines, and the use of sleep aids or medications like melatonin, zolpidem, or alerting agents. In some cases, sleep medicine specialists may recommend light therapy, CPAP machines for sleep apnea, or even neurostimulators.
The combination of DST with these treatments, particularly ECT, was controversial and led to patient deaths at Chelmsford Private Hospital. As a result, DST is no longer widely practiced, and other forms of sleep therapy are typically preferred, such as CBT-I and sleep hygiene in combination with behavioural and psychological approaches.
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Frequently asked questions
Deep sleep therapy (DST), also known as prolonged sleep treatment or continuous narcosis, is a form of psychiatric treatment in which drugs are used to keep patients unconscious for days or weeks. DST was popularised in the 1920s by Swiss psychiatrist Jakob Klaesi, who used barbiturates to treat patients with schizophrenia.
DST is a discredited and controversial practice. It led to the deaths of 25 patients at Chelmsford Private Hospital in New South Wales, Australia, from the 1960s to the 1970s. DST was practised by Dr Harry Bailey at the same hospital until 1979. The therapy was rescinded in June 2023.
Sleep therapy is an umbrella term for various approaches and techniques to improve sleep quality. This includes cognitive behavioural therapy for insomnia (CBT-i), which is recommended by the American College of Physicians as the first treatment for insomnia. Relaxation techniques such as deep breathing and visualisation can also help reduce stress and improve sleep.
