Does anaesthetic unconsciousness = restorative sleep?

[DaveC426913]

TL;DR

If you don't dream under anaesthesia, does that mean no restorative sleep?

I just came home from a procedure, and I asked if I could buy a case of whatever they used to knock me out.

Anaestheisa seems to knock out one's internal clock as well, suggesting it's pretty deep.

I was just wondering if being under anaesthetic counts toward sleep. You don't dream and you don't experence the passage of time. Does that mean the brain isn't using the time to collate and store memories, etc.?

I wonder if anyone's done an assessment of the long-term effects - of anasthesia replacing natural sleep - on sleep deprivation.

 

[Bystander]

TL;DR Summary: If you don't dream under anaesthesia, does that mean no restorative sleep?

I just came home from a procedure, and I asked if I could buy a case of whatever they used to knock me out.

Major? Prolly not. Minor? Depends on the procedure.

 

[.Scott]

There have been a couple of articles this year (which I will not attempt to track down) that have relevance to this question. One indicated that brain inactivity does allow "waste" levels to drop to better levels. The other was that it is common for some parts of the brain to simply go offline when not used - partial inactivity.

Those would be mechanisms that suggest anethesia provides "restoration".

What is completely unknown is whether there are other things that happen during sleep that require the brain to remain active. Since it is, in fact, very active during some stages of sleep, one would guess that those stages have some benefit over anesthesia.

 

[phyzguy]

Google what killed Michael Jackson.

 

[DaveC426913]

Google what killed Michael Jackson.

Indeed.

My family carries the RYR1 gene, which is a risk factor for malignant hyperthermia triggered by certain anaesthetics such as propofol. We all had to get tested for it. I am positive.

 

[marcusl]

REM sleep seems to be vital to restoration. Experiments in which people are deprived of REM sleep show (if I remember rightly)increased irritability, aggression, sleepiness. Mice die if deprived of REM sleep long term. That suggests to me that dreamless unconsciousness gives only partial rest to the body.

 

[DaveC426913]

REM sleep seems to be vital to restoration. Experiments in which people are deprived of REM sleep show (if I remember rightly)increased irritability, aggression, sleepiness. Mice die if deprived of REM sleep long term. That suggests to me that dreamless unconsciousness gives only partial rest to the body.

Right, so this turns the question on its head.

Would long-term anaesthesia prevent REM sleep, as well as the restorative functions associated with it?

In a thought experiment: if a patient were put under 8 hours each night for a week, would they start to show cognitive signs of sleep deprivation?

 

[marcusl]

Interesting question. Let us know once you’ve tried it.

 

[tech99]

TL;DR Summary: If you don't dream under anaesthesia, does that mean no restorative sleep?

I just came home from a procedure, and I asked if I could buy a case of whatever they used to knock me out.

Anaestheisa seems to knock out one's internal clock as well, suggesting it's pretty deep.

I was just wondering if being under anaesthetic counts toward sleep. You don't dream and you don't experence the passage of time. Does that mean the brain isn't using the time to collate and store memories, etc.?

I wonder if anyone's done an assessment of the long-term effects - of anasthesia replacing natural sleep - on sleep deprivation.

I remember dreaming under anaesthesia with nitrous oxide as a child.

 

[Hornbein]

I had a general anesthetic to have my appendix removed. It took about a week to recover. I wouldn't want to do that again.

 

[nsaspook]

I had a general anesthetic to have my appendix removed. It took about a week to recover. I wouldn't want to do that again.

I'm going under again in about 10 days (something different this time, knees). I'm not looking forward to that general anesthetic again. I guess I'm one of the 5% that have issues with propofol. Brain fog for days but it was well worth it, knowing I was good, up there.

https://www.yalemedicine.org/conditions/anesthesia-choices-for-colonoscopy

 

[Hornbein]

I'm going under again in about 10 days (something different this time, knees). I'm not looking forward to that general anesthetic again. I guess I'm one of the 5% that have issues with propofol. Brain fog for days but it was well worth it, knowing I was good, up there.

https://www.yalemedicine.org/conditions/anesthesia-choices-for-colonoscopy

If I ever have the choice again I'll take a local.

I had a colonoscopy and I hardly remember it so it was pretty small potatoes. I think I would have refused a general. Or maybe drugs have improved in the last fifty years.

 

[Kringle]

A number of procedures which aren't really surgery, such and colonoscopies and throat endoscopies use what is called 'twilight sleep' concoctions. The major meds used are a mixture of fentynal and midalzapram, or fentynal and propofol. They aren't considered to cause a general anethesia, they simply cause lower pain perception and amnesia about the procedure. The patient can typically still respond to questions if asked by the doctor including fairly detailed biographical information. I've undergone that twice and the entire procedure is a complete blank to me. However, supposedly, I would not have been truly 'out'.

Then of course there are other procedure in which total anethesia and unconsciousness is desired, such as significant surgeries and some dental procedures. I was given I believe pentathol or pentobarbital 40 years ago when I had four impacted wisdom teeth removed and I believe I was totally out. There as also dissassociative anesthetics like PCP and Ketamine which don't produce the same neurological effects as the GABA agonistic anethetics.

 

[pinball1970]

If I ever have the choice again I'll take a local.

I had a colonoscopy and I hardly remember it so it was pretty small potatoes. I think I would have refused a general. Or maybe drugs have improved in the last fifty years.

Mine was extremely unpleasant and subsequent polypectomy was agony, wide awake and felt everything, if they offered me general going forward I would take it.

 

[pinball1970]

fentynal and midalzapram

That's the one. Horrific but better than colorectal cancer.

 

[pinball1970]

TL;DR Summary: If you don't dream under anaesthesia, does that mean no restorative sleep?

I was just wondering if being under anaesthetic counts toward sleep

I found this.

https://www.brainfacts.org/thinking...ifference-between-sleep-and-anesthesia-051121

 

[DaveC426913]

I found this.

https://www.brainfacts.org/thinking...ifference-between-sleep-and-anesthesia-051121

Thanks. That's super helpful.


I also recall a random factoid, though I have no reference. Apparently, there is a correlation between the success with which one recovers from anaesthesia and the risk for Alzheimer's. Those who recover poorly appear more prone to contracting Alzheimer's.

I was worried about this last time (decades ago), as I took a long time to recover. But this time, I recovered 100% immediately, so I am relieved.

 

[nsaspook]

Thanks. That's super helpful.


I also recall a random factoid, though I have no reference. Apparently, there is a correlation between the success with which one recovers from anaesthesia and the risk for Alzheimer's. Those who recover poorly appear more prone to contracting Alzheimer's.

I was worried about this last time (decades ago), as I took a long time to recover. But this time, I recovered 100% immediately, so I am relieved.

"I am relieved"

The cynical would say it shows you already have Alzheimer's. Taking a long time means you can tell your mind is not in the normal state. I hope it takes a long time for my next anaesthesia recover if that's the case.

 

[nsaspook]

If I ever have the choice again I'll take a local.

I had a colonoscopy and I hardly remember it so it was pretty small potatoes. I think I would have refused a general. Or maybe drugs have improved in the last fifty years.

The general wasn't too bad. The pre-procedure colonoscopy purge cleaning, that was not fun. Low-residue diet for 3 days, enough Miralax and Dulcolax for an elephant and gallons of water and lemonade flavored electrolytes every like 10 min until you become a squirt gun in the bathroom.

Wear loose shorts and TUCKS® are your friend.

Being knocked out for an hour or so was very restorative.

 

[DaveC426913]

"I am relieved"

The cynical would say it shows you already have Alzheimer's.

I don't follow your logic.

Taking a long time means you can tell your mind is not in the normal state. I hope it takes a long time for my next anaesthesia recover if that's the case.

When I went under, decades ago, it took me about 12 hours to recover. I was driven home and sat down, and it was about three hours before my wife asked if I'd like to take off my coat and stay awhile. It hadn't even occurred to me to move from the chair. Even later that night, when I was ... physically active ... my muscles locked up like a charlie horse in my entire core.

This time, I was fully recovered within a minute or so, and zero lingering effects.

So, regardless of whether there were circumstantantial differences in the first one versus the last one, at least now I know that full, immediate recovery is in the cards for me. That's a good sign.

 

[nsaspook]

I don't follow your logic.


When I went under, decades ago, it took me about 12 hours to recover. I was driven home and sat down, and it was about three hours before my wife asked if I'd like to take off my coat and stay awhile. It hadn't even occurred to me to move from the chair. Even later that night, when I was ... physically active ... my muscles locked up like a charlie horse in my entire core.

This time, I was fully recovered within a minute or so, and zero lingering effects.

So, regardless of whether there were circumstantantial differences in the first one versus the last one, at least now I know that full, immediate recovery is in the cards for me. That's a good sign.

No, it's not but I was mainly commenting about the study you referred to.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3939441/

Attribution of risk​

Anaesthesia and surgery are inseparable in clinical settings. Thus, it is difficult to establish whether the increased risk of dementia development observed was attributable to anaesthesia per se, the surgical process, or both. It is noteworthy that there is a growing body of laboratory evidence suggesting that anaesthetic agents may interact with Alzheimer’s disease neuropathology at multiple levels in the involved pathways.

I also recall a random factoid, though I have no reference.

 

[DaveC426913]

Anaesthesia and surgery are inseparable in clinical settings. Thus, it is difficult to establish whether the increased risk of dementia development observed was attributable to anaesthesia per se, the surgical process, or both.

Ah. Interesting. In all my procedures, I have not had to be opened up.

I got my tongue snipped (actually, my frenulum).
I got my wisdom teeth out.
I got epoxy injected into my splenic artery.
I got probed.

None of these involved major insults to the integrity of my body.

And now you know more about me than anyone should have to.

 

[pinball1970]

Low-residue diet for 3 days, enough Miralax and Dulcolax for an elephant and gallons of water and lemonade flavored electrolytes every like 10 min until you become a squirt gun in the bathroom.

 

[.Scott]

I just came home from a procedure, and I asked if I could buy a case of whatever they used to knock me out.

Anaestheisa seems to knock out one's internal clock as well, suggesting it's pretty deep.

I was just wondering if being under anaesthetic counts toward sleep. You don't dream and you don't experence the passage of time. Does that mean the brain isn't using the time to collate and store memories, etc.?

I wonder if anyone's done an assessment of the long-term effects - of anasthesia replacing natural sleep - on sleep deprivation.

I had my gall bladder remove last summer. My awaking in the recovery room was interesting.
It's been almost 10 months now - let's see if I can assemble the details...

When I first regained consciousness, I still had my eyes shut and I was not connected to any tactile sensory input at all. But my memory was entirely on line, and in particular I had an audio clip in what I call my sing-song memory - the same memory I would use if you asked to me repeat exactly what you said - and then you said something completely meaningless. That audio clip was of short duration and contained a kind of scream followed by a voice or two - perhaps reacting to the scream. It was simply pasted into my memory with no time stamp of any kind.

At that moment, I presumed I was still under the knife and my thought was that if I ended up remembering anything painful after surgery, I would expect a suitable degree of embarrassment from the anesthesiologist.

My sense of time was not good. Not only did I not know how much time had elapsed while I was out - but I had no immediate way of checking how time was elapsing - or had elapsed since the "scream". Later I was able to reconstruct the timeline and verified that within seconds of regaining consciousness, I was keeping time normally.

Over a period of a few seconds, my tactile senses came back on line - and a few items were of interest.

First my throat. It had obviously been exercised and clearly that primordial "scream" was the product of that exercise. I later learned that it was loud enough to capture everyone's attention is that general recovery area. And about a minute later, I overheard a conversation where one nurse claimed to the other that I would not remember. She was more or less right. I don't actually remember doing it nor did I immediately hear it.

Second way that I was in a reclined position on a possibly narrow surface. It actually wasn't all that narrow, but I was still wise not to try to roll over.

Third, although I was comfortable enough, I was also hot. And that would become the immediate mission. Next time I will make it clear that, for me, being a little on the cold side is better than being buried in layers of blankets.

In another minute, it was clear to the attending nurse that I was back.

 

[nsaspook]

I didn't get the total knockout juice this time, only the happy juice but it was still painful during the procedure.
https://en.wikipedia.org/wiki/Midazolam


https://pmc.ncbi.nlm.nih.gov/articles/PMC6635137/

Genicular Nerve Radiofrequency Ablation for Painful Knee Arthritis: The Why and the How​

https://pmc.ncbi.nlm.nih.gov/articles/PMC6635137/#video1

Well tolerated is relative, the pre-op requires you stop your normal knee pain meds for 4 days. It as a 8 on the 10 pain scale walking in. The 'happy' juice knocked it down to maybe a 5 until the locals really kicked. I asked the for more local because in was very uncomfortable during the procedure.

The good news is, I'm at constant 2 now while exercising and hope it stays the way for a while.

Sort of a strange side note on the happy drug they used on me.
https://www.nbcnews.com/news/us-new...ruth-serum-terror-suspects-after-9-11-n935911

After months of research, the agency decided that a drug called Versed, a sedative often prescribed to reduce anxiety, was "possibly worth a try." But in the end, the CIA decided not to ask government lawyers to approve its use.

Versed is a brand name for the sedative midazolam, used since the late 1970s and today sold commonly as a generic. It causes drowsiness and relieves anxiety and agitation. It also can temporarily impair memory, and often is used for minor surgery or medical procedures such as colonoscopies that require sedation but not full-blown anesthesia. It's in a class of anti-anxiety medications known as benzodiazepines that work by affecting a brain chemical that calms the activity of nerve cells.

 

[nsaspook]

Day #2 after the dope wore off. Even better, pain level after a poor nights sleep near zero.

Sedation:
Received 2 mg midazolam and 50 mcg fentanyl.

No wonder I was feeling so stupid yesterday. The recovery was much better but could not fall asleep once my brain recovered to near normal.

 

[WWGD]

I heard REM helps you if you're in the corner losing your religion.

 

[Pythagorean]

There are two primary hypotheses for the purpose of sleep:
1) cellular maintenance (neuron are busy cells that undergo a lot of physical stress between electroactivity and chemical activity, rest periods help the cells "regenerate" (clear out waste, restock neurotransmitter, reinforce structural integrity, etc)
2) memory consolidation. Generical model: autobiographical memories stored in the hippocampus are 'consolidated' and encode information across the associative cortex and the hippocampus is prepped to handle the next day's autobiographical memories.

presumably you get 1) but not 2).

But for 1) I guess the question is does anesthesia vs. sleep shut down the same sensory neurons? E.g. even if your ability to experience it is shut down, does one or the other still leave audio processing neurons active and therefore they are still getting fatigued and not getting cellular maintenance.

 

[sbrothy]

Ah. Interesting. In all my procedures, I have not had to be opened up.

I got my tongue snipped (actually, my frenulum).
I got my wisdom teeth out.
I got epoxy injected into my splenic artery.
I got probed.

None of these involved major insults to the integrity of my body.

And now you know more about me than anyone should have to.

I know this is downright childish but are you sure the people who "probed" you were actual doctors?

 

[Guineafowl]

Broadly speaking, the answer to the OP is ‘no’. Sleep is an active process. If you’re interested, try the pop-sci book Why We Sleep by Walker.

For the same reason, it’s important to be sparing in the use of sleeping pills such as midazolam - regular use can suppress the process of coming to terms with bereavement, for example.