Deep sleep therapy

Position Statement 34: Deep Sleep Therapy has been rescinded – for details about past practices in psychiatry please see Position Statement 84: Acknowledging and learning from past mental health practices.

Definition

“Deep Sleep Therapy” (also referred to as continuous narcosis or deep sedation therapy) is the term used for a procedure in which a patient is maintained (for a period of at least several days) in a comatose or semi comatose state with sedative and other psychotic drugs. The term “deep sleep” is in fact a misnomer; as such a state is not normal sleep.

Evidence

Deep Sleep Therapy was notoriously practised between 1962 and 1979 in Sydney, Australia, at the Chelmsford Private Hospital during which it was anticipated that patients' minds would be able to overcome mental afflictions. Deep Sleep Therapy was prescribed for various conditions ranging from schizophrenia, anxiety and depression to obesity and addition. This involved periods of induced coma, often for several weeks, caused by the intermittent administration of intravenous barbiturates. Many patients either died during the sleep or awoke from it with varying degrees of impairment, ranging from permanent amnesia to chronic panic. At least twenty-four patients died and many others suffered permanent physical and psychological damage at the hospital during that period (Anderson, 1991). The hospital was forced to close in the early 1980s and the Chelmsford Royal Commission was established in the 1990s to investigate the deaths that occurred there (Slattery, 1991).

Recommendations

Intermittent administration of intravenous barbiturates has no place in the treatment of psychiatric illnesses for the following reasons:

• It has not been demonstrated to be effective in any psychiatric condition, and its administration poses particular hazards.
• The morbidity and mortality rates associated with the practice were unacceptably high.

Responsible committee: Committee for Evidence-Based Practice

References

Anderson I (1991) Nightmare on Chelmsford. Sydney New Scientist, 5 January 1991.

Slattery JP (1991) Report of the Royal Commission into Deep Sleep Therapy. NSW Government Printer.

Disclaimer: This information is intended to provide general guidance to practitioners, and should not be relied on as a substitute for proper assessment with respect to the merits of each case and the needs of the patient. The RANZCP endeavours to ensure that information is accurate and current at the time of preparation, but takes no responsibility for matters arising from changed circumstances, information or material that may have become subsequently available.