If you underwent surgery and were put under general anesthesia, it turns out that you weren’t “put to sleep”, but it was more like you were put into a coma-like state. Physicians don’t generally explain it that way to patients because they realize it may make them anxious.
Research and studies have been done to explore the relationship between sleep, comas, and general anesthesia. That information will hopefully help treat patients with sleep disorders, facilitate recover from comas, and lower risks associated with anesthesia such as complications from suppressed breathing in patients with certain risk factors.
According to the article “General Anesthesia, Sleep, and Coma” by Emery N. Brown, M.D., Ph. D., Ralph Lydic, Ph. D., and Nicholas D. Schiff , MD in the New England Journal of Medicine, “general anesthesia is, in fact, a reversible drug-induced coma."
In Medscape Today, the article “General Anesthesia: A Reversible Coma, Not Sleep” reports about their correspondence with those authors. Schiff stated that “measuring brain circuit mechanisms may lead to greater diagnostic accuracy and targeted therapeutic strategies for predicting and supporting the recovery process from coma after severe brain injuries,” and that “monitoring brain function under general anesthesia may also help in developing new sleep aids.”
In the abstract for “Recovery from Sleep Deprivation Occurs During Propofol Anesthesia,” it describes a test that was done to determine if anesthesia could facilitate sleep in environments where sleep deprivation is common. Another study looked at whether being sleep deprived or the time of night before receiving anesthesia was a factor in the amount of medication needed to administer to make the anesthesia effective.
Other studies have detected that there may be genetic clues that could help anesthesiologists determine how much medication to safely administer to patients so they are getting the best dosage. Too little could cause the patient to feel pain, and too much could make it hard to rouse them and may cause other problems such as difficulty breathing.
Being that I am a red head, I was interested to find out that there was a study that proved that the genetic mutation of the MC1R gene, which causes the pigment making red hair, also interacts with receptors making it harder to block the pain and requires red heads to need more anesthesia. I have experienced first hand, unfortunately, the effects of not having enough pain relief at both the dentist and during childbirth. Knowing how much extra to give patients that have a hard time becoming sedated or numb is important because of the risk in giving them too much. That is a bit alarming to me, and probably explains why they have such a hard time rousing me after surgery. Maybe they will discover a similar connection to why it is so hard for me to rouse myself from sleep in the morning.
Another study reported in The Journal Of the American Medical Association’s article Studies Probe Anesthesia, Sleeep Links, by Bridget M. Kuchin found a possible genetic link between the amount of sleep needed for individuals and how much anesthesia is required for people that have a certain gene mutation. Although the experiment was done on minisleep flies, they believe the findings may have relevance for humans because they report that the “mechanisms behind sleep regulation appear to be highly conserved across species.” Bernd Weber, PhD, one of the researchers in the study, concludes, “it might be possible in humans that single gene mutations have an influence on the anesthetic requirement.”
The Society of Anesthesia and Sleep Medicine points out some features shared by sleep and anesthesia on their web-site. They mention that the unconscious state of both is “accompanied by muscle relaxation, decreased breathing effort and increased upper airway collapsibility.” These factors can be predictors of complications during anesthesia for people with certain sleep issues such as obstructive sleep apnea and hypoventilation, or under-breathing. They also point out that it is “notable that sleepiness appears to decrease anesthetic requirements, as does performing anesthesia late at night rather than during the day.” Another interesting aspect they are looking at is whether anesthesia can have some of the restorative powers of sleep.
From the various articles I read, I found it surprising that while anesthesia has been administered in America since the 1800’s in America, they often said what a mystery it had been until recently, especially since this mystery has been putting people, mostly safely, into coma-like states and bringing them back to consciousness. One article even described it as “brainstem death,” which gave me the shudders. However, complications seem rare, and it is interesting and hopeful to know how much continues to be learned and gained in the scientific and medical field to improve the quality of people’s lives, even when we sleep.