Despite many years of study, the biological meaning of sleep eludes us, and the effects of prolonged sleep loss continue to be the subject of controversy. Early workers noted perceptual changes, with some transient disruption of behavior and attention. During the 1940's, research with Army volunteers focused on aspects of the transient episodes of ego disruption occurring during sleep loss, which were compared with the symptoms of schizophrenia. However, it was not until the Korean Conflict, when the Red Chinese used sleep deprivation in their brainwashing techniques, that medical interest became centered on the immediate and longlasting psychotogenic potential of prolonged wakefulness. Throughout the 1950's, workers became more impressed with both the transient and prolonged pathogenic potential of sleep loss. In 1962, in a review article, West described the "Psychosis of Sleep Deprivation."1
In a recent issue of the Archives of General Psychiatry, workers at the University of California,