A founder of the field of sleep medicine, ardent campaigner against the dangers of drowsiness, and teacher of Stanford’s hugely popular Sleep and Dreams course, William Dement has died.
June 18, 2020 - By Rosanne Spector
William Dement, MD, PhD, known as the father of sleep medicine, died June 17 after a two-year battle with cardiovascular disease. He was 91.
With a handful of other scientists, Dement, a longtime faculty member of the Stanford School of Medicine, created the fields of sleep research and sleep medicine, and his many books and lectures helped raise awareness of sleep disorders and the dangers of sleep deprivation. His mission was to educate the world about the importance of sleep, which he believed was dangerously undervalued. His motto, “drowsiness is red alert,” is a message he tirelessly broadcast to his students, trainees, members of Congress and the world at large.
“He passed away early this morning — in his sleep, of course,” said Rafael Pelayo, MD, clinical professor of psychiatry and behavioral sciences and a longtime colleague of Dement’s at Stanford.
For Dement, sleep was always a priority.
“Bill Dement made unparalleled contributions as a scientist investigating sleep and sleep disorders, as a physician, and as an advocate promoting the importance of sleep to health, performance and public safety,” said James Kiley, PhD, director of the Division of Lung Diseases at the National Heart, Lung, and Blood Institute and former director of the National Center on Sleep Disorders Research.
A man of tremendous energy and confidence, Dement, the Lowell W. and Josephine Q. Berry Professor in the Department of Psychiatry and Behavioral Sciences, Emeritus, was a legendary Stanford teacher. Some 20,000 students took his hugely popular undergraduate course, Sleep and Dreams.
“The first presentation of Sleep and Dreams was winter quarter 1971. To my utter amazement, approximately 600 undergraduates registered, and no classroom of that size was available,” Dement said in a 2009 Stanford Magazine article. “My friend Davie Napier, the dean of the chapel, allowed me to teach Sleep and Dreams in Memorial Church. I delivered only one lecture from the pulpit. It seemed a bit blasphemous since I am not a preacher.”
A designated sleeping section
Out of respect for the dangers of drowsiness, Dement designated a sleeping section in his classroom for students expecting to doze off. But if he caught a student sleeping elsewhere in the classroom, he woke the napper with a shot from his trusty squirt gun, with the exhortation to stand up and recite “drowsiness is red alert.”
Among Dement’s key achievements were elucidating the phases of the human sleep cycle and identifying the physiological basis of dreams. His efforts to wake up policymakers to the dangers of sleep deprivation and sleep disorders led to legislation that established the National Center on Sleep Disorders Research and increased National Institutes of Health funding for sleep. He wrote the first university textbook on sleep and founded the world’s first sleep disorders center and the first professional organization for sleep researchers, the American Sleep Disorders Association, now the American Academy of Sleep Medicine, serving as its president for 12 years.
“William Dement was a force of nature. A pioneering researcher and clinician, and a legendary teacher, his passion to uncover sleep’s secrets and to share these discoveries was unquenchable,” said Lloyd Minor, MD, dean of Stanford University School of Medicine. “Not only did he make great contributions to Stanford, but his efforts directly led to the birth and development of the field of sleep medicine.”
“There are not a lot of people who can say they saved the lives of hundreds of thousands of people,” said Emmanuel Mignot, MD, PhD, professor of psychiatry and behavioral sciences at Stanford and the Craig Reynolds Professor of Sleep Medicine. “But just by pushing this field forward, making sleep apnea recognized, as well as sleep disorders and sleep deprivation, Bill did that. Without him it would have still happened, but maybe 10 years later. Ten years is a lot of deaths.”
Native of Washington state
Born in Wenatchee, Washington, in 1928, Dement grew up in Walla Walla, Washington, and later served in the U.S. Army in Japan, where he was editor of the regiment newspaper. Dement went to college at the University of Washington, living on a houseboat and helping pay his way through school by working as a jazz bass player. He got his start studying sleep in the 1950s in graduate school at the University of Chicago at a time when most scientists thought the topic was a snooze. Dement worked with physiologist Nathaniel Kleitman, PhD, and graduate student Eugene Aserinsky, PhD, to unveil the rich drama of slumber. With this team, Dement discovered and described rapid eye movement sleep — the phase during which we’re most likely to dream — coining the term REM. He earned a medical degree in 1955 and a PhD in neurophysiology in 1957.
He went on to serve his internship at Mount Sinai Hospital in New York, where he set up a sleep lab in a Manhattan apartment. There, he studied the impact of dream deprivation on several REM-deprived Rockettes, the famous dancers, who had answered his newspaper ad. It wasn’t easy finding research subjects, so he studied himself (relying on his wife to wake him during REM sleep) and relatives.
He came to Stanford in 1963, lured by the weather and academic excellence, he said in a 2016 video, without fully solving the riddle of the purpose of dreams, which remains a mystery to this day, and turned his focus to sleep disorders and the fundamental physiology of sleep.
During his early years at Stanford studying sleep problems and recruiting volunteers for trials, Dement discovered that many people had disorders such as insomnia or narcolepsy that had gone undiagnosed — and untreated — for years. That led him to launch the Stanford Sleep Disorders Clinic, now known as the Stanford Sleep Medicine Center, believed to be the world’s first, in 1970.
At the sleep clinic, he worked with fellow sleep medicine pioneer Christian Guilleminault, MD, where they blazed the sleep medicine trail. Among their accomplishments was recognizing the dangers of sleep apnea — now recognized as one of the most common chronic illnesses in the United States — and developing treatments. People with sleep apnea stop breathing, sometimes for long periods, while sleeping. The condition causes sleepiness and is associated with an increased risk of high blood pressure, Type 2 diabetes, strokes and heart attacks. But when Dement first presented data showing its prevalence, fellow scientists were dubious.
“He was very passionate about sleep,” Mignot said. “Sometimes that would get him in trouble. It was the late 1980s, and he told me he was going to present data on sleep apnea, showing it affects 20% of the population. At the time, most thought it affected more like 2%. I said, ‘Don’t say this. People will think you’re crazy. You will appear as a lunatic.’ He did sometimes appear like a lunatic. But the problem is, he was right. Now people think sleep apnea is one of the major causes of high blood pressure.”
“I have loved being a pioneer and a leader,” Dement told the publication Sleep & Health in 2003 of the early years of his career. “There were no precedents or guidance. Everything had to be established.”
Dement also developed polysomnography, which expanded sleep studies beyond eye movements and brain waves to include more variables, including blood oxygen levels, breathing rates and patterns, heart rates, leg movements and snoring. And with graduate student Mary Carskadon, PhD, now a professor of psychiatry and human behavior at Brown University, they developed a sleep disorder diagnostic tool, the multiple sleep latency test, to measure daytime sleepiness. Under Dement’s leadership, the sleep center’s scientists focused their efforts on studying and treating sleep apnea, insomnia, narcolepsy, restless leg syndrome, sleepwalking and other disorders.
“Physicians used to be skeptical about the high prevalence of sleep disorders and even about their existence, but that’s definitely changing,” Dement said in a 2004 interview published in Stanford Report. Today, the Stanford sleep center is recognized as one of the world’s largest and best-known sleep centers in the world, and nearly every hospital has a sleep clinic.
“Bill’s work has touched millions of lives throughout the planet,” Pelayo said. “One key to his success was he was unusually open-minded. He was so open-minded he created his own medical specialty, sleep medicine, and ended up having to sign his own certification diploma. I have it in my office.”
At Stanford, Dement was the first resident faculty adviser for the school’s first black-themed dorm. This experience propelled him and a group of black students to found Stanford’s first black pre-medical society.
Jazz musician and aficionado
And despite his serious pursuits, his playful nature was never far from the surface. Throughout his life, he loved music, playing jazz, and had the chance to jam with some greats, including Quincy Jones and Stan Getz. In the late 1980s, he led the Committee for Jazz at Stanford, a group of Stanford community jazz supporters, which backed the Department of Music’s new academic jazz program.
“Bill was instrumental in helping to establish the new jazz program on firm footing at a time when its very existence depended on outside support,” said Jim Nadel, founder of the Stanford Jazz Workshop and lecturer in jazz studies.
Dement launched the Sleep and Dreams course in 1971. He retired in 2003 but continued teaching the course the rest of his life, lecturing, sometimes driving students to class in his golf cart, which was emblazoned with “Sleep and Dreams,” and participating virtually during the COVID-19 pandemic.
Alongside his research, teaching and work with patients, Dement devoted himself to educating the public about the importance of sleep and the risks and prevalence of untreated sleeping disorders. Perennially frustrated by the lack of respect afforded to sleep, he spread the word about the dangers of sleep debt, which, he said, contribute to 50,000 deaths a year. In the 1970s, he even appeared on The Tonight Show starring Johnny Carson to tell the host that “sleepiness is a signal to go to bed.”
Sleep-awareness programs, congressional testimony
Dement launched numerous sleep-awareness programs, published several consumer-aimed books, and testified on sleep in front of Congress and the California Legislature many times. He tried to turn his students into an army of sleep advocates: An integral part of his undergraduate course was the requirement for students to carry out an outreach project of their own.
Clete Kushida, MD, PhD, now chief of psychiatry's sleep medicine division at Stanford Health Care, got turned on to sleep in the Sleep and Dreams class. He went on to study sleep medicine, with Dement as his mentor.
“He never failed to recognize the big picture and to passionately and persuasively point out to you what was really important, not only for you and your career, but, importantly, for the field of sleep medicine and research,” said Kushida, professor of psychiatry and behavioral sciences.
Dement’s many other accomplishments and accolades range far and wide: Dement and Guilleminault were the founding editors of the journal Sleep, the first major international journal devoted to sleep, publishing the first issue in 1978. He was the author of books for lay readers, including The Promise of Sleep, Some Must Watch While Some Must Sleep and The Sleepwatchers. The 2012 comedy film Sleepwalk with Me featured The Promise of Sleep and Dement in a cameo.
Dement co-authored more than 500 scientific publications and was co-editor of the definitive textbook Primary Practices of Sleep Medicine. He co-founded the Sleep Research Society and served as president for its first 12 years. He was the inaugural recipient in 1994 of the AASM’s academic achievement award, which now bears his name. He is also a two-time recipient of the AASM’s Nathaniel Kleitman Distinguished Service Award, and in 1997 he received the AASM Mark O. Hatfield Public Policy or Advocacy Award. In 2001 he was awarded the first Lifetime Achievement Award by the National Sleep Foundation for his contributions to the field of sleep research and sleep medicine.
Dement believed that despite all of his efforts, drowsiness and sleep disorders were still a major threat, Mignot said. “He’d still be fighting this battle if he could,” he said. “But he has created a legion of students to carry on.”
Dement is survived by his two daughters, Elizabeth Dement and Catherine Roos; his son, Nick Dement, MD; his son-in-law Gary Roos; and six grandchildren. His wife, Pat Dement, died in 2014.
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