Infants and children it is well known require much more sleep than adults. In these latter the organism, being already matured, demands only so much sleep as will enable it to make up for the daily waste of the body, which waste falls very far below the amount of nutrition required by the growing infant. In a still earlier state of development, viz., the
fœtal one, life may be said to be passed entirely in slumber; whilst children prematurely born scarcely ever wake except for food. We may assume that, as a general rule, infants take treble the amount of sleep that adults do, and that very young infants thrive the better the larger the amount of sleep they get, is borne out by the experience of medical practitioners, who affirm that they have known many children who were born small and weakly, but who slept the greatest part of their early existence, afterwards became strong and healthy; whilst those children on the contrary who, being born large and strong, were not good sleepers, became subsequently enfeebled and unhealthy. As regards the sleep of adults, if the slumber has been of average length, or the subject of it awakes fully refreshed therefrom, a second sleep instead of being conducive is prejudicial to health, and should never be encouraged.
During sickness a patient, if in a very helpless and enfeebled state, may often be exposed whilst asleep to great peril, unless the nurse who attends him exercises intelligence and a proper amount of vigilance. In his work on ‘Household Medicine’ Dr Gardner has pointed out the dangers that beset the sleeping patient, and the means by which they may be avoided. “Having disposed,” he says, “of the patient in bed in the best manner, be careful that no part of the pillow can project over the mouth or nose, and that the bedclothes do not cover the mouth.
“The attendant should be particularly attentive to these points, when a narcotic has been taken, when the disease is paralysis, fever, head diseases, bronchitis, or any pulmonary complaint. The patient should be watched until he sleeps, and during his sleep, if a nurse is not constantly present, should be visited frequently, to observe whether the mouth and nostrils are free, and nothing obstructs the breathing.
“Very little suffices for an obstruction in such cases, which may extinguish life. Hundreds, perhaps we may say thousands of persons die prematurely from suffocation during sleep, in a low condition of the vital energies.
“How often does it happen that a patient left in a calm sleep is found dead upon being visited an hour or two after. Soft yielding pillows, in which the head and face get buried, are the instruments of suffocation to weakly persons, very, very often.”
The larger amount of sleep indulged in by the very old, over adults, is referable to the incapacity of the aged for exercise, and to their enfeebled powers of nutrition. Besides age, temperament, habit, and surrounding circumstances exercise considerable influence on the amount of sleep necessary for man. Persons of lymphatic temperament are generally great sleepers; whilst those of a nervous and active nature are mostly the reverse. The late Earl Russell was we believe in the years of his active
political life a very small sleeper, his slumbers seldom extending over five hours. So, likewise was the Duke of Wellington; General Elliott, the defender of Gibraltar, seldom slept more than four hours out of the twenty-four. As a contrast to these cases may be mentioned that of Dr Reid, the metaphysician, of whom it is stated that he could take as sufficient food and afterwards as much sleep as would suffice for an ordinary man for two days.
Several well-attested cases of excessive slumber are on record in which the sleep lasted in some cases for weeks, and in others even for months.
In the ‘Comptes Rendus’ for 1864 Dr Blanchet records the case of one of his patients, a lady of 24 years of age, who had slept for 40 days when she was 18 years of age. Two years later she had a sleep lasting 50 days. Upon a subsequent occasion she fell asleep on Easter Sunday, 1862, and did not wake till March, 1863. She was fed during this period with milk and soup. She continued motionless and insensible, the pulse was low, the breathing scarcely perceptible, there were no evacuations, and she betrayed no signs of wasting away, whilst her complexion is described as florid and healthy.