This article is Vol. 1 in a new series highlighting the professional lives and careers of Fellows. From lifetime achievements to cool ventures to hidden talents to career-defining moments, we want to tell your stories! Email us your ideas: email@example.com.
“I started in ’62, so that’s 54-plus years — half a century!”
Roger Broughton, MD, PhD, FRCPC, almost seems surprised by his own admission.
He sits across from me at a coffee shop, smartly dressed in a dark blue suit and crisp, white-collared shirt. He is surprisingly spry, belying his 81 years.
We’re here to talk about his career — one in which he’s played a seminal role in the development and advancement of sleep research and sleep medicine both in Canada and internationally.
Among his many contributions,
- a landmark research paper (hint: sleepwalking is actually not dreams-lived-out),
- expert testimony in a milestone forensic medicine case (legal quandary: are you guilty of murder if you were asleep when you committed the act?);
- the distinction of being the founding president of the Canadian Sleep Society (once uncertain of its future, the society just celebrated its 30th anniversary in 2016).
“Because of luck and some critical, early-career decisions, I am widely considered one of the pioneers of sleep medicine... and that’s nice,” he said, smiling.
Science runs in the family
Roger’s father was a researcher of some renown. He headed up a National Research Council laboratory in Ottawa and was a world expert on testing oils and lubricants, particularly how they perform in cold weather. Growing up, Roger was exposed very early on to the scientific process; and often, to great minds in research.
“My father used to invite eminent researchers for supper. I always thought ‘Oh wow. That must be a neat life.’ I liked the idea of doing research. The issue arose for me of whether I wanted to do only research, only clinical work, or both. And I decided that I would do both.”
How a braggart lawyer changed his career trajectory
After earning his medical degree from Queen’s University in 1960, Roger headed to Saskatchewan where he did a rotating internship at the University Hospital in Saskatoon. He wanted to get some experience in Neurology and had the possibility of being on the Neurology and Neurosurgery services in the fall to help see if that was what he really wanted to do.
His career then took a marked turn.
“I went with my wife Joan to a backyard barbecue hosted by of the head of Neurology in Saskatoon. He had a very pleasant and quite charming daughter, and there was a lawyer there who was sort of putting his moves on the daughter and bragging about how every year he spent two or three months in Europe. That caught my imagination. When we went home, my wife fell asleep right away but I stayed up thinking. I knew I’d like to have a European experience and at the same time find out if I like research. At about 3 a.m., I woke my wife up telling her, ‘we’re moving to Europe!’”
Roger laughed, recalling his wife’s confused and sleep-filled reaction. But when they revisited the topic in the morning, she was supportive. He then wrote to 7 or 8 neuroscience centres that do research in Europe, asking if they would take him on as a researcher. All but one wrote back. Noncommittal, they invited him to visit. Maybe something can be worked out, they said.
Undeterred and focused, Roger went across the ocean on a grain freighter out of Fort Churchill in search of a laboratory.
His first interview was at the Karolinska Institute in Stockholm, Sweden. From there, he visited four other cities in three different countries, finally settling in Marseille, France. There, he met a dynamic supervisor in Professor Henri Gastaut. Professor Gastaut was already world-renown for his work in epilepsy and clinical neurophysiology, and had recently become interested in sleep research.
“And there I landed,” he said.
A career-defining residency in Marseille
By Roger’s estimation, Europe in the mid-1960s was at least five years ahead of North America in their sleep research and sleep medicine. Already, there were about a dozen sleep labs in France alone. European researchers were using 15-16 EEG channels (looking at eye movements, muscle tone, brainwaves, respiration, ECG, etc.) as opposed to the only eight channels being used in North America. An understanding of the whole body in various sleep states was beginning to emerge.
Professor Gastaut was head of the laboratory at the Centre St. Paul (now called the Centre Henri Gastaut) that was conducting clinical sleep studies with epileptic children.
“I arrived and Gastaut said, ‘look, we’ve got all these children and most of them are epileptic and some of them have nocturnal enuresis. What we don’t know is whether they’re having seizures at night with incontinence or whether they’re epileptic children who just have ordinary bedwetting problems. I’ll be gone for two months and I want to know the answer when I get back.’”
It was a call-to-action that Roger took to heart. Rolling up his sleeves, he got to work.
Roger found that most of the epileptic children had normal bedwetting, meaning their anti-epileptic medication didn’t need to be changed. He and his co-workers repeated this research with children with sleepwalking disorders and those with sleep terrors. Later, they studied these same incidents in non-epileptic children and adults. In all cases, episodes began in deep non-REM sleep, never in REM “dreaming” sleep.
“The other thing we found — and this really was one of my bigger contributions — was in incidents of sleepwalking, sleep terrors and confusional arousals in the children or the adults, if you force awaken the subject in the deepest portion of slow wave sleep (which is the deepest sleep that we have) you can often precipitate an attack.”
Why was this significant?
Roger explained, “A lot of people at that time thought sleepwalking and sleep terrors were just exteriorized dreams; but it would be unreasonable to believe that the forced arousals provoking attacks were occurring at the exact moments when the ongoing dreaming or other mentation (unknown to the researcher) was about to cause an attack. Therefore exteriorized behavior of dreaming was no longer a rational explanation for somnambulism or sleep terrors.”
His career-defining paper, “Sleep disorders: disorders of arousal?” was published in the journal Science in 1968. It classified nocturnal enuresis, somnambulism, sleep terrors and confusional arousals as “disorders of arousal,” not of dreaming.
It was a breakthrough finding.
Ever since, sleep disorder classifications group sleepwalking, sleep terrors and confusional arousals as “disorders of arousal.”
Recognition in the sleep community
Roger returned to Canada in 1964, shortly before his seminal paper was published. He worked for four years in the Department of Neurology and Neurosurgery at McGill. He also worked in the Department of Clinical Neurophysiology at the Montreal Neurological Institute and Hospital, doing clinical work and research (which led to his PhD degree).
By the close of the 1960s, he had relocated to Ottawa where he extended his reputation as a prolific researcher and scholar on
- sleep and sleep deprivation (including sleep in unusual environments)
- sleep disorders (narcolepsy-cataplexy, movement disorders in sleep, etc.),
- performance decreases and evoked potential measures of sleepiness,
- chronobiology (wake/sleep rhythms) and
- epilepsy (he co-authored the book, Epileptic Seizures, with Professor Gastaut and played a major role in the writing of the WHO Dictionary of Epilepsy).
Roger also developed the world’s first commercialized automatic sleep analyzer (its prototype is in the Canadian Museum of Science and Technology).
For many years, Roger served as head of Neurology and director of the Department of EEG and Clinical Neurophysiology at the Ottawa General Hospital (now, Ottawa Hospital). From his arrival in 1968 until 2004, he was also the director of the hospital’s Sleep Centre. To his knowledge, this centre was “the first open referral, full-service sleep medicine centre in North America; and one of the first two or three in the world.”
In 1972–1975, Roger became the president of the world sleep research society, the APSS (Associated Professional Sleep Societies). In 1986, he was elected the founding president of the Canadian Sleep Society. He remains very active in the sleep community, regularly attending meetings. In 2003, the society honoured him with the creation of the “Roger Broughton Young Investigator Award.”
Dr. Broughton gives much of the credit for his successful career to the remarkable support staff, graduate students and foreign research fellows who worked with him. He also recognizes the strong and sustained financial support of the Canadian Institutes for Health Research.
Called to the stand: R. v. Parks (on sleep and aggression)
When asleep, are you culpable for your actions? That question made national and international headlines in the late 1980s during the murder trial of Mr. Kenneth Parks. Mr. Parks was accused of murdering his mother-in-law and attempting to murder his father-in-law. He confessed to the crimes, showing up at the police station shortly after they were committed. The catch? He claimed to have been asleep the whole time.
Roger was called to the stand as a medical expert for the defense in this case, whose “not guilty” verdict was appealed but eventually upheld at the Supreme Court level.
He explained, “The issue was if somebody is sleepwalking, are they aware of their actions and do they have control of their actions? The evidence is overwhelmingly no, they don’t. That’s one of the cardinal signs of sleepwalking. When sleepwalkers wake up they don’t know what they’ve been doing. While these cases are extremely rare, to the layperson it was unimaginable that sleepwalking could lead to a killing.”
The evolution of sleep medicine
Once relatively small, the sleep medicine community now numbers in the tens of thousands and is continuing to grow exponentially.
Roger explained, “Sleep was a mystery up until people decided to do objective research on it. I think there is much more acknowledgement, nowadays, of the importance of sleep, the need of obtaining quality sleep, and the importance of sleep medicine.”
Technological advances are also making it possible to map the genetic components of the various sleep states and sleep disorders.
Related: Read “Sleep Disorder Medicine in Canada: gaining traction.”
Roger now considers himself semi-retired (though his CV still notes various emeritus, board and editorial positions). Earlier this fall, he travelled from his home in France to Prague for the World Sleep Congress. He recently finished authoring two chapters for a new textbook on Sleep Medicine. He also agreed to be a guest editor of a special issue of the journal Sleep Medicine that will celebrate the life and contributions of the late Professor Michel Jouvet, who was known for decades as the preeminent of all sleep researchers.
“One of the great things about Sleep Medicine,” Roger summarized, “is that you can almost always help your patients. So, it’s very rewarding to the physician.”