Dr. Charles Czeisler said Jackson's request for a teleprompter to remember the words to his classic songs "was shocking and indicated to me the profound impact this sleep deprivation was having on his memory."
Czeisler, who has a medical degree and a doctorate, testified that propofol brings on "a drug-induced coma" that is far different from sleep. Not only does it not satisfy the body's need for rest, it dissipates the sleep drive, "leading to a massive sleep deficiency."
"That is what I believe happened in the case of Mr. Jackson," Czeisler testified.
He said the symptoms Jackson exhibited — laid out in emails and testimony from people who watched him during rehearsals for his scheduled London concerts — were "consistent with what you might expect to see in someone suffering from total sleep deprivation over a chronic period of time."
He said the emails provided better descriptions than observations researchers make during their experiments.
"The meticulous detail of his deterioration was both profound and sad," the tall, white-haired Czeisler said.
Those symptoms included weight loss, paranoia, anxiety, chills, difficulty with balance and an inability to perform his dance steps.
Jackson died June 25, 2009, of an overdose of propofol that Dr. Conrad Murray administered at the singer's rented Holmby Hills mansion to treat his insomnia. Murray was convicted of involuntary manslaughter.
The suit against AEG Live and two of its executives was brought by Jackson's mother and three children. They say AEG, which was promoting and producing the concerts, negligently hired and controlled Murray. The entertainment giant says that the doctor worked for Jackson and that any money it was supposed to pay him was an advance to the singer.
Czeisler testified that based on records he reviewed, Murray ordered more than four gallons of propofol in April, May and June 2009. "It's a stupendous amount," he said.
The sleep expert said that according to the toxicology report, the amount of the anesthetic in Jackson's system was the same as a patient undergoing major abdominal surgery. The drug is not approved for use to treat insomnia.
The Harvard professor said that based on the records, Jackson was receiving propofol from Murray for 60 days.
Czeisler, who never treated Jackson personally, said Jackson had sleep problems for decades but it was not disabling most times. The condition, however, was exacerbated by the anxiety brought on when he was on tour or preparing for one.
"It was rather mild when he was not in tour mode or tour preparation mode," Czeisler said. "It was disabling to him when he was on tour or preparing to tour."
Czeisler also testified that a nurse and another of Jackson's doctors suggested he visit a sleep expert, but the singer refused.
jeff.gottlieb@latimes.com
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