Sleep holds immense significance. However, despite the remarkable scientific and technological achievements of the 21st century, the remarkable advancements in sleep medicine largely go unnoticed, ignored, or dismissed by the majority of healthcare professionals.
The lack of clinical sleep knowledge is particularly evident in the treatment of individuals with mental health conditions, who frequently struggle with sleep disorders and frequently express their concerns.
Many people suffering from mental health problems such as anxiety, depression, PTSD, and suicidal thoughts also grapple with diagnosable and treatable sleep disorders. Unfortunately, these conditions are rarely examined or understood from the perspective of modern sleep medicine.
Instead, individuals facing mental health and sleep disorders are often told, sometimes for years, to believe in only two approaches to address their sleep issues. Firstly, their doctors and therapists, with good intentions, explain that once their mental health is restored, their sleep problems should disappear. In other words, the focus is on fixing the mental health issue as the primary cause of sleep problems.
Alternatively, they are prescribed a range of sedating medications listed in medical references. Mental health patients often hear both theories and are encouraged to take prescription or over-the-counter drugs until their mental condition improves.
However, these theories are incorrect for around 90 percent of individuals diagnosed with mental health disorders and co-existing sleep symptoms. Furthermore, they may prove completely wrong for those unfortunate individuals whose sleep disorders are more debilitating than recognized or properly treated.
This is why sleep is so crucial when it comes to mental health. The great news is that three decades of research have demonstrated that sleep problems are independent of mental health conditions and should be treated separately.
Interestingly, most mental health patients are already aware of this truth about sleep, while few healthcare professionals have paid attention to their advice. Mental health patients seek expert assessments and sleep treatments beyond medication because they recognize that better sleep will lead to improved mental health.
It is regrettable that it took healthcare professionals and researchers decades to scientifically unravel this valuable clinical insight, while patients intuitively understood and experienced it firsthand.
These facts have been repeatedly proven for conditions such as anxiety, depression, and PTSD, and to some extent for suicidal thoughts or behaviors. This information should be widely disseminated so that mental health patients can finally receive the sleep treatments they require. Specifically, potent, evidence-based interventions that are largely drug-free can improve sleep disorders associated with mental health complaints and sometimes even cure them.
The puzzling question, for now, is how so many healthcare professionals in various branches of medicine and psychology over the past three decades overlooked all this scientific evidence. The answer may surprise you. These well-meaning professionals followed the conventional belief that sleep is solely about the number of hours slept and uninterrupted sleep (sleep continuity).
However, this outdated theory regarding sleep quantity has been replaced by a biologically more relevant theory focused on “sleep quality.” Take a moment and consider how many times you have heard the phrase “quality over quantity” in your life. Sleep is no exception. Most healthcare professionals only consider sleep quantity or continuity, assuming that counting hours or uninterrupted hours is the key factor in sleep disturbances. Since they primarily deal with individuals struggling to fall asleep or stay asleep (insomnia), it seems logical to focus on sleep duration. However, nearly all insomniacs also experience nonrestorative sleep, meaning poor sleep quality, which often plays a more significant role in fueling insomnia.
But the problem goes beyond insomnia. The bigger issue is the implicit and explicit biases suggesting that sleep disturbances in mental health patients are solely caused by psychological factors. While this “it’s-all-in-your-mind” approach is partially correct, it overlooks a significant, unexpected, and physical aspect.
The mind resides in the brain, and the brain is where sleep can be observed most directly. How do we observe sleep in the brain? It’s simple—the brain generates specific, physiologically driven electrical impulses that measure the depth and quality of sleep. It is essential to understand that sleep, in all its aspects, includes a physiological (physical) dimension. Therefore, it is inaccurate to attribute sleep problems in mental health patients strictly to psychological causes.
Sleep measurement is comparable to measuring electrical impulses from the heart. Rarely is someone’s heart arrhythmia solely caused by psychological factors. So why do we assume that sleep problems must be exclusively psychological?
There is much more to learn as we delve deeper into sleep physiology, which will enhance your understanding of the significant impact sleep has on your health. Have you ever come across conditions like kidney or liver failure where major organ systems fail to eliminate toxic waste from the body, leading to death? Similarly, “brain failure” is a condition that evokes thoughts of head trauma, severe strokes, or comas. However, brain failure associated with sleep is a gradual process, although it can have deadly consequences because the brain also needs to remove toxic waste. And you might be surprised to learn when the brain is most active and effective in eliminating this toxicity.
If you guessed “during sleep,” you’re on the right track, but it’s not just any sleep—it’s deep sleep. The deeper you sleep, the better your brain’s cleansing system functions. This brings us back to the point that achieving deep sleep requires attaining the highest possible sleep quality.
Now you understand that counting hours of sleep can be as futile as counting sheep. As we guide you towards new and exciting possibilities to help you improve your sleep quality and, consequently, enhance brain and mental health, we’ll start by offering practical advice on how you can measure your own sleep quality.
Please take the time to reflect on these points, as they may just save your life.