The Flow (and Ebb) of Sleep

That sleeping well plays a vital part in a good and happy life has been understood for about as long as human beings have been understanding things.

A recent article in the New York Times underscores this connection between sleeping well and feeling good. It reports on a study finding that curing insomnia in people with depression—and more than half of depressed people suffer from insomnia—”could double their chance of a complete recovery.” Scientists are finding that insomnia can lead to depression, just as being depressed can lead to insomnia: the conditions are mutually reinforcing. (To be diagnosed with insomnia you must have “endured at least a month of chronic sleep loss that has caused problems at work, at home or in important relationships.”)

The good news for insomniacs is that this research used talk therapy rather than drugs—sleeping pills are not that effective and they have side effects, as I pointed out in an earlier post on some facts about sleep. Instead of drugs, researchers used cognitive behavioral techniques to teach “people to establish a regular wake-up time and stick to it; get out of bed during waking periods; avoid eating, reading, watching TV or similar activities in bed; and eliminate daytime napping.”

Why is sleep so vital? A recent article in Science News reports that “Sleep hoses garbage out of the brain, a study of mice finds.” Ms. Saey continues, “The trash, including pieces of proteins that cause Alzheimer’s disease, piles up while the rodents are awake. Sleep opens spigots that bathe the brain in [cerebrospinal] fluids and wash away the potentially toxic buildup.” This process is aided by glial cells in the brain that swell and shrink to control fluid flow. When awake, the cells expand and reduce flow; when asleep the cells contract and the faucet opens. The region between brain cells changes in volume by at least 60 percent.


A psychologist I know once observed that in her experience sleeplessness and insomnia can be a method people use (unconsciously) to numb themselves to their feelings. People suffering in one way or another—whether from high stress, unsatisfying jobs or relationships, or other personal problems—often seek ways to block the psychic pain by using drugs, alcohol, TV and other entertainments, or sleeplessness as ways of dulling their awareness. I’ve certainly noticed that when I haven’t been sleeping well I feel more emotionally disconnected and zombie-like. It feels as though there’s something obstructing the flow of thought and feeling.

It’s striking that science’s mechanical explanation of what happens in the brain during sleep resembles these phenomenological observations about the mind. In both cases, good sleep promotes flow, whether it be the flow of cerebrospinal fluid flushing the day’s detritus from the brain, or the flow of thought and feeling during our waking lives. How symbolically apt that using sleep deprivation to block suffering while we’re awake might be mirrored by increased blockage in the brain.

It may turn out that in most cases the cerebral blockage that could contribute to depression, as well as to serious neurodegenerative disorders such as Alzheimer’s, is caused by our minds, not our bodies. In other words, while insomnia and depression are both mind-body phenomena, the evidence suggests that sleeplessness primarily stems from the kind of life we’re leading.

This is hardly a novel or surprising conclusion, but it does raise a host of questions, some of them discomfiting and controversial. Might it be that sleeping well, like exercising and eating well, is a virtue? Could it be that sleeping poorly reflects badly on our character? Such thoughts are hardly likely to ease the mind of the insomniac seeking sleep.

I’ll address these matters in a future post, but for now we may all rest (well, I hope) in the assurance that it’s simplistic to imagine we’re entirely to blame for poor sleep patterns.

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One Response to The Flow (and Ebb) of Sleep

  1. mwfogleman says:

    Hi Gary,

    I enjoyed thinking about this post. Something like sleep apnea, which I fear I suffer from (although I wasn’t diagnosed when I did a sleep lab last year), would seem to suggest that your qualifying last sentence is right.

    You may find this article by Piotr Wozniak (of late, one of my heroes) of interest:

    The rest of that site is pretty interesting too.


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