I have found over the last few years of working for Capital EAP that, to a large extent, clients are not aware of how vitally important is their quality and quantity of sleep. Rarely do I learn from clients that they get enough sleep, or that they really value the importance of getting enough. Almost without exception, my clients have reported that they get less than the recommended required sleep in a 24 hour period, and for many of them they get much less sleep than that. A few months ago, a client told me that he has been getting about 3 hours a night over a period of several years, and he said “I’m fine with that.” I recommended to him the commonly understood number of hours advised by doctors, as I do with every client: eight per night.
I found many different definitions of sleep as a behavior and as a process. A nice, simple one is from Medline Plus: “sleep is a complex biological process that helps you process new information, stay healthy, and feel rested.” That is pretty easy to understand—no difficult medical jargon. To unpack this definition a bit, we can say that sleep is complex, it is biological, it is a process, it helps you integrate new information, and it is healthy. It is, of course, psychological as well as biological, as you know from experiences of sleep depravation and what that can do to your mind and your mental health. My hypothesis, having talked to thousands of people about their sleep habits, is that lack of sleep is directly related to the level of anxiety people are dealing with. And, as I talked about in previous articles for “The Mentor,” America is experiencing a pandemic of anxiety.
Here’s a definition of sleep from my favorite source, Wikipedia: “Sleep is a state of reduced mental activity in which consciousness is altered and certain sensory activity is inhibited.” I wonder what they mean by “reduced mental activity”? How reduced is it? And wouldn’t it be a different kind of mental activity from the waking state? The article goes on to say that “during sleep, there is a marked decrease in muscle activity and interactions with the surrounding environment.” That is obvious.
What about the amount of sleep we should get, how important is uninterrupted sleep, and how important is it to experience the various levels of sleep? The two categories of sleep are rapid eye movement sleep “REM,” and non-REM (or NREM). There are three NREM stages and following that is a REM cycle, when dreams are experienced. After a REM cycle, the sleeper starts a new sleep cycle. The average sleep cycle lasts about 90 to 120 minutes, and most people experience four or five sleep cycles per night when they get enough sleep. It is a pretty complicated process and very interesting to read about. The Cleveland Clinic has a nice article on this. See the list of resources below.
According to the National Institutes of Health, sleep is “a basic need, like eating, drinking, and breathing.” It is something that needs to be taken seriously. Think of Maslow’s hierarchy of needs. Without stablizing that first and basic level of the pyramid, one cannot find stability in the layers above it. Getting enough proper sleep is vital to the health and wellbeing of the individual. NIH reports that an estimated 50 to 70 million Americans have chronic sleep disorders. Sleep deficiency is linked to injuries, accidents in the home, broken bones, mistakes in judgment, memory problems, traffic accidents, etc. According to their surveys, nearly 40% of adults report falling asleep during the day when not meaning to do so.
According to an article on sleep deprivation and mental health published by Columbia University’s Department of Psychiatry, Americans were having trouble getting good sleep before COVID-19, and with the pandemic things have gotten even worse. They published a study in late 2021 with over 22,000 adults, showing that one third of them had clinical symptoms of insomnia, and 20% of them met criteria for a diagnosable sleep disorder. It showed that insomnia had doubled from rates prior to the pandemic! The article shows that sleep disturbances are linked to higher levels of psychological distress, including anxiety, depression, frustration, anger, confusion, and suicidal ideation.
Elizabeth Blake Zakarin, assistant professor of psychology at Columbia, was quoted as saying “Just like our electronics need to be charged, sleep resets and recharges the brain to optimize functioning” (https://www.columbiapsychiatry.org/news/how-sleep-deprivation-affects-your-mental-health). A good night’s sleep is critical to both mental and physical health. Good sleep is associated with everything in our lives: mood, attention, learning, memory, healthy appetite vs. cravings for junk food, problem solving, management of stress, and to overall healing of the body and mind. During sleep, the body repairs cells, discards damaged cells, stores memories, regulates metabolism, and removes toxic waste byproducts. An article called “The Neuroprotective Aspects of Sleep,” explains that when a person experiences sleep deprivation, “the glymphatic system of the brain does not have time” to cleanse itself of toxins (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4651462/).
I’ll be doing further research on this topic over the next few months and will continue to educate myself on the importance of sleep to mental health. So keep an eye out for part two of “Sleep and Mental Health.”
By: Terry McMaster, LMSW, EAP Counselor