Worrying, grinding, tossing. You barely slept a wink. And yet you feel rested the next day. Did you sleep more than you thought?
Last night it happened again. He hadn’t been in bed for two hours before he woke up again. Even earlier than usual, at 1.20 am. Then the turning from one side to the other begins. He fears the worst for the next day at work, he is a training manager in secondary vocational education, 57 years old. But to his surprise, he often feels remarkably energetic during the day. Is it true that he slept so little?
The prevailing idea is still that a major switch flips in the brain when you fall asleep, says Eus van Someren, sleep researcher at the Netherlands Institute for Neuroscience and professor of neurophysiology at VU University Amsterdam. “That you are either asleep or awake. Patients with insomnia are sometimes sent home as posers if they do see sleep waves in the lab.”
Scandalous, says Van Someren, because sleeping and waking can certainly go together. “We think that one of the brain nuclei continues to produce the substance noradrenaline, which is important for all waking activities. It results in restless sleep, where it can feel like you’re just practicing and waiting to fall asleep. That remains horrible.”
Some people panic after a period of restless sleep. “They wonder how many days they have left before they fall over. You cannot do without sleep, animal research shows that you eventually die from lack of sleep. So the longer it takes, the fear and gloom in many people increases.”
In fact, epidemiological studies show that anxiety disorders and depression often start with poor sleep, says Van Someren. “Many psychiatrists think this is a side effect of the depression. It seems the other way around. But how? How does poor sleep lead to anxiety and gloom?”
Emotions and facts are disconnected
REM sleep, the phase in which emotions are processed, plays a key role in this. “Suppose you see a traffic accident during the day, a cyclist is hit by a truck at an intersection, then such an incident or fact becomes intertwined with emotions. When you retell it hours later, your heart beats in your throat again. But in the days that follow, those bodily reactions normally lose their sharpness. And that, we think, is because REM sleep disconnects facts from emotions.”
Those who sleep well, are a lot less emotional the next day at the memory of the accident. But that does not apply to the bad sleepers. “If you keep shooting out of REM sleep, it can even bother you more the next day. The connections between facts and emotions then turn out to be even more closely intertwined.”
If such a bad sleeper then walks past a random intersection, the same emotions can just be triggered again, says Van Someren. “The traffic accident is an extreme example, but if you don’t lose the tension from all the daily things, the emotions can pile up. Something that can easily turn into an anxiety disorder or depression.”
If doctors see a patient with poor sleep and depressive symptoms, Van Someren recommends that they first give a sleep treatment. “You provide education and tips. Don’t spend too long in bed, don’t take naps during the day, and learn to relax. As a result, people sleep better, but as it turns out, the depressive symptoms also decrease substantially.”
Van Someren is now looking through ‘sleep register.nl’ for people who will soon start an anxiety treatment. This is to test whether a sleep treatment for an anxiety disorder works just as ‘fantastic’ as for a depression.
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