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5 min readSleep problems are not just a symptom of mental health disorders—they can be a cause. Philip Gehrman, a professor of clinical psychology and psychiatry at the University of Pennsylvania who directs the sleep neurobiology and psychopathology lab, explains that dozens of longitudinal studies now show that people who have trouble sleeping but do not meet criteria for any mental health condition are roughly two to three times more likely to go on to develop depression, anxiety, or substance use disorder. Poor sleep, in other words, increases vulnerability to poor mental health. Yet most mental health providers receive virtually no education about sleep in graduate school, despite the fact that we spend a third of our lives doing it.
What happens in the sleeping brain
Sleep plays multiple critical roles for healthy brain functioning. It is tied to emotion regulation abilities and even to the clearance of waste products from the brain. The waste product that has been studied most is the protein beta amyloid, which is thought to play a role in risk for Alzheimer’s disease. One night of total sleep deprivation in healthy individuals is associated with a 20% increase of this protein in the brain. Gehrman notes that chronically not getting a good night of sleep may increase risk for dementia, and that inflammation may be one of the pathways for these associations.
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What you'll learn
- 1 (00:30) **Sleep as a Necessity, Not a Luxury** - Host Kim Mills introduces the episode's central theme: the critical role of sleep in mental and physical health, and the potential of sleep-based interventions for treating mental health disorders.
- 2 (02:29) **Why Sleep Matters for Brain Health** - Dr. Philip Gehrman explains the essential functions of sleep for the brain, including emotional regulation and the clearance of waste products.
- 3 (03:12) **Sleep as a Cause, Not Just a Consequence, of Mental Health Issues** - The discussion shifts to how the field now understands poor sleep as a risk factor that can precede and cause mental health problems.
- 4 (04:34) **Implications for Clinicians: A Wider Toolbox** - Dr. Gehrman discusses how this new understanding opens up treatment options for mental health professionals, emphasizing the effectiveness of sleep-focused therapies.
- 5 (05:20) **Sleep, Brain Cleaning, and Inflammation** - The conversation explores the link between sleep, the clearance of waste products like beta-amyloid from the brain, and its connection to inflammation and dementia risk.
- 6 (06:35) **The Prevalence and Impact of Insomnia** - Dr. Gehrman breaks down how common insomnia is and its two-fold impact on mental health: immediate next-day effects and long-term risk.
- 7 (08:04) **Effective Treatments for Chronic Insomnia** - The two main evidence-based approaches are compared: medication and Cognitive Behavioral Therapy for Insomnia (CBT-I).
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Show Notes
Too often, we treat sleep as something we can sacrifice when life gets busy. But a growing body of research finds that sleep is essential to both mental and physical health -- and that sleep problems can be a cause, not just a consequence, of conditions like depression and anxiety. Philip Gehrman, PhD, discusses what happens in the brain while we sleep; how insomnia and disrupted circadian rhythms affect mental health; why psychologists are paying more attention to sleep; and what all of us can do to get better, more restorative sleep.
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