Chapter 7:
Our brain scanning experiments in healthy individuals offered reflections on the relationship between sleep and psychiatric illnesses. There is not major psychiatric condition in which sleep is normal. This is true of depression, anxiety, post-traumatic stress disorder (PTSD), schizophrenia, and bipolar disorder, once known as manic depression. Psychiatry has long been aware of the coincidence between sleep disturbance and mental illness. However, a prevailing view in psychiatry has been that psychiatric illness caused sleep disruption, a one-way street of influence. Instead, we have demonstrated that otherwise healthy people can demonstrate a neurological pattern of brain activity similar to that observed in many of these psychiatric conditions simply by having their sleep disrupted or blocked. Indeed, many of the brain regions commonly impacted by mood psychiatric disorders are the same regions that are involved in sleep regulation and impacted by sleep loss. Further, many of the genes that show abnormalities in psychiatric illnesses are the same genes that help control sleep and our circadian rhythms. Had psychiatry go the causal direction wrong, and it was sleep disruption instigating mental illness, not the other way around? No. I believe that it is equally inaccurate and reductionist to suggest. Instead, I firmly believe that sleep loss and mental illness is best described as a two-way street of interaction, with the flow of traffic being stronger in one direction or the other, depending on the disorder. I'm not suggesting that all psychiatric conditions are caused by absent sleep. However, I am suggesting that sleep disruption remains a neglected factor contributing to the instigation and/or maintenance of numerous psychiatric illness, and has powerful diagnostic and therapeutic potential that we are yet to fully understand or make use of.
Later in Chapter 7:
"...The hippocampus, the information inbox of the brain that acquires new facts. There was lots of healthy learning activity in the hippocampus in the participants who had slept the night before. However, when we looked at this same brain structure in the sleep deprived participants, we could not find any significant learning activity whatsoever. It was as though sleep deprivation has shut down their memory inbox, and any new incoming information was simply being bounced. You don't even need the blunt force of a whole night of sleep deprivation. Simply disrupting the depth of an individual's NREM sleep with infrequent sounds, preventing deep sleep and keeping the brain in shallow sleep, without waking the individual up, will produce similar brain deficits and learning impairments."
Chapter 11:
"...the causes of the sleep problem must stand alone in order for you to be suffering from true insomnia. The two most common triggers of chronic insomnia are psychological. One: emotional concerns or worry, and two: emotional distress or anxiety. In this fast-paced information-overloaded modern world, one of the few times that we stop our persistent information consumption and inwardly reflect is when our heads hit the pillow. There is no worse time to consciously do this. Little wonder that sleep becomes nearly impossible to initiate or maintain, when the spinning cogs of our emotinal mind start turning, anxiously worrying about things we did today, things that we forgot to do, things that we must face in the coming days, and even those far in the future. That is no kind of invitation for beckoning the calm brain waves of sleep into your brain."
Chapter 13:
"It is clear that a tired, under slept brain is little more than a leaky memory sieve, in no state to receive, absorb, or efficiently retain an education. To persist in this way is to handicap our children with partial amnesia. Forcing youthful brains to become early birds will guarantee that they do not catch the worm, if the worm in question is knowledge or good grades. We are therefore creating a generation of disadvantaged children, hamstrung by privaiton of sleep. Later school start times are clearly and literally the smart choice. One of the most troubling trends emerging in this are of sleep and brain development concerns low-income families, a trend that has direct relevance to education. Children from lower socioeconomic backgrounds are less likely to be taken to school in a car, in part because their parents often have jobs in the service industry, demanding start times at or before 6am. Such children therefore rely on school buses for transit, and must wake up earlier than those taken to school by their parents. As a result, those already disadvantaged children become even more-so because they routinely obtain less sleep than children from more affluent families. The upshot is a vicious cycle that perpetuates from one generation to the next, a close-looped system that is very difficult to break out of."
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