Primer on Neurobiology and Neuropsychiatry of Sleep – Application to Clinical Practice
Humans spend 1/3rd of their life sleeping. Sleep is critical to adaptive human functioning with its links to cognition, mood, activity, immune regulation, metabolic and endocrine health.
Innocent sleep. Sleep that soothes away all our worries. Sleep that puts each day to rest. Sleep that relieves the weary labourer and heals hurt minds. Sleep, the main course in life’s feast, and the most nourishing―William Shakespeare, Macbeth (2.2.50–52).
Both poor sleep quality and sleep deprivation increase the risk of physical and psychiatric morbidity, with poor sleep quality showing a more significant effect.
The top three factors determining subjective sleep quality are: [Ramlee et al., 2017]
- Total sleep time.
- How one felt after sleep.
- Whether one felt refreshed upon waking and subsequently experienced a good mood during the day.
Thus, subjective poor sleep quality reflects a failure of overnight brain processes that promote waking up feeling good.
Pandi-Perumal, S. R., Smits, M., Spence, W., Srinivasan, V., Cardinali, D. P., Lowe, A. D., & Kayumov, L. (2007). Dim light melatonin onset (DLMO): a tool for the analysis of circadian phase in human sleep and chronobiological disorders. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 31(1), 1-11.
Isotalus, H. K., Carr, W. J., Blackman, J., Averill, G. G., Radtke, O., Selwood, J., Williams, R., Ford, E., McCullagh, L., McErlane, J., Durant, C., Bartsch, U., Jones, M. W., Wearn, A. R., Grogan, J. P., & Coulthard, E. J. (2023). L-DOPA increases slow-wave sleep duration and selectively modulates memory persistence in older adults. Frontiers in Behavioral Neuroscience, 17