Patrick M. Fuller, PhD, MS, a neuroscientist who studies how the brain regulates sleeping and waking, is a professor in the UC Davis Department of Neurological Surgery and vice chair for research. He discusses what scientists know about sleep and insomnia, why sleep is so important for health (including brain health), and what habits facilitate a good night’s sleep. 

What happens to your brain health when you don’t get enough sleep?

Sleep deprivation affects your ability to remember and concentrate. Sleep-deprived people have a compromised ability to make good decisions. Your reaction time is also reduced. A sleep-deprived driver has the same poor response time as someone who is legally intoxicated. Not getting enough sleep makes us more emotionally unstable. We can have really strong emotions, such as extreme sadness or anger, simply driven by a lack of sleep. 

What is insomnia?

Insomnia is a major health condition in which you have trouble falling or staying asleep (or sometimes both). Insomnia can be primary or secondary. Primary insomnia is not associated with any other identifiable medical condition. The diagnosis of primary insomnia is a complex clinical task. It typically requires a full psychiatric and medical exam and a workup in a sleep lab. Secondary insomnia means there is another medical condition, often a neuropsychiatric one, driving the insomnia. Most people have secondary insomnia caused by something else like depression or anxiety. 

Also, there are different forms of insomnia. You can have onset insomnia, or the inability to fall asleep. You can have maintenance insomnia, which is difficulty staying asleep. And then there’s terminal insomnia, where you wake up too early and can’t get back to sleep. 

What’s happening in your brain when you have insomnia?

There is now a consensus in the sleep field that insomnia is a state of hyperarousal. Your brain’s arousal system is amped up, and your sleep system can’t turn it off. 

Any final advice for those who struggle to sleep?

It’s really helpful to have a bedtime routine you enjoy. Your routine should be individualized to what you like and find comforting. So, if you like doing word puzzles, reading or listening to quiet music, that’s great. Some people find a cup of warm milk at bedtime comforting. Others might find warm milk revolting, but like having a cup of herbal tea. Whatever you enjoy. We think of routines as important to kids, but even though we are adults, our brains still like comforting routines, and they can facilitate sleep at night.

And finally, I think we have established as a cultural norm that sleep is expendable to a certain degree. How often have you heard, “I pulled an all-nighter” or “I only need four hours a night of sleep?” Unfortunately, statements like these have become badges of honor in our culture. I think one of the greater gifts we can give ourselves and the next generation is an appreciation and respect for a good night’s sleep.

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