One of the concerns that Dr. Walker shares in our recent podcast discussion are that many times the very substances we take in to help us sleep, may have subtle effects that ultimately undermine the enormous beneficial qualities that underpin sleep itself — something covered in great detail in the episode — by changing the architecture of sleep.
Alcohol, which many people appreciate for its ability to sometimes initially promote sleep owing to its qualities as a sedative, ultimately promotes fragmented sleep and can impact REM sleep. Moreover, the way alcohol impacts sleep can change between the beginning of your sleep and the latter portion as the ethanol levels decline throughout the sleep period.
More concerning than alcohol, however, is that sleeping pills may have under-appreciated effects as well: changes in the electrical signature of sleep, changes in susceptibility to infection and possibly cancer (associative data), and a reduction in neural plasticity in an animal research paradigm called “monocular deprivation” which tests the ability of the visual cortex to produce changes in ocular dominance.
While it may not be that surprising that if you alter the architecture of sleep — though nothing alters it as much as simply not getting it — that some of the benefits it clearly has been shown on the brain and the immune system might be subtly undermined. Even a partial night of sleep deprivation been shown to cause decline of ~30% in Natural Killer T cell activity.
Perhaps it is because of emerging research such as this, that the American College of Physicians has made the recommendation the sleeping pills no longer be the first-line recommended treatment and instead recommend Cognitive Behavioral Therapy for Insomnia in its place, mentioned by Dr. Walker.
Relevant pubs:
• “Polysomnographic sleep disturbances in nicotine, caffeine, alcohol, cocaine, opioid, and cannabis use: A focused review.”
• “Partial night sleep deprivation reduces natural killer and cellular immune responses in humans.”
• “The Non-Benzodiazepine Hypnotic Zolpidem Impairs Sleep-Dependent Cortical Plasticity”
(And, of course, Matt’s book Why We Sleep)
- - -
re:
Dr. Matthew Walker on Sleep for Enhancing Learning, Creativity, Immunity, and Glymphatic System