Medical-psychological implications of recent sleep research.

Abstract

Recent sleep research has shown that the conventional concept of sleep as a period of inactivity for recovery from fatigue is outmoded. Active neurophysiological mechanisms regulate the sleep cycle in a manner similar to other circadian rhythms. The slow wave (NREM) part of the sleep cycle appears to be involved in recovery from muscular fatigue; the dreaming (REM) part appears to be involved in psychological adaptation to life events. Since most hypnotic drugs suppress REM sleep, they should be used after careful consideration of the possible psychological effects. For example, some depressions may be alleviated by agents which suppress dreaming at the cost of isolating the patient from his inner emotional life. Chloral hydrate, chlordiazepoxide, and diazepam avoid this problem because they do not affect REM sleep. Some sleep disorders like severe nightmares may be treated by suppressing deep NREM sleep. Other disorders like enuresis and narcolepsy appear to be psychosomatic conditions and require a medical psychological-approach. There is some evidence that methods which increase or substitute for REM sleep may eventually be useful in facilitating emotional adjustment.