Dr. Matt Walker

So focus on all of those four macros of sleep, quantity, quality, regularity, and timing.

And notice that if you want to try to optimize some of those, that emotional reactivity imbalance, you may want to...

slightly over-index on your REM sleep in that regard.

And one easy, cheap way of doing that, if you can, lifestyle permitting.

And again, of course, I understand everyone has a life to live and pressures, but that's the way that if you were to ask me, can you do it and do it simply?

Yes, you probably can.

Great.

It is because if you look at the diagnostic criteria for PTSD, firstly, you see sleep disturbance.

And as I said, right at the top of this episode, there is no major psychiatric disorder where there isn't some mention of sleep problems in its diagnostic criteria.

But something else was intriguing about PTSD that compelled me to think about it and then create a theory around it.

It's not just sleep problems, it's also nightmares, and specifically repetitive nightmares.

In fact, repetitive nightmares form part of the diagnostic criteria for you to receive a diagnosis of PTSD.

That's how reliable they are.

And as I thought more about this model of overnight therapy, this notion that sleep, and particularly REM sleep, provides a form of emotional first aid, PTSD stood out to me as something that I had to return to to explain.

Why?

if you think about ptsd and a veteran it is the perfect example of the process that i described of emotional deep potentiation failing because what i started to realize is that in ptsd there is this trauma experience and then perhaps what's happening is that sleep

the brain goes back to sleep that night and says, okay, please do your elegant trick of stripping away the emotion from the memory, and it fails.

So then what happens the next night?

The brain comes back and says, I'm sorry, but I still got this very emotionally charged memory.

Please do your elegant dissipation, depotentiation of the emotion from memory, and it fails again, almost like this broken record that was so indicative of these repetitive nightmares.