Dr. Matt Walker

You can say, well, perhaps that's because Matt, you also spoke to me that REM sleep may be important for some aspects of the emotional brain.

And when you are depressed, the brain knows that REM sleep is required and it calls it up on the menu of the series of dishes that you're going to be served earlier on in the night because it's needed more significantly.

The other, and that's the adaptive theory, the other is the maladaptive theory, which is that arriving...

with your REM sleep too early does not do your brain good things.

And therefore it's some abnormality of emotional processing.

The data that's interesting there is that if you look at some antidepressants, many of them will either delay the onset of REM sleep or they will reduce it significantly.

Now, there's a huge debate about the efficacy and the utility of antidepressants, and I don't have a horse in that race, and I don't know enough about that literature to comment.

I would simply say, though, that it's at least intriguing to me that some medications that

that are commonly prescribed as antidepressants will alter specifically REM sleep and push it later or try to reduce it down.

And that would fit with the maladaptive hypothesis that this arrival of REM sleep so early in depression and perhaps having a little too much REM sleep isn't optimal.

And when you push back against that with pharmacology, i.e.

antidepressants, you seem to get some degree of resolution or reduction

in the depression symptomatology.

Again, I don't think we clearly understand that.

Another strange thing that has been often cited to me many times about sleep and depression is a literature that suggests that if you deprive people of sleep, which time and again in this episode we've said leads to bad outcomes for mental health, it does exactly the opposite in depression.

That if you sleep deprive a depressed patient,

you get a resolution of the depression.

And that is the claim that's often made to me.

Now, it is a very clear set of data in the literature, but there are two potential concerns with it.

The first concern is that not all patients respond to sleep deprivation.