Getting enough sleep allows the brain to cycle through the two main functions of sleep
We know sleep is important, but why is it important? There are two functions of sleep — and likely more we haven’t discovered, says Dr. Amy Kruse. “One function is to help our brains clean themselves out,” she says. “A lot of proteins and detritus from our daily lives accumulate in our brains.” Slow-wave sleep helps remove what doesn’t need to be there. The other known function of sleep is memory formation and consolidation, which happens during REM sleep and is associated with dreaming. These different roles in sleep is “one reason why healthy sleep [and] long-enough sleep times are important because our brains need to cycle through those stages,” Dr. Kruse explains. “If you don’t sleep enough or if you have disturbed sleep, your brain isn’t able to go into those stages.”
Some best practices for good sleep hygiene include regular sleep and wake times, reducing light and screens an hour before bed, and not eating close to bedtime. “I realized that my body tends to wake up at the same time every morning, so if I wanted to get more sleep, I actually had to go to bed earlier, not sleep in,” says Dr. Kruse of her own sleep hygiene. “That has actually given me more energy in the morning to then exercise and get rolling.”
As we age, we have to engineer our sleep better
We typically sleep less as we age and spend less time in slow-wave sleep. “So unfortunately, as we age, we get shorted on some of the most restorative elements of sleep,” says Dr. Kruse. She recommends doubling down on what we know affects and impacts sleep: good nutrition and hydration, reducing caffeine, and exercising. “All of those things can help push us back into slow-wave sleep bouts and the more restorative form of sleep. We really have to, as we age, engineer our sleep a little bit better.”
Neurotechnology will aid sleep better than any sleep medication
Neurotechnology is a growing space, and there’s a lot of it out there. “I really think sleep will be the first thing where we see an intervention, not just a wearable or a recording device,” says Dr. Kruse. On the consumer side, there are headbands that measure the stages of sleep and deliver electrical stimulation to the brain during slow-wave sleep to drive certain frequencies. On the clinical side, researchers are looking at using low-intensity ultrasound to modulate the brain in cases of insomnia and other shift work disorders.
These tools are moving us towards what Dr. Kruse sees as the “golden age of sleep,” one where neurotechnology overtakes prescription sleep aids, which can impact your sleep structure. “Infrequent use [of drugs like Ambien] is probably okay. However, sustained use drives the nervous system,” says Dr. Kruse. “You just don’t want to go there.” That’s why this emergence of neurotechnology is so exciting. “Any time you can avoid taking a prescription if you don’t have to is advantageous.”
Our new understanding of the networks in the brain will allow for more effective mental health therapies
“Plasticity and neuroplasticity is one of humanity’s greatest gifts,”
“Plasticity and neuroplasticity is one of humanity’s greatest gifts,” says Dr. Kruse. As we age, we can learn new information, new skills, new languages. “Engaging the neuroplasticity of the brain is a way to not only bolster against cognitive aging, but also develop resilience in the brain and nervous system.”
This understanding plays into the renaissance with psychedelics, what Private Medical is calling neuroplastic therapeutics. “When the great chemists came up with SSRIs, [including] Prozac, it really was that synaptic molecular view of the brain, like, we just fix the synapses,” explains Dr. Kruse. “Now we have a much more functional understanding of the networks in the brain and how they’re interacting with one another.”
What we’re seeing in people’s experiences with psilocybin and other medicines is that they’re shifting these networks in the brain. “You’re having this reset experience that allows you to — I’m going to use a euphemistic term — get out of your own head,” she says. In Michael Pollan’s How to Change Your Mind, he refers to this as the ego death — a quieting of the default-mode network (Dr. Kruse thinks of this as the “thinking-about-yourself network”).
Maintaining that plasticity while in therapy or counseling “allows you to then cement those new changes in a way that transforms the networks in the brain in a very holistic way, meaning from a functional network perspective, not just getting in there and futzing with the synapses.”
The future of our “neuroscience toolkit” will give us more control over our cognitive states
Another emerging area of interest for Dr. Kruse is neurostimulation — using noninvasive techniques to stimulate the brain, including electricity magnets and low-intensity ultrasound to try and target some of these same areas and networks from outside the brain.
“What I think is really exciting about what’s happening right now is that we have kind of this renaissance in these old medicines and… we have this whole emerging space of brain stimulation, peripheral nerve stimulation, [like vagal nerve stimulation used for stroke and PTSD recovery] that also is a network into the brain for long term changes.” Dr. Kruse sees these new techniques as a new “neuroscience toolkit that will give us access to both drug therapeutics as well as neurostimulation therapeutics” instead of a one-size-fits all approach.
“I believe that eventually using all of these tools and techniques that we’ve talked about, we will be able to dial in the particular mental states, cognitive states that we want to be in of our own doing,”
Dr. Kruse posits that, in the future, we’ll be able to choose specific mental states, like “focus” and “good sleep.” “I believe that eventually using all of these tools and techniques that we’ve talked about, we will be able to dial in the particular mental states, cognitive states that we want to be in of our own doing,” says Dr. Kruse.