Dr. José Luis Marín warns about the “slow suicide” of chronic sleep deprivation

Dr. José Luis Marín, president of the Spanish Society of Psychosomatic Medicine and Psychotherapy and director of Psychotherapy Training, recently presented a compelling technical paper analyzing the devastating effects of sleep deprivation on brain architecture. In this training session for clinicians, the doctor explained how the deprivation of rest alters the glymphatic system, preventing the clearance of metabolic waste and causing a state of chronic inflammation. According to Marín, sleep is not a passive state, but an active and unavoidable biological process for human survival and emotional stability.

The core of the news is based on the discovery that, during deep sleep, neurons reduce their size to allow cerebrospinal fluid to circulate and flush out toxins accumulated during the day. Marín describes this process as a cerebral “sewer cleaning” that only occurs when we get the necessary hours of sleep. If this process is systematically interrupted, the brain begins to accumulate beta-amyloid protein, the same substance found in the senile plaques of Alzheimer's patients. Therefore, sleeping too little is not a lifestyle choice, but a direct biological aggression.

The psychiatrist was emphatic in stating that habitually sleeping less than six hours constitutes a “slow suicide.” Current society, marked by productivity and screen use, has normalized prolonged wakefulness, ignoring that the brain needs this time of disconnection to consolidate memory and regulate emotions. When we don't sleep, the amygdala becomes hyperactive, placing us in a permanent state of alert. This phenomenon explains why lack of sleep generates irritability, lack of concentration, and a manifest inability to manage daily stress in patients.

During the intervention, the expert analyzed how lack of rest becomes a critical risk factor for the development of severe mental disorders. A brain that is not cleaned is an inflamed brain, and neurobiological inflammation is the basis of depression, anxiety, and psychotic episodes. Marín argues that many current psychiatric diagnoses could improve significantly if sleep hygiene were prioritized as a first-order clinical intervention. The clinician cannot limit themselves to treating sadness if they have not first assessed how many hours the individual actually rests.

A critical point of the presentation was the denunciation of the indiscriminate use of benzodiazepines to force sleep. Marín explained that these drugs often induce a state of sedation, but not quality physiological sleep. By taking pills, the patient “shuts down,” but does not enter the necessary phases for glymphatic clearance to occur. This creates a false sense of rest while the brain continues to accumulate neurotoxic waste. The doctor urged professionals to seek the root of insomnia, which is often linked to unresolved traumas or emotional deficiencies.

The relationship between sleep and relational trauma was another central theme of the session. The traumatized patient lives in a state of hypervigilance that prevents them from “surrendering” to sleep, as they perceive the loss of consciousness as a threat. For these individuals, sleeping means letting down their guard, something their nervous system does not allow due to past wounds. In these cases, insomnia is not the illness, but an adaptive defense mechanism that tries to protect the individual from a danger that no longer exists in the present.

Marín recommended that therapists stop viewing sleep as a secondary symptom and start considering it a biographical pillar. In consultation, the question about how the patient sleeps must be mandatory and profound. It is not enough to know if they sleep, but how they do it and what they feel upon waking. The presence of recurrent nightmares or fragmented rest are clear indicators that the brain is trying to process emotionally heavy information that has not been integrated during wakefulness. Authentic healing necessarily requires restoring the circadian rhythm.

The doctor also warned about the metabolic consequences of sleep deprivation, linking it to obesity and type 2 diabetes. When we don't sleep, the hormones that regulate hunger and satiety, such as leptin and ghrelin, become imbalanced. This pushes the individual to seek high-calorie foods to compensate for the lack of energy, creating a vicious cycle of systemic inflammation. A tired brain lacks the willpower to make healthy decisions, ultimately affecting the entire body's economy and life expectancy.

For the psychiatrist, sleep must be defended as a human right and a sacred biological necessity. He criticized the culture of “I'll sleep when I'm dead,” warning that this attitude only accelerates the process of physical and mental deterioration. The brain is an extremely delicate organ that requires rigorous daily maintenance. The medicine of the future, according to Marín, will involve understanding that brain health depends on this subtle balance between daytime activity and nighttime repair. Without quality rest, any other therapeutic intervention will see its real effectiveness limited.

In the final stretch of the training, it was emphasized that the treatment of insomnia must be multidisciplinary. It is essential to educate the patient on sleep hygiene, limiting the use of electronic devices and creating an environment of total darkness. However, Marín reminded that if insomnia persists, it is usually because there is a “story that doesn't let one sleep.” The psychotherapist's job is to help the patient descend into their own hells with a flashlight so that, once their biography is pacified, the nervous system can finally allow itself to rest.

The session concluded with a call for social responsibility from health professionals. Dr. Marín argued that the prevention of dementias begins decades before the first symptoms, by taking care of sleep quality today. A brain that cleans itself every night is a resilient brain capable of aging with dignity. True medicine is not only what cures, but what teaches the individual to respect their own biological rhythms. Only by recognizing the vital importance of sleep can one aspire to comprehensive and lasting mental health.