When you're sitting with a patient who is tired, anxious, inflamed, or chronically unwell, one of the simplest questions you can ask is this:
How well are you sleeping?
Sleep is often treated as a secondary issue to address once the “main problem” is under control. Yet from a physiological perspective, sleep is not optional. It's one of the most fundamental processes that sustains life.
Every organism on earth sleeps. Even fish display sleep-like states, and other simple organisms such as worms move through cycles of activity and rest. When sleep is removed entirely, life begins to break down.
In the 1980s, a series of sleep deprivation experiments in rats demonstrated just how essential sleep is to survival. In these studies, rats were prevented from sleeping continuously. Despite eating more food than usual, the animals progressively lost weight, developed lesions on their tails and paws, and became increasingly debilitated. All of them died within two to four weeks.
Modern sleep research shows that insufficient sleep affects almost every system in the body and studies have linked chronic sleep deprivation with increased risk of conditions such as type 2 diabetes, cardiovascular disease, depression and anxiety, cognitive decline and Alzheimer’s disease.
Sleep researcher Matthew Walker has highlighted the importance of sleep for immune function, noting that regularly sleeping less than six or seven hours a night can significantly weaken immune defences. He has also done research into the real-world consequences of sleep deprivation. For example, road safety research suggests that fatigue contributes to a significant number of accidents comparable to, or exceeding, those caused by alcohol.
So if you're working with people who present with chronic inflammation, immune dysregulation, hormonal imbalance or persistent fatigue, it's worth remembering how strongly these processes are influenced by sleep.
Sleep really is a mystery. From an evolutionary perspective, sleep seems quite impractical - even dangerous. Think about it: for nearly a third of our lives we lie in a vulnerable state with our eyes closed, muscles relaxed, and little awareness of our external environment!
Aristotle suggested that sleep occurred when vapours from digesting food rose from the stomach and “gassed” the brain. Later scientists proposed that blood rose into the head during sleep, temporarily shutting the brain down. And although sleep was once thought to exist mainly to conserve energy, research now shows that the energy savings are surprisingly small. For example, a person weighing around 90kg burns roughly 80 calories per hour during sleep, compared with about 95 calories per hour when sitting quietly awake. The difference across an entire night is relatively small.
Sleep therefore serves far more important purposes than simple energy conservation.
Although the body appears to be resting, sleep is actually a time of intense physiological maintenance and repair and during sleep, a range of biological processes take place:
When you’re working with people whose health seems unable to stabilise or recover, it's often worth looking carefully at the quality of their sleep. Fragmented, insufficient or non-restorative sleep can quietly undermine many other aspects of their health.
Sleep is not the only form of rest the brain requires and if you have a patient struggling to sleep at night, suggest they make time to rest during the day.
Neuroscience research has shown that when we are not actively engaged in tasks, for example when we are daydreaming, resting quietly, or allowing our minds to wander, certain regions of the brain become active. Together these regions form what is known as the Default Mode Network.
This network becomes active when we reflect on past experiences, imagine the future, explore social and emotional themes or make sense of our experiences. These processes help us integrate what we have learned and adapt to our environment as well as replenishing attention and motivation, and supporting creativity and learning.
Yet many people today live with almost no true mental rest. Their days are filled with work, screens, constant stimulation and little opportunity for the mind to slow down.
Encouraging patients to build small pockets of quiet, restorative downtime into their day is an important step in supporting nervous system recovery.
When sleep difficulties are connected to mental overactivity or nervous exhaustion, the tissue salt Kali Phos can sometimes provide gentle support.
Kali phos is traditionally associated with states of nervous fatigue and situations where the mind feels overstimulated yet depleted at the same time. Clients may describe difficulty switching their thoughts off at night, hypersensitivity to noise or stimulation, or a sense of mental exhaustion.
While it is not a stand-alone solution for insomnia, Kali Phos can sometimes help settle an overwrought nervous system and support recovery in people experiencing burnout, brain fog or prolonged stress.
From a nutritional perspective, foods rich in potassium and phosphorus may also support nervous system health. These include:
It can be tempting to focus on sophisticated interventions, complex formulas, intricate prescribing strategies, or advanced therapeutic techniques when working with clients.
Yet again and again we are reminded that health rests on a few fundamental pillars - sleep, nourishment, movement, emotional balance and restorative rest. When these foundations are neglected, the body struggles to maintain equilibrium.
Sleep, perhaps more than anything else, reminds us that healing often begins not with doing more, but with allowing the body the time and space it needs to restore itself. Next time you have a patient you are struggling to help, ask yourself how well they're sleeping? And if they're not sleeping, are they at least allowing themself to rest?
If you enjoy reflecting on how physiology, lifestyle and therapeutics weave together in practice, you may enjoy continuing the conversation in my practitioner learning groups where we explore these themes together through discussion and shared clinical experience. You can find out more here ->
Please note: The reflections shared in this Practitioner’s Notebook are intended to encourage curiosity and thoughtful exploration among practitioners and students of natural and integrative health. They are not intended to replace structured professional training, clinical supervision, or independent clinical judgement. Practitioners remain responsible for applying appropriate professional standards and referring patients for medical care where appropriate.
Photo by Sincerely Media / Unsplash
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