When asked to name a person’s most basic needs, most people will reliably name food, shelter and clothing. A quick Google search adds air, safety, warmth, health and sex. Sometimes one or two other ideas like companionship get tossed out, and Wikipedia adds sanitation, education, healthcare and internet to the list. (I suppose if you’re Wikipedia, you have to say the internet is a necessity.)
Amazingly, sleep seems to escape everyone’s notice.
Almost everyone recognizes the necessity of sleep. Numerous clinical studies have shown the negative effects of lack of sleep on health, cognition, student test scores and any number of other measures. Even if a person hasn’t heard about the studies, they know what insomnia or pulling an all-nighter in college is like. From my own experience working graveyard shifts, inadequate sleep impairs judgment, reduces the pleasure of normally enjoyable experiences, promotes unhealthy habits like eating junk food and more.
Sadly, the effects of chronic sleep deprivation go far beyond late-night ice cream binge eating. For the homeless, those in abusive relationships, those who experience chronic stress because of financial instability and others, sleeplessness can cause or exacerbate mental illness as well as physical problems. In extreme cases, psychosis (including hallucinations) can develop. With no safe place to sleep, often fearing the theft or destruction of personal belongings, and knowing that tomorrow will not be any better than today, these individuals are far more susceptible to chronic sleep deprivation than the general population.
After 20 years of working with those experiencing homelessness, I’ve learned a little of what sleeplessness will do to someone. Otherwise functional individuals can be reduced to paranoia, aggression and self-destructive decisions simply because their brains are forced to operate without one the most basic resources it needs. In situations like this, many of the stereotypes of a homeless person as mentally ill, drinking alcohol and unable to function in normal society are true, but ironically, it is the homelessness and accompanying sleeplessness that cause the problems, not the other way around.
Amazingly, lack of sleep is often overlooked by mental health workers and medical professionals when screening and providing services to patients. This is not always the case, but it happens often enough to raise questions. Speaking for myself, I understand how this can happen. Even working for agencies that serve the homeless, I can’t manufacture housing for everyone. I know that despite my best efforts people will still have to sleep outside in the cold and will be tired when they wake. I’d rather focus on the problems that I can solve than face the ones I can’t. In the same way, doctors and others can’t just pull out a cot in their office and let a patient crash for hours at a time. They have to focus their efforts on a diagnosable and treatable problem.
I wish I could wrap this article with some wise insight that would solve the problem of sleeplessness for at least one person, but I can’t. I just not insightful enough. All I can ask is that, the next any of us run into someone who is facing a tough time and is rundown because of it, we will understand and cut them some slack as we recognize what they are dealing with.
This article originally appeared in “The Alley,” the newspaper for the Phillips neighborhood of Minneapolis.