In clinical practice, sleep is often reduced to a quick question for the patient: “Do you sleep well?” Rarely do we approach it with the same seriousness as diet, exercise, or regular check-ups. Yet recent science forces us to rethink: sleep is not passive rest; it is active biology that protects memory, cognition, and perhaps even the very nature of our dreams.
A few days ago, Eric Topol shared a landmark study on this topic. I bring it back here because it illustrates a bigger challenge: every year, more than 3 million scientific articles are published worldwide. With limited time, no physician can possibly read them all. That’s why we need to filter, select, and translate what truly matters.
The glymphatic system, described barely a decade ago, reshaped how we understand sleep. During deep NREM sleep, the space between neurons expands, allowing cerebrospinal fluid to flow like an invisible river, clearing toxic proteins such as beta-amyloid and tau. It is, literally, a nightly cleaning shift. When sleep is fragmented or poor, this mechanism loses efficiency and is linked to long-term cognitive decline and neurodegeneration.
And what about dreams? This is where speculation begins. REM sleep —where our most vivid and emotional dreams occur— serves other roles: consolidating memories, integrating emotions, processing experiences. There is no direct evidence yet that glymphatic efficiency changes the quality or content of dreams. But the question is inevitable: if a brain wakes up “cleaner,” could it also dream differently or recall dreams more clearly?
What the recent Molecular Psychiatry (2025) study shows
- What was measured? Glymphatic function via DTI-ALPS (an MRI-based proxy), sleep quality through polysomnography and questionnaires, and multiple brain network markers.
- Who participated? 72 older adults from the community.
- Key findings:
- Limitations: Observational design, DTI-ALPS as an indirect proxy.
- Clinical implications: Reinforces that deep sleep must be seen as a determinant of brain health, not a secondary variable.
Even without direct proof about dreams, this study provides enough evidence to redefine our relationship with rest. Deep sleep is non-negotiable. It is not idle time; it is biological maintenance without which the brain literally poisons itself.
This post also reflects my personal journey. I write because I worry that too many essential discoveries get lost in thousands of papers that very few ever read outside research labs. And this is, in fact, the first time I publicly mention the book I am working on: Sueños Cuánticos (Quantum Dreams), where I explore these questions in greater depth.
We still don’t know if this nightly “brain wash” also modulates the dream experience. But we do know one thing with certainty: without deep sleep, the brain accumulates waste, loses plasticity, and weakens its future. That is reason enough to insist: sleep is not a luxury — it is an active intervention for brain health.
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