Interview with Dr. Edward Franz Pace-Schott
Pascale Fung
Dr. Edward Franz Pace-Schott is a researcher at Harvard Medical School’s Division of Sleep Medicine and is an Associate Professor of Psychiatry at Harvard Medical School. He also currently teaches the MBB course MBB980T: Sleep and Mental Health at Harvard College. In his Sleep and Anxiety Disorders Laboratory, he uses polysomnography, fMRI, psychophysiology, self-report and related techniques to investigate how sleep helps humans regulate their emotions. He is particularly interested in how sleep influences evolutionarily ancient learning and memory processes like fear extinction that contribute to human emotion regulation and are deficient in anxiety disorders and PTSD.
What initially drew you to the intersection between sleep and mental health?
I actually took a course in 1990 at the Harvard Extension School that drew me to the intersection between sleep and mental health. My background was in aquatic biology, but at that point I took a course with Allan Hobson, a prominent sleep and dream researcher. I worked in his lab for a number of years while also doing some clinical work, but ultimately decided to go into research and got a PhD. My interest began largely from working in Allan’s psychiatry lab at Massachusetts Mental Health Center, where I studied psychiatric patients and was introduced to biological psychiatry.
From either your own research or from your role as a professor at Harvard College, what would you say is the biggest issue with sleep in college students?
I would say that insufficient sleep is generally, in our society, one of the major problems, particularly for busy undergraduates at a university like Harvard where there’s so much to do and people are trying to cram so much into one day. There’s a sleep-wake pattern, which has been dubbed “social jetlag” and is common in college students. Social jetlag arises from the fact that, during the week, many students get less sleep than they need and may be sleeping at a different circadian phase than their own internal circadian clock. Then there comes the weekend, when lost sleep is made up but is shifted later because of social events and travel, causing weekend sleep to occur during yet a different circadian phase . It is believed that this pattern is a physiological stressor for students.
Should students stay up later to do work or wake up earlier to do work?
It is most beneficial to work when it is favorable to your chronotype (your body’s natural tendency to sleep and wake at certain times). If you are a morning person, the morning is preferable, but if you are an evening type, it may be preferable to lose some sleep at night to work rather than waking up early. It is individualized when your energy peaks. However, in general, to strive to get enough sleep, young adults should target 7-9 hours for sufficient sleep duration despite differences between individuals. You know how much sleep you need based on how long you sleep on vacation or when you have no other demands in your life.
How can students maximize the sleep that they are able to get?
There are many sleep hygiene recommendations such as not drinking caffeine before bedtime, and if you’re really sensitive to caffeine, to not drink it after noon. Another recommendation is to sleep somewhere quiet and have a regular bedtime to the best of your ability. If you can, refrain from looking at screens for about half-an-hour or so before bed. Try to have the room sufficiently dark and not too hot. Also, try not to spend too much time in bed doing things other than sleeping, such as doing homework, eating, or watching TV during the day or early night. It’s best to use the bed specifically for sleep.
Does improving sleep truly improve mental health?
Yes, yes. Chronic insufficient sleep, from epidemiological research and laboratory research with sleep deprivation studies, definitely has an effect on one’s mental health. Research suggests that pre-existing sleep problems are a risk factor for psychiatric disorders such as depression or anxiety disorders. One of the findings that has come about because of the military deployment of soldiers is that those who have sleep problems (nightmares, insomnia, or habitual short sleep) before they are deployed, who then have a traumatic experience while they are deployed, are at greater risk of developing PTSD. You are more vulnerable to trauma that causes a psychiatric effect if you are sleep deprived.
What are the lasting impacts of chronic sleep deprivation or consistently pulling all-nighters?
There are risk factors to insufficient sleep over the long term, which include things like chronic inflammation that leads to other effects like cardiovascular and metabolic issues such as insulin resistance or metabolic syndrome. It’s really not good for you to be so sleep deprived, but young people with their first jobs in, for example, a financial industry, work long hours for a year or more and experience those risk factors in spite of being resilient in the short term.
In terms of psychiatric disorders, we know that chronic insufficient sleep is a risk factor for new-onset depression and anxiety disorders or even PTSD if you have had a traumatic experience. The one that’s particularly problematic is bipolar disorder, where insufficient sleep can lead to manic episodes that further deprive one of sleep.
From your experience in the field of sleep research, what is one finding that surprised you the most?
Though not recent, there have been some discoveries about new biochemical and neurological controls of sleep, one being the discovery of orexin, which is a general wake-promoting substance that is deficient in people with narcolepsy. Also discovered has been the photoreceptor for circadian control, that occurs in specialized cells of the retina containing the photopigment melanopsin, and is important for resetting or synchronizing the circadian clock with the environment.
Every now and then, there is some finding that makes a larger impact. For example, it was found, in the rat, that there is a second sleep-promoting center in the brainstem that is different from the sleep-promoting center first discovered in the hypothalamus. This center is located in a part of the brainstem called the medulla, and it explains why you can damage one of the brain’s sleep-promoting areas and still sleep. If there was only one sleep-promoting center, you would expect the animal to experience insomnia if that area was damaged.
Another finding that was surprising and significant was that the onset of REM sleep behavior disorder later in life– a disorder characterized by loss of the normal muscle atonia (inhibition of movement) during REM sleep. that can result in people acting out their dreams– is often an early sign of neurodegenerative diseases such as Parkinson’s Disease or Lewy Body Dementia. There is also some evidence that the mis-folding of a protein that causes these neurodegenerative diseases can sometimes originate in the gut, and may then travel up the vagus nerve (major pathway between the brain and our internal organs) to the brainstem to interfere with the part of the brainstem that promotes atonia. This can manifest as REM behavior disorder before the other symptoms of neurodegenerative disorders arise.
What’s some new research in the field of sleep and/or mental health that you are excited for?
Research on the interaction between sleep, the immune sleep, and psychiatric illnesses is of great interest to me. Chronic inflammation, a function of the innate immune system, is found to be one of the underlying causes of psychiatric illnesses and also contributes to other cardiovascular and metabolic diseases.
Another area of interest is the increasing ability to look at the genetic basis for different sleep traits using techniques such as the Genome-wide association studies (GWAS) where researchers look at many people to reduce the chance of false positives to find genes associated with sleep or circadian characteristics in individuals. That’s a very interesting new area.
Also, neuromodulation in sleep is a new area of research in sleep that includes Transcranial Magnetic Stimulation (TMS), Transcranial Direct Current Stimulation or tDCS (which alters brain excitation), and Focused Ultrasound (that can be aimed at specific brain parts). All of these modalities have a lot of influence on psychiatry in general as well as in insomnia research.
About the Author
Pascale Fung ('27) is a junior at Harvard College concentrating in Neuroscience (MBB).
What initially drew you to the intersection between sleep and mental health?
I actually took a course in 1990 at the Harvard Extension School that drew me to the intersection between sleep and mental health. My background was in aquatic biology, but at that point I took a course with Allan Hobson, a prominent sleep and dream researcher. I worked in his lab for a number of years while also doing some clinical work, but ultimately decided to go into research and got a PhD. My interest began largely from working in Allan’s psychiatry lab at Massachusetts Mental Health Center, where I studied psychiatric patients and was introduced to biological psychiatry.
From either your own research or from your role as a professor at Harvard College, what would you say is the biggest issue with sleep in college students?
I would say that insufficient sleep is generally, in our society, one of the major problems, particularly for busy undergraduates at a university like Harvard where there’s so much to do and people are trying to cram so much into one day. There’s a sleep-wake pattern, which has been dubbed “social jetlag” and is common in college students. Social jetlag arises from the fact that, during the week, many students get less sleep than they need and may be sleeping at a different circadian phase than their own internal circadian clock. Then there comes the weekend, when lost sleep is made up but is shifted later because of social events and travel, causing weekend sleep to occur during yet a different circadian phase . It is believed that this pattern is a physiological stressor for students.
Should students stay up later to do work or wake up earlier to do work?
It is most beneficial to work when it is favorable to your chronotype (your body’s natural tendency to sleep and wake at certain times). If you are a morning person, the morning is preferable, but if you are an evening type, it may be preferable to lose some sleep at night to work rather than waking up early. It is individualized when your energy peaks. However, in general, to strive to get enough sleep, young adults should target 7-9 hours for sufficient sleep duration despite differences between individuals. You know how much sleep you need based on how long you sleep on vacation or when you have no other demands in your life.
How can students maximize the sleep that they are able to get?
There are many sleep hygiene recommendations such as not drinking caffeine before bedtime, and if you’re really sensitive to caffeine, to not drink it after noon. Another recommendation is to sleep somewhere quiet and have a regular bedtime to the best of your ability. If you can, refrain from looking at screens for about half-an-hour or so before bed. Try to have the room sufficiently dark and not too hot. Also, try not to spend too much time in bed doing things other than sleeping, such as doing homework, eating, or watching TV during the day or early night. It’s best to use the bed specifically for sleep.
Does improving sleep truly improve mental health?
Yes, yes. Chronic insufficient sleep, from epidemiological research and laboratory research with sleep deprivation studies, definitely has an effect on one’s mental health. Research suggests that pre-existing sleep problems are a risk factor for psychiatric disorders such as depression or anxiety disorders. One of the findings that has come about because of the military deployment of soldiers is that those who have sleep problems (nightmares, insomnia, or habitual short sleep) before they are deployed, who then have a traumatic experience while they are deployed, are at greater risk of developing PTSD. You are more vulnerable to trauma that causes a psychiatric effect if you are sleep deprived.
What are the lasting impacts of chronic sleep deprivation or consistently pulling all-nighters?
There are risk factors to insufficient sleep over the long term, which include things like chronic inflammation that leads to other effects like cardiovascular and metabolic issues such as insulin resistance or metabolic syndrome. It’s really not good for you to be so sleep deprived, but young people with their first jobs in, for example, a financial industry, work long hours for a year or more and experience those risk factors in spite of being resilient in the short term.
In terms of psychiatric disorders, we know that chronic insufficient sleep is a risk factor for new-onset depression and anxiety disorders or even PTSD if you have had a traumatic experience. The one that’s particularly problematic is bipolar disorder, where insufficient sleep can lead to manic episodes that further deprive one of sleep.
From your experience in the field of sleep research, what is one finding that surprised you the most?
Though not recent, there have been some discoveries about new biochemical and neurological controls of sleep, one being the discovery of orexin, which is a general wake-promoting substance that is deficient in people with narcolepsy. Also discovered has been the photoreceptor for circadian control, that occurs in specialized cells of the retina containing the photopigment melanopsin, and is important for resetting or synchronizing the circadian clock with the environment.
Every now and then, there is some finding that makes a larger impact. For example, it was found, in the rat, that there is a second sleep-promoting center in the brainstem that is different from the sleep-promoting center first discovered in the hypothalamus. This center is located in a part of the brainstem called the medulla, and it explains why you can damage one of the brain’s sleep-promoting areas and still sleep. If there was only one sleep-promoting center, you would expect the animal to experience insomnia if that area was damaged.
Another finding that was surprising and significant was that the onset of REM sleep behavior disorder later in life– a disorder characterized by loss of the normal muscle atonia (inhibition of movement) during REM sleep. that can result in people acting out their dreams– is often an early sign of neurodegenerative diseases such as Parkinson’s Disease or Lewy Body Dementia. There is also some evidence that the mis-folding of a protein that causes these neurodegenerative diseases can sometimes originate in the gut, and may then travel up the vagus nerve (major pathway between the brain and our internal organs) to the brainstem to interfere with the part of the brainstem that promotes atonia. This can manifest as REM behavior disorder before the other symptoms of neurodegenerative disorders arise.
What’s some new research in the field of sleep and/or mental health that you are excited for?
Research on the interaction between sleep, the immune sleep, and psychiatric illnesses is of great interest to me. Chronic inflammation, a function of the innate immune system, is found to be one of the underlying causes of psychiatric illnesses and also contributes to other cardiovascular and metabolic diseases.
Another area of interest is the increasing ability to look at the genetic basis for different sleep traits using techniques such as the Genome-wide association studies (GWAS) where researchers look at many people to reduce the chance of false positives to find genes associated with sleep or circadian characteristics in individuals. That’s a very interesting new area.
Also, neuromodulation in sleep is a new area of research in sleep that includes Transcranial Magnetic Stimulation (TMS), Transcranial Direct Current Stimulation or tDCS (which alters brain excitation), and Focused Ultrasound (that can be aimed at specific brain parts). All of these modalities have a lot of influence on psychiatry in general as well as in insomnia research.
About the Author
Pascale Fung ('27) is a junior at Harvard College concentrating in Neuroscience (MBB).