How Long Should We Sleep? And When?

We explore the important relationships between depression, antidepressants, sleep, and sleep disorders.

How can clinicians distinguish nightmare disorder from sleep terrors, nocturnal hallucinations and REM sleep behavior disorder—and what treatments are supported by the strongest evidence? In this Mayo Clinic Sleep Medicine podcast, sleep specialists discuss the clinical presentation, differential diagnosis and management of nightmare disorder. The conversation explores psychiatric and medication-related contributors to frequent nightmares, idiopathic nightmare disorder, and the role of imagery rehearsal therapy as a practical behavioral treatment. The discussion also examines exposure-based therapies, cognitive behavioral approaches, lucid dreaming techniques and medications such as prazosin, including the limitations of current evidence for pharmacologic treatment of idiopathic nightmare disorder.

Can clinical hypnosis play a meaningful role in treating parasomnias and other sleep disorders? In this episode of the Mayo Clinic Sleep Medicine Podcast, sleep specialists discuss the principles, clinical application and emerging evidence surrounding hypnosis as a therapeutic option for parasomnias. Dr. Michael Silber is joined by Dr. Bhanu Kolla, a Mayo Clinic psychiatrist and board-certified sleep specialist with training in clinical hypnotherapy. The conversation explores how clinical hypnosis uses focused attention, deep relaxation and therapeutic suggestion, along with what current research suggests about its potential neurologic mechanisms. Dr. Kolla also walks through a typical hypnosis session, including induction, mental imagery, progressive relaxation, therapeutic suggestion, reorientation and at-home self-hypnosis practice. The discussion examines Mayo Clinic follow-up data involving patients treated with hypnosis for parasomnias, including non-REM parasomnias, overlap parasomnias and REM sleep behavior disorder. The physicians discuss reported treatment responses, limitations of the retrospective research, possible mechanisms of benefit and areas where hypnosis appeared less effective. This episode is intended for physicians, advanced practice providers, nurses and other health professionals interested in sleep medicine, parasomnias and nonpharmacologic approaches to patient care.

PTSD and sleep disturbances frequently overlap in clinical practice. In this episode of Mayo Clinic Sleep Medicine, Dr. Michael Silber speaks with Dr. Bhanu Kolla about the evaluation and management of sleep-related symptoms associated with post-traumatic stress disorder (PTSD). The discussion addresses PTSD-related nightmares, including the role of prazosin and psychotherapeutic approaches, as well as dream enactment behavior and trauma-associated sleep disorder. The panel also reviews insomnia in patients with PTSD, including cognitive behavioral therapy for insomnia (CBT-I), and considers whether early treatment of sleep disturbance after trauma could influence subsequent PTSD risk. Additional topics include the relationship between PTSD and obstructive sleep apnea, other comorbid sleep disorders, and emerging research involving MDMA and psychedelic-assisted approaches for PTSD. The discussion emphasizes areas where evidence is established, where clinical uncertainty remains, and where additional research is needed. Dr. Bhanu Kolla is a professor of psychiatry at Mayo Clinic College of Medicine and Science and a board-certified specialist in sleep medicine and addiction medicine.

In this episode of Mayo Clinic Sleep Medicine Podcasts, Dr. Bhanu Kolla, a Mayo Clinic specialist in sleep medicine and addiction medicine, joins host Dr. Michael Silber to discuss cannabinoids and their relationship to sleep. The conversation explores the body's endocannabinoid system and how compounds such as tetrahydrocannabinol (THC) and cannabidiol (CBD) may influence sleep. The experts review current evidence on cannabis and sleep architecture, including its potential effects on different stages of sleep. The discussion also examines the available research on cannabis and several sleep disorders, including insomnia, obstructive sleep apnea, restless legs syndrome, and REM sleep behavior disorder. Additional topics include potential risks and side effects of cannabis use, medication considerations, cannabis withdrawal, and how long cannabis may remain detectable in urine testing. Finally, the episode addresses an important question for both patients and healthcare professionals: Does current scientific evidence support the use of cannabis or cannabinoid-based products in the treatment of sleep disorders?