Pop Quiz
True or False:
If a patient reports feeling “amazing” after 8–9 hours of uninterrupted sleep following a stressful week, the clinician should help the patient achieve this every night.
(Answer below)
A Story From Training
I’m sitting in the interview room with my psychiatry attending after completing an oral exam testing my clinical skills.
He asked if I was going into a fellowship after training and I replied,
“Yes, I’m applying for sleep medicine.”
“Sleep?!” he exclaimed incredulously.
“We’re supposed to keep our patients awake, not put them to sleep!”
Back then, sleep was not a hot topic the way it is now.
Wearables, “sleepmaxxing,” sleepy girl mocktails, AI-enabled mattresses, influencer podcasts, melatonin in every medicine cabinet—none of this existed.
But to me, it was obvious:
Helping patients sleep is one of the most direct ways to help them feel more alert, awake, and alive.
The Problem: Too Much Sleep Advice
Fast forward to today.
Sleep is everywhere.
And the messaging has shifted—from neglecting sleep to obsessing over sleep.
That might sound like progress.
But there’s a growing concern:
We may be overcorrecting—and making insomnia worse.
The American Academy of Sleep Medicine 2025 Sleep Prioritization Survey found:
76% of respondents have lost sleep due to worries about sleep problems
In other words:
People aren’t just losing sleep.
They’re losing sleep worrying about sleep.
Why This Matters for Clinicians
If your patients are more anxious about sleep than ever…
Then more advice isn’t necessarily the solution.
Better messaging is.
This is where the work of Michelle Jonelis MD becomes highly relevant.
She’s a sleep physician, neurologist, and lifestyle medicine doctor who is reframing how we think—and talk—about sleep in clinical practice.
Watch the Full Discussion
Watch the full video here:
What You’ll Learn (Clinician Takeaways)
- Why your sleep advice might be making insomnia worse
- The hidden reason patients feel better after an “8-hour night”
- What rebound sleep is (and why wearables can mislead patients)
- Why many adults cannot consistently sleep 8 hours
- The concept of a sleep set point
- How to use the SLEEPY acronym to identify what’s disrupting sleep
- The one word that can reduce sleep anxiety almost immediately
- And more
Key Concept: What Is Rebound Sleep?
- Stress
- Sleep restriction
- Illness
- Travel
- Lifestyle disruption
“This is how I’m supposed to sleep every night.”
But that’s incorrect.
Rebound sleep is not a baseline—it’s a correction.
Trying to replicate it nightly creates:
- Unrealistic expectations
- Increased sleep effort
- Heightened anxiety
- Worsening insomnia
Clinical Insight: Sleep Is Not a Performance Task
One of the most important reframes:
Sleep is not something patients can force.
It behaves more like a vital sign than a skill.
That means:
- You can’t “try harder” to sleep better
- More effort often leads to less sleep
- The focus should shift from sleep itself → sleep conditions and habits
A Practical Tool: The SLEEPY Acronym
Dr. Jonelis introduces a simple framework to assess sleep in clinic:
SLEEPY
- S – Safe and settled (stress, hyperarousal)
- L – Long enough awake (sleep drive)
- E – Entrainment (circadian rhythm alignment)
- E – Engagement (mental, physical, social activity)
- P – Practices (habits, environment, substances)
- Y – Your sleep opportunity fits your need
Instead of chasing sleep duration, this helps you:
Identify what’s actually disrupting sleep
A Simple Language Shift That Changes Everything
Most clinicians say:
“Sleep is important.”
A more effective version:
“Healthy sleep habits are important.”
Why this works:
- Sleep itself is not directly controllable
- Habits are
- This reduces pressure and performance anxiety
Answer to the Pop Quiz
False.
Those “perfect” 8–9 hour nights are often rebound sleep.
They feel amazing—but they are:
- Temporary
- Physiologic
- Not reproducible nightly
Trying to achieve them consistently leads to:
- Increased sleep effort
- Frustration
- Worse insomnia
Final Takeaway for Clinicians
We’ve spent decades telling patients:
“Get more sleep.”
Now we’re seeing the unintended consequence:
They’re trying too hard—and sleeping worse.
The opportunity moving forward:
- Shift from quantity to context
- Shift from control to conditions
- Shift from sleep to habits
Continue Your Learning
Did you learn something new?
Explore CME and structured learning here:
https://champions.learner.plus/?champion=Dr%20Nishi%20Bhopal
References
1. American Academy of Sleep Medicine. Sleep Prioritization Survey 2025: Losing Sleep to Worries. Published 2025.
