Sleeping under a bridge. Sleeping on a park bench. Sleeping in a car.
These images spring to mind when someone talks about homelessness because these are common places for the homeless. The misnomer is in the word “sleeping.” While homeless people may catch a couple of hours of sleep here and there it is neither restful nor sufficient for good health.
Personal wellness depends on at least seven or more hours of restful sleep per night. There is laboratory evidence that short sleep durations of 4-5 hours have negative physiological and neurobehavioral consequences. Homeless people have little opportunity to obtain even this level of good sleep for many obvious reasons:
- Safety is compromised by homelessness. Robbery and assault are constant threats.
- Police interrupt people sleeping outside. Sometimes they will wake people up just to tell them to move along. In some communities homelessness is now a crime and the police have to arrest homeless people.
- Other homeless people wake a sleeping person for more innocent reasons. It could be just to bum a cigarette or it could be a person in the throes of a manic episode who wants someone to listen to them.
- Something as simple as the urge to go to the bathroom can wake people. For a homeless person it may mean walking to a public bathroom. Before they can even do that they have to gather up all their belongings so they won’t get stolen. There’s no chance they will easily return to sleep.
- Weather conditions are a huge factor. Do we really think a person can sleep well in the rain or cold? Most of us don’t sleep well in excessive heat either. Residents of a home without air conditioning lie awake during a heat wave.
- Homelessness is straining shelter capacity. In my community we have waiting lists for the shelters.
- Even shelters are not particularly restful places. They resolve the obvious issue of exposure to the elements. People have at least a cot and a pillow. But shelter residents are mixed in with others who talk at night, pace or snore loudly enough to drown out a train.
It is intuitive that severely mentally ill people are at risk of homelessness. They struggle to maintain steady income. They are often estranged from family or friends, leaving them without any support systems. Their symptoms and related behaviors interfere with lease compliance, leading to eviction.
On the other hand there have always been people who experience homelessness brought on by other deficits. They lost their jobs. Medical bills pushed people into bankruptcy. The housing foreclosure crisis forced people out of their homes and ruined their credit. Such individuals may have enjoyed reasonably good mental health all their lives until the trauma of homelessness hit.
The effect of sleep deprivation on homeless people is profound. Studies are showing that sleep deprivation can bring on psychosis. In fact, sleep deprivation creates so much misery it is used as an “enhanced interrogation technique” in hostile situations. There are well documented correlations between insufficient sleep and deterioration of physical and emotional health.
The latest research findings add to the growing body of scientific knowledge indicating that sleep problems cause dysfunction in the brain. Those dysfunctions may contribute to emotional difficulties and psychiatric conditions. According to research conducted at the University of California, Berkeley sleep deprivation compromised participants’ ability to judge emotion in human faces. Consider how debilitating this can be for a person already suffering from paranoia.
- Just one night without sleep can lower inhibition and increase impulsive reactions to negative stimuli. Negative stimuli are everywhere for the homeless.
- Lack of sleep makes most of us cranky and short tempered. Our stress levels increase. High stress can make it more difficult to sleep, and people may fall into a vicious cycle
Many mental disorders come with a side of sleep problems, including depression and bipolar disorder.Sleep problems and schizophrenia may have common roots. This means researchers may be able to mitigate this devastating disorder by helping patients overcome insomnia. This won’t be much help to people who cannot sleep safely.
Identifying the number of homeless people with mental illness is a moving target. Homeless people are transient. Yet actual street counts tell us that anywhere from 25 to 35% of the homeless population have a severe mental illness.
If 25 to 35% of homeless people have an existing mental illness, are we actually fostering mental illness among the remaining 65 to 75%? The possibility that we are doing just that is real. Evidence shows persistent sleep deprivation will ravage one’s mental health. Until we provide homes for people who do not have them we are just magnifying economic damage and human suffering.
Homeless people must sleep with one eye open as part of survival. Housing is the best treatment for the preventable illness called sleep deprivation.