"Insanity is hereditary. You can get it from your children."
And then as soon as they are in their 20s and reasonably self sufficient we had to get a puppy to keep me sane!
Did you have empty nest syndrome?
NGL I'm low key wondering if my messed up natural rhythm of 9pm-4am is going to be potentially handy.
Although... I was up until 4am and got up at 6:30am and feel surprisingly great, so it still happens from time to time. :)
As I'm typing this my 1.5yo is napping. I had maybe 6h of sleep but I'm after (part time) work and at home already, so I should probably nap as well.
Can't. My adult body won't go to sleep right now even though I'm feeling drowsy because it's too bright, too loud and chiefly I already had too much caffeine in the morning and I have like 15 minutes until I'll have to head out to collect my older child from preschool.
My SO is knocked out cold at the moment though, so I'll be relying on her this evening.
There's so much helpful stuff out there now it's rather a blessing.
Chronic sleep deprivation is the larger issue. And how we really don't have treatments on how to fix that, and how ultimately sleep phase issues are a social issues (being forced to follow a fixed modern schedule). Not to mention how closely that's tied to ND people. So a lot of us deal with sleep issues since we were little, but work and school dont give us the flexibility we need. For example, flex hours could be helpful here. I would rather work 10am to 6pm or 11am to 7pm most days. Or 5-6 hours during the day and 2-3 hours late at night.
Sure we do, however, not everyone is willing to hike 20-30 miles a day and sleep in a tent. It's not practical but it is very effective.
People have natural sleep rhythms. Society should conform to that, instead capitalism demands we conform to what it deems profit maximizing.
It usually works for the first few days of doing it but then it's like my body (probably moreso my mind) gets used to it and it doesn't help with sleep anymore.
Arguably it feels even more unhealthy because it's like my body is fully exhausted and tired but my mind won't let me sleep so no restoration can happen.
Sleep deprivation is often caused by alcohol, inconsistent sleep/wake times, high color temperature lighting (>3000K) in the hours before bed, failure to spend time outdoors in natural light in the morning, temperature too warm (68F is ideal), caffeine (or other stimulants) in the afternoon, associating the bedroom with tasks other than sleep and sex, or simply spending too much time in bed.
Following doctor's advice for the last one: Start by going to bed at, say, 1am and waking up at 6am. Follow this without fail for a few weeks. You'll be exhausted but keep at it. Eventually you should find yourself falling asleep quickly. If you wake up exhausted, pull back bedtime by 10 minutes. Do this for a week. Rinse and repeat until you are waking up at 6am refreshed. That is how you determine how many hours your body needs to sleep, and how long you should be in bed. Helped me.
ND people get this pretty badly. 2023 study: The incidence of sleep problems in ASD patients ranges from 32 to 71.5%, especially insomnia, while an estimated 25–50% of people with ADHD
Insomnia is different, but tbf, insomnia for many people can't be treated well or if not at all. CBT is helpful if you look at the studies and ignore the follow up studies showing relapses between 40-70%. We can stuff people with melatonin and hypnotics but after a while that no longer works. So looking at this, it looks like things like drugs and CBT can help 70% of insomnia sufferers but the relapse rate is as high as 70%, so we're looking at people who can actually be cured as low as 15-20% of total insomnia sufferers.
Its not caffeine or screens for us, its just how the machinery of the human body works. This is like telling a depressed person to just 'cheer up.' I'm glad that worked for you, but your story is just an anecdote, and the science for this is still pretty dismal unfortunately.
The science can't work because at this point we're going against our nature. A lot of people cannot subscribe to a modern industrialized sleep schedule because its not natural for us to have extremely strict sleep and wake times.
I pop up 5 minutes later and feel completely refreshed.
My experience after sleeplessness nights is that even few seconds help significantly, especially when you're almost unable to function anymore.
If the nap lasts longer than 30 minutes, though, you have a good chance of feeling groggy afterwards.
When I owned some property out in the country, it was a 2 1/2 hour car trip to get there. Sometimes I just couldn't finish the drive home but pulling over to the side of the road for a 10-minute nap made me feel fully refreshed.
I pretty much wait until I feel drowsy, and then take a 15-30 minute nap
But on rare occasions (like a couple of times a year), I get migraine auras and stuff disappears from my field of view. Can last about an hour. I feel like that's my visual cortex falling asleep.
[1] https://thelastpsychiatrist.com/2007/08/how_to_take_ritalin_...
1. Ritalin, and other stimulants are not cognition enhancing for non-ADHD adults and may in fact do the opposite.
https://www.cam.ac.uk/research/news/smart-drugs-can-decrease...
2. > Because the doctor will rigorously apply artificial and unreliable diagnostic categories backed up by invalid and arbitrary screens and queries to make a diagnosis. So after this completely subjective and near useless evaluation is completed, your doctor should be able to exercise prudent clinical judgment to decide if Ritalin could be of benefit.
What else can you do for psychiatric conditions? We don't have a magic ADHD-o-meter but know that it statistically impacts lifespan, health, etc. Even for more objective measures like blood glucose, BP, BMI, clinical interventions are based on discrete thresholds that don't exist in nature.
That, or maybe try a laxative.
(Man, if ever there was a time I wanted emoji support on HN, this is it!)
bombed a midterm halfway though, but at least i felt good about it.
I've attributed it to a my brain moving to power-saving mode and muting some of my anxiety / perfectionism tendencies. Does this explanation resonate with you at all?
But, I definitely crash harder than I did in my 20s and need longer to recover after. In my 20s, would be fine if the next night was a normal one, now it takes multiple days.
It's definitely something I try to avoid at this age, as opposed to just being standard procedure back in college.
Hard to imagine that it would be worth more than a few percent though.
You need to take it for a while for it to build up, and for water to accumulate in cells.
It would also be disgusting in a cup of coffee!
Once a memory lapses you have to relearn from life experience (or not at all).
Compare, from https://evolutionistx.wordpress.com/2016/12/16/anthropology-... :
> at the first news of English ships in the area, Buckley rushed to the spot. He attempted to make contact, but couldn’t swim out to the ship and couldn’t convince the ship to send a boat to him (Buckley had, at this point, forgotten how to speak English.) Buckley was again heartbroken until another ship showed up, and he found the English colonists and tried to approach them:
> “Presently some of the natives saw me, and turning round, pointed me out to one of the white people; and seeing they had done so, I walked away from the well, up to their place, and seated myself there, having my spears and other war and hunting implements between my legs. The white men could not make me out–my half-cast colour, and extraordinary height and figure [Buckley was around 6’5” or taller,]–dressed, or rather undressed, as I was–completely confounding them as to my real character. At length one of them came up and asked me some questions, which I could not understand; but when he offered me bread–calling it by its name–a cloud appeared to pass from over my brain, and I soon repeated that, and other English words after him. …
> “Word by word I began to comprehend what they said, and soon understood, as if by instinct, that they intended to remain in the country; that they had seen several of the native chiefs, with whom–as they said–they had exchanged all sorts of things for land; but that I knew could not have been
I submit that it takes more than a day to learn English if you don't already know it.
Once I was in a Toys-R-Us and noticed a cover image among the bottom-of-the-barrel DVD display which caused me to put what I was doing on hold for several minutes while I stared at the DVD. I bought it, and it turned out to be a movie I had watched many times when I was very young, but that information hadn't been accessible to me.
https://en.wikipedia.org/wiki/Recovered-memory_therapy (see research section)
Some of the techniques used in the therapy include giving patients sedative-hypnotic drugs to put the patient in a waking dream-like state while the therapist asks leading questions to get them to "remember" an event. The same drugs they used are known to be associated with false memories, like when someone falsely recalls something from a vivid dream as having actually happened.
I am not advocating for it, just stating the near total lack of substantive scientific evidence presented either in support or opposed.
Proof: "colloidal silver has been used to attempt to cure cancer".
Solid logic.
Some of the techniques included hypnosis or even giving the patients (including children) sedative-hypnotic drugs before pressuring them with the leading questions.
If they could eventually get the person or child to claim to have some memory of the event (after asking a lot of leading questions and maybe even drugging them) they considered it to be a recovery of the memory.
On top of that, I have legitimate memories that were not traumatic, but still related to the same traumas because said person attempted to encourage these activities throughout my young life on rare occasions. I didn't remember what happened as a kid, but I knew something wasn't right and I wasn't comfortable. It wasn't until I was almost 30 that I had my first "flashback" which was a fractured memory, I still remember it looked like a faded photograph in my mind, and it was accompanied by an extremely uncomfortable feeling.
The re-surfacing memories aren't real in a sense, but in my case they aren't entirely fake either.
I wonder if it's possible that things can be completely imagined with absolutely no basis what-so-ever in certain circumstances, and I also wonder how difficult it is to discern that. It seems to be a difficult concept to manage.
On the other hand, I do have some Gandalf "I have no memory of this place" moments for other things.
The idea of "repressed memories" was that people had hidden memories that they couldn't access, even if they tried. According to the theory, even if someone brought up the past event and tried to remind the person about it, they would be unable to recall it happening because their brain had blocked it out.
The idea was that only intervention by a therapist or some other special event could help the person "unlock" the repressed memories, making them available for remembering again.
What was really happening was that some therapists were leading people into "remembering" things that didn't happen through aggressive prompting and pushing, much like what happens when an aggressive investigator convinces a vulnerable person to falsely confess to something they didn't do.
Other things about that day were surfaced. How my braces felt and the fear I felt about forgetting a textbook.
All real, but unsurfaced until then.
Though you're right - a specific scent can easily call up an ancient, forgotten memory.
It is specifically about trauma, and generally you don't forget traumatic events and that's often a big part of the problem. We are not talking about trivial things like the name of your maths teacher in high school, which have a tendency to come and go.
It is also specifically about therapy, that is an environment where you are actively encouraged to recall memories. We know how easy it is to make up memories, especially with the help of a third party (here, the therapist).
Combine the two: memories that are hard to forget and an environment conductive to making false memories and it becomes very likely that the "lost" memories are completely made up.
That depends on how many you endured really. Only so much room in the old noggin with everything else important going on.
Oh, of course you can.
One remembered memories of a WWII pilot named James Huston Jr. and the other a deceased Hollywood agent named Marty Martyn.
Putting aside the reincarnation hypothesis for the moment, do you think the kids invented the details and coincidentally happened to match to a real person or were they fully coached? Maybe they didn’t get enough sleep or got too much sleep?
I'm reminded of the story of dragon sightings in Great Britain: after the printing press and newspapers and newspaper reporters chasing stories emerged, as news distribution out from city centers into rural areas increased, it seems dragons picked up and moved farther away, only being spotted in the hinterlands without news.
You apparently would keep your mind open to the idea that dragons don't like the smell of newsprint as no other conclusion could be more plausible sheerly on the basis of logic?
You're saying that those memories are exactly the same as all the other memories.
Every time you "recall" something, you are not pulling up some file that is always the same. You are actively recreating the memory.
There's nothing "fun" or insightful about this, this mechanism has been known for a long time.
Obviously it's not unique to psychotherapy.
> may have been created
Most things that "may" have happened do not warrant absolute statements such as "that's not a thing" (which, incidentally, is a particularly empty statement in any context, since every thing is a thing)
Yes, witness testimony is always potentially flawed.
But knowing "some repressed memory recovery is false" does not justify saying that repressed memories are not a real thing. Repressed memories do happen. They do come back sometimes. When they do, they are just as valid as any normal memory that a person thinks they always had.
I know because I had them myself. Mine were of trauma in the age range from 5-9. I had a high "ACE score" when I eventually looked into this. I did not have any therapy session prompting the recall, I just remembered them spontaneously around age 15 when I was empathizing with a schoolmate who told me about domestic violence. It was a sickening feeling to have this whole phase of my past come unlocked.
Amazingly, it submerged into repression again. I next remembered it at about age 20. In between, I had years of basically not remembering/knowing that I had any of this trauma or that I had experience the earlier recall. They all came back together, again triggered by an empathetic moment in college. Again it was disorienting to have this whole aspect of my past reopen.
At that later point, I confronted people who were around my childhood and got enough of a painful discussion, confession, and apology to know that these memories were not invented.
I had other forms of childhood trauma that never submerged. I don't know why this one section did.
I find it very offensive for someone to make broad statements that these phenomena do not exist.
If it happens in therapy, that doesn't mean the memories are "implanted". And not all memories lack the ability to validate them... for example, if you've forgotten someone's name, then remember it later, you can call out to them by their name to confirm that you've correctly remembered it.
Memories tumble around in the brain all the time, not all memories are easy to access, but that doesn't mean they're inaccessible.
The point that memories can also be implanted or fabricated during therapy is absolutely an important one, but dismissing the possibility for memories to resurface (and conflating any situation where this might happen with a specific type of discredited therapy) is needlessly reductive.
It might be something that one might not understand if he/she doesn't live through it I guess
Sometimes yes, created to validate, sometimes no, unlearns to disassociate
Every memory your brain has ever produced is still there, even if most are beyond conscious access. Memories quite literally become a permanent part of you.
A lot of people mistakenly think of human memory as a sort of hard drive with limited capacity, with files being deleted to make room for new ones. It's very much not like that.
If you just mean that human memory has a finite capacity that's much larger than anyone has come close to reaching by storing the memories of a normal human lifetime, that might make sense.
Do you have any references for your statements about memory? I'm not familiar with whatever science there is in this area.
If you have questions about my comment, I'm happy to try to explain myself better
"I didn't understand you at all, so you must have meant either A or B" is not the way to reach an understanding
How would that not imply infinite storage?
It is almost certainly false, but it doesn't require infinite storage to be true.
Which would put it into the category of the second part of my comment--which the person I was responding to said was not relevant to what they meant.
I didn't ask for that. I asked if you have references for what you said. Even if I misunderstood you, that shouldn't be a reason for you not to give references for your statements, if you have them.
If you don't have any references to back up your statements, then I'm not sure what you're basing them on.
True, but it doesn't really detract from his statement because do we really know what that upper bound even is? I don't think we come close to the theoretical storage limit... So saying "every memory you have is permanently stored" is effectively true, at least true enough for a thought experiment like this. Perhaps when people live to be 200 years old and we know more about the brain we can test this, though.
I used to be weary of learning new, complex things, thinking I'd "lose" old knowledge XD
That was the point of the second part of my comment--which the person I was responding to said was not relevant to what he meant.
Consider an exponentially weighted moving average - you can just keep putting more data in forever and the memory requirement is constant.
The brain stores information as a weighted graph which basically acts as lossy compression. When you gain more information, graph weights are updated, essentially compressing what was already in there further. Eventually you get to a point where what you can recall is useless, which is what we would consider forgotten, and eventually the contribution of a single datapoint becomes insignificant, but it never reaches zero.
It implies enough capacity to store everything. But what you describe is not storing everything.
> lossy compression
Which means you're not storing all the information. You're not storing everything.
> When you gain more information, graph weights are updated, essentially compressing what was already in there further.
In other words, each time you store a new memory, you throw some old information away.
Which the person I was responding to said does not happen.
Memories seem to be constructed by a group of neurons together, and it seems clear that neurodegeneration is a thing, whether by trauma or due to aging. When pathways degenerate, maybe you have a partial memory that you brain can help fill the gaps with(and often incorrectly), but that does not make it the original memory.
The way I understand it, it's just that, unlike on disk, the deletion process is not binary. Weak connections that are not revisited regularly gradually become weaker, until they're undistinguishable from noise (false memories).
I don't know where I got this trick. Likely some survival show or some novel. But I don't have any background in survival, otherwise, I would have brought a lot more water.
So my brain knew there was a memory that could help and made up a dream about it is my theory.
Attention lapses due to (sleep deprivation due to flushing fluid from brain).
(Attention lapses due to sleep deprivation) due to flushing fluid from brain.
Hard disagree there. If you get any anxiety during the test it's better to take it only while studying.
Here is some literature that I've perused to support my experimentation with BHB salts:
1. β-hydroxybutyrate is a metabolic regulator of proteostasis in the aged and Alzheimer disease brain (https://www.sciencedirect.com/science/article/pii/S245194562...)
2. Refueling the post COVID-19 brain: potential role of ketogenic medium chain triglyceride supplementation: an hypothesis (https://www.frontiersin.org/journals/nutrition/articles/10.3...)
My motivation for pursuing this was protracted sleep disturbance from long-covid.
If you have 15m, search this on YT for a guided practice and test it yourself.
However, it is very, very fragile to any kind of interruption, so they stopped looking into it.
The video (?) was related to clearing of plaques from the brain with a view to mitigating Alzheimer's effects.
It was not the NSDR (Non-Sleep Deep Rest) videos a sibling commenter posted.
It seems likely that you'll get those flushes right after falling asleep, so a nap of a few minutes could help a lot.
In my experience, after a night without sleep even a 30 seconds nap reinvigorates you significantly.
But I'm not sure the mouth taste comes from the brain's waste.
To some degree, if you had your brain inflamed by bad eating habits, fasting would revert that and make the flushing more efficient as well.
Again please take with with double grain of salt, since I don't even know inflame brain is a thing for sure, or the correct term.
> Lewis and colleagues showed that CSF flow during sleep follows a rhythmic pattern in and out of the brain
> Most significantly, they found a flux of CSF out of the brain just as those lapses occurred. After each lapse, CSF flowed back into the brain.
I can't believe the authors of the article didn't address one of the most obvious questions: Where does the CSF flow to and where does it flow back from? It's not like there are pipes leading out of the brain, or the CSF will just leave my brain through my ears or anything, will it?¹ What happens with the waste products? (¹ Though it would be kinda funny if this was where snot comes from.)
EDIT: Wikipedia's got the answer:
> Clearing waste: CSF allows for the removal of waste products from the brain,[3] and is critical in the brain's lymphatic system, called the glymphatic system. Metabolic waste products diffuse rapidly into CSF and are removed into the bloodstream as CSF is absorbed. When this goes awry, CSF can become toxic […]
There are, in fact, “pipes” leading out of the brain. Cerebrospinal fluid is (and this is probably somewhat oversimplified) produced from material in the bloodstream in the ventricles in the brain, flows through the system of ventricles and then out of the brain into the subarachnoid space around the brain and spinal cord, and is then reabsorbed into the bloodstream.
https://www.mayoclinic.org/tests-procedures/brain-shunt/abou...
To abuse a metaphor, the sleep-deprivation-induced spontaneous CSF flush is slamming on the brakes of a car, and ADHD related attention shifts would be more like a drunk toddler is turning the steering wheel wherever they please, but the gas/brakes still work fine.
My wife still has to work 24 hour shifts with no sleep, performing emergency surgeries no matter how long it has been since she slept. During residency only a few years ago she and her co-residents were almost weekly required to do 36 hour shifts (on top of their regular 16 hours per day, 5 day per week schedule) and once even a 48 hour shift when the hospital was short staffed.
Of course I’m sure they won’t. No one cares if doctors are over worked.
Yes, a tired doctor sucks. But a tired doctor who already has the patient's state loaded into their head may still be better than doctor who is completely fresh in both senses.
It's a hard problem.
The world doesn't run on boolean logic. A solution can improve an issue without solving it completely.
(not defending, I also think its insane, just devils advocate)
This would not appear to apply to emergency surgeries. They aren't done by doctors who are familiar with the patient anyway. (Neither are non-emergency surgeries. Surgeries are done by doctors who do that kind of surgery. Familiarity with the patient is useful in deciding what surgery should be done, but not in doing the surgery.)
12:00am - 6:00am: Doctor 1 and Doctor 4 are doing everything together.
6:00am - 12:00pm: Doctor 1 and Doctor 2 are doing everything together.
12:00pm - 6:00pm: Doctor 2 and Doctor 3 are doing everything together.
6:00pm - 12:00am: Doctor 3 and Doctor 4 are doing everything together.
This way, all 4 doctors only do 12 hour shifts, and the patient's state is maintained continuously through all 24 hours.
AI fixes this. Imagine the boot time of loading a patient's state from dozens of labs and files vs. a summary that gets you to exactly what they're going to end up remembering anyways. And if a doctor finds something interesting that the AI doesn't flag, they should be flagging it in the chart for the next doctor anyways.
Doctors boards and AGME (partly governed by AMA, but there is some amount of public representation) control residency admissions and board certification. We don't necessarily want low admissions standards, but there is a lot potential conflict of interest in constraining supply.
Some states, I think I read Florida recently, have started pushing back to allow in foreign doctors.
I do think it's maximially optimized to extract revenue. That can sometimes be good (e.g. good access to healthcare) but often times it's not great.
Given healthcare, along with education should be a national priority, both should be heavily "configured" to serve peoples' goals first and any financial goal should be secondary (although arguably useful).
I suspect the current shareholder structures from hedge funds are (intentionally or not) driving things in the wrong direction wrt to public health goals. This is article from a few days ago is also interesting https://news.ycombinator.com/item?id=45680695
Don't you, as presumably a SWE in the US, make a sh!tton of money?
Howcome your wife still is forced into such detrimental working conditions?
Reads like being more or less forced to me, it doesn't to you?
> and why the personal attack?
Not at all my intention! It's a genuine question, which I would ask myself too were I in OP's shoes
I don't think what I said would come across this negatively in person though, but okay..
Imagine doing your best to help someone and they die as a direct result.
Then you get to go to work and deal with the next case.
Or the patient has life changing, negative outcomes. Damn, that bad. Next case.
Living in that mental state takes a pretty unusual character type. We can expect some extreme behaviour.
It’s also interesting watching the change over time. The trainee versus consultant, or the surgeon as they near retirement.
I’m not a surgeon or a doctor and so I see a small part of their world but see some of the perks (they get everything) and some of the downsides, and there are a lot.
if you get through and into a good med school -match into surgery- you are Peak in a way very few are.
I don’t see this changing unless they reduce the requirements for med school; if they let anyone in who wants in and force that group to work 30hr shifts - you’ll get enough bad outcomes the system will change.
There was a study, I believe on nurses and shift durations. The study found the nurses were happier with shorter shifts - but the patients did worse. Patients come first.
I could see a group of Doctors loudly proclaiming love for Donald Trump (and mentioning very much how great he is) and pleading the case for a change and something happening. He is an interesting president.
I would be interested in hearing a european drs perspective, I heard they work shorter shifts (but no EU dr I met has confirmed, it’s like meeting a unicorn)
A fraction of a fraction of a percentage of people are good at surgery.
If I need someone cutting me, I’d prefer someone good, and that they were rested.
This is specifically the area we work in traditionally called slow-wave enhancement which is stimulating the restorative function of sleep.
This paper [1] specifically looks at amyloid response as a result of stimulation and shows a corresponding relationship between stimulation response, amyloid response, and memory. I wouldn't say it's putting a bow on the results, but it is a very promising result.
If you're curious about what we're building, I'll be posting a ShowHN next week which dives into some of the data in a way regulatory requirements don't permit us to do on our website, but until then, check out https://affectablesleep.com
One day, I went to a grocery store and mid-turn onto another street, I forgot what city I was in. Worse, I was half a mile from my apartment in my home town.
The MIT study shows CSF waves—normally a sleep-only process that flushes metabolic waste—intruding into wakefulness when you're sleep-deprived. Your brain is apparently so desperate for the cleanup that it forces the process to happen anyway. Cost: attention lapses.
From what I've read, delirium tremens during alcohol withdrawal seems to follow a similar pattern, except it's REM sleep intruding into waking consciousness instead of CSF flushing.
[Polysomnographic studies from the 1960s-80s](https://pubmed.ncbi.nlm.nih.gov/7318677/) documented this. Patients in alcohol withdrawal exhibit what researchers call ["Stage 1-REM"](https://www.sciencedirect.com/topics/neuroscience/delirium-t...)—a hybrid state where wakefulness and REM sleep characteristics get mixed together. Right before full-blown DTs, [some patients hit 100% Stage 1-REM](https://link.springer.com/chapter/10.1007/978-1-4757-0632-1_...). The hallucinations appear to be [literally enacted dreams](https://www.sciencedirect.com/science/article/abs/pii/S01651...) occurring while technically awake. The sleep-wake boundary just completely breaks down.
What strikes me is the system-level similarity here. Sleep normally maintains clean states: you're either awake (alert, reality-testing intact, no CSF flushing) or asleep (offline, dreams permitted, maintenance running). But when the system gets stressed enough—whether through sleep deprivation or the neurochemical chaos of alcohol withdrawal—it seems to start making desperate tradeoffs.
The brain apparently needs certain processes to run. Period. Total no-brainer! CSF flushing can't wait indefinitely. Neither can REM sleep, which serves its own critical functions. So when normal sleep architecture fails, the system appears to force these processes anyway, even though the conditions are completely wrong for them.
Maybe that's why the costs are so specific. CSF intrusion during wakefulness costs you attention. REM intrusion costs you reality testing, because REM is the state where your brain accepts impossible narratives without question. Same compensatory mechanism, different critical process forced into the wrong state.
What I find interesting is how the brain knows what lever it needs to pull and how it pulls it. Sleep deprivation forces waste removal. REM deprivation forces wakeful dream states; which might be a side effect not the actual goal. The brain seems to know what maintenance is overdue and attempts the repair, consequences be damned.
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