METTL3-dependent m⁶A maturation of miR-140-3p contributes to hippocampal neuronal apoptosis through the OTX2/Wnt/β-catenin axis under chronic stress.

Sleep—an essential pillar of health—has historically been considered not only a biological phenomenon but also based on experiences interpreted through spiritual, moral, existential, and cultural frameworks worldwide [–]. Across societies, dreams, nightmares, sleep paralysis, and nocturnal visions have frequently been attributed to soul journeys, spirits, precognitions, moral conflict, supernatural attack, and ancestors [, –]. Yet, contemporary sleep medicine remains predominantly grounded in biomedical models despite growing recognition of more holistic frameworks. For instance, Whole Person Health—developed by the National Center for Complementary and Integrative Health—adopts a biopsychosocial-spiritual approach that recognizes physical, mental, social, and spiritual dimensions of health and wellbeing are interconnected and can collectively shape health outcomes relevant to sleep []. Religion and spirituality remain highly prevalent globally, with approximately 75.8% of the world’s population affiliated with a religious tradition []. Additionally, nearly one-quarter of the global population is religiously unaffiliated, yet many continue to identify as spiritual or endorse spiritual beliefs and practices despite lacking formal religious affiliation []. Sleep-related spiritual experiences are also common; 53% of US adults report dream or other experiences involving deceased loved ones [], 70% of Brazilians report at least one precognitive dream [], and out-of-body experiences—including those occurring during sleep or sleep–wake transitions—have been reported by up to 20% of the population []. Such experiences may become sources of distress and prompt healthcare seeking, particularly when individuals lack cultural, spiritual, or social frameworks through which to understand them []. Underscoring its clinical relevance, the American Psychiatric Association expanded—in 2025—the DSM-5-TR code Z65.8 from “Religious or Spiritual Problem” to “Moral, Religious, or Spiritual Problem,” recognizing moral and spiritual distress/conflict as a clinically significant foci warranting attention without pathologizing them as psychiatric disorders []. Such concerns are likely relevant to sleep medicine given evidence associating trauma exposure, moral injury, and spiritual distress with nightmares, hyperarousal, and insomnia symptoms [].