A ReLACSing Blog #6: Why Did the Apostles Fall Asleep in the Garden of Gethsemane?

Raphael’s depiction of the apostles’ attempt to keep watch with Jesus

For full disclosure, though I actually did major in religious studies, I did not study Catholic/Christian theology in college so I am no expert on the biblical understanding of the Agony in the Garden. However, I am familiar with the accounts of the disciples falling asleep in the garden of Gethsemane and, of course, always get excited about biblical passages that involve sleep. As I am writing this today, on Good Friday, I thought it would be interesting to reflect upon these passages from the Gospels and how they intertwine with aspects of sleep. 

The Catholic Church uses John’s Gospel on Good Friday, which does not include an account of the apostles falling asleep in the garden but the other three Gospels do. Last Sunday, Palm Sunday, there was the account of Luke 22:39–46 in which Jesus was in such agony and he prayed so fervently that his sweat became like drops of blood falling to the ground. Jesus returned from a stone’s throw from the disciples and found them sleeping from grief. (This differs significantly from the accounts in Matthew and Mark as below.) He then said to them, “Why are you sleeping? Get up and pray that you may not undergo the test.” From a sleep and physiological perspective, this passage highlights several aspects of the physiology of sleep. The episode from Gethsemane is late at night after the Last Supper and likely past Jesus and the disciples’ natural bedtime. They had a right to be sleepy from a circadian rhythm (biological clock) perspective. However, Jesus, considered both fully divine and fully human in many Christian denominations, demonstrates the human principles of cognitive and emotional hyperarousal, stress activation of the central nervous system, and sympathetic drive. Hyperarousal is the concept of the brain being overly active at bedtime, when normally it should be in a relaxed state and allowed to transition physically into sleep. Jesus was facing imminent betrayal by Judas and the brutal course through his crucifixion, so the level of cognitive and emotional activity was through the roof. Thus, it was absolutely appropriate for him not to be able to sleep, even if physiologically the appropriate time for his body to be asleep. Jesus was under tremendous emotional stress with “fervent” prayer with such intensity that sweat became like drops of blood. This highlights the sympathetic nervous system activation, which is the body’s natural “fight or flight” response. This department of the nervous system kicks up when we have to flee an attacker or fight off an enemy. It gathers our energy for survival in battle. It was completely reasonable for the sympathetic nervous system to be fully activated in Jesus’ case as emotionally, despite submitting peacefully to the crowd, Jesus' natural human reaction would have been to prepare for a fight. The disciples were clearly in for a fight as one of them struck the high priest’s servant and cut off his right ear. (Lk 22:51) 

The sympathetic nervous system should not be overly activated during sleep as sleep should be a dominant parasympathetic state (rest and digest system). Some overactivity will lead to lighter or reduced sleep quality, and significant overactivity of the brain will completely prevent sleep. We should not be asleep if we are about to fight off the attacker or run away from the threat. The sympathetic nervous system causes physical changes to the body including increasing heart rate, sweating, and also heightened arousal. Nightmares are a classic example of the intrusion of sympathetic drive into sleep and one of the main pharmacological treatments for nightmares, prazosin, targets the reduction in the sympathetic response. It makes sense that we would be vigilant when about to be threatened. Other physiologic properties within Jesus would have been hormonal activation of cortisol which is a stress hormone released by the adrenal gland and signaled by the hypopituitary-adrenal axis. In part, cortisol has a role to help with the above fight or flight functions, as well as causing a release of glucose (energy) into the blood. Cortisol naturally rises in us in the morning around the time we wake up to help get us ready for the day to give us the energy and resources to hunt or gather for food. Those of you using continuous glucose monitoring (CGM) should note a spike in blood sugar levels in the morning, despite not having eaten all night, and this can be attributed to the morning rise in cortisol. Cortisol excess can be a bad thing if levels are high chronically, which can occur with chronic stress, detailed beautifully in the famed stress book by a former professor, Robert Sapolsky, Why Zebras Don’t Get Ulcers . Anyway, the combination of worry, emotions, elevated cortisol, stress response, sympathetic activation, etc. clearly illustrates why Jesus was WIDE awake in Gethsemane prior to his capture. 

These same circumstances can explain why we may not be able to sleep when we have an anxiety-provoking event the next day such as a big test, speech to deliver, musical recital at which to perform, etc. However natural these circumstances would be, it can become pathological if this is the type of hyperarousal one has frequently, which can lead to chronic primary and secondary insomnia. Primary insomnia is best addressed through cognitive and behavioral therapy for insomnia (CBT-I) as the factors keeping us from sleeping are often due directly to factors around sleep itself. Secondary insomnia can also become chronic and the factors indirectly affecting sleep should be addressed first but the same cognitive and behavioral approaches can be applied as well. Sleeping pills or hypnotic agents function by chemically decreasing alertness, to deactivate the overactive mind in some sense. Most sleep experts would agree that Unisom or Ambien would not have put a dent in Jesus’ hyperarousal during the Agony in the Garden!

The interesting part in Luke’s Gospel is that they were sleeping from grief. To me, the level of grief would cause the same alerting factors as above and lead to the inability to sleep, such as how one would sleep when there is a recent death to a close relative or friend. Alternatively, Luke, who is the patron saint of physicians by the way, could be highlighting the power of the homeostatic sleep drive. This is the “fuel for sleep” that accumulates by being awake throughout the day. If we need 7 hours of sleep per night, we need to be awake 17 hours during the day to sleep well for those 7 hours. The disciples had been through a lot after entering into Jerusalem and their semi-awareness of the upcoming crucifixion of Jesus. Perhaps they had such poor sleep for the nights leading up to Gethsemane that not even the stress of Jesus’ crucifixion could keep them awake. Their homeostatic sleep drive was so high that their anxiety and hyperarousal could not overcome it. This is exactly what I tell patients with insomnia. Many with chronic insomnia feel like they are getting so little sleep that they could drop dead. Like an impetuous child holding his or her breath to threaten mom or dad, they will eventually pass out and start breathing again. The body has a similar safety mechanism for sleep in that if the homeostatic sleep drive accumulates enough sleep debt, the body will eventually just fall asleep, regardless of how bad the insomnia is. This is why drowsy driving can be so deadly as often willpower to stay awake is insufficient to prevent dozing off for a few seconds and crash. When we do CBT-I in sleep medicine, part of the treatment is sleep restriction, in which patients begin to get a little sleep deprived—intentionally—and the increase in the homeostatic sleep drive forces the person to sleep and sleep more deeply, despite all the other anxieties and hyperarousal phenomena. This helps patients re-learn the good feeling of sleeping deeply, a reminder that they still have it in them. Could this built up sleep drive have been the case for the disciples’ inopportune snooze? Or is it something to do with their emotions such that they became so mentally and emotionally exhausted that their brains just shut down. We sometimes see this in depression in which the brain can become so depressed that a person does not have the energy or motivation to do anything and may stay in bed, sleeping excessively. 

In contrast to Luke’s account, Mark and Matthew do not speak of sleep due to grief, but perhaps their human failures and the lack of dedication to Jesus’ mission. In Matthew, when Jesus returns from praying to find the disciples asleep, He said to Peter, “So you could not watch with me for one hour…The spirit is willing but the flesh is weak.” (Mt 26:40–41) He then returned two more times and the third time he said to them, “Are you still sleeping and taking your rest? Behold, the hour is at hand when the Son of Man is to be handed over to sinners.” (Mt 26:45) From a spiritual standpoint, Peter, James and John have insisted on always being at Jesus’ side, even to the point of death. However, their flesh was too weak physically to stay awake but spiritually it is a metaphor that despite pure intentions, the human condition is prone to sin. Here, from a sleep standpoint, it suggests that the anguish that was facing Jesus, to drive up his alertness in the middle of the night, was not present in the disciples to the extent that they could remain awake. If they truly realized the suffering that was to come to Jesus and the implications of his self-sacrifice, there should not have been any way they could have fallen asleep, no matter the poor sleep quality, sleep deprivation, or any other physical factors (too much wine with Last Supper???) that preceded the scene from the garden of Gethsemane. 

In short, as revealed in the Agony in the Garden and the ill-timed sleep of the apostles, the Gospel writers use sleep to illustrate the failures of the disciples as followers of Jesus in stark contrast to the passionate anguish of Jesus himself driving his wakefulness.

-Andy Berkowski, MD, amateur sleep & Bible scholar

ReLACS Health