A new paradigm is fundamentally reshaping the way medicine understands the brain. No longer viewed as an isolated organ sealed within the skull and reduced to a mere computational device, the brain is now recognised as a living, dynamic ecosystem, constantly interacting with the body, the mind, and the broader social environment.
This concept was at the heart of the scientific event held at the UniCamillus Auditorium on 19th May 2026, which brought together clinicians, researchers, and academics for an interdisciplinary dialogue of exceptional scientific depth and emotional resonance: the conference, titled ‘Brain Health: An Integrated Approach to Sleep Medicine, Mental Health, Nutrition, and Oral Health’.
The meeting was organised by Andrea Romigi, a lecturer in Neurology at UniCamillus and Head of the Sleep Medicine Centre at IRCCS Neuromed, as part of the third edition of the UniCamillus Third Mission Conference Series, ‘Where Science Meets Society’.
The event was moderated by Professor Barbara Tavazzi, Head of the Faculty of Medicine and Surgery at UniCamillus, and Donatella Padua, Rector’s Delegate for the Third Mission and Scientific Coordinator of the conference series.
Alongside Romigi, speakers included UniCamillus Professor Gianfranco Peluso (Head of the MSc in Human Nutrition Sciences), Professor Paola Cozza (Head of the MSc in Dentistry and Dental Prosthetics), Professor Stefania Chiappini (Lecturer in Psychiatry), Professor Vera Kopsaj (Lecturer in Sociology of Cultural and Communication Processes and in General Sociology), Professor Valentina Alfonsi (Lecturer in General Psychology), and Professor Angelo Giovanni Icro Maremmani (Lecturer in Psychiatry).
Tavazzi: “The brain as an ecosystem”
Professor Barbara Tavazzi opened the session by outlining a markedly renewed vision of contemporary medicine.
“Traditionally, the brain was regarded as an organ enclosed within the skull, responsible for complex yet isolated functions. Today, however, it is understood as a genuine ecosystem, constantly interacting with the body’s other systems. This perspective allows us to appreciate how brain well-being is shaped by multiple factors, including sleep, mental health, nutrition, and oral health”.
In an era defined by stress, hyperconnectivity, and performance pressure, the brain becomes the point where numerous biological and environmental influences converge.
“Caring for these dimensions does not simply mean preventing disease; it means enhancing overall quality of life. A healthy balance between sleep and mental well-being also strengthens social relationships and personal stability, helping individuals feel more centred, calm, and in harmony with themselves and others”.
Padua: “The Third Mission and the value of shared knowledge”
Professor Donatella Padua emphasised the central role of the University’s Third Mission: opening scientific knowledge to society. She described knowledge as a ‘mosaic’, where each discipline represents a tile that is incomplete on its own but, when combined with others, forms a coherent picture of human health.
“In this context, sleep can be viewed from a dual perspective: on the one hand as the outcome of a state of health or illness, and on the other as a factor that actively contributes to generating well-being or disease. Sleep is not an isolated element, but part of a circular process involving the individual’s entire balance. It is therefore essential to understand where to intervene: whether sleep should be considered a cause or a consequence of our states of well-being or distress.”
Romigi: “Sleep as a pillar of brain health”
Professor Andrea Romigi opened the first thematic session on sleep medicine by emphasising a crucial concept: sleep is not passive rest, but a form of intensely active biological work. During sleep, the brain clears metabolic waste, consolidates memory, reorganises synaptic connections, and regulates emotions and learning.
Yet sleep remains significantly understudied. “Globally, there is still a marked inequality in scientific knowledge on this topic: only 40% of the world’s population has been included in systematic sleep studies, while in many regions data remain scarce”.
Epidemiological evidence further underscores the public-health impact of insufficient sleep. “If this risk factor were removed, we would observe a marked reduction in strokes, depression, and workplace accidents. The economic burden of sleep-related disorders is substantial, amounting to tens of billions of dollars—a figure that clearly indicates that sleep must be treated as a strategic priority in public-health planning”.
In Italy, the data are equally compelling. “At least six million people live with sleep apnoea, a condition in which breathing repeatedly stops during sleep, leading to micro-awakenings and fragmented rest. A further eight to nine million people suffer from chronic insomnia. Following the pandemic, requests for clinical support for sleep disorders increased by 30%. This trend is particularly concerning because insufficient or poor-quality sleep is strongly associated with a higher risk of obesity, diabetes, and mortality”.
Sleep is shaped not only by biological mechanisms, but also by social life and daily routines. “Our body is regulated by three distinct ‘biological clocks’: the internal clock (which governs physiological rhythms), the social clock (linked to school, work, and daily commitments), and the solar clock (the light–dark cycle)”. When these clocks fall out of alignment, a condition known as social jet lag emerges—a mismatch between the body’s natural rhythm and the rhythm imposed by social life. This phenomenon is particularly common among adolescents and may contribute to depression, increased use of stimulants, weight gain, and metabolic disturbances.
The takeaway is unmistakable: good sleep is not optional—it is a basic biological need.
Peluso: “Nutrition, Sleep, and the Microbiota: The Gut as a ‘Second Brain’”
Professor Gianfranco Peluso illustrated the central role of the gut microbiota—the community of microorganisms that inhabit our intestines and work in synergy with the human body.
He explained that the microbiota is not merely a collection of bacteria, but a true biological resource. “These microorganisms possess far more genes than humans do and help us produce substances we could not synthesise on our own”. In other words, these bacteria ‘work with us’, expanding the functional capacities of the body. The intestine is therefore not only responsible for digestion; it is connected to the brain through nerves, hormones, and the immune system.
Peluso highlighted the link with sleep: intestinal bacteria produce substances such as serotonin, GABA, and melatonin, which influence mood and the sleep–wake cycle. When the microbiota is balanced, it supports healthy sleep; when altered (dysbiosis), it may contribute to insomnia, night-time awakenings, stress, and mood disturbances. The relationship is bidirectional: not only does the gut influence sleep, but insufficient or poor-quality sleep can also worsen the intestinal flora.
Peluso’s conclusion was unequivocal: “Poor nutrition can alter the microbiota within just a few days and, if the imbalance persists, it may have long-term consequences for overall health—including the brain and sleep.”
Cozza: “Oral health and sleep: the mouth as the ‘gateway of breathing’”
Professor Paola Cozza emphasised how sleep disorders directly involve oral health, given the mouth’s central role in night-time breathing.
Although sleep-related breathing disorders are multifactorial, they often originate in the oral cavity. Cozza explained that one of the key mechanisms concerns the relationship between the tongue and the bones that ‘contain’ it (the mandible and maxilla).
During sleep, muscles relax: the tongue loses tone and, if space in the mouth is limited, tends to shift backwards toward the throat. When this occurs, the tongue may approach or press against the upper airways, narrowing airflow. This posterior collapse can obstruct breathing during sleep and contribute to snoring, micro-awakenings, and—in more severe cases—sleep apnoea. These disruptions lead to daytime sleepiness, reduced concentration, and poorer quality of life.
Orthodontics can intervene by improving the geometry of oral structures. However, in adults, the effects of such devices are often mainly symptomatic. In children, by contrast, intervention is more effective. For this reason, Cozza stressed the importance of early prevention: “Intervening early means modifying craniofacial growth and preventing future respiratory disorders.”
Chiappini: “Sleep and the mind have a bidirectional relationship”
Professor Stefania Chiappini explored the deep and reciprocal connection between sleep disorders and mental health. Insomnia, anxiety, depression, and mood disorders are not separate conditions, but interconnected phenomena that share the same neurobiological circuits. When sleep is disrupted, psychological balance is affected as well.
Sleep is not simply a time for ‘rest’; it is essential for regulating emotions, memory, and the ability to cope with stress. When sleep is disturbed, the brain operates under conditions of overload. “Sleep alterations, particularly insomnia, can modify the stress response and contribute to the development of mental disorders.”
A central role is played by the internal biological clock. Chiappini reminded the audience that the circadian system regulates the body’s functions: “It is a system governed by a central clock and by genes such as CLOCK and BMAL1, which synchronise sleep, hormones, metabolism, and emotions”. When this system becomes disrupted, mental balance is destabilised.
Chiappini also highlighted how mood disorders are often linked to this desynchronisation: night-shift work, jet lag, or insufficient exposure to light can increase the risk of anxiety and depression precisely because they disturb the body’s natural rhythm.
Another key point concerns the two-way relationship between sleep and psychiatric disorders. “Not only does poor sleep worsen mood, but anxiety and depression also worsen sleep, creating a vicious cycle”.
Sleep is composed of different phases, such as REM and NREM, which are essential for processing emotions and memories. When these phases are interrupted, coping with daily stress becomes more difficult. Sleep is therefore a central component of mental health: protecting it means protecting emotional balance and psychological well-being.
Kopsaj: “Sleep as a social factor”
Vera Kopsaj shifted the focus from biology to the social dimension of sleep. Her talk opened with a simple yet provocative question: “Are you sleepy? If so, why aren’t you sleeping right now?”
From this starting point, she emphasised that sleep depends not only on physical tiredness, but also on the context in which we live. “We do not sleep only when we are sleepy, but when social conditions allow us to do so”. Kopsaj proposed a change in perspective: the brain is not merely a biological organ, but a profoundly relational system, shaped by everyday interactions. When we go to sleep, we do not leave our social lives outside the bedroom; we carry with us emotions, conflicts, relationships, and stress. “Sleep is influenced by emotional relationships, job insecurity, economic anxiety, and digital hyperconnectivity”.
Social relationships play a crucial role: strong support networks improve general well-being and sleep quality, while loneliness and isolation increase the risk of insomnia and stress.
From this perspective, sleep is not only an individual factor, but a social phenomenon influenced by age, work, economic conditions, relationships, and even the sense of personal safety.
Alfonsi: “The life cycle and the fragility of sleep”
Professor Valentina Alfonsi explained that sleep is not static, but changes profoundly across the lifespan, both in quantity and quality. “In children, sleep is much longer and supports brain development, while in adults it stabilises, and in older people it tends to decrease and become lighter”.
With ageing, not only does the amount of sleep change, but also its structure. Alfonsi noted that “wakefulness increases while deep, restorative sleep decreases”. REM sleep is reduced, and sleep becomes more fragmented, with more night-time awakenings and less continuous rest.
Biological rhythms also shift. “In older adults, there is an anticipation of the sleep–wake rhythm, with a tendency to fall asleep and wake up earlier”. This means that the internal clock effectively shifts forward. These changes are physiological, but may become problematic when combined with chronic illnesses, medications, or social isolation.
A key aspect concerns what happens in the brain during sleep. “During sleep, a sort of ‘cleaning system’ is activated, eliminating waste substances and potentially toxic proteins accumulated during the day. This mechanism is essential for protecting memory, learning, and cognitive functions”. When sleep is insufficient or fragmented, this process becomes less effective, allowing proteins associated with neurodegenerative diseases—such as beta-amyloid and tau, both linked to Alzheimer’s disease—to accumulate more easily.
However, not all older adults experience this decline. Alfonsi referred to the so-called ‘super agers’, people over eighty who maintain strong cognitive abilities. In these cases, “sleep remains one of the main protective factors for healthy ageing”.
Maremmani: “The risk of oversimplification”
Professor Angelo Giovanni Icro Maremmani brought the discussion back to clinical practice, stressing how sleep is often underestimated. In psychiatry, sleep is never secondary.
“It is often viewed merely as a symptom, but it can appear in different forms: insomnia in mood disorders, insomnia in depressive conditions, or hypersomnia”. These signs are often early indicators of a broader imbalance.
The main issue arises when managing insomnia. In clinical practice, the risk is oversimplification. “The patient simply says, ‘I can’t sleep,’ and often the discussion stops there”, he explained. From there, treatment often moves quickly toward medication.
From this point, treatment often moves quickly toward medication. “Hypnotic drugs are prescribed correctly according to guidelines, but in reality many patients are unable to stop taking them.” This may lead to functional drug dependence: the medication becomes necessary for sleep without addressing the underlying cause. The result is a double problem—chronic sleep disturbance and potential drug dependence.
Maremmani therefore emphasised the need for a more careful and multidisciplinary approach, encouraging clinicians to view insomnia not as an isolated symptom, but as a complex condition requiring thorough assessment.
A Common Thread: Health as a Living Balance
What emerged powerfully from the entire event was a single, compelling idea: nothing in the brain exists in isolation.
Sleep interacts with the microbiota. The microbiota influences the mind. The mind shapes social behaviour. Society affects sleep. Sleep, in turn, modulates the brain. It is a circular, dynamic, continuous network.
The Brain Health event at UniCamillus was not merely a scientific conference, but a powerful demonstration of shared vision: it demonstrated that brain health is not built in a laboratory or within a single medical specialty, but at the intersection of disciplines, people, and life contexts.
The final message was simple yet profoundly human: caring for the brain means caring for sleep, the body, the mind, and the relationships that shape our lives—a quiet but powerful invitation to rethink medicine not as a sum of separate parts, but as attentive care for the individual as a whole.
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