In light of the current pandemic, I wanted to focus on the integral role of sleep and immune function. Sleep is one of the most underrated aspects of our lives. And its under constant attack by modern society. We are incredibly sleep-deprived, with more than half of all adults saying they have a hard time sleeping at least a few times each week. The number of adults that take sleeping pills has doubled in the recent past. There is much cultural messaging in society today that tells that sleep is “for the weak” or “a waste of time” or “useless.” Nothing could be farther from the truth. Adequate, quality sleep is a critical component of a healthy life. It is critical to so many aspects of a good life, from healthy mental states, to learning, growing, problem-solving, etc.
Human beings are the only creatures on earth that will willfully and intentionally avoid sleep. As a result, Mother Nature has not evolved a safety net to compensate for the loss when we do this to ourselves. The consequence is that we see the damage in our health and well-being fairly quickly when sleep is consistently and purposely thwarted. Extended sleep deprivation is so damaging to functioning and well-being, that it is recognized as a means of torture by the United Nations. As a matter of fact, prolonged sleep deprivation can even lead to death.
Our immune system is intricately connected to our internal body clock
We are wired for 12 hours each of lightness and darkness (more or less). When this rhythm is thrown off, say from jet lag, night-shift work, late night movies or outings, or even staring at your phone late at night, then our immune system is also thrown off. A healthy pattern of sleeping and waking, lightness and darkness is critical to keeping the immune system functioning optimally. A study from the University of California showed that consistently sleeping less than 6 hours per night was associated with chronic inflammation. And we already know that low-lying inflammation is the basis for almost all modern diseases, including heart disease, cancer, diabetes, cognitive decline, mood disorders, etc.
Other research shows that sleep helps T cells, which are a class of immune cells, improve their functioning in fighting pathogens and disease during sleep. Individuals who get poor sleep will not have T cells that are functioning at optimum potential.
Our body produces melatonin each evening, preparing us for a night of slumber. Melatonin is also responsible for increasing your cytokine function, a critical component of the immune system, that helps protect against infection. This is why when you’re sleeping-deprived, you are much more likely to get sick.
The importance of a stable sleep-wake cycle is so closely linked to health and optimal functioning that the World Health Organization declared night shift work as “probably carcinogenic to humans.” A growing number of studies continue to connect shift work with disease and unhealthy outcomes.
The following are the different sleep stages:
Stage 1 is when you’re getting sleepy and are ready to drift off.
Stage 2 is when your brainwave activity quickens and follows a steadier rhythm. Your core temperature and heart rate start to decrease.
Stage 3 is when slower brain waves start. This is when you switch from light sleep to deep sleep.
Stage 4 is the deep sleep stage, also known as delta sleep and slow-wave sleep. This is a critical stage because it’s where much of the highest-quality sleep occurs. This is where restorative sleep happens.
Stage 5 is the REM (rapid-eye movement) stage, where most dreams occur.
Stages 3 and 4 are particularly important because this is when the body decreases your the stress hormone levels, cortisol, and inflammation levels. It is also during these stages that the immune system grows stronger.
Many benzodiazepines, such as Ambien, Lunesta, Valium, Xanax etc., actually reduce the amount of Stage 4 slow-wave sleep, despite making you drowsy and sleepy. Therefore, these are not a solution to your sleeplessness. In addition, these medications cause dependency which can sometimes be difficult to overcome.
Other issues they can cause are rebound insomnia, constipation, memory loss, daytime drowsiness, and troubling sleep-walking behaviors. Finally, one of the most troubling pieces of research to come out on the use of benzodiazepines shows that individuals taking this class of medications are 60% more likely to develop dementia than those who did not use the drugs.
It’s best to address sleep issues early rather than later, because as sleep debt accumulates, your body will have a harder and harder time trying to compensate and pay off the debt.
Practice Good Sleep Hygiene:
Keep it consistent. Wake up at the same time everyday, go to sleep at the same time every night. Even on weekends.
Keep it cool. Keep your bedroom on the cool side. 65F or 18C is typically a comfortable temperature for sleeping.
Keep it low-tech. Keep gadgets and screens out of the bedroom.
Keep it simple. Use the bedroom only for sleeping (and sex). All other activities - working, answering emails, watching TV, being awake - should take place elsewhere in your home.
Keep it dim. Turn off all extra and unnecessary lights throughout the house a couple of hours before bedtime. Install or enable “Night Shift” or “Night Mode” on your cell phones and “Night Light” on your computer screens to help filter out sleep-ruining blue light. F.lux is another option for filtering computer blue light (justgetflux.com).
Keep it boring. Try to stay off your TV, cell phone or laptop at night. Even if you’ve filtered the blue light, the psychologically engaging content that you take in can delay sleep onset considerably.
Additional ways to get in the mood for slumber:
Take an Epsom salt bath before bed: This can be very relaxing because of its high magnesium content, which is absorbed through the skin. Be sure to sit for at least 15-20 min to take advantage of its relaxation properties.
Avoid any caffeine after 12 noon. Remember, even decaf coffee contains caffeine.
Get outside in the sunlight during the day, especially morning and midday sun, even if it’s cloudy outside. It will help your body reset its circadian clock, and you’ll get some Vitamin D to boot.
Implement a regular exercise routine - it can be as simple as a 20 minute walk each day or more elaborate based on your time and preferences. Regular exercise improves sleep onset and sleep quality.
Make an evening routine and stick to it. It can be more elaborate on evenings when you have more time, and simpler on busier evenings. Pick one or a few of the following and implement them regularly: have an herbal tea (chamomile, Sleepy Time, peppermint, etc. are all good options), write in your journal, take a bath with lavender and epsom salt, meditate, do the yoga “corpse pose.”
Supplements to improve your sleep:
The following supplements might be helpful for occasional sleeplessness. If it’s a chronic issue, this could be an indicator that you have other imbalances that need to be addressed. Work with a qualified integrative practitioner to get to the root cause of your sleep issues. Such issues could be hormonal imbalances, stress, nutrient deficiencies, poor diet, etc.
Magnesium Bisglycinate: magnesium is a relaxing mineral that can help your body unwind and get ready to sleep. Take 200-400 mg about a 1/2 hour before bed.
Phosphatidylserine is a fatty substance that the body produces and that we also take in from our food. Supplementing with this has been shown to improve sleep quality and quantity. 300 mg a couple of hours before bed can be helpful.
GABA: Gamma amino-butyric acid is a calming neurotransmitter that the body naturally produces. It helps us calm down, stop running in circles in our heads, and allows the body to transition into a relaxed state. Certain conditions decrease GABA levels in the body causing a prolonged state of stress or anxiety in individuals, making sleep difficult. Do not use GABA if you are taking antidepressants, benzodiazepines or anti-anxiety medications.
5-HTP: Again, this is a natural compound made in the body from amino acids. It converts into serotonin, which also then converts into melatonin. Melatonin is the hormone that keeps the body’s sleep-wake cycle in check. It also helps bring about REM sleep and increases deep-wave sleep. Supplementing with 5-HTP has been shown to improve both sleep quality and quantity. Do not take 5-HTP if you are taking antidepressants, benzodiazepines or anti-anxiety medications.
Valerian Root: Known as Nature’s valium, valerian is an age-old remedy for insomnia. As a mild sedative, valerian is useful for calming anxiety and decreasing wakefulness. It comes as a tincture that can be taken as drops, or more conveniently, as a dried herb that you can consume as a tea. Do not take valerian if you are taking antidepressants, anti-anxiety medications, Xanax, benzodiazepines or other neuropsychiatric medicines.
I hope some of these suggestions help you realize the importance of sleep, particularly in light of your immune health. Therefore, I hope you will prioritize your sleep, as it is critical for good health. Aim for 7.5 - 8 hours per night.
Sleep as if your life depended on it, because it does.
Common sense disclaimer: Please work with a qualified integrative practitioner, herbalist or other specialist to help you determine if and which supplements are right for your specific situation. Natural doesn’t mean harmless: there are many contraindications to herbs and supplements, which is why I usually hesitate to list common dosages. Only a thorough understanding of your bio-individuality will determine which supplements are best for your health. My purpose here is to celebrate the many healing remedies of the natural world and show you that there are effective alternatives to prescription medications, that are free of damaging side-effects when consumed appropriately and under supervision.
References:
American Academy of Sleep Medicine. (2007, June 14). Reduced Sleep Quality Can Aggravate Pre-existing Psychological Conditions. ScienceDaily. Retrieved May 3, 2020 from www.sciencedaily.com/releases/2007/06/070613071126.htm
Buxton, O. M., Pavlova, M., Reid, E. W., Wang, W., Simonson, D. C., & Adler, G. K. (2010). Sleep restriction for 1 week reduces insulin sensitivity in healthy men. Diabetes, 59(9), 2126-2133.
de Gage, S. B., Bégaud, B., Bazin, F., Verdoux, H., Dartigues, J. F., Pérès, K., ... & Pariente, A. (2012). Benzodiazepine use and risk of dementia: prospective population based study. Bmj, 345, e6231.
Dijk D. J. (2009). Regulation and functional correlates of slow wave sleep. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 5(2 Suppl), S6–S15.
IARC Monographs Vol 124 group. Carcinogenicity of night shift work. Lancet Oncology. 2019; 20: 1058-1059
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