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Sleep Is the Ultimate Holistic Remedy

The risks of sleep deprivation include more than just fatigue.

Key points

  • Sleep is one of our most potent methods for treating illness and preventing disease.
  • Sleep deprivation has increased in recent decades, to the detriment of our population's health.
  • Our brain is highly active while we sleep and undergoes a crucial deep cleaning.

Let’s consider the adaptations humans have made to avoid threats in their environment: significant increases in body size and strength, the development of complex language and tools, and the potent fight-or-flight reflex.

Then comes sleep. Not only are we unconscious for 7-8 hours, but during rapid eye movement (REM) sleep, our skeletal muscles are actually paralyzed. This normal occurrence may be good for our bed partners during our active dreams, but it certainly doesn’t improve our chance of successfully fleeing predators.

The benefits of sleep, therefore, must be so essential that we have made the trade-off to spend those hours in such a vulnerable position. Indeed, as we learn more about the multitude of restorative activities happening during sleep, it’s clearly our most holistic path to good health.

Are we getting enough sleep?

Ironically, as our knowledge of the benefits of sleep increase, our population is getting less rest than ever. In a recent consensus statement from the American Academy of Sleep Medicine and Sleep Research Society, they recommended a minimum amount of sleep: 7 hours per night for adults. However, between the years 1985 and 2012, the percentage of adults sleeping 6 or fewer hours of sleep per night doubled from 38.6 million to 70.1 million. The CDC considers this prevalence of sleep deprivation to be a public health emergency.

Insomnia is not the same thing as sleep deprivation.

It may be most helpful to understand insomnia as “distress about poor sleep” rather than an inability to sleep. Individuals may be in bed for as many as 9 or 10 hours, but the quality of their sleep is unsatisfying and frustrating. They also may experience significant anxiety about sleep.

Sleep deprivation, however, occurs when an individual is unable to spend enough time in bed to meet their biological need. Let’s consider a common scenario, particularly during the past year of persistent pandemic-related overwhelm. A mother is trying to work from home while her children sign on to remote learning platforms. She watches in dismay as her work efficiency declines further after each interruption from their children. When she finally tucks them into bed, her true workday begins. She then crawls into bed at 2 a.m., and her children are up again at 6, asking, “What’s for breakfast?”

Adequate sleep is crucial to our health.

A consistently inadequate amount of sleep (less than 6 hours per night) has been associated with numerous health concerns, including heart disease, cancer, obesity, diabetes, depression, and anxiety. Societal pressures, including lack of adequate childcare, employment without benefits leading to multiple part-time positions, and good-paying jobs increasingly out of reach without higher education, have led to a massively sleep-deprived and subsequently less healthy population.

Sleep is one of our most powerful drives and provides an incredible number of benefits for our health and well-being. These include boosting our immune system, stabilizing our appetite and metabolism, so we don’t overeat high-calorie foods and store them as adipose (fat), and lowering our risks of anxiety and depression.

Sleep and our immune systems

As the country becomes vaccinated, it is important to consider the effects of sleep on our immune systems. Dr. Prather at UCSF performed a study of participants with a nasal introduction of the rhinovirus (i.e., the virus causing the common cold) and reviewed infection rates by sleep hours. Notably, nearly half of those who slept fewer than 5 hours over a period of one week contracted a cold, which was 4.5 times greater than their well-rested counterparts (who slept >7 hours per night).

Sleep also increases our vaccine response. For example, in a study of 125 healthy subjects receiving the three-dose hepatitis B vaccine, individuals who slept on average fewer than 6 hours per night had a much higher risk of inadequate antibody response than peers sleeping more than 7 hours per night. In fact, these sleep-deprived subjects were 11.5 times less likely to be protected from hepatitis B following vaccination.

Sleep is time for your brain’s deep cleaning.

Additionally, much activity is happening in your brain during sleep, particularly a crucial deep cleaning to remove harmful toxins. First fully described by Iliff and colleagues in 2012, the glymphatic system is the brain’s drainage machinery, flushing waste products before they can cause damage. This removal is particularly active during deep, non-REM sleep.

Scientists have noted the removal of beta-amyloid (Aß) and tau molecules from the brain during this nightly cleaning process. This is important because Aß and tau contribute to two key formations (Aß plaques and tau tangles) noted in Alzheimer’s disease. For example, even one night of total sleep deprivation causes a measurable increase in the Aß burden in the thalamus and hippocampus, two crucial brain regions for memory and information processing.

Decreases in glymphatic activity have been noted in individuals performing shift work, as well as those with a sedentary lifestyle or history of a traumatic brain injury. Exercise appears to improve glymphatic drainage, which may explain the suggested cognitive benefits of regular physical activity.

How can we reach our goals for health and longevity?

Although adequate sleep, along with a healthy diet, regular exercise, and manageable stress levels, will not prevent all illnesses, we can give ourselves a powerful, holistic headstart by making sure we remain well-rested. Even when society tells us to “work hard, play hard,” and sleep only when exhausted, recent discoveries should make us think twice about the significant risk of sleep deprivation. Nothing else provides as much healing power as a good night’s rest, and our bodies, as well as our clean, refreshed brains, will certainly thank us for our effort.

References

Iliff J et al. A Paravascular Pathway Facilitates CSF Flow Through Brain Parenchyma and the Clearance of Interstitial Solutes, Including Amyloid ß. Sci Transl Med 2012. Aug 15; 4(147):147ra111.

Komaroff AL. Does Sleep Flush Wastes From the Brain? JAMA. Published online May 17, 2021. doi:10.1001/jama.2021.5631

Prather AA, Hall M, Fury JM, Ross DC, Muldoon MF, Cohen S, Marsland AL. Sleep and antibody response to hepatitis B vaccination. Sleep. 2012 Aug 1;35(8):1063-9. doi: 10.5665/sleep.1990. PMID: 22851802; PMCID: PMC3397812.

Prather AA, Janicki-Deverts D, Hall MH, Cohen S. Behaviorally Assessed Sleep and Susceptibility to the Common Cold. Sleep. 2015 Sep 1;38(9):1353-9. doi: 10.5665/sleep.4968. PMID: 26118561; PMCID: PMC4531403.

Sullan MJ, et al. Glymphatic system disruption as a mediator of brain trauma and chronic traumatic encephalopathy. Neurosci Biobehav Rev. 2018;84:316–324.

Von Holstein-Rathlou S, et al. Voluntary running enhances glymphatic influx in awake behavior, young mice. Neurosci Lett 2018 Jan 1;662:253-258.

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