How Does Sleep Affect Your Immune System?

Consistently getting quality sleep should be at the top of your to-do list if you want to keep your immune system strong.

Woman in bed wearing an eyemask
Photo Credit: Twenty20

You may be taking COVID-19 precautions — toting a mask 24/7, socially distancing like a champ, and obsessively washing your hands — but poor sleep could be sabotaging your intentions to stay healthy.

According to the National Institutes of Health (NIH), the coronavirus pandemic has had an undeniably detrimental impact on sleep, despite the fact that many of us aren't in the office from 9 to 5 anymore, and experts say the effects could be undermining our efforts to stay healthy.

“Getting a good night’s sleep during the pandemic helps boost the immune system and should be an important part of your daily routine, along with healthy eating and staying physically active,” says Michael Twery, Ph.D., director of the NHLBI’s National Center on Sleep Disorders Research.

So, how and why does sleep act as an immune-boosting essential activity and what can we all do to ensure we’re getting the very best rest we can, even in this anxiety-provoking time? We reached out to experts to find out.

Why Is Sleep Important for the Immune System?

To put it simply: “Sleep enhances the body's immunity,” says Valerie O'Meara, ARNP, a Seattle-based nurse practitioner at One Medical. “Hand washing, masking, and social distancing don't enhance the body's immunity, but rather provide barriers to the potential of a pathogen invading the body in the first place.”

So while all the standard COVID-protective protocols are essential, they serve a different (but important!) purpose than the everyday wellness strategies we should all be doing to maintain our health.

“I would rank sleep and a healthy diet as equally important to keeping the immune system in top shape, as food provides the fuel for the body's systems — including the immune system — to work properly,” O’Meara says.

To fully understand the role sleep plays on immunity, it’s helpful to have a crash course in some basic biology terminology:

  • T-cells are a special kind of white blood cells that are produced in the bone marrow and help protect your body from infections.
  • Helper T cells are a type of T-cell that recognize foreign antigens and secrete substances called cytokines. This helps activate other types of cells involved in the immune response.
  • Cytokines are small proteins that are secreted by your cells that influence communication between cells and can move cells toward the sites of infections, inflammation, or trauma.
  • Antigens are substances that your immune system doesn’t recognize. These can include substances like bacteria and viruses, or even chemicals and pollen, but they can also form inside your body. To respond to these unrecognized substances, your immune system produces antibodies against them in an effort to fight them off.
  • Antibodies are Y-shaped proteins that bind to antigens and trigger a series of actions in the body to destroy specific antigens.

“Sleep has a regulatory effect on the immune function of T-cells and cytokines,” O'Meara says. “By enhancing cytokines that promote the interaction of antigen-presenting cells (foreign invaders) and T-helper cells, sleep has a specific role in the formation of immune system memory or adaptive defense to a foreign invader.”

According to a 2011 paper published in Pflügers Archiv: European Journal of Physiology, “sleep and the circadian system are strong regulators of immunological processes” and prolonged sleep deprivation can “produce immunodeficiency” along with chronic low-grade inflammation — both of which can have negative health effects.

“The power of a good night’s sleep cannot be downplayed, for our physical and emotional health,” says life coach and holistic nurse practitioner, breathwork facilitator, and host of the Feminist Wellness Podcast, Victoria Albina, NP, MPH. “When we’re well-rested, our bodies perform optimally and so do our minds. We can make our best decisions when we are conscious to life and not reactive from our reptile or lizard minds, which can happen when we’re acutely or chronically sleep-deprived.”

Albina doesn’t think we necessarily need to create a hierarchy of best immunity practices that prioritizes one good habit over another, but she says proper sleep can set a strong foundation for a myriad of health-promoting choices.

“When you’re well-rested, your cognitive power to decide to choose foods that support you, to wash your hands, to keep a safe social distance is optimal,” she says.

"For many of us, sleep is a crucial place to start. Prioritizing our sleep over distractions like social media or TV also reminds us and our inner children that we can prioritize ourselves and trust ourselves to put us to bed when we need to, as our own best parent.”

Can Sleep Aids Help You Get More Health-Enhancing Sleep?

If you’ve had a particularly tough time getting rest during this roller coaster of a year, perhaps you’ve turned to over-the-counter (OTC) or natural sleep aids.

While medications and natural remedies may help provide short-term relief in the form of total unconsciousness, it’s important to know exactly what you’re taking and how it may impact the quality of your sleep (and in turn, your immunity).

O’Meara says the short-term use of OTC sleep aids shouldn’t significantly alter the quality of sleep, but you should always consult a medical provider regarding your individual medical history before using OTC sleep aids — especially those containing antihistamines (like Benadryl), since they can have an adverse effect, particularly in the elderly population.

According to a 2019 study published in the journal Nutrients, “For sleep to have a restorative effect on the body, it must be of adequate duration and quality.” The problem is, some of the medications used to induce drowsiness or address insomnia (like the benzodiazepines Xanax, Valium, and Klonopin) can suppress an essential part of the sleep cycle: rapid eye movement sleep, or REM.

Known to play a role in learning and memory consolidation, REM is essential for solid sleep and strong immunity. “Many studies have demonstrated that total sleep deprivation and REM sleep deprivation modify various components of the immune system,” says O’Meara.

“Many chemical sleep aids — [I'm] not talking about melatonin and herbal options — can interfere with sleep architecture,” Albina says. “So you may think you’re getting more rest, but you’re not getting the deep rest you need and deserve.” Albina says that she considers supplements like melatonin, l-theanine, Lavela (enteric-coated lavender oil) and tools like exercise and meditation to be safer and more reliable methods for managing sleep issues.

How to Score Immune-System-Boosting Sleep Every Night

It doesn’t take a miracle or any special effort to snag the kind of Zzz’s that boost your immunity — all you need to do is start implementing tried and true sleep-hygiene tactics to ensure quality rest.

Wind down activities an hour before you plan to go to sleep,” recommends O’Meara. “Go to bed at the same time every night and set an alarm to awaken at the same time every morning, including weekends.”

Your bedroom ambiance also plays a critical role in the quality of rest you get. “The room where you sleep should be dark, quiet, and comfortable — no cell phone, books, TVs — and use that room for sleeping only,” she says.

And even in this unprecedented odd time, be sure to also:

  • Establish a soothing nighttime ritual that’s free of devices. Read a book (avoid doomscrolling the news if you can help it), take a bath, listen to calming music (here’s a playlist) — do whatever you can to unplug from your day.
  • Get outside every single day if you can, even if it’s just for a short walk around the block. Research has shown that the great outdoors may help reset your circadian rhythms to be more in tune with natural light-and-dark cycles.
  • Move your body during the day, whether that means a quick yoga flow, a prolonged sweat session on a stationary bike, or something else physically engaging. Studies show that both moderate and vigorous forms of exercise can help improve sleep quality in people of all ages.

READ NEXT: Why You Need a Good Night’s Sleep Before Getting Your Flu Shot — Or the COVID-19 Vaccine

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