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Sleep and Your Immune System in the Time of COVID-19


Understandably, the question of poor sleep and it’s impact on the health of our immune system has become a hot topic lately. This makes sense. In the face of the novel corona virus (COVID-19) we are all interested in keeping our immune system as strong and healthy as possible. Keep reading for scientifically based information on how poor sleep impacts the immune system, how much sleep you need to be healthy, and strategies for maximizing sleep.

What The Science Tells Us About Sleep and the Immune System

At this point, there is no doubt that sleep is critical to the health of the immune system. But how is sleep connected to what really matters…the risk of infection and outcomes of infection? Here are a few examples of what current research studies tell us.

  • Poorer sleep efficiency and shorter sleep duration (less than 7 hours per night) in the weeks preceding exposure to a virus are each associated with lower resistance to illness.
  • Compared to individuals reporting average sleep of 7-8 hours per night, those reporting 5 hours or less per night had greater risk for pneumonia and were more likely to have had a respiratory infection in the last month.
  • Poor sleep quality and presence of insomnia are each associated with reduced immunity to the influenza virus and reduced response to the flu vaccine.

Given the information from these studies and many others, we should all be thinking about our sleep health during this time. One positive piece of knowledge that comes from the research is that the negative effects of sleep deprivation and disruption on the immune system are not permanent. A return to normal sleep appears to restore healthy immune function.

When we’re thinking about sleep and the immune system there are two things to consider.

  1. Are you getting enough sleep or are you sleep deprived?
  2. Is the sleep you are getting healthy and restorative or disrupted/disordered?

How Much Sleep Do You Need to Be Healthy?

Sleep need is a tricky thing. In news reports it’s easiest to pick a research study that points to an average healthy amount of sleep, usually seven or eight hours per night. Generally I agree that getting 7-8 hours sleep per night is a good goal and this I was my patients and I strive for when we’re working on solving a sleep disturbance. The problem with this is that you are an individual with an individual sleep need. This means that in order to feel and function well, and maintain your health, you may need more or less than the average.

So how do you know how much sleep you need? More importantly, how do you know if you’re getting enough? The simplest answer to these questions is that if you FEEL you’re getting enough then you probably are. If you’re FEELING tired, sleepy, moody or fatigued during the day and feel like you need more sleep then you probably do. Or, the sleep you are getting may by disordered or nonrestorative.

What Can You Do to Get More Sleep?

If the problem is one of simple sleep deprivation, then the solution is probably simple too. Here are some basic strategies for getting more sleep.

Everyone Needs a Nap Sometimes:
There is some research showing that napping is a good way to counteract the effects of sleep deprivation on the immune system. You may be shocked to hear this from a sleep specialist, but I do recommend napping fairly often…as long as you follow some basic guidelines. Here they are:

  • Set an alarm and lie down for no more than 30 minutes.
  • If you are at home, nap in your bed.
  • No napping or dozing within 6 hours of bedtime.

Spend a Little More Time in Bed:
You probably don’t need me to tell you this, but If you’re sleep deprived then give yourself more opportunity to sleep. The general rule is to allow yourself opportunity for 8 hours sleep per night. However, if you’ve been sleep deprived, it can be good to give yourself as much as 10 hours in bed for a few days to support recovery from sleep deprivation.

Follow Good Sleep Hygiene Habits:
Sleep hygiene is all the things you can do to give yourself the best chance for a good night’s sleep. It includes things like avoiding caffeine and exercise before bed and making sure your bed and bedroom are comfortable. CLICK HERE to see my list of sleep hygiene instructions if you want to take a look.

These strategies make sense if the problem is just one of figuring out how to fit more sleep into a day. But what if you can’t get enough sleep even when you try? And what are you supposed to do if you’re getting what should be the right amount of sleep but still not feeling rested?

What Should You Do If You Have Disturbed Sleep or a Sleep Disorder?

Sleep disturbances or disorders can cause sleep deprivation and keep normal amounts of sleep from doing the job of keeping your immune system strong and healthy. The two most common patterns of disturbed or disordered sleep are insomnia and sleep apnea and they often happen together in the same individual.

Insomnia is a sleep disorder characterized by difficulties getting to sleep or staying asleep that cause problems with energy, mood, thinking, or other areas of daytime performance or quality of life. Many people I talk to are confused about whether their difficulties sleeping represent insomnia or if they’re just the good old-fashioned poor sleep that everyone experiences from time to time. CLICK HERE to take my insomnia versus poor sleep quiz to see which category your sleep difficulties fall into.

Sleep apnea is a sleep disorder involving difficulties breathing during the night. The most common signs and symptoms of sleep apnea are snoring, pauses in breathing while sleeping, difficulties maintaining sleep, and problems with daytime sleepiness or fatigue.

If you believe you have either of these sleep disorders, I highly encourage you to speak with a licensed healthcare provider. Your primary care provider is knowledgeable about the diagnosis and treatment of these sleep disorders and can discuss assessment and treatment options with you. Additionally, we would be happy to offer you a free 15-minute phone consultation to discuss your sleep pattern and help you decide the best way forward. Call us or CLICK HERE to request a free phone consultation.

References (See the Research For Yourself)

  1. Taylor et al. Is Insomnia a Risk Factor for Decreased Influenza Vaccine Response? Behav Sleep Med. 2017;15(4):270–287. doi:10.1080/15402002.2015.1126596.
  2. Cohen et al. Sleep Habits and Susceptibility to the Common Cold. Arch Intern Med. 2009;169(1):62–67. doi:10.1001/archinternmed.2008.505.
  3. Besedovsky et al. The Sleep-Immune Crosstalk in Health and Disease. Physiol Rev. 2019;99(3):1325–1380. doi: 10.1152/physrev.00010.2018: 10.1152/physrev.00010.2018.

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