Reduce Chronic Inflammation With Sleep: Part 1
Now it’s more important than ever that you reduce chronic inflammation with sleep, because if your baseline inflammation is high, your risk of getting infected by SARS-CoV-2 virus and the Covid-19 disease goes up. Here are five daytime and eight nighttime rituals to help ensure you get deep, restorative sleep.
There’s a systematic approach you can use to reduce chronic inflammation with sleep. Although you might not think that inflammation is a health issue for you, it inevitably is as we age, which why there’s a term for this association — inflammaging.
In this age of the SARS-CoV-2 pandemic, ensuring that you get enough deep, restorative sleep is important to help keep you from getting infected with the virus, and essential should you get infected.
I’m in the process of creating a course on “Covid-19 Immunity”, and want to share a part of it with you in a three part series that together covers how to reduce baseline inflammation.
Here’s how it will layout:
- Reduce Chronic Inflammation With Sleep, Part 1 (you’re reading this now)
- Reduce Chronic Inflammation With A Daily Mindfulness Practice and 3 Adaptogens, Part 2
- How Nutrition and Exercise Can Reduce Chronic Inflammation, Part 3
If you’re not already a Subscriber, go here to get on the list and you’ll be notified when Parts 2 and 3 are published.
Chronic Disease Is Linked To Systemic Inflammation
To underscore the importance of reducing your chronic, or baseline, inflammation as a bulwark against chronic disease and SARS/Covid, consider the following chronic diseases that either amplified by or is made worse by inflammation; and a conceptual illustration of pre and post virus infection baseline inflammation.
Chronic Diseases caused by that cause systemic (baseline) inflammation:
- cardiovascular disease (CVD)
- arthritis and other joint diseases
- chronic obstructive pulmonary disease (COPD)
- rheumatoid arthritis
Importantly, on that list above are five diseases that make Covid-19 health issues much more acute: diabetes, obesity CVD, allergies and COPD.
The Covid-19 Fatality Risk Linked To Baseline Inflammation Level:
The image above is a screen shot from a recent study that focuses on the importance of getting inflammation under control in order to minimize SARS-CoV-2 infection and any resulting Covid-19 disease.
Sorry it’s blurry, but I can quickly tell you what it shows:
- An infection of the virus will inevitably ramp up your baseline level of inflammation (the beginning of the curves to their peak).
- The higher your baseline inflammation to begin with (the lowest point on the curve before it peaks), the closer it gets to a potentially lethal level, indicated by the top horizontal line — Patient’s Fatality Risk Threshold.
What we want to do is to reduce or eliminate factors that drive excess inflammation (inflammation that has no value in a normal immune response to a pathogen, like a virus).
Most of us have some baseline level of systemic inflammation. As mentioned, this is especially true as we age. Various chronic diseases increase this systemic inflammation, and this increases our vulnerability to getting really sick if infected with COVID-19, as well as nearly every chronic disease you can think of.
Thus, it’s really important that we do what we can to reduce our baseline level of inflammation before we get infected. You want to strenuously reduce the risk of experiencing the escalating inflammation that’s been characterized as the “cytokine storm” should you get infected.
The good news is that there’s plenty you can do. Here, we’ll focus on sleep, and in the Parts 2 and 3 of this three-part series, we’ll turn our attention to reducing inflammation via stress abatement, mindfulness, nutrition and exercise. These are the various lifestyle factors that can have a substantial impact on your foundational resistance to infection, as well as how harmful to your health any subsequent Covid-19 disease could be.
OK, all that said, let’s dive into sleep.
Reduce Chronic Inflammation with Sleep by Better Modulating Your Immune System Response
An inadequate amount of sleep increases the risk of all infectious illness. One study found that less than five hours of sleep increased the risk of developing a rhinovirus associated cold by 350% when compared to individuals who slept at least seven hours per night.
What about COVID-19, specifically?
The NLRP3 inflammasone is a critical component of the innate immune system that mediates the processing and release of various kinds of cytokines (a category of signaling molecules that mediate and regulate immunity, inflammation and blood cell making (hematopoiesis)).
The innate immune system consists of physical, chemical and cellular defenses against pathogens. The main purpose of the innate immune response is to immediately prevent the spread and movement of foreign pathogens throughout the body.
Healthy sleep is anti-inflammatory and promotes a balanced T cell response to infection. T cells are a type of lymphocyte (a type of white blood cell) develops in the thymus gland (hence the name) and plays a central role in the immune response.
A subset, sorta speak, of T cells are T helper type 1, or Th1 cells, and Th2 cells. You want your immune system response to an invading pathogen to be balanced, or modulated between Th1 and Th2. If Th2 is overly expressed, it can create a damaging degree of inflammation.
Disordered sleep promotes inflammation and Th2 response, at the expense of healthy Th1 response.
Now that you know how important sleep is to help you fight off COVID-19, let’s address how to get the sleep you need. We’ll begin with five daytime and six nighttime rituals that you can incorporate into your sleep regimen.
5 Daytime Sleep Rituals
These five rituals are down during the day to help ensure your get deep, restorative sleep come nighttime. Again, the objective is to reduce chronic inflammation with sleep.
You may think that most of these are no-brainers, but I ask you: Are you doing them? Knowing something without doing something is really not knowing it all; and if all you can do is recite the list, nothing on it will be helpful to you.
(1) Establish a consistent routine
Get up at the same time every day. This helps to set your body’s natural clock, the circadian rhythm, which is one way our bodies regulate sleep.
In addition to sleep, stick to a regular schedule for meals, exercise, and other activities. It would be helpful to make this a priority for everyone in your household.
(2) Get morning light
Get up, get out of bed, and then get some sunlight. Sunlight is the main controller of your circadian rhythms, and regular exposure to light in the morning helps to set the body’s clock each day. Natural sunlight is best, as even cloudy days provide more than double the light intensity of indoor lighting.
So, expose yourself to natural light by stepping outside, at a distance from others, for at least 20 minutes every day.
(3) Exercise during the day
Exercise helps improve your sleep quality at night, reduces stress, and improves mood. I’ll speak to the immune system benefits gained from exercise in Part 3. But for now I want to underscore that getting out of the house while the sun is out and moving your body with some vigor goes a long way to preparing you for restful sleep.
(4) Don’t use your bed as an escape
Make your bed a single-service device — to sleep. (Of course, if you’re coupled up there may be another use for it. That’s what I’ve been told.) By using your bed mainly for sleep, you get conditioned that bedtime is sleep time, not TV time, reading time, social media time, etc.
If you’re a napper, keep it under 30 minutes, and don’t nap at night.
(5) Avoid caffeine late in the day
This is another a no-brainer — you know you want to avoid the stimulus of caffeine several hours before bedtime. But there’s also the matter of cortisol.
Cortisol is your body’s main stress hormone. It works with certain parts of your brain to control your mood, motivation and fear. It’s best known for helping fuel your body’s “fight-or-flight” instinct in a crisis. When you’re in such a crisis, cortisol is a good thing and you want the cortisol to be flowing. Otherwise, you want your cortisol levels to naturally ebb as the evening approaches. Caffeine will ramp it up again.
Too much cortisol in your system can make you anxious, feel stressed and disrupt your sleep.
Now, let’s get into what to do before bed.
8 Nighttime Sleep rituals
Just as there are things you can do during the day to prepare you for deep, restorative sleep, there’s also a checklist to guide you just before bed time.
(1) Minimize mental and emotional stimuli
Whatever gets you cranked up… avoid that.
So, before bed, don’t fill your head with news that aggravates you, or engage in topics that do the same.
If your mind is swirling with thoughts you can’t seem to put aside, try writing down — pen to paper — what’s disturbing you. Remind yourself that you can review the list in the morning and deal with it then.
(2) Reduce blue light
Turn off cell phones, tablets, and all electronic devices. Engaging with screens before bedtime makes it harder for your brain to turn off. The reason for this is that any light emitted from various screen-based devices — which is referred to as “blue light” — may delay the release of the hormone melatonin, which interferes with your body clock.
Blue wavelengths are beneficial during daylight hours because they boost attention, reaction times, and mood, but at night it disrupts your sleep.
While light of any kind can suppress the secretion of melatonin, blue light at night does so more powerfully.
Harvard researchers and their colleagues conducted an experiment comparing the effects of six and a half hours of exposure to blue light to exposure to green light. They found that blue light suppresses melatonin for about twice as long as the green light and shifts circadian rhythms by twice as much, three hours for the blue light vs. 1.5 hours for the green light.
In another study of blue light, researchers at the University of Toronto compared the melatonin levels of people exposed to bright indoor light who were wearing blue-light–blocking goggles to people exposed to regular dim light without wearing goggles. The fact that the levels of the hormone were about the same in the two groups strengthens the hypothesis that blue light is a potent suppressor of melatonin.
(3) Reduce blue light with F.lux
Turn off screens between one and two hours before bedtime, or use an app called F.lux. It makes the color of your computer’s display adapt to the time of day, warm at night and like sunlight during the day.
(4) Set a regular bedtime hour
I covered this already, but it’s worth repeating.
Just like the daytime ritual of getting up at the same time, set a regular time to go to bed. A regular and consistent sleep pattern helps ensure you’re getting the targeted number of hours of sleep every night and keeps your circadian rhythms optimized.
(5) Reduce stress
The evening and bedtime hours are also a good time to perform some relaxation techniques, such as slow breathing techniques, which I’ll cover in Part 2. There are also many free resources available for bedtime meditation, including binaural beats available on Youtube.
(See my article on brain synchronization.)
(6) Take an epsom salt bath
There are three reasons to consider taking an epsom salt bath prior to bedtime:
- If you do this regularly, you’ll be establishing in your mind the intention of proactively doing a ritual for the purpose of getting restorative sleep;
- Warm water is relaxing and may make you drowsy; and
- The epsom salt in the bath contains magnesium. One tablespoon of epsom salt has 3.4 grams of magnesium.
Let’s talk magnesium.
By helping to quiet your nervous system, this mineral may help prepare your body and mind for sleep.
Magnesium activates the parasympathetic nervous system, the system responsible for getting you calm and relaxed.
It also regulates the hormone melatonin, which, as you know by now, guides sleep-wake cycles in your body.
Magnesium binds to GABA receptors [gamma-aminobutyric acid]. GABA is the neurotransmitter responsible for quieting down nerve activity. It’s the same neurotransmitter used by sleep drugs like Ambien.
If you choose not to bathe with epsom salts, but want the magnesium, you can take a magnesium supplement.
Magnesium can help improve sleep quality in people who have low magnesium levels — which are many of us — but it does not have a sedative effect, so you don’t need to worry about getting sleepy after taking a magnesium supplement.
The standard dose for magnesium is 200 mg of elemental magnesium, though doses of up to 400 mg can be used.
Magnesium can be supplemented through magnesium citrate, magnesium malate, magnesium diglycinate, and magnesium gluconate. Magnesium oxide is not recommended for supplementation because it is more likely to cause intestinal discomfort and diarrhea, and is known to have less absorption than other forms.
If you take magnesium gluconate, do so with a meal to increase its absorption. Other forms of magnesium can be taken either with food or on an empty stomach.
(7) Take a melatonin supplement
Let’s dig into melatonin a bit more.
It’s a hormone that regulates the sleep–wake cycle. It’s primarily released by the pineal gland in your brain. As a dietary supplement, melatonin is widely used to enhance sleep, but a key reason to consider using it in the context of COVID-19 is that it inhibits NLRP3 inflammasome activation and reduces airway inflammation.
Melatonin has also been identified as a potential therapeutic drug in computer modeling of the effects of SARS-CoV-2 on human cell expression.
Unfortunately, like a lot of things, the older we get the less melatonin our body makes, so supplementation can be a good idea.
In some countries, you need a prescription for melatonin. In others, like the U.S., melatonin is widely available in stores or online. Take around 1–5 mg, 30 to 60 minutes 30 minutes before bed. Time release melatonin capsules may be more effective at sustaining sleep throughout the night.
Start with a low dose to assess your tolerance, and then increase it slowly as needed. Since melatonin may alter brain chemistry, it’s advised that you check with a healthcare provider before use.
(8) Optimize your sleep environment
You want your bedroom to be cool, dark and quiet.
To get darkness, I simply use an eye mask. I find that it’s easier to put on then to go around the bedroom and let down window shades, which still lets in ambient light from outdoor lights.
For coolness, the windows are open or the blanket is light.
I don’t like earplugs; fortunately, it’s quiet in my neighborhood.
Your Reduce Chronic Inflammation With Sleep Takeaway
It’s tough to incorporate a lot of new behaviors into your lifestyle at the same time, so I suggest you simply choose a couple from the day and nighttime list that you have the least resistance to doing. Once they’ve become habitual, add some more.
During his pandemic, it’s more important than ever — especially if you’re older and/or have any chronic disease issues — to get deep, restorative sleep that will empower your immune system, principally by helping to modulate the inflammatory response of your immune system to an invading pathogen, such as the SARS-CoV-2 virus.
So, right now, scroll back up and choose:
- Two daytime sleep rituals, and
- Two nighttime sleep rituals.
Then tomorrow, give them a try. Rinse, repeat until they’re habitual, than go choose another two.