A Root Cause Medicine Approach
|
September 25, 2023

An Integrative Medicine Approach to Understanding Sleep's Role in a Healthy Immune System

Medically Reviewed by
Updated On
September 17, 2024

Those who chronically get under seven hours of sleep a night are three times as likely to develop the common cold as those who regularly get at least eight hours. On average, more than one-third of U.S. adults don't meet sleep recommendations and get less than seven hours of sleep per night. Deep, restorative sleep is a foundation for good health; research shows that those who suffer from sleep disorders or chronically get insufficient sleep are at higher risk of having weaker immune systems and getting sick.

[signup]

The Basics of Sleep

Sleep is a natural, recurring state of altered consciousness and reduced sensory activity essential for the overall well-being of humans and many animals. It is a complex physiological process characterized by distinct stages, each serving different functions. There are two primary categories of sleep: non-rapid eye movement (NREM) and rapid eye movement (REM) sleep. (11

NREM sleep consists of three stages: N1, N2, and N3. N1 is the transition phase between wakefulness and sleep, characterized by light sleep and easily disrupted by external stimuli. N2 is a deeper stage where brain waves become slower, and sleep spindles and K-complexes appear. N3, known as slow-wave sleep, is the deepest and most restorative stage. It is essential for physical restoration, memory consolidation, and overall well-being. (5

REM sleep is a unique stage marked by rapid eye movements, increased brain activity, and vivid dreaming. During REM sleep, the body experiences muscle atonia, preventing physical movement and ensuring dreams remain internal. This stage is crucial for cognitive function, emotion regulation, and learning. The sleep cycle typically progresses through these stages in approximately 90-minute cycles throughout the night, with more extended periods of REM sleep occurring later in the sleep cycle. (5

Two internal biological mechanisms work together to regulate when you are awake and sleeping. The first is the circadian rhythm, controlled primarily by the body's 24-hour internal clock. The suprachiasmatic nucleus (SCN), a cluster of cells within the brain's hypothalamus, receives external light cues and controls melatonin and cortisol production to regulate the sleep-wake cycle. The second mechanism is sleep-wake homeostasis, which keeps track of the need for sleep and regulates sleep intensity. Sleep disorders can result when factors – including medications, stress, sleep environment, and light exposure – dysregulate either of these mechanisms. (5

Before the 1950s, people believed sleep was a passive activity during which the body and brain were dormant; however, this belief has since been negated, and we now understand the brain actively engages in many activities necessary for life and health during sleep (33). Sleep requirements change throughout the lifespan. Babies initially sleep up to 18 hours per day. By adulthood, the recommended amount of sleep is 7-9 hours nightly. Unfortunately, about one-third of the American adult population reports not getting enough sleep. 

The Immune System: A Vital Defense Mechanism

The immune system is a complex network of cells, tissues, and organs that is fundamental in safeguarding the body against harmful pathogens such as viruses, bacteria, and fungi. Its primary functions are to identify and recognize foreign substances, distinguish them from the body's own cells and tissues, and then mount a coordinated defense to eliminate or neutralize these invaders. The immune system achieves this through various mechanisms, including the production of specialized proteins called antibodies, the activation of immune cells like T cells and B cells, and the coordination of immune responses to ensure a targeted and effective defense. Additionally, the immune system possesses memory, enabling it to "remember" previously encountered pathogens, thereby providing immunity against future infections. (19)

When the immune system isn't functioning properly, complications arise. If the body's frontline defense against pathogens fails, overactivation of immune components develops, or the loss of self-tolerance occurs, health conditions including infection, allergies, autoimmune disease, and cancer develop. Various biological and environmental factors can weaken and dysregulate the immune system. Common factors include genetics, immune-suppressing medications, malnutrition, excessive alcohol consumption, intestinal dysbiosis, chronic stress, and inadequate sleep (19).

Sleep and Immune Function

The link between sleep and immune function is a critical and intricate one, with sleep playing a pivotal role in maintaining the body's ability to defend itself against infections and nurture a healthy immune system. Sleep and the immune system have a bidirectional relationship: active immune responses can affect sleep and vice versa. Over the years, evidence has emerged to support the notion that adequate sleep strengthens the immune system. In contrast, sleep deprivation contributes to a person's short- and long-term risk of getting sick. In short, science strongly indicates that sleep deprivation can make you sick. (29)

Why is this? During sleep, the immune system increases the production of cytokines, chemical proteins that help regulate immune responses. This cytokine production is essential in fending off impending infections, but research has also indicated this nighttime immune activity acts to strengthen the adaptive ("memory") subset of the immune system. Conversely, insufficient or poor-quality sleep reduces the production of immune cells and antibodies, weakening the immune system and making the body more susceptible to infections. (16, 21

Additionally, insufficient sleep causes increased secretion of cortisol. Cortisol, especially when chronically elevated, impairs immune function by inducing apoptosis (programmed cell death) of T cells, suppressing B cell antibody production, and reducing other immune cell functions during inflammatory immune reactions. (3, 32

Sleep is an important factor that increases vaccine efficacy; studies of vaccines for hepatitis and influenza have found that sleep deprivation before and after vaccination reduces the body's immune response to the vaccine, reducing its effectiveness in disease prevention. 

Not only is the circadian rhythm responsible for managing a healthy sleep-wake cycle, but research has also connected it to the control of allergic reactions. Therefore, we can assume circadian disruption may increase the likelihood of developing allergies. One study that has supported this theory demonstrated that sleep deprivation reduced the allergen threshold in patients with peanut allergy by 45%, making them more susceptible to having an allergy attack. 

Other research shows that a consistent lack of sleep, defined as losing just one and a half hours of sleep nightly, upregulates inflammatory immune responses and systemic inflammation. Chronic inflammation has been associated with many disease processes, including cancer; diabetes; depression; neurodegenerative disorders; and cardiovascular, autoimmune, liver, and kidney diseases.

Functional Medicine Labs to Assess Sleep and Immune Function

Along with a sleep study, functional medicine labs help practitioners identify the causes of sleep disturbances, assess immune status, and personalize treatment options for their patients struggling with poor sleep and symptoms of a lowered immune system.

Sleep & Stress Hormones

A salivary sleep and stress panel measures diurnal patterns in melatonin and cortisol levels. Alterations from standard patterns can result from and contribute to sleep disorders and illness. 

Neurotransmitters

Neurotransmitters play a crucial role in regulating the sleep-wake cycle and controlling the transition between wakefulness and the different stages of sleep. Neurotransmitters are also partially responsible for modulating immune responses. Therefore, a neurotransmitter panel can be an important specialty lab to consider ordering to evaluate sleep patterns and immune function. (14, 28

Immunoglobulins

Measuring total immunoglobulins is used to assess immune function. Total immunoglobulin measurement quantifies the IgM, IgA, and IgG antibody levels in a person's blood. Low levels may suggest an immune deficiency, making individuals more susceptible to infections.

Lymphocyte MAP

The Lymphocyte MAP test is a newer test on the market that better measures the integrity of the immune system by identifying various immune cell patterns. This test helps to provide practitioners with a detailed picture of underlying conditions and specific imbalances within the immunological cascade triggering health conditions related to immune dysfunction.

Inflammation

Inflammation markers, including hs-CRP and ESR, can quantify systemic inflammation that may be triggered by sleep deprivation and help estimate the risk for various chronic diseases.

[signup]

Integrative Medicine and Sleep

Integrative medicine approaches sleep issues by recognizing that these problems often stem from a complex interplay of physical, mental, and lifestyle factors unique to each individual. Rather than employing one-size-fits-all solutions, integrative medicine emphasizes an individualized treatment approach. It considers not just the symptoms but also the underlying causes of sleep disturbances. Integrative practitioners may combine conventional medical therapies with complementary approaches such as acupuncture, mindfulness-based stress reduction, dietary changes, and cognitive-behavioral therapy for insomnia. This holistic approach addresses the immediate sleep problem and the patient's overall well-being, aiming for sustainable improvements in sleep quality and duration. By tailoring treatment plans to each patient's specific needs and circumstances, integrative medicine offers a more comprehensive and personalized approach to tackling sleep issues, ultimately promoting better sleep and overall health.

Lifestyle Factors That Impact Sleep and Immunity

Below are some complementary and integrative modalities that functional medicine providers will use to create holistic treatment plans for their patients to optimize sleep and support the immune system. 

The Influence of Diet on Sleep and Immunity

A well-balanced and nutrient-rich diet can support both sleep and immune function. Prioritizing whole foods, minimizing processed and inflammatory foods, and paying attention to meal timing is essential to promoting a healthy relationship between diet, sleep, and immunity. 

Chronic inflammation, often linked to a diet high in processed foods, sugars, and unhealthy fats, can negatively affect sleep and weaken the immune system. Inflammation can disrupt the production of sleep-regulating hormones and cytokines, leading to sleep disturbances and an increased risk of infections. (19

The gut microbiome, influenced by diet, plays a crucial role in immunity and sleep. An imbalanced gut microbiome can lead to digestive issues, inflammation, and sleep problems. A diet rich in fiber, prebiotics, and probiotics supports a healthy gut, which, in turn, positively impacts immune function and sleep regulation. (18

Eating high-sugar, refined carbohydrate foods can cause rapid spikes and crashes in blood sugar levels. These fluctuations can disrupt sleep by causing nighttime awakenings and weaken the immune system over time. (8, 26

The consumption of caffeine and alcohol can interfere with sleep patterns. Both substances can disrupt the natural circadian rhythm and reduce the overall quality of sleep, making it more challenging for the body to maintain immune health. Avoidance or restricting consumption of either drink, especially in the afternoons and close to bedtime, is recommended. (8

Supplements and Natural Remedies for the Immune System and Sleep Balance

Many natural supplements can support the immune system and sleep quality. To get the most bang for your buck, consider using a couple of options that have been proven to support healthy immune function and sleep patterns. 

Research suggests that vitamin D may influence sleep patterns by playing a role in regulating the body's circadian rhythm and sleep-wake cycle. Adequate vitamin D levels are also associated with improved immune function, as it plays a crucial role in activating immune cells and the body's defense against infections.

Melatonin supplementation is commonly used to address sleep-wake disorders. Supplemental melatonin effectively reduces the time it takes to fall asleep and improves sleep duration and quality. Melatonin also has some potential implications for immune function, with studies showing its ability to modulate and strengthen immune responses to protect the body against infectious pathogens and cancer. 

The Role of Physical Activity in Promoting Better Sleep and Immunity

Research indicates that engaging in regular, moderate-intensity exercise can improve sleep patterns and promote better sleep quality. Exercise can reduce the time it takes to fall asleep, increase the duration of deep sleep, and decrease the frequency of nighttime awakenings.

Regular exercise is associated with enhanced immune function. It can help increase the production and circulation of immune cells, such as T cells and natural killer (NK) cells, which play crucial roles in defending the body against infections. Exercise also reduces chronic inflammation, a state linked to weakened immunity. (23

When exercise and sleep are optimized together, their synergistic effects on immune function can be particularly beneficial. Regular exercise can promote better sleep, and improved sleep quality, in turn, can enhance the immune response. This positive feedback loop contributes to overall immune resilience.

Improving Sleep for a Stronger Immune System

Sleep hygiene refers to a set of practices and habits that promote healthy and restorative sleep. Good sleep hygiene is essential for maintaining overall well-being and ensuring you get the rest your body needs. Here are some key components of sleep hygiene:

  • Go to bed and wake up at the same time every day, even on weekends. Consistency helps regulate your body's internal clock, making it easier to fall asleep and wake up naturally.
  • Make your bedroom conducive to sleep by keeping it cool, dark, and quiet. Invest in a comfortable mattress and pillows, and remove any disruptive sources of noise or light.
  • The blue light emitted by smartphones, tablets, computers, and TVs can interfere with your sleep by suppressing the production of melatonin, a hormone that regulates sleep-wake cycles. Avoid screens at least an hour before bedtime.
  • Avoid heavy or spicy meals close to bedtime, as they can cause discomfort and disrupt sleep. Minimize the consumption of liquids in the evening to reduce the likelihood of waking up to use the restroom at night.
  • Practice relaxation techniques such as deep breathing, meditation, or progressive muscle relaxation to reduce stress and anxiety, which can interfere with sleep.
  • While short naps can be rejuvenating, long or irregular daytime naps can disrupt nighttime sleep. If you nap, keep it brief (20-30 minutes) and earlier in the day.
  • Use your bed primarily for sleep and intimate activities. Avoid working, watching TV, or using electronic devices in bed to strengthen the association between your bed and sleep.
  • Exposure to natural sunlight during the day helps regulate your circadian rhythm and reinforces your body's natural wake-sleep cycle.

[signup]

Summary

The relationship between sleep and immune function is complex, but research overwhelmingly suggests a bidirectional relationship between the two. When one is compromised, so is the other. Sleeping well is essential to ensuring a healthy immune system and preventing disease. Improving sleep starts with focusing on lifestyle habits and sleep hygiene. People with chronic sleep issues should talk with a doctor to discuss additional labs, testing, and integrative medicine options that can further help them get a good night's sleep and strengthen their immunity.

Those who chronically get under seven hours of sleep a night may be at a higher risk of developing the common cold compared to those who regularly get at least eight hours. On average, more than one-third of U.S. adults don't meet sleep recommendations and get less than seven hours of sleep per night. Deep, restorative sleep is a foundation for good health; research suggests that those who experience sleep disorders or chronically get insufficient sleep may have weaker immune systems and could be more prone to getting sick.

[signup]

The Basics of Sleep

Sleep is a natural, recurring state of altered consciousness and reduced sensory activity essential for the overall well-being of humans and many animals. It is a complex physiological process characterized by distinct stages, each serving different functions. There are two primary categories of sleep: non-rapid eye movement (NREM) and rapid eye movement (REM) sleep. (11

NREM sleep consists of three stages: N1, N2, and N3. N1 is the transition phase between wakefulness and sleep, characterized by light sleep and easily disrupted by external stimuli. N2 is a deeper stage where brain waves become slower, and sleep spindles and K-complexes appear. N3, known as slow-wave sleep, is the deepest and most restorative stage. It is essential for physical restoration, memory consolidation, and overall well-being. (5

REM sleep is a unique stage marked by rapid eye movements, increased brain activity, and vivid dreaming. During REM sleep, the body experiences muscle atonia, preventing physical movement and ensuring dreams remain internal. This stage is crucial for cognitive function, emotion regulation, and learning. The sleep cycle typically progresses through these stages in approximately 90-minute cycles throughout the night, with more extended periods of REM sleep occurring later in the sleep cycle. (5

Two internal biological mechanisms work together to regulate when you are awake and sleeping. The first is the circadian rhythm, controlled primarily by the body's 24-hour internal clock. The suprachiasmatic nucleus (SCN), a cluster of cells within the brain's hypothalamus, receives external light cues and controls melatonin and cortisol production to regulate the sleep-wake cycle. The second mechanism is sleep-wake homeostasis, which keeps track of the need for sleep and regulates sleep intensity. Sleep disorders can result when factors – including medications, stress, sleep environment, and light exposure – dysregulate either of these mechanisms. (5

Before the 1950s, people believed sleep was a passive activity during which the body and brain were dormant; however, this belief has since been negated, and we now understand the brain actively engages in many activities necessary for life and health during sleep (33). Sleep requirements change throughout the lifespan. Babies initially sleep up to 18 hours per day. By adulthood, the recommended amount of sleep is 7-9 hours nightly. Unfortunately, about one-third of the American adult population reports not getting enough sleep. 

The Immune System: A Vital Defense Mechanism

The immune system is a complex network of cells, tissues, and organs that is fundamental in safeguarding the body against harmful pathogens such as viruses, bacteria, and fungi. Its primary functions are to identify and recognize foreign substances, distinguish them from the body's own cells and tissues, and then mount a coordinated defense to manage these invaders. The immune system achieves this through various mechanisms, including the production of specialized proteins called antibodies, the activation of immune cells like T cells and B cells, and the coordination of immune responses to ensure a targeted and effective defense. Additionally, the immune system possesses memory, enabling it to "remember" previously encountered pathogens, thereby providing immunity against future infections. (19)

When the immune system isn't functioning properly, complications can arise. If the body's frontline defense against pathogens is compromised, overactivation of immune components develops, or the loss of self-tolerance occurs, health conditions including infection, allergies, autoimmune disease, and cancer may develop. Various biological and environmental factors can weaken and dysregulate the immune system. Common factors include genetics, immune-suppressing medications, malnutrition, excessive alcohol consumption, intestinal dysbiosis, chronic stress, and inadequate sleep (19).

Sleep and Immune Function

The link between sleep and immune function is a critical and intricate one, with sleep playing a pivotal role in maintaining the body's ability to defend itself against infections and nurture a healthy immune system. Sleep and the immune system have a bidirectional relationship: active immune responses can affect sleep and vice versa. Over the years, evidence has emerged to support the notion that adequate sleep may strengthen the immune system. In contrast, sleep deprivation might contribute to a person's short- and long-term risk of getting sick. In short, science strongly indicates that sleep deprivation can make you more susceptible to illness. (29)

Why is this? During sleep, the immune system increases the production of cytokines, chemical proteins that help regulate immune responses. This cytokine production is essential in supporting the body's defense against potential infections, but research has also indicated this nighttime immune activity acts to strengthen the adaptive ("memory") subset of the immune system. Conversely, insufficient or poor-quality sleep may reduce the production of immune cells and antibodies, potentially weakening the immune system and making the body more susceptible to infections. (16, 21

Additionally, insufficient sleep may cause increased secretion of cortisol. Cortisol, especially when chronically elevated, can impair immune function by inducing apoptosis (programmed cell death) of T cells, suppressing B cell antibody production, and reducing other immune cell functions during inflammatory immune reactions. (3, 32

Sleep is an important factor that may increase vaccine efficacy; studies of vaccines for hepatitis and influenza have found that sleep deprivation before and after vaccination may reduce the body's immune response to the vaccine, potentially reducing its effectiveness in disease prevention. 

Not only is the circadian rhythm responsible for managing a healthy sleep-wake cycle, but research has also connected it to the control of allergic reactions. Therefore, it is suggested that circadian disruption may increase the likelihood of developing allergies. One study that has supported this theory demonstrated that sleep deprivation reduced the allergen threshold in patients with peanut allergy by 45%, making them more susceptible to having an allergy attack. 

Other research suggests that a consistent lack of sleep, defined as losing just one and a half hours of sleep nightly, may upregulate inflammatory immune responses and systemic inflammation. Chronic inflammation has been associated with many disease processes, including cancer; diabetes; depression; neurodegenerative disorders; and cardiovascular, autoimmune, liver, and kidney diseases.

Functional Medicine Labs to Assess Sleep and Immune Function

Along with a sleep study, functional medicine labs may help practitioners identify the causes of sleep disturbances, assess immune status, and personalize options for their patients struggling with poor sleep and symptoms of a lowered immune system.

Sleep & Stress Hormones

A salivary sleep and stress panel measures diurnal patterns in melatonin and cortisol levels. Alterations from standard patterns can result from and contribute to sleep disorders and illness. 

Neurotransmitters

Neurotransmitters play a crucial role in regulating the sleep-wake cycle and controlling the transition between wakefulness and the different stages of sleep. Neurotransmitters are also partially responsible for modulating immune responses. Therefore, a neurotransmitter panel can be an important specialty lab to consider ordering to evaluate sleep patterns and immune function. (14, 28

Immunoglobulins

Measuring total immunoglobulins is used to assess immune function. Total immunoglobulin measurement quantifies the IgM, IgA, and IgG antibody levels in a person's blood. Low levels may suggest an immune deficiency, making individuals more susceptible to infections.

Lymphocyte MAP

The Lymphocyte MAP test is a newer test on the market that may better measure the integrity of the immune system by identifying various immune cell patterns. This test helps to provide practitioners with a detailed picture of underlying conditions and specific imbalances within the immunological cascade that could be related to immune function.

Inflammation

Inflammation markers, including hs-CRP and ESR, can quantify systemic inflammation that may be triggered by sleep deprivation and help estimate the risk for various chronic conditions.

[signup]

Integrative Medicine and Sleep

Integrative medicine approaches sleep issues by recognizing that these problems often stem from a complex interplay of physical, mental, and lifestyle factors unique to each individual. Rather than employing one-size-fits-all solutions, integrative medicine emphasizes an individualized approach. It considers not just the symptoms but also the underlying factors contributing to sleep disturbances. Integrative practitioners may combine conventional medical therapies with complementary approaches such as acupuncture, mindfulness-based stress reduction, dietary changes, and cognitive-behavioral techniques for sleep improvement. This holistic approach addresses the immediate sleep problem and the patient's overall well-being, aiming for sustainable improvements in sleep quality and duration. By tailoring plans to each person's specific needs and circumstances, integrative medicine offers a more comprehensive and personalized approach to tackling sleep issues, ultimately promoting better sleep and overall health.

Lifestyle Factors That Impact Sleep and Immunity

Below are some complementary and integrative modalities that functional medicine providers may use to create holistic plans for their patients to optimize sleep and support the immune system. 

The Influence of Diet on Sleep and Immunity

A well-balanced and nutrient-rich diet can support both sleep and immune function. Prioritizing whole foods, minimizing processed and inflammatory foods, and paying attention to meal timing is essential to promoting a healthy relationship between diet, sleep, and immunity. 

Chronic inflammation, often linked to a diet high in processed foods, sugars, and unhealthy fats, can negatively affect sleep and may weaken the immune system. Inflammation can disrupt the production of sleep-regulating hormones and cytokines, leading to sleep disturbances and an increased risk of infections. (19

The gut microbiome, influenced by diet, plays a crucial role in immunity and sleep. An imbalanced gut microbiome can lead to digestive issues, inflammation, and sleep problems. A diet rich in fiber, prebiotics, and probiotics supports a healthy gut, which, in turn, positively impacts immune function and sleep regulation. (18

Eating high-sugar, refined carbohydrate foods can cause rapid spikes and crashes in blood sugar levels. These fluctuations can disrupt sleep by causing nighttime awakenings and may weaken the immune system over time. (8, 26

The consumption of caffeine and alcohol can interfere with sleep patterns. Both substances can disrupt the natural circadian rhythm and reduce the overall quality of sleep, making it more challenging for the body to maintain immune health. Avoidance or restricting consumption of either drink, especially in the afternoons and close to bedtime, is suggested. (8

Supplements and Natural Remedies for the Immune System and Sleep Balance

Many natural supplements may support the immune system and sleep quality. To get the most benefit, consider exploring a couple of options that have been suggested to support healthy immune function and sleep patterns. 

Research suggests that vitamin D may influence sleep patterns by playing a role in regulating the body's circadian rhythm and sleep-wake cycle. Adequate vitamin D levels are also associated with improved immune function, as it plays a crucial role in activating immune cells and the body's defense against infections.

Melatonin supplementation is commonly used to address sleep-wake disorders. Supplemental melatonin may help reduce the time it takes to fall asleep and improve sleep duration and quality. Melatonin also has some potential implications for immune function, with studies showing its ability to modulate and support immune responses to help protect the body against infectious pathogens and cancer. 

The Role of Physical Activity in Promoting Better Sleep and Immunity

Research indicates that engaging in regular, moderate-intensity exercise can improve sleep patterns and promote better sleep quality. Exercise can reduce the time it takes to fall asleep, increase the duration of deep sleep, and decrease the frequency of nighttime awakenings.

Regular exercise is associated with enhanced immune function. It can help increase the production and circulation of immune cells, such as T cells and natural killer (NK) cells, which play crucial roles in defending the body against infections. Exercise also reduces chronic inflammation, a state linked to weakened immunity. (23

When exercise and sleep are optimized together, their synergistic effects on immune function can be particularly beneficial. Regular exercise can promote better sleep, and improved sleep quality, in turn, can enhance the immune response. This positive feedback loop contributes to overall immune resilience.

Improving Sleep for a Stronger Immune System

Sleep hygiene refers to a set of practices and habits that promote healthy and restorative sleep. Good sleep hygiene is essential for maintaining overall well-being and ensuring you get the rest your body needs. Here are some key components of sleep hygiene:

  • Go to bed and wake up at the same time every day, even on weekends. Consistency helps regulate your body's internal clock, making it easier to fall asleep and wake up naturally.
  • Make your bedroom conducive to sleep by keeping it cool, dark, and quiet. Invest in a comfortable mattress and pillows, and remove any disruptive sources of noise or light.
  • The blue light emitted by smartphones, tablets, computers, and TVs can interfere with your sleep by suppressing the production of melatonin, a hormone that regulates sleep-wake cycles. Avoid screens at least an hour before bedtime.
  • Avoid heavy or spicy meals close to bedtime, as they can cause discomfort and disrupt sleep. Minimize the consumption of liquids in the evening to reduce the likelihood of waking up to use the restroom at night.
  • Practice relaxation techniques such as deep breathing, meditation, or progressive muscle relaxation to reduce stress and anxiety, which can interfere with sleep.
  • While short naps can be rejuvenating, long or irregular daytime naps can disrupt nighttime sleep. If you nap, keep it brief (20-30 minutes) and earlier in the day.
  • Use your bed primarily for sleep and intimate activities. Avoid working, watching TV, or using electronic devices in bed to strengthen the association between your bed and sleep.
  • Exposure to natural sunlight during the day helps regulate your circadian rhythm and reinforces your body's natural wake-sleep cycle.

[signup]

Summary

The relationship between sleep and immune function is complex, but research overwhelmingly suggests a bidirectional relationship between the two. When one is compromised, so is the other. Sleeping well is essential to supporting a healthy immune system. Improving sleep starts with focusing on lifestyle habits and sleep hygiene. People with chronic sleep issues should talk with a doctor to discuss additional labs, testing, and integrative medicine options that can further help them get a good night's sleep and support their immunity.

The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

Learn more

No items found.

Lab Tests in This Article

1. A Consistent Lack of Sleep Negatively Impacts Immune Stem Cells, Increasing Risk of Inflammatory Disorders and Heart Disease. (2022, September 21). Mount Sinai Health System. https://www.mountsinai.org/about/newsroom/2022/a-consistent-lack-of-sleep-negatively-impacts-immune-stem-cells-increasing-risk-of-inflammatory-disorders-and-heart-disease

2. Abboud, M. (2022). Vitamin D Supplementation and Sleep: A Systematic Review and Meta-Analysis of Intervention Studies. Nutrients, 14(5), 1076. https://doi.org/10.3390/nu14051076

3. AlDabal, L. (2011). Metabolic, Endocrine, and Immune Consequences of Sleep Deprivation. The Open Respiratory Medicine Journal, 5(1), 31–43. https://doi.org/10.2174/1874306401105010031

4. Aranow, C. (2011). Vitamin D and the immune system. Journal of Investigative Medicine: The Official Publication of the American Federation for Clinical Research, 59(6), 881–886. https://doi.org/10.2310/JIM.0b013e31821b8755

5. Brain Basics: Understanding Sleep. (2022, September 26). National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/health-information/public-education/brain-basics/brain-basics-understanding-sleep

6. Cermakian, N., Lange, T., Golombek, D., et al. (2013). Crosstalk between the circadian clock circuitry and the immune system. Chronobiology International, 30(7), 870–888. https://doi.org/10.3109/07420528.2013.782315

7. Cloyd, J. (2023, March 15). The Relationship Between the Sleep Stress Cycle. Rupa Health. https://www.rupahealth.com/post/the-relationship-between-the-sleep-stress-cycle

8. Cloyd, J. (2023, August 25). A Root Cause Medicine Protocol For Patients With Insomnia: Testing, Therapeutic Diet, and Supportive Supplements. Rupa Health. https://www.rupahealth.com/post/a-root-cause-medicine-protocol-for-patients-with-insomnia-testing-therapeutic-diet-and-supportive-supplements

9. Creedon, K. (2022, August 4). 6 Speciality Labs That Get To The Root Cause Of Insomnia. Www.rupahealth.com. https://www.rupahealth.com/post/6-speciality-labs-that-get-to-the-root-cause-of-insomnia

10. Disorders of the Immune System. (2014, January 17). National Institute of Allergy and Infectious Diseases. https://www.niaid.nih.gov/research/immune-system-disorders

11. Division of Sleep Medicine. (2021, October 1). Science of Sleep: What is Sleep? Harvard Medical School. https://sleep.hms.harvard.edu/education-training/public-education/sleep-and-health-education-program/sleep-health-education-47

12. Dua, S., Ruiz-Garcia, M., Bond, S., et al. (2019). Effect of sleep deprivation and exercise on reaction threshold in adults with peanut allergy: A randomized controlled study. Journal of Allergy and Clinical Immunology, 144(6), 1584-1594.e2. https://doi.org/10.1016/j.jaci.2019.06.038

13. Harley, R. (2023, August). Immune-Boosting Effects of Melatonin. Life Extension. https://www.lifeextension.com/magazine/2020/6/immune-boosting-effects-of-melatonin

14. Hodo, T. W., de Aquino, M. T. P., Shimamoto, A., & Shanker, A. (2020). Critical Neurotransmitters in the Neuroimmune Network. Frontiers in Immunology, 11. https://doi.org/10.3389/fimmu.2020.01869

15. How Sleep Affects Your Immune System. (2023, March 13). Yale Medicine. https://www.yalemedicine.org/news/how-sleep-affects-immunity

16. Irwin, M. R. (2019). Sleep and inflammation: partners in sickness and in health. Nature Reviews Immunology, 19(11). https://doi.org/10.1038/s41577-019-0190-z

17. Irwin, M. R., & Opp, M. R. (2017). Sleep Health: Reciprocal Regulation of Sleep and Innate Immunity. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 42(1), 129–155. https://doi.org/10.1038/npp.2016.148

18. Khakham, C. (2023, May 15). Boosting Your Patient's Immunity Through Gut Health: Testing, Nutrition and Supplements. Rupa Health. https://www.rupahealth.com/post/the-gut-microbiome-and-immunity-how-integrative-approaches-can-boost-immune-function

19. Maholy, N. (2023, May 10). A Functional Medicine Immune Support Protocol. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-immune-support-protocol

20. Maholy, N. (2023, June 15). The Role Of Sleep And Circadian Rhythms In Neurological Health. Rupa Health. https://www.rupahealth.com/post/the-role-of-sleep-and-circadian-rhythms-in-neurological-health

21. Olson, E. J. (2018, November 28). Lack of sleep: Can it make you sick? Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/insomnia/expert-answers/lack-of-sleep/faq-20057757#

22. Pahwa, R., & Jialal, I. (2019, June 4). Chronic Inflammation. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK493173/

23. Pelinski da Silveira, M., Kamila da Silva Fagundes, K., Bizuti, M. R., et al. (2020). Physical exercise as a tool to help the immune system against COVID-19: an integrative review of the current literature. Clinical and Experimental Medicine, 21(1). https://doi.org/10.1007/s10238-020-00650-3

24. Prather, A. A., Hall, M., Fury, J. M., et al. (2012). Sleep and Antibody Response to Hepatitis B Vaccination. SLEEP, 35(8). https://doi.org/10.5665/sleep.1990

25. Prather, A. A., Pressman, S. D., Miller, G. E., et al. (2020). Temporal Links Between Self-Reported Sleep and Antibody Responses to the Influenza Vaccine. International Journal of Behavioral Medicine, 28(1), 151–158. https://doi.org/10.1007/s12529-020-09879-4

26. Preston, J. (2022, December 20). Building Natural Immunity During Flu Season. Rupa Health. https://www.rupahealth.com/post/building-immunity-during-flu-season

27. Shamim, S. A., Warriach, Z. I., Tariq, M. A., et al. (2019). Insomnia: Risk Factor for Neurodegenerative Diseases. Cureus, 11(10). https://doi.org/10.7759/cureus.6004

28. Sleep/Wake Cycles. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/sleepwake-cycles

29. Suni, E. (2020, November 19). Sleep & Immunity: Can a Lack of Sleep Make You Sick? Sleep Foundation. https://www.sleepfoundation.org/physical-health/how-sleep-affects-immunity

30. Suni, E. (2021, February 8). Sleep Statistics (K. Truong, Ed.). Sleep Foundation. https://www.sleepfoundation.org/how-sleep-works/sleep-facts-statistics

31. Suni, E. (2022, April 8). Melatonin and Sleep. Sleep Foundation. https://www.sleepfoundation.org/melatonin

32. Thau, L., Gandhi, J., & Sharma, S. (2019, February 15). Physiology, Cortisol. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538239/

33. The Science of Sleep: Understanding What Happens When You Sleep. (2019). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-science-of-sleep-understanding-what-happens-when-you-sleep

34. Vazquez, K. (2022, August 22). How Gut Dysbiosis Negatively Affects Hormone Regulation, Immune System Activation, and Neurotransmitter Production. Rupa Health. https://www.rupahealth.com/post/how-gut-dysbiosis-negatively-affects-hormone-regulation-immune-system-activation-and-neurotransmitter-production

35. WebMD Editorial Contributors. (2022, August 22). How Much Sleep Do I Need? WebMD. https://www.webmd.com/sleep-disorders/sleep-requirements

36. What Are Sleep Deprivation and Deficiency? (2022, March 24). National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/sleep-deprivation

37. Youngstedt, S. D., & Kline, C. E. (2006). Epidemiology of exercise and sleep. Sleep and Biological Rhythms, 4(3), 215–221. https://doi.org/10.1111/j.1479-8425.2006.00235.x

Order from 30+ labs in 20 seconds (DUTCH, Mosaic, Genova & More!)
We make ordering quick and painless — and best of all, it's free for practitioners.

Latest Articles

View more on A Root Cause Medicine Approach
Subscribe to the magazine for expert-written articles straight to your inbox
Join the thousands of savvy readers who get root cause medicine articles written by doctors in their inbox every week!
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Subscribe to the Magazine for free to keep reading!
Subscribe for free to keep reading, If you are already subscribed, enter your email address to log back in.
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Trusted Source
Rupa Health
Medical Education Platform
Visit Source
Visit Source
American Cancer Society
Foundation for Cancer Research
Visit Source
Visit Source
National Library of Medicine
Government Authority
Visit Source
Visit Source
Journal of The American College of Radiology
Peer Reviewed Journal
Visit Source
Visit Source
National Cancer Institute
Government Authority
Visit Source
Visit Source
World Health Organization (WHO)
Government Authority
Visit Source
Visit Source
The Journal of Pediatrics
Peer Reviewed Journal
Visit Source
Visit Source
CDC
Government Authority
Visit Source
Visit Source
Office of Dietary Supplements
Government Authority
Visit Source
Visit Source
National Heart Lung and Blood Institute
Government Authority
Visit Source
Visit Source
National Institutes of Health
Government Authority
Visit Source
Visit Source
Clinical Infectious Diseases
Peer Reviewed Journal
Visit Source
Visit Source
Brain
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Rheumatology
Peer Reviewed Journal
Visit Source
Visit Source
Journal of the National Cancer Institute (JNCI)
Peer Reviewed Journal
Visit Source
Visit Source
Journal of Cardiovascular Magnetic Resonance
Peer Reviewed Journal
Visit Source
Visit Source
Hepatology
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Clinical Nutrition
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Bone and Joint Surgery
Peer Reviewed Journal
Visit Source
Visit Source
Kidney International
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Allergy and Clinical Immunology
Peer Reviewed Journal
Visit Source
Visit Source
Annals of Surgery
Peer Reviewed Journal
Visit Source
Visit Source
Chest
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Neurology, Neurosurgery & Psychiatry
Peer Reviewed Journal
Visit Source
Visit Source
Blood
Peer Reviewed Journal
Visit Source
Visit Source
Gastroenterology
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Respiratory and Critical Care Medicine
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Psychiatry
Peer Reviewed Journal
Visit Source
Visit Source
Diabetes Care
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of the American College of Cardiology (JACC)
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Clinical Oncology (JCO)
Peer Reviewed Journal
Visit Source
Visit Source
Journal of Clinical Investigation (JCI)
Peer Reviewed Journal
Visit Source
Visit Source
Circulation
Peer Reviewed Journal
Visit Source
Visit Source
JAMA Internal Medicine
Peer Reviewed Journal
Visit Source
Visit Source
PLOS Medicine
Peer Reviewed Journal
Visit Source
Visit Source
Annals of Internal Medicine
Peer Reviewed Journal
Visit Source
Visit Source
Nature Medicine
Peer Reviewed Journal
Visit Source
Visit Source
The BMJ (British Medical Journal)
Peer Reviewed Journal
Visit Source
Visit Source
The Lancet
Peer Reviewed Journal
Visit Source
Visit Source
Journal of the American Medical Association (JAMA)
Peer Reviewed Journal
Visit Source
Visit Source
Pubmed
Comprehensive biomedical database
Visit Source
Visit Source
Harvard
Educational/Medical Institution
Visit Source
Visit Source
Cleveland Clinic
Educational/Medical Institution
Visit Source
Visit Source
Mayo Clinic
Educational/Medical Institution
Visit Source
Visit Source
The New England Journal of Medicine (NEJM)
Peer Reviewed Journal
Visit Source
Visit Source
Johns Hopkins
Educational/Medical Institution
Visit Source
Visit Source

Hey practitioners! 👋 Join Dr. Chris Magryta and Dr. Erik Lundquist for a comprehensive 6 week course on evaluating functional medicine labs from two perspectives: adult and pediatric. In this course, you’ll explore the convergence of lab results across different diseases and age groups, understanding how human lab values vary on a continuum influenced by age, genetics, and time. Mastering these norms is essential before identifying levels of dysfunction, and this foundation will guide you in analyzing lab results confidently for patients of all ages. Buy Course.