Last week we wrote about the role of social connections and stress in the development of chronic systemic inflammation.  Positive social connections have been well shown to reduce chronic  inflammation and increase longevity.  On the other hand chronic stress has been shown to do the opposite.

ALSO READ : Turning the Tide – Systemic stress contributes to lifestyle diseases

This week we will be examining the role of sleep and factors which affect sleep quality in the management of chronic systemic inflammation.

Sleep and inflammation According to Dr Michael Breus, the “Sleep Doctor”, sleep, immune function and inflammation share a common regulator.  Our sleep is regulated by circadian rhythms, which drive hormones and other physiological changes that affect our sleep/wakefulness. These same circadian rhythms also regulate our immune system.  Having a sleep routine helps to govern both our sleep and immune function. 

We are all aware of how lack of sleep puts us at risk of infections, like the common cold, or influenza.  It has also been shown to increase our risks of insulin resistance, cancer and heart disease. 

Lack of sleep diminishes the effectiveness of the immune system for controlling acute infections but  paradoxically can also increase chronic inflammation. 

Just one night of insufficient sleep can increase inflammatory markers.  But raised markers can also be caused by excessive sleep, with studies showing increased C-reactive protein in those getting more than 7-9 hours sleep per night. 

Check out Dr Michael Breus’ very readable article here.

Other markers of inflammation which can be increased from sleep disorders include interleukin-6 (IL-6) and tissue necrosis factor (TNF).

Another more academic article provides the results of multiple studies around the world that confirm that sleep deprivation, or excess sleep can influence chronic systemic inflammation with resulting increased all-cause mortality. 

This article explores some of the complex mechanisms in which sleep affects the immune system and chronic inflammation, for those who are scientifically minded. What is important to know that sleep is not a waste of time, and is essential for many different functions. 

Here is a concise article from the National Institute of Neurological Disorders and Stroke in the USA on sleep:    (This information is on a free public forum so readily available to be copied as long as the source is acknowledged. The next paragraph is from that source, with additions of my own in brackets.)

Tips for Getting a Good Night’s Sleep

• Set a schedule – go to bed and wake up at the same time each day.
• Exercise 20 to 30 minutes a day but no later than a few hours before going to bed. (The best time to exercise to improve sleep is in the morning at sunrise as this sets your body clock for the next 24 hours).
• Avoid caffeine and nicotine late in the day and alcoholic drinks before bed.
• Relax before bed – try a warm bath, reading, or another relaxing routine.
• Create a room for sleep – avoid bright lights and loud sounds, keep the room at a comfortable temperature, and don’t watch TV or have a computer in your bedroom.
• Don’t lie in bed awake for hours on end.  If you can’t get to sleep, do something else, like reading or listening to calming music, until you feel tired.
• See a doctor if you have a problem sleeping or if you feel unusually tired during the day. Most sleep disorders can be treated effectively.  (There may be other health issues interfering with sleep such as obesity, chronic pain, interactions with medications or depression/anxiety – which all need medical professional intervention. Taking sleeping tablets as a knee jerk reaction to insomnia has long-term unhealthful consequences.)

Having done a bit of night shift work in my life, I am aware of the disruption this causes to one’s physiology. 

Research has shown that night-shift work increases the risk for metabolic syndrome, obesity, type 2 diabetes and cardiovascular disease, as well as breast, ovarian, prostate, colorectal and pancreatic cancer. 

There’s another reason why we need to appreciate and honour our health care workers, security officers and others who work unearthly hours to benefit all of us “daylighters”.

Next week we will be discussing an interesting topic – the last in the series on chronic systemic inflammation –  the role of spiritual health in reducing inflammatory markers, and the effects of inflammation on chronic diseases. Keep well, Dave Glass

Dr David Glass graduated from UCT in 1975.  He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital.  He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world.  He no longer delivers babies but is still very clinically active in gynaecology. An old passion, preventive health care, has now replaced the obstetrics side of his work.  He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc. He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing.  He is active in community health outreach and deeply involved in church activities.  He enjoys teaching and sharing information.

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