At Dr. Autoimmune, the tenets of functional medicine inform every consultation about sleep optimization. We work with patients to uncover what might be behind sleep issues and setting goals to achieve an amazing night’s sleep!

Do you personally struggle with sleep? Falling asleep, waking up throughout the night, struggling with chronic exhaustion, or just achieving a consistent schedule of rest – these are all common nighttime struggles. No matter the reason, a great amount of Americans find adequate sleep to be elusive.

Why does this matter? Well, with 1 in 3 adults not getting enough sleep, the CDC states that insufficient sleep is actually considered a public health problem!¹ According to the National Heart, Lung & Blood Institute, people with sleep deficiency are at greater risk of health complications, including heart and kidney disease, high blood pressure, diabetes, stroke, and obesity. And from a functional medicine perspective, research indicates that if a person is not getting adequate sleep, all other health practices, such as diet and exercise, potentially become irrelevant. Sleep optimization just may take the gold medal when talking about maximizing health.²

While sleep is certainly essential to many known physiological functions, such as hormone regulation and metabolism, an increasing body of research suggests that another one of those essential functions may also include the theory of the glymphatic system (or paravascular clearance pathways), highlighting the critical role of sleep in the clearance of many brain toxins.³

The glymphatic system is a newly discovered waste clearance system in the brain. The word “glymphatic” is a combination of the words “glial” and “lymphatic,” as the glymphatic system is theorized to work through the utilization of glial cells to help clear the brain of waste in a way similar to the lymphatic system. Glial cells surround neurons and hold them in place, supply nutrients and oxygen to neurons, insulate one neuron from another, and destroy pathogens and remove dead neurons. The lymphatic system is part of the vascular system and an important part of the immune system, composed of a large network of lymphatic vessels that carry a clear fluid called lymph. Put these two systems together, and there is the glymphatic system theory. 

Essentially, the glymphatic system is suggested to actively transport cerebrospinal fluid (CSF) through brain spaces, pushing CSF into glia cells that line the par avascular space. At night, this space expands, and harmful proteins and waste products are transported out of the brain. In plain language, research says sleep is critical for our bodies to rid themselves of brain toxins.⁴ When the glymphatic system is not activated due to lack of sleep, the consequences show up as brain fog, fatigue and depression, just to name a few! Even more concerning diseases like Alzheimer’s, heart and liver disease and more become possible when long-term sleep deprivation is an issue.⁵

For many, understanding sleep’s vital role in human health seems to be the easy part, but actually practicing better sleep hygiene can be very difficult. So, what can you do to optimize your sleep? Start by implementing these simple sleep hygiene hacks:

1. Limit or block blue light. The blue light emitted from your TV, laptop and smartphone causes your brain to think it’s daytime, which gets in the way of your body releasing melatonin, a natural sleep hormone. If you just can’t turn off your electronic device, consider wearing amber-colored glasses or adding blue-light blockers to your screens. Such inexpensive options can be found on Amazon and can reduce blue-light melatonin suppression by about 60%.
2. Keep your room like a cave – dark, cool and quiet. Your body associates light with waking hours, and even dim light during sleep can affect your cognitive function when you most need it. Invest in black out curtains or a sleep mask to help maximize your rest. As well, keep your bedroom between 65-72°F to support your body in naturally reducing its temperature. And finally, keep it quiet! Just like light and temperature can disrupt your sleep, so can sound.
3. Stick to a sleep schedule. Not only does sleep rely on timing of hormones released in the body, but many other physiological cues contribute to sleep quality as well. For example, our bodies naturally release cortisol at specific times throughout the day so that it is lowest when we are falling asleep. Wacky sleep schedules are disruptive to your body’s systems and result in your body having no idea when to send appropriate sleep-promoting signals. 
4. Limit eating before bed. The act of eating tells your body to immediately go to work processing, breaking down, and digesting. Don’t confuse things! When it comes time for bed, your body should be focused on rest.
5. Keep the bedroom for sleep. Train your mind and body for rest and only use your bed for sleep. Avoid working, watching TV or eating in bed, and create a consistent nighttime routine of brushing your teeth, putting on PJs and such, to let your body know it’s sleeping time!
6. Exercise your brain and body regularly. Releasing energy from a daily grind, as well as the hormones and chemicals exercise helps draw out, results in your body wanting rest and relaxation. 

And what happens when even these things are not helping you get a healthy amount of quality sleep? We still have options. It may be time to look at your sleep brain wave, or “Delta” level, using mapping. Brain mapping is a non-invasive way to dive further into the root causes of insomnia, and neurofeedback can actually train these pathways back into a healthier place. Further functional medicine testing of your circadian rhythm can also clue us into whether stress is driving problematic sleep.

For all these reasons and more, we strongly encourage optimizing sleep, both in quantity of hours and quality of rest. If shut eye continues to elude you and our sleep hacks don’t work, simple practices like breathing, meditation, neurofeedback, supplements and more may help.

And if all this fails? We remain optimistic! At Dr. Autoimmune, we work with each patient individually to uncover what might be behind sleep issues, and we co-author plans of action to work towards an amazing night’s rest:

References:

1. Jones JM. In U.S., 40% get less than recommended amount of sleep. Gallup Well-Being. Published December 19, 2013. Accessed August 2, 2019. https://news.gallup.com/poll/166553/less-recommended-amount-sleep.aspx
2. Lichtenstein GR. The Importance of Sleep. Gastroenterol Hepatol (N Y). 2015;11(12):790
3. Iliff JJ, Wang M, Liao Y, et al. A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid ?. Sci Transl Med. 2012;4(147):147ra111. doi:1126/scitranslmed.3003748.
4. Rasmussen MK, Mestre H, Nedergaard M. The glymphatic pathway in neurological disorders. Lancet Neurol. 2018;17(11):1016-1024. doi:1016/S1474-4422(18)30318-1