Marie-Noelle Marquis (00:07):
Welcome to the AIP Summit Podcast, your go-to resource for taking control of your autoimmune health, presented by AIP Certified Coaches. Hi, I'm Marie-Noelle Marquis.
Jaime Hartman (00:17):
And I'm Jaime Hartman. And we're here to equip you with the tools, knowledge and support you need to effectively use the autoimmune protocol.
Marie-Noelle Marquis (00:25):
Today we are taking a closer look at one of the key lifestyle foundations of this protocol. Sleep. Although many people think of AIP as a diet AIP, Certified Coaches help clients evaluate and make changes in all aspects of lifestyle that medical studies show can be mediator of healing for people with autoimmune disease. These mediators of healing are also commonly referred to as pillars of the AIP, and they include stress management movement, connection to nature, connection to others. And our topic for today, sleep. In a moment, we'll get into the science of sleep as a mediator of healing for autoimmune disease, but first we want to share a bit of our personal experiences in regards to sleep. Jaime, what role has sleep played in your autoimmune healing journey?
Jaime Hartman (01:16):
It wasn't really apparent to me until I actually made some changes that allowed me to have better sleep that I realized that sleep truly is the absolute non-negotiable foundation for me when it comes to my wellness, my continued wellness, I made all the diet changes first and I thought that would be enough, but at the time I was traveling for work, I was crossing time zones. I really didn't have any control over my sleep schedule, my sleep routine, staying up late, sometimes, not other times. And I didn't realize how much it impacted me until I made the changes in my life that naturally led to me having more consistent sleep. And I realized in retrospect how important it had been, which is why I really advocate for that point with my clients. How about you?
Marie-Noelle Marquis (02:10):
Yeah, I agree. I think for me, I've worked, I used to work night shifts for decades in my life, working long hours, many, many, many, many sleepless night as well, working in film production and just pushing through. And that was always normal to me. And I feel like I started that even in my teens, just pushing through, not really sleeping, going on two, three hours a night. And same, I really was addressing the diet part of AIP I and when I made the change to sleep, and I would say even the biggest change wasn't just getting more sleep, but it was getting more sleep at a decent actual that between 10 and midnight sort of window where you get more repair and I could really, really feel that difference, whereas I used to get sleep, but from 9:00 AM until 4:00 PM and I can really tell the difference how that doesn't repair you as well.
(03:16):
So not just bringing sleep into my life, but really giving it the healthier hours of sleep. That made a huge difference. And I feel like if I skip on sleep, that is the first thing that will put me back in a flare up. I feel like my body has the resilience I be able to handle potentially being exposed to a food that maybe might not be ideal, but as long as I get enough sleep, I'll recover through it just fine. But if I skip a night of sleep or multiple hours of sleep, then I definitely feel it fast.
Jaime Hartman (03:49):
Thanks for sharing that. I know our listeners appreciate hearing the personal perspectives. Now, listeners, we want to help you understand the science of sleep and sleep's influence on the immune system. And we can think of no one better to do that than our colleague Dr. Sybil Cooper. Dr. Cooper is a PhD immunologist, a national board certified health and wellness coach, a functional nutrition counselor, a sleep performance coach, and an AIP Certified Coach. Like both of us, Dr. Cooper also lives with autoimmune disease herself and her mission is to educate, empower and support clients to be their own health advocate and to make nutrition, lifestyle and behavior changes that are critical to living a full life.
Marie-Noelle Marquis (04:35):
Today we're sharing the audio from the presentation Dr. Cooper made at the AIP Summit in January, 2023 entitled Sleep and AIP Foundation. If you're a member of the AIP Summit Community, you can find the video recording of her full presentation with the visuals. And if you're not a member yet of the AIP Summit Community, you will find a link in the show notes where you can learn more about membership benefits and options.
Jaime Hartman (04:59):
Now let's listen and learn from Dr. Cooper and Marie-Noelle and I will be back on the other side to wrap things up.
Sybil Cooper (05:10):
Hi and welcome to the AIP Summit 2023. My name is Sybil Cooper and today I am going to talk to you about sleep and immunity. I started my career as an immunologist, and so speaking to you today on sleep and immunity is like the perfect marriage between two of my passions. I'm an N-B-C-H-W-C Certified Coach, certified AIP coach among others as well as a sleep performance coach. My passion for nutrition and health really started with trying to heal my son after his battle with Lyme disease. Subsequent to that, I was diagnosed with Sjogren's syndrome, followed by some lupus like symptoms, myasthenia gravis and ultimately mixed connective tissue disease. That along with seeing my blood glucose and A1C slowly creeping up in my forties despite eating a whole food anti-inflammatory diet, really pushed me into learning and understanding how our lifestyle sleep, stress these behaviors help to influence both our general health as well as our art immunity.
(06:46):
So managing my stress and focusing on the quality of my sleep was really critical and it still is instrumental to managing my overall health in autoimmunity. And at 55 years old, I am very keenly aware of protecting my brain health as well. And so sleep is really the common factor in all these aspects of health. So what we're going to cover today, this may be a little bit more sciencey than what you're used to with a sleep talk, but with my clients, I love to explain to them how and why their bodies are functioning and performing in a certain way to really help fuel the motivation that is required to make what is often very profound lifestyle behavior changes, especially with sleep because so much of our sleep habits have been ingrained over years if not decades, and it can take time to make those changes and to cement those changes. So we'll talk about sleep architecture, the glymphatic system, sleep and immunity, and finally some sleep hygiene tips. You also have a PDF that you can download that will have some sleep tips and guidance on how to optimize both your morning and your evening routines so that you can have higher quality sleep.
(08:20):
So are you sleeping enough in this age of wearables and technology, these are the most simplest questions you can ask yourself to determine if you're sleeping enough. Are you often tired? Do you require caffeine to get through the day? Do you wake often during the night? Do you wake up feeling refreshed or exhausted or do you get drowsy during meetings? Do you get drowsy while driving or watching tv? That was the issue that I had that signaled I was having issues with my sleep. And do you wake up with a dry mouth? And these questions can be even more difficult for those of us in the autoimmune community because it's hard to dissect what might be a sleep issue versus what is fatigue that's being caused by our autoimmune disease. And those two things are often tied together. So have you had these thoughts? I know I've had probably most of them.
(09:24):
I will sleep when I'm dead. That was definitely me in my thirties. I've been at work all day or taking care of kids all day, so I need to stay awake later to grab some me time. I think a lot of us have been there and that's called bedtime revenge procrastination, where that revenge is shaving off time from sleeping so that we can have that me time that we deserve, that we crave. I need to wake up one hour earlier to grab my me time so I can get my workout 10 before everyone gets up and starts demanding my time. So I'm guilty of that one too, and I don't need as much sleep as other people. I'm fine on five to six hours per night. Now that one was done me, but I've heard that one often from clients. So hopefully by the end of this webinar you'll really begin to understand that focusing on your sleep is just critical so quickly.
(10:25):
We'll go through the sleep stages. There are awake, light sleep, deep sleep, and REM sleep. So awake is just the time that you're in bed before falling asleep or those brief moments of wakefulness during the night. Light sleep is when your muscles were relaxed and they may jerk you kind of just drifting off to sleep. Your heart rate starts to decrease, your body temperature starts to drop, and waking up from a light sleep is much easier. Deep sleep, your blood pressure further drops, your brain begins to flush waste through the glymphatic system, which we'll talk more about in a minute. Waking up is much more difficult when you're in deep sleep. And if you are, you have that really groggy sort of hungover feeling. And ultimately this is where all the growth and repair occurs in your tissues. So blood flow increases to the muscles for muscle growth and repair, especially after a hard workout.
(11:32):
Growth hormone is also released to build muscle and bone. And if you're like me, you're a woman in your fifties, it's definitely a time to start focusing on building muscle and building bone. And even if you're a guy, it's definitely a time to focus on those things as well. And finally, REM sleep or rapid eye movement sleep. So your breathing and your heart rate starts to increase. Dreaming occurs. This is where you have that feeling of being paralyzed that you can't move so that you don't act out your dreams and memory consolidation and learning occurs. So all of the events that's happened during the day, that's where those things are cemented into long-term memory storage during REM sleep.
(12:25):
On this slide, I have image from the or ring.com website showing a typical night's sleep over three to five cycles. So a cycle of sleep, depending on your genetics is roughly 90 minutes. And you want to aim for three, ideally five cycles per night, which is about eight hours. And you can see that in the first half the night. If you look at, this is one of my own aura tracings and I went to bed a little bit later than usual. So 11:16 PM is where I fell asleep. And you can see in the first half of the night is where you're getting predominantly all of your deep sleep. And we're going to address why that is just so important in a minute. And then in the later half the night is when your body is focused more on that memory consolidation and learning where you're getting all of that wonderful REM sleep.
(13:31):
And this timing of the deep sleep and the REM sleep is actually tied to your circadian rhythm, which is regulated by one thing, and that's your sunlight exposure first thing in the morning. And that's going to be my number one top sleep tip is to get sun on your eyeballs soon after waking. Because this deep sleep happens typically between 10 and 2:00 AM for most people. If you're on that normal circadian rhythm, it can be different if you're a night shift worker and you've completely shifted your sleep. But for most of us, this is when this deep sleep is triggered to occur. So the impact of poor sleep on the body is numerous. So poor sleep increases a hormone called cortisol, and you may hear of the cortisol being our stress hormones. So when we're under a lot of stress, we get that quick adrenaline rush and then that's replaced more long-term by cortisol.
(14:41):
That increases your blood sugar, it causes sugar cravings, it causes weight gain. And if you're entering an autoimmune protocol elimination diet, having a high cortisol level from poor sleep or outside stresses from work or family, et cetera, can really make that more difficult because your body is really craving those comfort foods, those high sugar, high fat combination foods. So it's not your lack of willpower that is the problem, but it's really ultimately a function of your hormones. And that really helps to relieve a lot of people of the guild of thinking. They just don't have enough willpower understanding why their body is functioning and behaving in a certain manner. High cortisol leads to increased inflammation when elevated chronically. This inflammation leads to cardiovascular disease, diabetes, neurological disorders, and other chronic disorders. Poor sleep can contribute to cognitive and mood disorders such as anxiety, depression, and impaired memory.
(15:53):
So I hope I will convince you why all of those things are true in this slide. So the lymphatic system is the network of vessels all throughout our body that carries the fluid in the proteins from within the tissues to put it back into circulation. So that's the lymph fluid and it also carries all of our white blood cells and it plays a very important and critical role in the immune system. The brain lacks that conventional lymphatic system. Believe it or not, the glymphatic system for glial lymphatic system was discovered in 2013. Yeah, not very long ago. And what they found was that during that critical deep sleep period I talked to you about in the previous slides, the brain actually contracts to create more extracellular space to allow that fluid to remove the old fluid proteins and waste and replace it with fresh, clean, cerebral spinal fluid. And so that's called the glymphatic pathway, and it's a function of cells, the astrocytes in the brain that actually have an immune origin.
(17:30):
So why is it important to cleanse the brain? Well, aging and traumatic brain injury as well as neurodegenerative diseases such as Parkinson's and Alzheimer's disease are thought to all be linked to a reduced functioning of the glymphatic. Just think if you don't have the street sweepers going around town, cleaning up all the debris from the streets, that dirt and that debris just keeps building up and it makes it difficult for the cars a k, a, the neuronal impulses to be transmitted between the nerve cells. So it inhibits you from driving from point A to point B if the streets are always filled with dirt and debris. And as you can see, this is another one of my or ring data sets. And you can see I had excellent deep sleep here, almost one hour and 45 minutes. And here is the little street sweeper. The deep sleep is the dark boo here is going through and cleaning out all of the toxins I may have been exposed to as well as all the metabolites that the brain is creating.
(18:57):
The brain takes a lot of energy, it creates a lot of waste, and that needs to be taken away just like our kidneys are responsible for making urine and cleaning out all the metabolites from all of our organs throughout our body so that we can eliminate it. That's the functioning of the glymphatic system. And without that cleaning process, your brain essentially gets gummed up and that can be translated into accelerated aging. It's seen in TBIs as well as in neurodegenerative diseases. So that's why getting that deep sleep and trying to be asleep between 11 and 3:00 AM is so important.
(19:45):
Sleep in the immune system. The sleep triad is an intersection of the nervous system, the endocrine system, which is all of your hormones and the immune system. This is a bit of a busy slide, but we're going to go through it. This image here is not important for you to look at it right now, but I just wanted to impress upon you. It's showing where melatonin is secreted in the brain and at the organ level. It has an impact on the adrenals, the thyroids, the heart, the pancreas, liver, fat muscle in the gut. And what is missing from this slide, the immune system. So yes, melatonin, which is responsible for regulating our sleep, also regulates the immune system, and it's also a very potent anti-inflammatory. In addition to its sleep promoting functions, it stimulates the production of these progenitor cells that later become granulocytes and macrophages, which are really important for combating bacteria, viruses, and fungi that you're exposed to during the day, as well as for natural killer cells and CD four positive T cells, which are also critical for finding pathogens as well as detecting and eradicating cancer cells in the body.
(21:11):
And interestingly, it's now known that melatonin is also produced by lymphocytes. So melatonin really has a critical role to play in the immune system. And just as during REM sleep when we encode memories and things that we've learned and encountered during the day, our immune system encodes create memories and then consolidates those memories at nighttime while we're sleeping. Lack of sleep is known to exacerbate allergies, asthma and autoimmunity due to that increase in cortisol that we spoke about and an increase in other inflammatory hormones and cytokines. And cytokines are just the proteins that the immune system uses to communicate amongst its components. Lack of sleep has been shown to lower antibody production in response to vaccines, and it also increases susceptibility to common cold viruses. So with that one, they took a bunch of college students who are often willing to do anything for money, and they inoculated them with a common code, rhinovirus up their nose, and then they altered their sleep patterns and found that the people in the study who were sleeping less than six hours a night had up to a five fold more chances of having symptoms from the rhinovirus.
(22:43):
And finally, an inflammatory response to pathogens can increase deep sleep, slow wave sleep, the timing and the duration. And so when your body is busy trying to fight a pathogen, you can often require more sleep in order for your immune system to do its job. And that's for several reasons. The immune system like the brain and the digestive system, it's a huge energy hog, so it requires lots of energy, so it wants to conserve energy everywhere else so that you can use that to combat whatever pathogen you're battling at the time.
(23:32):
So circadian sleep and immunity patterns. So here is another recent tracing this week here you can see I slept for eight and a half hours. I had been missing a few nights sleep, I was pet sitting, and so I definitely needed that catch up time. And so here again in the dark blue is when the white blood cells actually go into the lymph nodes around your body where they can communicate with all the other cells that have been roaming around your body throughout the day. And they're talking to these cells, these macrophages and others about the encounters they've had during the day, the bacteria, the viruses, the fungi, any cancer cells, cytokines that the immune system uses to activate cells and to kill pathogens, to kill pathogens. Just TNF interleukin one, interleukin six, interleukin 12 at interferon gamma are actually their highest while we're sleeping.
(24:42):
And sometimes that can be why, especially folks with rheumatoid arthritis can actually wake up with their symptoms feeling worse, their joints feeling worse because of this heightened immune response during the night. And memories of the intruders encountered during the day are consolidated during sleep. And then here on the right side during the wi sleep, the memories are consolidated and learning is cemented, and that's when dreams occur. And so during the day, just like when we're studying or reading a paper or talking to our friends and loved ones, things that our body decides to encode for long-term storage occurs. The same thing is happening with your immune system. That encoding of information happens during the day and at night that's consolidated. That's where the memory happens, and that's when the next time you see a pathogen, your immune system can react even faster because now it remembers those exposures.
(25:56):
One night of four sleep has been shown to reduce the efficiency and efficacy of natural killer cells by 75%. Natural killer cells are really instrumental in fighting viruses and other pathogens. Now, once you resume sleeping, they rebound. So don't worry about it if you miss one night sleep, but we certainly want to overall really focus on having quality and quantity of sleep. So the intersection of sleep and autoimmunity. So as I hope you have seen, sleep is critical for proper regulation of the immune system. However, severe infection or high inflammatory states can decrease deep sleep and REM sleep leaving us with fatigue even if we're in bed for the required hours each day. And what if your art immunity comes with significant pain that disrupts your sleep? So if you're sick with some pathogen and you're having a difficult time sleeping, you just have to rest, hydrate, fuel your body and let your immune system do its job and sleep as best you can and get the rest throughout the day.
(27:26):
Now, if you're dealing with autoimmune pain, it may be time to seek help from your healthcare practitioner to try medications to reduce your autoimmune symptoms or for something to treat the pain in the short term so that you can get good sleep. And in that way, you can help your body to self-regulate your immune system so that you can either reduce your medication or eliminate it altogether. Also, be open to other pain relieving modalities such as acupuncture, red light therapy, and physical therapy so that you can get the restful sleep you need to help balance and regulate your immune system. And finally, discuss with your healthcare practitioner if it is time to seek more of a sleep assessment from a sleep practitioner and have sleep be really a key pillar of your autoimmune care because it is just so important to get quality sleep and quantity sleep to help regulate and minimize your autoimmune symptoms.
(28:49):
So some sleep hygiene chips in addition to what you'll get in the PDF. Now, given the importance of the deep sleep for the G lymphatics clearance of neurotoxic waste, as well as the proper interaction of your lymphocytes within lymph nodes during sleep, focus on getting that quality sleep between 11:00 PM and 3:00 AM. And so that may mean starting your wind down routine at 9:00 PM so that you can get in bed and start preparing by 10:00 PM so that you're fully asleep by 10 30 11. Obviously, if you are a swing shift worker or a night shift worker, I would have other tips for you, but for people who are on a standard circadian rhythm, this would apply to you. So my number one recommendation, as I mentioned earlier, is to get sunshine on your eyes for five to 20 minutes soon upon waking. And I know it's wintertime, it's getting to be very cold and not so nice outside in many parts of the country, in other parts of the world.
(30:09):
I know it's summer. But if it's not so nice for you outside, even just standing in front of a window is going to have the benefit of getting that blue light exposure on your eyeballs and helping to set your circadian rhythm so that your body knows at about what time sleep is expected in the evening. Next is to prepare your sleep sanctuary. When you walk into your bedroom, is it a calm, relaxing, soothing space? I mean, that is so key. Is it dark? Do you have any light emitting devices covered up or turning off? And is it cool? So that sweet spot for most people is 65 to 68 degrees. If you're used to keeping your room very warm, especially for those of us without immune disease, if you shift that temperature too quickly, it can trigger some autoimmune symptoms. So if you're used to having your room very warm and you want to try it cooler temperatures to see if that impacts your sleep, just step that down very gradually so that it's comfortable for you. And lastly, have a consistent morning and evening routine. So much of our body operates with hormones on a circadian pattern because your body likes to know what to expect. So your evening routine should involve relaxation and a mental release from the day, such as journaling, breath work, stretch, routine. Your morning routine should involve getting that sunlight on your eyeballs. And if you can get outside and have a good brisk 10, 15 minute walk, even better just to get that full body sunlight exposure.
(32:08):
So I'm going to end this presentation with one of my favorite poems bed in summer. I know it's not summer, but I absolutely love this poem, so I hope you enjoy it as well. You can get in touch with me at my website. There's a big contact me button there. I also will answer dms on Instagram, and you can email [email protected]. My QR code will also take you to get in touch with me button I, and again, I hope you find the PDF that I've created for you useful. And if you need help with your sleep or any other health concerns, please get in touch with me. I would love to have a chat with you. I hope you enjoy the rest of our sessions. Bye.
Marie-Noelle Marquis (33:09):
We're so grateful to Dr. Cooper for sharing her expertise with us. You'll find a link in the show notes to her profile in the AIP Certified Coach directory where you can learn more about her services and how to get in touch with her directly. We hope that this presentation has provided you with useful information about AIP, which is not just a diet, but a complete lifestyle protocol. Through this podcast, AIP Certified Coaches bring you resources so that you can feel confident about doing AIP on your own, but with the knowledge that you're not doing it alone,
Jaime Hartman (33:39):
We'll be back with another episode in two weeks. So make sure you subscribe to the AIP Summit Podcast in your favorite podcast player if you haven't already.
Marie-Noelle Marquis (33:47):
And if you'd like to leave us a rating and a review, it will help others find this podcast where we are committed to helping you use the power of the Autoimmune Protocol to elevate your wellness journey to new heights.
Jaime Hartman (34:02):
The AIP Summit Podcast is a Gutsy By Nature production. Content presented is for informational purposes only, and is not intended to be a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
