Sleep to Heal

Chronic pain and poor sleep go hand in hand. A good night’s sleep is the best way to start feeling better.

Recently I met a little boy patient, 8 year old Brian, who had just come back from a family vacation in Walt Disney World in Florida. While at the park, Brian’s feet were hurting so much, he was unable to walk. The family was very alarmed and brought him to me. He had flat feet. That would make it harder to walk; muscles have to actively do the work bones normally do. And flat feet absorb less shock, so that would contribute to pain. But he was just a small boy and only 8, so it seemed to me that something else was contributing to the problem.

“Brian, what time do you go to bed?” 11 PM says Dad. “That’s late

for an 8 year old. A more normal bedtime for that age would be at about 8 PM.” It’s August so there’s no school yet. “Okay, well, Brian, are you sleeping okay?” No, I’m awake all night. If I go to sleep, I have nightmares about watching a movie called ‘The Tomorrow Wars’. Dad was pretty surprised to hear this. He had no idea.

I made a cast of Brian’s feet for orthotics (custom arch supports). Orthotics would hold Brian’s growing feet in a straighter position with the goal of improving the shape of the foot over time. Orthotics would take away a lot of the pain. But it was important to also give instructions about Brian not watching scary movies, and to establish a better sleep routine even if there is no school.

You already know that your immune system is tied to sleep. You can remember a time when you had a bad cold or flu. All you could do was spend the day in bed sleeping. Every night, falling asleep is initiated by your immune system (through interleukin 2.) These products come from T cells, and you know about T cells now because they are in the news lately.

T cells remember Covid19 and tell B cells to make antibodies. T cells produce interleukin and that puts you to sleep. Why? Because in the dark, your brain produces cyclic, ever increasing waves of melatonin. Don’t take melatonin by mouth because you will wipe out the wave-like pattern produced by your pineal gland. There are also studies that show that taking melatonin can shrink the pineal gland and decrease your natural production. That would be really bad.

While you are sleeping in the dark, the rise and fall of melatonin throughout the night is what initiates the different phases of sleep. The first phase is the same as meditation, the interim between consciousness and sleep. This is also, when you wake without an alarm clock, the last phase of sleep. Then there is light non-REM, third is deep-REM, then Delta sleep, and then after about 90 minutes, you enter REM sleep which is dreaming. It is the rising or falling of melatonin that moves you from one phase to the next. The change in melatonin levels also triggers T cells to produce substances called cytokines which trigger responses by white blood cells.

As you move into deeper phases of sleep, muscles become relaxed until they are, in REM sleep, immobile. This is when the serious job of house cleaning is done by the white blood cells of your immune system.

Changing levels of melatonin also trigger a lowered body temperature. That’s why when you are sleeping you need to be wrapped in a blanket. The lowered temperature is a way to limit the growth of pathogenic bacteria, mostly in your gut. It’s the same thing as storing food in the fridge to limit the growth of bacteria. Oxidation occurs less quickly in cooler temperatures. Too much oxidation in the body means too many molecules with charged electrons that go bouncing around wrecking things, things like DNA. Oxidative stress is related to arthritis, cancer, heart disease, and diabetes. So if you think of melatonin as a body temperature lowerer, than melatonin is an anti-oxidant. A much more fabulous statement is that the melatonin you produce from your pineal gland prevents cancer by lowering oxidative stress.

Scientists have done thousands of sleep studies that show how easy it is to catch a contagious disease based on how much sleep you get. At five hours of sleep you have a 50% chance of getting sick when in contact with a contagious virus. At eight hours of sleep, the chance is less than 20%. That’s an important fact at the present time with the Delta variant of Covid19 out there.

10 PM is the best bedtime. This is coming from Fitbit, and other sleep monitoring device companies. 10 PM is also recommended in the latest Israeli sleep studies related to the infectious nature of Covid19. Even the original significant sleep studies from the NIH done in the 1990’s, recommended a 10 PM bedtime.

You need to sleep at least 8 hours, less is not good. A better amount of sleep is 9 hours. At 9 to 10 hours of sleep, you will wake in the morning without an alarm clock. This is the best way to wake, when your body wakes of its own accord because it is satisfied with the amount of sleep it has had. The word ‘alarm’ in alarm clock sounds like a bad way to start your day. When you are waking in a natural way, you will end with Phase I sleep. This is a meditative state, the interim between sleep and consciousness. You can think, but you are not physically aware of your surroundings. Then you will become conscious, and aware that you are waking up. Does that sound familiar to you? It’s an important activity for the brain, this meditative stage.

Make sure your room is dark. Don’t use eye shades. Your body detects light from the skin on your face and stops melatonin production, so eye shades do nothing. There should be no light coming from the windows. If so, you need a black out shade and black out curtains as well. There should be no blinking lights. Cover them with electrical tape or an object. Nightlights should be red to trick your brain into thinking that any light it sees is just sunset. Don’t put on any lights when you get up to go to the bathroom. Don’t look at your phone or computer.

The room should be quiet. If there is no way to make it quiet, especially here in NYC, then you need to get a white noise machine. These are inexpensive, about $40, and you get them on the internet.

The room should be as cool as you can tolerate it. If you feel cold, use a thick blanket, but keep the air that you are breathing as cold as you can.

Go to bed every night at the same exact time. Your pineal gland is your internal clock and shutting the lights off at the same time helps that gland work at its best.

If you are suffering and still awake, you can take Tylenol PM or 8 hour Tylenol. Try not to take it every night because your body needs to get used to falling asleep on its own accord.

Get up by about 8 AM. If you go to bed at 10 PM, waking at 8 AM should be really easy and possible without an alarm clock. If you need to get up earlier for work or school, then you need to go to bed even earlier.

Getting a good night’s sleep is probably the best thing you can do to be help yourself be healthy. Doctors provide sick care, and only you can provide yourself health care.