Sleep and Gut Health
Sleep is as critical to our well-being as food, water, or shelter.
According to the Sleep Foundation - "After 20 hours of being awake, drowsy drivers are impaired on a level comparable to a 0.08 percent blood alcohol content, which is the current legal limit in most states. After 24 hours awake, impairment is equivalent to a blood alcohol content of 0.1 percent."
Feeling tired often and getting poor sleep on a regular basis is very stressful for our bodies.
We have all been there - late nights with friends, newborn babies, celebrations, music festivals, chronic pain, the need for alone time, fast approaching deadlines for school and work.
A study titled "Sleep Duration and All-Cause Mortality" found that sleeping less than seven hours on average over the course of 25 years increased all-cause mortality. All-cause mortality means more likely to die from anything. This is a startling fact since the average American gets about five hours of uninterrupted sleep.
There are many reasons a person may not be able to properly sleep, and chronic pain is at the top of that list. Working with someone that specializes in pain management may be the best support. Medications, acupuncture, frequency machines, physical therapy, regular bodywork (massage, chiropractic, Bowen, Ortho-Bionomy), class three medical devices lasers and low dose herbal medicine may be useful to help manage pain.
The real question is how the heck does poor sleep impact gut health?
Consider this scenario, you are a new parent and little one is waking up five times a night to feed. Mom is getting severely interrupted sleep to feed the future generation. She is often more likely to feel too tired to move her body in a way that feels good, we often crave comfort foods like high simple carb snacks. We get a quick energy boost from easy to digest carbohydrates, but we also get a blood sugar drop off which can look like moodiness and emotional lability. Rinse and repeat. Now add in another child both no longer breast feeding and the parents need adult time. They stay up a few hours after kiddos have gone to bed to catch up on their favorite TV show getting ALAN (artificial light at night) furthering the years of poor sleep.
According to the article titled "Gut microbiome diversity is associated with sleep physiology in humans" fragmented sleep contributes to reduction is microbial diversity especially in species that are associated with helping our body regulate our sleep-wake cycle, the circadian rhythm.
They also found that a specific inflammatory marker called IL-6 becomes increased with fragmented sleep. The study did state that they only worked with males and based on their research they suspect females may have a more pronounced impact on their gut health from fragmented sleep.
In simple terms this means poor sleep leads to gut inflammation and contributes to the development of intestinal permeability aka leaky gut. Intestinal permeability is associated with all kinds of negative health effects - autoimmune conditions, small intestinal bacterial/fungal overgrowth or SIBO/SIFO, stomach and small intestine ulcers, increased visceral hypersensitivity, the list goes on.
Visceral hypersensitivity, or the ability to feel the guts more than usual, is associated with irritable bowel syndrome (IBS) and previously we have thought that visceral hypersensitivity was a hallmark of IBS, but a 2016 article found that poor sleeps lead to increased sensitivity.
One last note before we move into some tips and tricks to help you improve your sleep at night...
When we are not sleeping, we spend more time in sympathetic dominant nervous system. This means are ready to fight, flight or freeze. When we get high quality sleep, we can drop into our parasympathetic nervous system or the rest and digest. The important thing here is that when we are in the rest and digest mode, which stimulates certain cells in our digestive system to produce mucus as the authors of the article called "Effect of REM sleep deprivation on gastric mucosa" found. This mucus is the protective coating along our entire gastrointestinal system.
Not getting adequate sleep is a double whammy because we chose comfort foods over fiber rich veggies, fruit, nuts and seeds which provide nourishment to the gut bugs and then we sit in sympathetic dominance reducing mucin production. These gut bugs get hungry and munch at the gut lining. This triggers further inflammation.
Below are some ways to support your sleep including – being mindful of the food and beverage we consume, limiting artificial light at night (ALAN), and using relaxation methods to achieve your long-term sleep goals.
Many people in today’s world suffer from insomnia due to a variety of reasons including:
● Having a sleep environment that is not ideal (e.g., poor mattress, room too hot or too cold, etc.)
● Daily routines that disrupt sleep patterns such as drinking caffeine after 12 pm or alcohol late in the evening to take the edge off, which disrupts sleep and prevents deep REM sleep from occurring
● Consuming too much food 2-3 hours before bed, the body is too busy digesting instead of resting and repairing during sleep
● Not getting adequate exercise for your body which affects overall health and the ability to attain high-quality sleep. The WHO recommends 30 minutes five days a week of moderate intensity (can still carry a breathy conversation).
To enhance your sleep, switch off the TV, computer, phone or other screens at least one hour before going to sleep. This is because we have a self-protection mechanism that triggers a “fight or flight” response dating back to when we were cave dwellers. TV watching can trigger this response. When this happens, adrenaline is released into the bloodstream, blood is pumped to the major muscles, the heartbeat quickens, the digestive system stops, the immune system is suppressed, and everything tenses up.
Ideally, we have zero electronic devices in the bedroom, including using the phone as an alarm. Buy an alarm clock or stick your phone in the room over so you can hear the alarm ring. Pull the bed out slightly away from the wall, many homes have 'dirty' electricity that is not great for our bodily electrical system.
This also includes rings, watches, straps and other Bluetooth devices from which we all love to collect data. The trouble here is that when you sleep great (feeling) and your fancy watch tells you otherwise, you then think your feeling was wrong and that the electronic device was more correct. This is a major contributor the anxiety and stress.
If you must collect data because you love data, great, collect the data for a few months of the year and be done with it. A human need to be tapped into themself, their feelings and trust themself not a silly little device that is now dictating how to function because it said you slept poorly.
Often, our lives are filled with activities that need to be done making it difficult to find enough time for ourselves to relax and reflect on our lives. If you have been kept awake by a “too-busy” mind, take some time for yourself during the day to problem solve, go over priorities for the following day, and develop a plan to work through those priorities to achieve them.
Taking the time to create a plan can provide you with more peace and help transition toward a nighttime mode of relaxation, reflection, or meditation, all leading toward sleep.
Sleep meditation helps to take you out of problem-solving mode and move you more into a living in the present moment outlook with a reflective/meditative mindset that helps enable restful high-quality sleep.
Historically humans spent much of the day not in a box, not on a screen, but rather outside on the earth without shoes. Perhaps you have heard of grounding/earthing? Which is the electrical discharge of positive ions directly to the ground (Earth, not cement or black top).
This matters because we are electrical beings and according to the EPA we spend 90 percent of our time indoors, never touching the earth. Most people aren't going to run outside to the nearest patch of grass. There's an earthing mat you can purchase and strap under your fitted sheet of your bed and plug it in to the nearest grounding outlet in your bedroom.
The most reasonably priced earthing mat can be purchased at www.earthing.com. Please DO NOT purchase an earthing mat from Amazon. There have been several incidents of a patient purchasing it from Amazon because it was $20 cheaper than the website above. The device overheats and causes issues for those patients. It is not worth it.
There are many methods that can improve your quality and quantity of sleep. These are just a few that have given people an easy, simple, and effective approach to help improve their sleep.
If you would like to nerd out - Why We Sleep by Matthew Walker is a detailed book on all things sleep, including sleeping medications and alcohol, both of which people love to use to 'improve' sleep.
For a general reference on improving sleep, please see Paul McKenna’s I Can Make You Sleep.
Beltran, N. et al. (2016) ‘Effect of REM sleep deprivation on gastric mucosa’, International Journal of Clinical and Experimental Medicine, 9(2), pp. 1964–1974.
Cappuccio, F.P. et al. (2010) ‘Sleep duration and all-cause mortality: A systematic review and meta-analysis of prospective studies’, Sleep, 33(5), pp. 585–592. doi:10.1093/sleep/33.5.585.
Pacheco, D. and Rehman, A. (2023) Driving while drowsy can be as dangerous as driving while drunk, Sleep Foundation. Available at: https://www.sleepfoundation.org/drowsy-driving/drowsy-driving-vs-drunk-driving#:~:text=After%2020%20hours%20of%20being,Even%20mild (Accessed: 24 July 2023).
Patel, A. et al. (2016) ‘Effects of disturbed sleep on gastrointestinal and somatic pain symptoms in irritable bowel syndrome’, Alimentary Pharmacology & Therapeutics, 44(3), pp. 246–258. doi:10.1111/apt.13677.
Smith, R.P. et al. (2019) ‘Gut microbiome diversity is associated with sleep physiology in humans’, PLOS ONE, 14(10). doi:10.1371/journal.pone.0222394.
Walker, M. (2017) Why we sleep. Scribner.