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Know the Link Between Sleep and Inflammation

Inflammation creates the “perfect storm” in autoimmune conditions, setting off a domino effect of disease activity, including demyelination for those with MS. One way to offset future inflammatory flareups is to prioritize sleep. Why?

The circadian connection

Our circadian rhythms regulate countless processes, sleep being one of the most important.

But the circadian system isn’t only in charge of managing sleep-wake cycles; it’s also a fundamental player in digestion and immune system function, as well as in the management of the inflammatory process.1

Inflammation is meant to help our bodies heal, so it’s not normally a bad thing. But in cases like MS, inflammation tends to run amok at the cellular level, contributing to damage to the central nervous system.

Inflammatory behavior is also directly linked to the immune system. As people living with MS, we need to pay attention to circadian disruptions, as they influence both our disease course and immune system function.

Unfortunately, one of the biggest circadian disruptions that all humans endure is the struggle to get enough quality sleep. For this reason, sleep is critical for offsetting inflammation in those with MS.

The effect of losing just one night’s sleep

It’s been well established that losing just one night of sleep, even among healthy people, can trigger inflammation.2 From research published in Science Daily in 2008: “Loss of sleep, even for a few short hours during the night, can prompt one’s immune system to turn against healthy tissue and organs.”

Recent research further shows that sleep disturbance, as a measure of sleep loss—as opposed to entire nights of lost sleep—is just as problematic in raising the risk for systemic inflammation.

The presence of two markers of systemic inflammation as products of poor sleep—CRP (C-reactive protein) and IL-6 (interleukin-6)—were confirmed in a 2016 study (Biological Psychiatry).3

Insomnia, then, or disrupted sleep by any cause (for people with MS, this could include other sleep disorders, pain, medication side effects, or symptoms from comorbid conditions) are poised to set off new chains of inflammation if we don’t make concerted efforts to get adequate nightly sleep

The microbiome

The gut-brain connection continues to make MS news these days because researchers believe that the microbiome houses anti-inflammatory antibodies in the intestines which could travel to the brain and fight against immune system attacks.4

“The cells in question are plasma cells—white blood cells that originate as B cells in the bone marrow but change their behavior when triggered by microbes in the gut,” writs Weiler and Oldfield for UCSF News Center in January 2019. They reported on research which found that gut-based plasma cells produced immunoglobulin A (IgA) antibodies which “appear to migrate to the central nervous system and produce an anti-inflammatory effect during MS flare-ups.”5

Dr. Michael J. Breus, better known as The Sleep Doctor, points out that the microbiome is called our “second brain” because it is home to more than 100 million neurons in its own dedicated nervous system.6

“The intestinal microbiome produces and releases many of the same sleep-influencing neurotransmitters—dopamine, serotonin, and GABA among them—that are also produced by the brain,” Breus writes. But, he warns, “emerging research indicates that when circadian rhythms are disrupted, the health and functioning of the microbiome suffers.”

Circadian disruptions we can all relate to include stress, medication usage, poor diet, and—of course—disturbed sleep.

The Goldilocks rule for sleep

How much sleep is enough to fend off inflammation? The range for adults is between 7 and 9 hours of uninterrupted sleep.7

But will sleeping more than 9 hours mean better health?

Not necessarily. The Biological Psychiatry study from 2016 also linked long duration sleep (9 or more hours nightly) with elevated levels of inflammatory markers.

Sleeping away the inflammation

People with MS are frequently told to avoid stress, for good reason.

Dr. Breus makes it plain that “sleep offers us significant protection against stress, itself a major contributor to chronic inflammation—a now known pathway to disease.”8

It goes without saying that poor sleep and stress are unwanted bedfellows. How can we avoid letting stress steal our nightly ZZZ?

Dr. Breus supports fighting back by prioritizing sleep. “Sleeping well can work directly to keep inflammation in check by avoiding the pro-inflammatory activity that occurs in the presence of poor, dysregulated sleep.”

For better sleep

  • Seek medical advice if you suffer from disrupted sleep
  • Practice good sleep hygiene. This includes keeping to a consistent sleep schedule, putting away your cell phone at night, watching caffeine and alcohol consumption (and their timing), making your sleep space “sleep friendly,” and looking carefully at drug side effects as they pertain to sleep.
  • Turn to relaxation techniques to help you fall asleep and return to sleep, should you awaken in the middle of the night.
  • Learn cognitive behavioral therapy techniques to banish racing thoughts at bedtime.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Kohsuke Yoshida, Teppei Hashimoto, Yoshitada Sakai, and Akira Hashiramoto, “Involvement of the Circadian Rhythm and Inflammatory Cytokines in the Pathogenesis of Rheumatoid Arthritis,” Journal of Immunology Research, vol. 2014, Article ID 282495, 6 pages, 2014.
  2. Elsevier. "Loss Of Sleep, Even For A Single Night, Increases Inflammation In The Body." ScienceDaily. (accessed April 8, 2019).
  3. Irwin MR, Olmstead R, Carroll JE. Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation. Biol Psychiatry. 2015;80(1):40–52. doi:10.1016/j.biopsych.2015.05.014
  4. Immune Cells from the Gut Can Turn Off Brain Inflammation in MS, Say Researchers Co-funded by the National MS Society. National MS Society. Published January 5, 2019. Accessed April 2019.
  5. Weiler N, Oldfield J. Gut Immune Cells Cut Inflammation in Multiple Sclerosis. UCSF News Center. Published January 3, 2019. Accessed April 2019.
  6. Breus M. The Latest on Sleep and Gut Health. The Sleep Doctor. Published May 29, 2018. Accessed April 2019.
  7. How Much Sleep Do We Really Need? National Sleep Foundation. Accessed April 2019.
  8. Breus M. 5 Things To Know About Sleep And Inflammation. The Sleep Doctor. Published January 1, 2019. Accessed April 2019.


  • potter
    9 months ago

    I got serious about solving sleep issues 5 years ago. I stay away from televisions, computer and phones for 45 minutes before I go to bed. I go to bed at eleven and get up at 7.30 and sleep with a sound machine. If I wake up I will listen to the machine until I fall asleep. It has really made a difference in how I feel daily and my MS hasn’t progressed any in the last 5 years. I just got my latest MRI. I also take a probiotic every morning for my microbiome system. Potter

  • kerste
    9 months ago

    I agree 100% that poor/disturbed sleep exacerbates my MS symptoms,and if I have just one night of poor sleep I feel ill effects the next day.

    I am totally convinced that my prolonged stress,anxiety and digestive disruption triggered my MS

  • Kim Dolce moderator
    10 months ago

    Tamara, thanks so much for this article, there’s so much information there that speaks to my own insomnia and digestion problems. I’ll definitely be thinking about and rereading your thoughts–perhaps especially during the wee hours when I wake and can’t get back to sleep! –Kim, moderator

  • messeeone
    10 months ago

    I agree, Kim. Tamara, I had to re-read this a few times, but each time I learned more. It’s very timely, too, as I increasingly struggle to manage behavioral and drug interventions to find the right combination for optimal sleep. It also explains why, when people ask, ” can you just rest or do you need to actually fall asleep to feel better,” my answer is always, ” I have to go unconscious!” I’m looking forward to reading more!

  • TK Sellman moderator author
    8 months ago

    Thanks so much, messeeone!

  • TK Sellman moderator author
    10 months ago

    Hi Kim
    Thanks so much for the feedback, I’m doing more research right now on the links between meal timing and sleep problems, and finding a correlation there, too. So many associations between sleep and other health conundrums. If you do reread, please filter the blue light on your device! 😉

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