Autoimmunity With Maria Berglund Rantén: Sleep And Circadian Rhythm
Rather often we receive questions about chronic disease symptoms and autoimmune diseases. Autoimmune diseases (AIS) are unfortunately something that many suffer from, but it is also common that people are unaware that they have an ongoing autoimmune (AI) process in the body. On average, it takes between 3 and 7.5 years for the affected person to be diagnosed, but sometimes the process can take as long as 10-15 years.
We happen to know that our favorite nutrition therapist Maria Berglund Rantén is particularly knowledgeable in the area and we’ve therefore turned to her to learn more.
– Why does it take so long before a diagnosis is made?
In the beginning when antibodies are formed you are usually symptom free, but the more they become the more stroke the cells take – and then eventually you start to develop symptoms. When you have very elevated antibodies and thus also cell damage, you generally suffer from so many symptoms that you go to the health care to get a diagnosis. Unfortunately, it is also true that if you have antibodies to a type of tissue, it is likely that there are more ongoing AI processes in the body, just to find them.
Another reason why the diagnosis is delayed is that it is so difficult to pinpoint a reason for AIS. This is because there usually isn’t only one trigger. This is what I usually tell my clients: if you are going to bake a really tasty cake, you won’t need one ingredient but a whole list. The same goes for AIS: there is always a list of reasons.
Of course, not every ingredient, or in this case trigger, are equally important. In baking you need more flour and eggs than vanilla sugar for example, but all the ingredients are needed for the end result to be good. In my own case with Hashimoto’s, which I suffered terribly from 11-12 years ago, diet is the biggest trigger.
The link between diet and autoimmune diseases has been extensively discussed, and I would therefore like to focus on some other lifestyle-related reasons why AIS is gaining momentum: namely, sleep and daily rhythm, stress and relationships, as well as exercise and recovery. I suggest we start with sleep and daily rhythm today, and take the other two at a later date.
– Sounds good, Maria. We want to know all about the connection between AIS and sleep. Please, tell!
Insomnia comes in different forms. The most common is that you either have trouble falling asleep at night or that you fall asleep easily but wake up frequently during the night. If this rarely happens, there is no danger but it is only when insomnia becomes chronic that it becomes a problem and a contributing factor to AIS. Sleep and immunity is something that has interested researchers for many years.
Sleep modulates the immune system and makes it work better. I think everyone can relate to the fact that poor sleep makes one more susceptible to colds. Likewise, we can flip that notion and say that most people have experienced how enough good sleep makes you feel stronger. This is why we have a great need for sleep when we are sick. Sleep helps the cells in our immune system work more efficiently.
– Yes, we can definitely recognize that. What does the research say?
Studies have shown that insomnia weakens the immune system. For example, our Natural Killer Cells (NKC) are reduced in number and their function to defend us. NKC, which is one of our most important immune defense cells, has gotten their name based on the way they destroy invaders. In a study in which healthy participants were exposed to rhinovirus, participants who slept less than 6 hours were 4 times more likely to become ill than participants who slept more than 7 hours. If researchers around the world conclude that sleep is important in reducing illness, then you can certainly imagine what a chronic stage of insomnia can contribute. Yes, you guessed right – AIS.
I’m not going to list a lot of studies because it’s probably just me who gets ramped up by them, but the main take home is that making sure we sleep well is important.
– What can we do to avoid sleep issues?
You can ask yourself some simple questions: how many hours of sleep do I get each night, do I wake up in the middle of the night, for example, to pee, do I have trouble falling asleep at night, and do I have regular times when I go to bed and get up? This and other questions regarding sleep and circadian rhythm receive a lot of focus in my clinic especially for those who say they don’t sleep like a sleeping beauty.
Relatively often, people with AIS, who come to my clinic, are already following an AIP diet (according to the autoimmune protocol), however they only experience marginal improvement through the diet. This provides clues for me that there are more triggers than the diet alone. Once we initiate lifestyle recommendations, such as better sleep, their symptoms often calm down.
I received an email from a client after last Christmas where she described that she had become much worse. She couldn’t understand why because she was “so good with the food”, and she wasn’t ill or anything. I replied that it was probably her jet lag and poor sleep in connection with the stress of the trip that triggered her reaction.
I just said that I would not mention any more studies but I just have to tell you about one more. It was done on patients with rheumatism. The researchers saw that dysfunctional circadian rhythm increased some inflammatory markers, which led to significantly more pain in the joints.
– Is it possible to cure AIS?
No sorry. Instead, you try to stay in remission as long as you can and make good lifestyle choices.
– Can you help us compile a concrete and good list of things that are good to think about?
Obvious! There are two points that I would place number one on the list, and which one becomes number one for you just depends on which need is greatest. The rest are good points to think about where you can “pick and mix”.
# 1 (option 1)
Early bedtime. Getting to bed around 10pm and sleeping 8 hours is a big puzzle piece in the AI puzzle. There are so many of my clients who fall asleep late. Why, I ask, aren’t you tired? Yes, most people answer. But after awhile they will start with late bedtimes again because it feels far too early to go to sleep as early as 20.30. They choose to push through, the cortisol goes up, and the sleep train leaves the platform, which ends with being awake until midnight. I try to send a clear message though that, while they are at the beginning of their health journey, they need to sleep when the sleep train arrives, even if it is only 20.30 in the evening.
# 1 (option 2)
Blood sugar control. The most common reason for not being able to sleep through the night is that the blood sugar has ridden the roller coaster during the day. Stabilizing their blood sugar usually goes fairly quickly (about two to three weeks). Make sure at every meal you get a sufficient amount of protein. Live on mostly vegetables and some fruits and berries, get good fats and prioritize complex carbohydrates. Avoid sugars, sweets, sweet snacking times, refined grains and other things that interfere with the sensitive glucose-insulin balance. I don’t mean to banish them 100% but keep the indulgene to a minimum. Most people need to eat three main meals a day and some need to add a snack in the morning or afternoon so as not to get a bigger dip.
– More good things to think about?
Caffeine. Stick to two normal sized cups of coffee per day and do not drink after lunch. If you are really sensitive to caffeine, try removing coffee and other caffeinated beverages altogether.
Alcohol. Stop drinking alcohol at least two hours before going to sleep and drink moderately, preferably no more than 1-2 glasses. Again, if you suffer from major sleep disorders, it is best to remove alcohol completely until you get into a routine where you sleep well again.
Allergens. Avoid gluten and casein as these proteins are common allergens that can cause discomfort and sleep disorders.
STRESS. The most common reason for not being able to fall asleep in the evening is stress. To-do lists, “I should”, “I must not forget” or other thoughts keep the brain screwed up and disturb the sleep. We can certainly all recognize ourselves in this and agree that it is totally worthless! Fortunately, there are plenty of stress reduction techniques to choose from.
Digital detox. Avoid tablets/mobiles/laptops etc late in the evening. Don’t watch stimulating TV shows late at night. In addition, electric gadgets radiate blue light which stimulates the brain to stay awake. Do a digital detox 30-60 minutes before going to sleep.
Read. Reading, yes! Not other people’s FB posts thought but a book or newspaper, it is relaxing and can be done for a while before you want to sleep.
Mindfulness, yoga, Chi gong, Thai chi or other relaxing exercises relax the body.
Gratitude. Writing down or just saying things you are grateful for and that gilded your day makes you feel better. This can help with grinding thoughts and help you fall asleep.
Train. Exercising 30-60 minutes a day can help to modulate the daily rhythm. This is just as important for big and small. Do work out if possible!
Prepare the bedroom. You sleep best in a dark and cool room. Also make sure to sleep in a really comfortable bed.
Supplements. There are a variety of supplements that soothe the body. Magnesium is a typical one that many recommend, but keep in mind that magnesium citrate can make you loose in your stomach. Therefore, I usually recommend magnesium bisglycinate.
Together with Jackie Cawthra, Maria Berglund Rantén is a partner in a new clinic called Nordic Wellth – a digital health platform that offers health-related products and services, such as lab tests, supplements, recipes, group programs, consultations with nutrition therapists and doctors, as well as a blog on research & health. Are you interested in a consultation contact Nordic Wellth which has clinics in Stockholm, Gothenburg and the Lunda area. Consultation over video link can also be offered. Follow Nordic Wellth on Facebook here.