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Can Good Sleep Prevent a Virus?

April 15, 2020
Chris Aiken, MD

Sleep deprivation increases the risk of viral infections and even mania. Here is the evidence.

Sleep deprivation increases the risk of viral infections and even mania. Here is the evidence.

Sleep deprivation increases the risk of viral and other infections. Animals deprived of sleep eventually die; sytemic infection is the cause. Sleep deprivation impairs immune function, cancels out some of the protective effects of vaccinations, and raises the risk of pneumonia or the commin cold 3- to 4-fold in people.

Cognitive Behavioral Therapy for Insomnia (CBT i) ranks first-line in guidelines for chronic insomnia.

But there's a catch. CBT-i works by restoring sleep drive through programmed sleep deprivation, and sleep deprivation increases the risk of viral infections.

Here's how sleep deprivation works.

1. Average sleep: Calculate the average time the patient slept per day over the past week, e.g. 6 hourshalf-hour as a buffer. eg, 6.5 hours.
2. Bed restriction: For the next week, they are only allowed to be in bed for that average time, plus a half-hour as a buffer. eg, 6.5 hours.
3. Sleep improves: After some initial sleep deprivation, they start to fall asleep faster and sleep longerhalf-hour as a buffer. eg, 6.5 hours.
4. Relax restrictions: Allow more time in bed as their sleep improves, and less time if it backslides.

Patients often fear those sleep-restricting steps will harm their health, but looks like the opposite is true.

A review in Nature Immunology concluded that it's "chronic sleep loss that is detrimental rather than acute sleep loss, which instead might enhance the immune system."l CBT-i improves immune function: CBT-i raised levels of interferons, neutrophils; lymphocytes, and interleukins in a randomized controlled trial of women with compromised immune function due to breast cancer.4 CBT-i is antiinflammatory and antidepressive: CBT-i treated depression in over a dozen randomized controlled trials, and reduced inflammatory markers like CRP and inflammatory cytokines in two randomized trials.5-7

Where to find CBT-i. In-person therapy; online (see moodtreatmentcenter.com/sleep); books (see Say Goodnight to Insomnia; The Depression and Bipolar Workbook; Prescription App (Somryst).

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