English dramatist Thomas Dekker once said that “Sleep is the golden chain that ties health and our bodies together.” If you’ve ever noticed that you’re more vulnerable to getting sick when you don’t get enough sleep, this quote likely rings true. Sleep has a significant effect on the function of our immune system. According to the National Institute for Occupational Safety and Health, even a modest amount of sleep loss can reduce important immune cells known as natural killer (NK) cells by as much as 72%. (25) Yet, one in three adults don’t get enough shut-eye to support a healthy immune response. (1)

Keep learning to learn more about how a good night’s sleep can benefit your immune health.


Woman resting her head on a pillow
Consistently getting a good night’s sleep supports a healthy immune system.

How sleep benefits your immune system

Consistently getting good sleep provides numerous benefits to your immune system, including:

  • Enhancing the stickiness of T-cells, helping them attach to pathogens (12)
  • Increasing the efficacy of vaccines (7)
  • Increasing the production of cytokines, particularly interleukins that modulate immunity (16)(23)
  • Redistributing T-cells to the lymph nodes—small glands that trap bacteria and viruses before they can cause an infection (7)
  • Reducing proinflammatory prostaglandins (5)
  • Supporting a healthy white blood cell count (8)

White blood cells are considered the superheroes of the immune system. These cells search out disease-causing organisms and destroy them. There are two main types of white blood cells, B cells and T cells. B cells identify pathogens and produce antibodies that lock on to foreign invaders. T cells, including NK cells, destroy the harmful microbes that have been identified by the B cells. (20) Granulocytes, which include neutrophils, are white blood cells that contain small particles that fight off infections. (13)

The effects of sleep deprivation

Just as beneficial sleep is essential for a strong immune system, chronic sleep deprivation (consistent lack of sleep) can undermine your immune response. In one study conducted at the University of Washington, researchers evaluated blood samples from 11 pairs of identical twins with different sleep patterns. One twin slept at least seven hours per night while the other twin typically got less than six hours nightly. After analyzing each participant’s blood sample, the researchers found that chronic short sleep shut down the mechanisms involved in releasing white blood cells that fight off pathogens. (30)

Research has shown that even an occasional bout of sleep loss can harm your immune system. When a group of healthy young men were forced to stay awake for 29 hours, researchers found that short-term sleep deprivation negatively impacted the immune system in much the same way stress does. The researchers noted a spike in white blood cells, especially granulocytes, in the sleep deprived men. The study authors noted that this increase in white blood cells mimicked the body’s immune response to fight or flight stress. (2)

Not only do these immune changes leave you more vulnerable to the common cold or flu, they can set you up for more serious problems. (10) Studies suggest that poor sleep increases the risk of heart disease. In one animal study, Harvard researchers found that high-quality sleep had a protective effect against atherosclerosis. (18) Other investigations have made a possible link between poor sleep and insulin resistance, a key factor involved in type 2 diabetes. (3) Chronic sleep deprivation or disrupted sleep may even increase the risk of developing cognitive decline and Alzheimer’s disease. (27)

Did you know? According to research, routinely getting less than seven hours of sleep per night can make vaccines significantly less effective. (21)

The effects of sleep apnea

In addition to sleep deprivation, obstructive sleep apnea—which affects as many as 7% of individuals in the United States—can also weaken the immune system. (22) Sleep apnea is a condition in which the upper airway repeatedly becomes blocked during sleep, reducing or stopping airflow to the lungs. (26)

Studies show that the fragmented sleep caused by sleep apnea reduces the number of T-cells in the body, triggers inflammation, and suppresses immune system function. (24) Over time, these changes don’t just make sufferers move vulnerable to infection, they can increase the risk of cardiovascular disease and metabolic disorders, as well as damage to other organs. (9)(15)

Did you know? Sleep apnea doesn’t just affect adults. It can also occur in children, especially those with large tonsils and adenoids, negatively affecting their immune response. (31)


Analog alarm clock
Research shows that logging at least seven hours of shut-eye each night can foster a healthier immune response.

How many hours of sleep do you need?

How much sleep do you need for a healthy immune response? According to the National Sleep Foundation, adults need seven to nine hours of sleep per night. People over the age of 65 need between seven and eight hours. (14) While getting enough sleep is important, it’s also the quality of the sleep you get that matters. Poor quality sleep can be just as harmful as not getting enough sleep. Noise, stress, pain, exposure to tobacco smoke, alcohol use before bedtime, or strenuous exercise shortly before turning in can all contribute to poor sleep. (4) Fortunately, there are simple things you can do to improve the quantity and quality of your sleep. This, in turn, will also improve the efficacy of your immune system.

Woman lying in bed looking at a tablet screen
Screen time before bed can delay sleep and interfere with your circadian rhythm. This can result in poor quality sleep.

Set yourself up for a good night’s sleep

If you’re routinely in need of a good night’s sleep, it’s time to focus on your sleep hygiene. Sleep hygiene is simply the technical term for adopting healthy sleep habits. One of the best places to start is with a bedtime routine that includes relaxing activities like gentle stretching or a warm bath. It’s also important to ensure that your bedroom is dark, quiet, and cool. (11)(19)(29)

If sleep still eludes you, you might consider supplementing with melatonin. Not only will melatonin help you fall asleep faster, it’s also been shown to enhance the immune system. (28) Combining melatonin with a few sleep-inducing habits can help improve your sleep quality and, therefore, your immunity.

The bottom line

Sleep plays a critical role in keeping your immune system functioning properly. Studies have found that getting less than seven hours of sleep per night can interfere with your immune response on a cellular level. On the other hand, routinely getting seven to nine hours of high-quality sleep can enhance T-cells, increase the production of infection-fighting cytokines, and help keep inflammation in check. These benefits not only protect against a cold or the flu, they may also help reduce the risk of more serious health issues like heart disease or type 2 diabetes. (6)(17) If you suspect sleep apnea or other medical conditions are at the root of your sleep problems, talk to your integrative health care practitioner about treatment options.

Create the
optimal workflow
Integrate now

Don’t have a free Fullscript account? Sign up now.

Fullscript simplifies supplement dispensing

Create your dispensary today I'm a patient
  1. 1 in 3 adults don’t get enough sleep. (2016). Centers for Disease Control and Prevention. https://www.cdc.gov/media/releases/2016/p0215-enough-sleep.html
  2. Ackermann, K., Revell, V.L., Lao, O., Rombouts, E.J., Skene, D.J., & Kayser, M. (2012). Diurenal rhythms in blood cell populations and the effect of acute sleep deprivation in healthy young men. Sleep, 35(7), 933-940.
  3. AlDabal, L. & BaHammam, A.S. (2011). Metabolic, endocrine, and immune consequences of sleep deprivation. The Open Respiratory Medicine Journal, 5, 31-43.
  4. Altun, I., Cinar, N., & Dede, C. (2012).The contributing factors to poor sleep experiences in according to the university students: a cross-sectional study. Journal of Research in Medical Sciences. 17(6), 557-561.
  5. Aoki, T. & Narumiya, S. (2012). Protaglandins and chronic inflammation. Trends in Pharmacological Science, 33(6), 304-311.
  6. Arora, T., Chen, M.Z., Cooper, A.R., Andrews, R.C., & Tahei, S. (2016). The impact of sleep debt on excess adiposity and insulin sensitivity in patients with early type 2 diabetes mellitus. Journal of Clinical Sleep Medicine, 12(5), 673-680.
  7. Besedovsky, L., Lange, T., & Born, J. (2012). Sleep and immune function. Pflugers Archiv, 463(1), 121-137.
  8. Boudjeltia, K.Z., Faraut, B., Stenuit, P., Esposito, M.J., Dyzma, M., Brohée, D., Ducobu, J., . . . Kerkhofs, M. (2008). Vascular Health and Risk Management, 4(6), 1467-1470.
  9. Chorostowska-Wynimko, J. & Kedzior, M.E. (2008). Role of immune system in the pathomechanism of obstructive sleep apnea. Pneumonologia i alergologia polska, 76(2), 101-110.
  10. Cohen, S., Dovie, W.J., Alper, C.M., Janicki-Deverts, D., & Turner, R.B. (2009). Sleep habits and susceptibility to the common cold. Archives of Internal Medicine, 169(1), 62-67.
  11. Desaulniers, J., Desjardins, S., Lapierre, S., & Desgagné, A. (2018). Sleep environment and insomnia in elderly persons living at home. Journal of Aging Research, 2018, 8053696.
  12. Dimitrov, S., Lange, T., Goutefangaes, C., Jensen, A.T.R., Szczpanski, M., Lehnnol, J., Soekadar, S., … Besedovsky, L. (2019). Gas-coupled receptor signaling and sleep regulate integrin activation of human antigen-specific T cells. Journal of Experimental Medicine, 216(3), 517-526.
  13. Granulocyte. National Cancer Institute. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/granulocyte
  14. Hirshkowitz, M., Whiton, K., Albert, S.M., Alessi, C., Bruni, O., DonCarlos, L., Hazen, N., … Adams-Hillard, P.J. (2015). National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health, 1(1), 40-43.
  15. Khalyfa, A., Kheirandish-Gozal, L., & Gozal, D. (2018). Exosome and macrophage crosstalk in sleep-disordered breathing-induced metabolic dysfunction. International Journal of Molecular Science, 19(11), 3383.
  16. Krueger, J.M., Majde, J.A., & Rector, D.M. (2011). Cytokines in immune function and sleep regulation. Handbook of Clinical Neurology, 98, 229-240.
  17. Kwok, C.S., Kontopantelis, E., Kuligowski, G., Gray, M., Muhyaldeen, A., Gale, C.P., Peat, G.M., . . . Mamas, M.A. (2018). Self-reported sleep duration and quality and cardiovascular disease and mortality: a dose-response meta-analysis. Journal of the American Heart Association, 7(15), e008552.
  18. McAlpine, C.S., Kiss, M.G., Rattik, S., He, S., Vassalli, A., Valet, C., Anzai, A., … Swirski, F.K. (2019). Sleep modulates haematopoiesis and protects against atherosclerosis. Nature, 566, 383-387.
  19. Okamoto-Mizuno, K. & Mizuno, K. (2012). Effects of thermal environment on sleep and circadian rhythm. Journal of Physiological Anthropology, 31(1), 14.
  20. Overview of the immune system. (2013). National Institute of Allergy and Infectious Diseases. https://www.niaid.nih.gov/research/immune-system-overview
  21. Prather, A.A., Hall, M., Fury, J.F., Ross, D.C., Mulfoon, M.F., Cohen, S., & Marsland, A.L. (2012). Sleep and antibody response to hepatitis B vaccination. Sleep, 35(8), 1063-1069.
  22. Punjabi, N.M. (2008). The epidemiology of adult obstructive sleep apnea. Proceedings of the American Thoracic Society, 5(2), 136-143.
  23. Rogers, N.L., Szuba, M.P., Staab, J.P., Evans., D.L., & Dinges, D.F. (2001). Neuroimmunologic aspects of sleep and sleep loss. 6(4), 295-307.
  24. Said, E.A., Al-Abri, M.A., Al-Saidi, I., Al-Balushi, M.S., Al-Busaidi, J.Z., Al-Reesi, I, Koh, C.Y., … Habbal, O. (2017). Altered bloos cytokines, CD4 T cells, NK and neutrophiles in patients with obstructive sleep apnea. Immunological Letters, 190, 272-278.
  25. Sleep and the Immune System. Centers for Disease Control and Prevention: The National Institute for Occupational Safety and Health (NIOSH). https://www.cdc.gov/niosh/work-hour-training-for-nurses/longhours/mod2/05.html
  26. Sleep apnea. National Heart, Blood, and Lung Institute. https://www.nhlbi.nih.gov/health-topics/sleep-apnea
  27. Spira, A.P., Chen-Edinboro, L.P., Wu, M.N., & Yaffe, K. (2014). Impact of sleep on the risk of cognitive decline and dementia. Current Opinions in Psychiatry, 27(6), 478-483.
  28. Srinivasan, V., Maestroni, G.J.M., Cardinali, D.P., Esquifino, A., Perumal, S.R.P., & Miller, S.C. (2005). Melatonin, immune function, and aging. Immunity & Ageing, 2, 17.
  29. Wams, E.J, Woelders, T., Marring, I., van Rosmalen, L., Berrsma, D.G.M., Gordijn, M.C.M., & Hut, R.A. (2017). Linking light exposure and subsequent sleep: a field polysomnography study in humans. Sleep, 40(12), zsx 165.
  30. Watson, N.F., Buchwald, D., Delrow, J.J., Altemeier, W.A., Vitiello, M.B., Pack, A., Bamshad, M., … Gharib, S.A. (2017). Transcriptional signatures of sleep duration discordance in monozygotic twins. Sleep, 40(1), zsw019.
  31. Zhang, Z. & Wang, C. (2017). Immune status of children with obstructive sleep apnea/hypopnea syndrome. Pakistan Journal of Medical Sciences, 33(1), 195-199.