When most people think about AIP, they immediately think of food. And it’s true—choosing nutrient-dense, anti-inflammatory foods and following an elimination and reintroduction diet is one of the most powerful ways to support the body. But it’s only part of the story. Research shows that certain lifestyle habits also play a powerful role in healing, and it’s when all of those pillars, as we call them, are combined that the structure for long-term health is built. One of these pillars is sleep. Yes, you’ve heard it all your life. But sleep might be the most powerful tool in your box.
One of the most toxic mindsets that stood out to me when I moved to the United States, particularly Los Angeles, was the association of sleep, rest, and vacation with negative images, such as laziness, being spoiled, and weakness. On the contrary, in many countries, those are not only prioritized but celebrated. Could this mindset of shaming us for not going nonstop enough contribute to our chronic illness epidemic? In fact, it might.
Far from being “rest,” sleep is an active biological process that allows the body to regulate the immune system, repair tissues, balance hormones, detoxify the brain, and restore energy. For anyone living with an autoimmune disease, these processes are not optional—they are the foundation of resilience and our tools for longevity.
Each night, while we sleep, the body moves through cycles of light, deep, and REM sleep. Deep slow-wave sleep is when cellular repair and tissue healing occur, and when growth hormone is released to help the body restore itself. REM sleep, on the other hand, plays a vital role in processing emotions and consolidating memory. Throughout the night, the brain’s glymphatic system, its built-in detox pathway, flushes out waste products and inflammatory proteins that build up during the day. Without these cycles, the body doesn’t just feel tired—it misses out on critical opportunities to heal.
For people with autoimmune disease and chronic inflammation, poor sleep can quickly translate into worsened symptoms. Studies show that inadequate sleep increases inflammatory markers such as CRP and interleukin-6, both of which are directly tied to autoimmune flares. Sleep deprivation also disrupts gut health by altering the microbiome and increasing intestinal permeability, known as “leaky gut,” which is one of the core root causes of autoimmunity. Hormones such as cortisol, thyroid hormones, and sex hormones all depend on healthy sleep-wake cycles to stay balanced, and when they fall out of alignment, fatigue, mood swings, and flare-ups become much more likely. Even blood sugar, another common trigger for flares, becomes unstable when sleep is compromised, as the body becomes less sensitive to insulin.
The effects of severe sleep loss are even more dramatic. When we get less than four or five hours of sleep, the body immediately responds by entering a state of stress. Insulin sensitivity can fall by nearly 40% after just one short night, leaving blood sugar elevated and increasing cravings for carbs and sugar the following day. Cortisol levels stay high, which not only fuels inflammation but also suppresses melatonin, making it harder to get good sleep the next night. The release of growth hormone plummets, slowing down tissue repair, while thyroid and reproductive hormone balance becomes more fragile. The gut barrier weakens, the microbiome shifts toward more inflammatory species, and the immune system loses its ability to self-regulate. In fact, natural killer cell activity—the immune system’s front line of defense—drops by about 70% after a single night without sleep.
The statistics on total sleep deprivation underscore the critical importance of this pillar of health. One night without sleep reduces immune defense by nearly 70%, weakens glucose clearance by 40%, raises inflammatory markers, and impairs cognition to a level comparable to being legally intoxicated. People who habitually sleep fewer than five hours a night have a 15% higher risk of early death. For someone managing an autoimmune condition, these are not abstract numbers—they reflect daily vulnerabilities that can either set the stage for flares or create a foundation for healing.
For many, sleep challenges don’t come just from a busy schedule but from work itself. Night-shift work or rotating shifts are considered a form of chronic circadian disruption. The World Health Organization has classified long-term night-shift work as a carcinogen, due to its suppression of melatonin and disruption of the body’s natural rhythms. Studies also show that shift workers are more likely to develop autoimmune diseases, especially conditions like multiple sclerosis and rheumatoid arthritis. The risks don’t stop there: night-shift workers have higher rates of type 2 diabetes, cardiovascular disease, depression, and anxiety. Even when they manage to sleep during the day, they average one to four hours less per 24-hour cycle, and that sleep is lighter and less restorative. For someone already navigating autoimmunity, the added stress of circadian disruption can compound symptoms and slow recovery.
So what can we do?
From a functional nutritional therapy perspective, sleep should be viewed as medicine. Here’s what I emphasize with clients:
- Prioritize Rhythm: Aim for 7–9 hours of consistent sleep, going to bed and waking up at the same time daily. For shift workers, keep sleep/wake times steady even on days off. This is just as important as choosing the right foods for your plate.
- Nourish for Sleep: Balance blood sugar with protein, healthy fats, and fiber. Avoid caffeine after noon. Include calming nutrients like magnesium and collagen before bed.
- Calm the Nervous System: Evening rituals like deep breathing, journaling, or a warm bath help shift into parasympathetic (“rest and digest”) mode.
- Optimize the Sleep Environment: Cool, dark, quiet, and screen-free bedrooms encourage natural melatonin release.
- Light Exposure: Morning sunlight supports circadian rhythm; block blue light at night to prevent melatonin suppression.
The takeaway is simple but profound: sleep is not a luxury for anyone. For those of us with autoimmune disease, it is an essential part of the healing protocol. The path to healing is not just about what we eat, but also about how we restore. By prioritizing sleep, you allow your body to do what it was designed to do: repair, regulate, and thrive.