Cold Keeps You Up at Night

I never used to worry too much about the amount of sleep I was getting. I was studying pharmacy, busy working in the industry so I could take over the world and retired to a Tahitian bungalow aged 40. Ironically, I would study the physiology of sleep at university, but in my private life, I wasn’t too phased. If I only got five to six hours, what was the harm? 

Well, I changed my opinion overnight. It was March of 2004, and our firstborn son had just come home from hospital. I watched the sun come up through bloodshot eyes, and understood for the first time why sleep deprivation is a torture technique. Over the next few months, I walked around, more zombie than man, bleary eyed and irritable. I once fell asleep standing upright on a bus. I resolved then and there that I would soak up whatever opportunities for sleep I could. Unfortunately, I had two more kids, and so that plan was put on ice for a few more years.

This brings me to my point. One of the biggest thieves of sleep is the common cold. 90% of people suffer from sleeping difficulties when sick. We seem to deal with it during the day, and then about 45 seconds after we climb into bed, it rallies, and you find yourself awake, coughing and wheezing until the early hours. The common wisdom was that you were distracted during the day, but when you hop into bed, it’s all you have to think about. There is an element of truth to this, but the science also shows that your body copes worse in the night time. Our bodies work to a routine called the circadian rhythm. This means that different hormones in your body rise and fall like the tide over this period. One of the big players here is a hormone called cortisol. This circulates through your bloodstream during the day, and one of its jobs is to suppress your immune system. This means your white blood cells (the foot soldiers in your war against the infection) are not as active during the day. I’ve written ad infinitem about how the symptoms you hate so much are actually your body’s immune system fighting back. So during the day time, you’ve called off the troops and you don’t experience the cold-like symptoms as acutely. It isn’t as good as it sounds. It’s akin to an army just letting the enemy advance with minimal resistance. So at night time when there is less cortisol in your blood, your white blood cells launch a counter attack, causing inflammation to fight the sickness. It’s truly painful but it is much more productive. Another factor is your body positioning. Standing upright allows gravity to do its work and pull the mucus away from your airways. If you’re really struggling, you can always add a second pillow to keep yourself as upright as possible. Additionally, something like Otrivin nasal spray right before bed can be incredibly helpful as you can clear up those sinus passages just in time for you to get to sleep.

This is going to sound a bit counter intuitive, but we really need to make sure we are getting enough sleep when we are battling the common cold. Shakespeare himself described sleep as the ‘balm of hurt minds’ and he was (as usual) spot on. When you’re asleep, your heart gets a rest as there are fewer organs and muscles demanding oxygenated blood. While things are quiet, your body can direct this oxygen rich blood, full of white blood cells, to the areas of your body where the infection is trying to gain a foothold. Your blood pressure drops and your pituitary gland releases a growth hormone to help your body repair itself. Your immune system also releases a helpful protein called cytokines. These work against inflammation, infection and trauma. If you aren’t getting enough sleep, you’re missing out on these vital tools in the fight, and you are drawing out the sickness. So it might be difficult, but you need to push past the cold and get to sleep. Here are some tips for making that happen:

  1. Drink a warm beverage just before bed. This raises your body temperature (which is a good thing in this context) and it also prevents your throat and sinuses from becoming dry and cold. This is exactly the conditions in which a cold can thrive, which is why you get sick less often in the sticky humidity of a sweltering summer.
  2. Take an inflammatory. I always recommend the combination of paracetamol and ibuprofen because they both target symptoms, but they do it in different ways so they partner beautifully.
  3. Use Otrivin nasal spray. This works well because it arrives exactly where you need it straight away. Tablets require 30 minutes or so to be digested and begin working, but Otrivin nasal spray is like a paratrooper. It reduces inflammation in your nose so that you can, you know… breathe.
  4. Stack your pillows. Now, it is easy to get this wrong. Two normal pillows is all you need. Any more than this and you will end up with neck issues the next day which will only compound the sickness.
  5. Get a humidifier. This is a great way to make sure the air in your bedroom doesn’t become too cold and dry throughout the night.

The reality is, a cold is usually going to last somewhere between seven and ten days. And when you’re in the thick of it, it feels like it has been months. If you are seeing no improvements after two weeks or so, you should probably seek medical attention. But in the meantime you’ve just got to slog it out. Hopefully, you’ve seen the importance of sleep in this process, and the paradox of how difficult it is to get to sleep. May you find ways through this anyway.

All the best,

Floyd - Senior Pharmacist


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