Important insights on sleep and the immune response

December 2, 2020
Categories: Life plan community, Senior living
Reading Time: 4 minutes

We all know how much better we feel after a good night’s sleep. It turns out that sleep may be vital in the fight against influenza and COVID-19.1 In a recent study by the International Journal of Behavioral Medicine, insufficient sleep the week before getting a flu shot can lead to producing less than 50% of the normal antibody response.

To better understand sleep’s role in protecting residents, we asked a few subject matter experts to help us understand sleep patterns and to explain findings of the link between sleep and immunity. And, of course, we are providing some best practices to help you improve the quality of sleep for your residents, along with some immune-strengthening strategies to help keep them healthy.

How common are sleep disorders for older residents?

According to the National Institute for Aging, being older doesn’t mean you have to be tired all the time. You can do many things to help you get a good night’s sleep.2

It has been well documented that sleep patterns change with age. As a person ages, the proportion of time spent in the deeper stages of sleep is reduced while time spent in the lighter stages of sleep increases. Moreover, repeated and frequent nighttime awakenings or arousals can disrupt sleep patterns. The amount of time it takes to fall asleep increases with age, creating long periods of lying awake before sleep ensues.

In Sleep Disorders in the Older Adult, Neikrug (2010) reports that nearly 50% of older adults complain of difficulty sleeping.3 Older adults use 40% of the sleeping medications prescribed in the United States, according to SleepMed, Inc.4

What some experts are reporting on sleep’s ability to reduce the risk of infection

A 2020 study in the Journal of American Medical Association and the International Journal of Behavioral Medicine reported that insufficient sleep in the week before getting a flu shot can lead to the production of less than 50% of the normal antibody response.

Bestselling author of Why We Sleep, Matthew Walker, told CNN that “good sleep hygiene” is important and that individuals who are sleeping less than seven hours are three times more likely to become infected by the common cold. Walker said, “We know that individuals who are sleeping five hours or less a night are 70% more likely to contract pneumonia.”5

The Walter Reed Army Institute of Research has ongoing studies investigating the relationship between sleep and immunity, and future planned studies to investigate sleep and vaccine efficacy.

Here are some ways you can encourage your residents to get a good night’s sleep:6

  • Make sure the bed and pillows are comfortable, and the room is cool; 60 to 67 degrees is best.
  • Don’t watch TV in bed, so your brain knows that your bed is just for sleeping.
  • Avoid coffee, tea, other stimulants, and fatty foods after 3 p.m.
  • Eliminate the blue light of cellphones and laptops and all other lights for bedtime.
  • Reduce dull sounds by using earplugs, a white noise machine, a fan, or a humidifier.
  • Get good exposure to natural light during the day to help regulate your circadian rhythm.
  • Establish a regular bedtime routine, such as taking a warm shower or bath, listening to calm music, reading a book, meditating, or doing light stretches.

Other contributing factors that affect sleep in older adults:

Comorbidities contribute to less sleep and increased stress, further reducing immune response, and should be assessed in the aging adult. Hormonal changes, prostate issues, high blood pressure, sleep apnea, heart failure, arthritis, dementia, and COPD are some of the major comorbidities that can contribute to lighter sleep and more episodes of awakening during sleep hours.

There are several ways to keep our aging adults more at ease in their communities. Longer periods of lowered stimulation always aid relaxation. Lowering lights, softer music, and low-stimulus group sessions in the early evening can help those who need extra time to relax before retiring.

While there are no medications or immunity-boosting supplements that can cure or prevent coronavirus, there are steps you can take to help make your residents’ defenses as strong as possible.

Immune-strengthening strategies for residents include:

  • Eat a healthy, balanced diet that is high in fruits and vegetables.7
    • Stock up on vitamins A, C, E, zinc, and proteins in your meal plans.
    • Experts recommend eating eggs, citrus fruits, sweet potatoes, yogurt, sunflower seeds, and tea at mealtime to help boost the immune system.8
    • Let’s not forget to add chicken noodle soup to the menu with healthy vegetables to add protein, vitamins, and minerals. It is a crowd-pleaser!
    • Ginger tea is an exciting change to the same old black or green tea.
  • Maintain a healthy weight, with a target BMI of 25 or lower.
  • Get quality sleep and practice good sleep hygiene.
    • Follow a regular sleep schedule – Turn in and get up at the same time each day, even on weekends or when you are traveling.
    • Avoid napping in the late afternoon or evening, if possible, as naps may keep you awake at night.
    • Use low lighting in the evenings and as you prepare for bed.
  • Exercise at regular times each day but not within three hours of your bedtime.
  • Avoid eating large meals close to bedtime—they can keep you awake.
  • Quit smoking– If you smoke, you can get support to help you quit.
  • Reduce stress and develop good coping mechanisms.

We can help support your efforts to improve sleep & immune response for residents.

With all of the viruses around this flu season, it stands to reason that a little investment in good sleep hygiene, stress reduction and quality nutrition will serve your residents, their families, and you, the care providers, very well. You can rest assured that MatrixCare can provide reports to identify your aging adults with these diagnoses, help in developing care plans with quantifiable outcomes, and help reduce the many adverse effects of sleep disorders. MealTracker can help set up meal plans and track increases in nutrients that can help keep residents healthy.

Additionally, using wearable sleep monitors can offer data for treating sleep disturbances. Many watch-type devices can help measure a person’s sleep cycles and even oxygenation levels during sleep. Residents and families can communicate and view sleep patterns in MatrixCare’s CareCommunity as wearable devices allow intrusion-free monitoring of sleep and can provide caregivers valuable insights into those who may need a little extra TLC to get a good night’s sleep.

Learn more about MatrixCare MealTracker

Explore what CareCommunity can do for you.


Want to learn more? Let’s connect!



  3. Neikrug AB, Ancoli-Israel S. Sleep disorders in the older adult—a mini-review. Gerontology. 2010;56:181-189.



The content in this presentation or materials is for informational purposes only and is provided “as-is.” Information and views expressed herein may change without notice. We encourage you to seek as appropriate, regulatory, and legal advice on any of the matters covered in this presentation or materials.


Kirby Cunningham
Kirby Cunningham

Kirby Cunningham is a Registered Nurse and joined MatrixCare in February of 2002 with the acquisition of AOD. He worked his way through the organization ranks managing several departments. Kirby has spent most of his Nursing career in the long term care industry and has held numerous leadership positions from Director of Nursing to Regional Consultant at major for-profit SNF organizations. Kirby graduated from Palm Beach State College with an ASN. He has extensive experience in Business Operations Management serving long-term care and other industries. Kirby is married, has three children, and resides in the Boca Raton area of South Florida.

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