Excerpt taken from Why We Sleep by Matthew WalkerThis is a completely fascinating book on the effects of sleep and health. We highly recommend this book to myeloma patients and caregivers alike. 

I was once fond of saying, "Sleep is the third pillar of good health, alongside diet and exercise." I have changed my tune. Sleep is more than a pillar; it is the foundation on which the other two health bastions site. Take away the bedrock of sleep, or weaken it just a little, and careful eating or physical exercise become less than effective, as we shall see. Every major system, tissue, and organ of your body suffers when sleep becomes short. No aspect of your health can retreat at the sign of sleep loss and escape unharmed. Like water from a burst pipe in your home, the effects of sleep deprivation will seep into every nook and cranny of biology, down into your cells, even altering your most fundamental self - your DNA. SLEEP LOSS AND THE IMMUNE SYSTEM Sleep fights agains infection and sickness by deploying all manner of weaponry within your immune arsenal, cladding you with protection. When you do fall ill, the immune system actively stimulates the sleep system, demanding more bed rest to help reinforce the war effort. Reduce sleep even for a single night, and that invisible suit of immune resilience is rudely stripped from your body. No matter what immunological circumstance you find yourself in - be it preparation for receiving a vaccine to help boost immunity, or mobilizing a mighty adaptive immune response to defeat a viral attack - sleep, and a full night of it, is inviolable. It doesn't require many nights of short sleeping before the body is rendered immunologically weak, and here the issue of cancer becomes relevant. Natural killer cells are an elite and powerful squadron within the ranks of your immune system. Think of natural killer cells like the secret service agents of your body, whose job it is to identify dangerous foreign elements and eliminate them- ))& types, if you will. One such foreign entity that natural killer cells will target are malignant (cancerous) tumor cells. Natural killer cells will effectively pun a hole in the outer surface of these cancerous cells and inject a protein that can destroy the malignancy. What you want, therefore is a virile set of these James Bond-like immune cells at all times. That is precisely what you don't have when sleeping too little. Dr. Michael Irwin at the University of California, Los Angeles, had performed landmark studies revealing just how quickly and comprehensively a brief dose of short sleep can affect your cancer-fighting immune cells. Examining healthy young men, Irwin demonstrated that a single night of four hours of sleep - such as going to bed at three a.m. and waking up at seven a.m. - swept away 70 percent of the natural killer cells circulating in the immune system, relative to a full eight-hour night of sleep. That is a dramatic state of immune deficiency to find yourself facing a, and it happens quickly, after essentially one "bad night" of sleep. You could well imagine the enfeebled state of your cancer fighting immune armory after a week of short sleep, let alone months or even years. With each passing year of research, more forms of malignant tumors are being linked to insufficient sleep. A large European study of almost 25,000 individuals demonstrated that sleeping six hours or less was associated with a 40 percent increased risk of developing cancer, relative to those sleeping seven hours a night or more. Similar associations were found in a study tracking more than 75,000 women across an eleven-year period. Part of the problem relates back to the agitating influence of the sympathetic nervous system as it is forced into overdrive by a lack of sleep. Ramping up the body's level of sympathetic nervous activity will provoke an unnecessary and sustained inflammation response from the immune system. Left switched on without a natural return to peaceful quiescence, a nonspecific state of chronic inflammation causes manifold health problems, including those relevant to cancer. Cancers are know to use the inflammation response to their advantage. For example. some cancer cells will lure inflammatory factors into the tumor mass to help initiate the growth of blood vessels that feed it with more nutrients and oxygen. Tumors can also use inflammatory factors to help further damage and mutate the DNA of their cancer cells, increasing the tumor's potency. Inflammatory factors associated with sleep deprivation may also be used to help physically shear some of the tumor from its local moorings, allowing the cancer to up-anchor and spread to other territories of the body. It is these cancer-amplifying and -spreading processes that we know a lack of sleep will encourage, as recent studies by Dr. David Gozal at the University of Chicago have shown. In his study mice were first injected with malignant cells, and tumor progression was then tracked across a four-week period. Half of the mice were allowed to sleep normally during this time; the other half had their sleep partially disrupted, reducing overall sleep quality. The sleep-deprived mice suffered a 200 percent increase in the speed and size of cancer growth, relative to the well-rested group. When Gozal performed postmortems of the mice, he discovered that the tumors were far more aggressive in the sleep-deficient animals. Their cancer had metastasized, spreading to surrounding organs, tissue and bone. In further studies, Gozal has shown that immune cells, called tumor-associated macrophages, are one root cause of the cancerous influence of sleep loss. He found that sleep deprivation will diminish one form of these macrophages, called MI cells, that otherwise help combat cancer. Yet sleep deprivation conversely boosts levels of an alternative form of macrophages, called M2 cells, which promote cancer growth. Dr. Derk-Jan Jijk, who directs the Surrey Sleep Research Center in England, has shown that the effects of insufficient sleep on genetic activity are just as striking in humans as they are in mice. Dijk and his prolific team examined gene expression in a group of healthy young men and woman after having restricted them to six hours of sleep a night for one week, all monitored under strict laboratory conditions. After one week of subtly reduced sleep, the activity of a hefty 711 genes was distorted, relative to the genetic activity profile of these very same individuals when they were obtaining eight and a half hours of sleep for a week. Interestingly, the effect went in both directions: about half of those 711 genes had been abnormally revved up in their expression by the loss of sleep, while the other half had ben diminished in their expression, or shut down entirely. The genes that were increased included those linked to chronic inflammation, cellular stress, and various factors that cause cardiovascular disease. Among those turned down were genes that help maintain stable metabolism and optimal immune responses. Insufficient sleep does more than alter the activity and readout of your genes; it attacks the very physical structure of your genetic material itself. The spiral strands of DNA in your cells float around in the nucleus, but are tightly wound together into structures called chromosomes, rather like weaving individual threads together to make sturdy shoelace. And just like shoelace, the ends of your chromosomes need to be protected by a cap or binding tip. That protective cap is called a telomere. If the telomeres at the end of your chromosomes become damaged, your DNA spirals become exposed and your now vulnerable genetic code cannot operate properly, like a fraying shoelace without a tip. Neglect sleep, and you are deciding to perform a genetic engineering manipulation on yourself each night, tampering with the nucleic alphabet that spells out your daily health story.