Dr. Kelsy Vick continues the April “spring cleaning” series on Wellness Big Sis The Pod by revisiting the glymphatic system—discovered in 2012—which functions as the brain’s waste-clearing system and works primarily during deep, non-REM sleep. She explains how cerebrospinal fluid helps transport and remove metabolic waste into the venous system, and notes animal research suggesting brain cell spaces expand during sleep to improve clearance. The episode links poor deep sleep to symptoms like brain fog, irritability, headaches, memory lapses, and difficulty concentrating, and discusses findings on sleep quality, norepinephrine fluctuations, and how sleep aids can impair restorative cleaning. She highlights research connecting sleep disruption to Alzheimer’s biomarkers and reviews early evidence suggesting menopause, estrogen, and sleep changes may affect women’s glymphatic efficiency. Practical takeaways include prioritizing deep sleep, limiting alcohol and blue light, keeping consistent sleep schedules, considering side sleeping, exercising, hydrating, and managing chronic stress.

Menopause Episode: https://youtu.be/HE7niP8P9iI?si=_EH-DzwJrazmAH1R

Glymphatic System Episode (episodee 5): https://player.captivate.fm/episode/06bd8798-6d74-4a02-873f-e9778063ec7b/

RESOURCES:

https://pmc.ncbi.nlm.nih.gov/articles/PMC3880190/

https://pmc.ncbi.nlm.nih.gov/articles/PMC8821419/

https://www.cell.com/cell/fulltext/S0092-8674(24)01343-6

https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1543725/full

https://www.nature.com/articles/s41467-026-68374-8

https://pmc.ncbi.nlm.nih.gov/articles/PMC7698404/

https://pmc.ncbi.nlm.nih.gov/articles/PMC11835678/

https://journals.sagepub.com/doi/full/10.3233/JAD-230527

https://pubmed.ncbi.nlm.nih.gov/37034667/

https://pmc.ncbi.nlm.nih.gov/articles/PMC4524974/

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You know that feeling after a bad

night's sleep where you can't think

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clearly, everything's a little foggy.

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You are more emotionally

reactive and irritable.

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There's actually a biological reason

for that, and it's not just tiredness.

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Your brain just didn't get

as cleaned up last night.

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There is a literal cleaning crew that

comes into your brain every single night.

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They work the night shift, they clear out

the metabolic waste, the toxic compounds,,

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the byproducts of a full day of

thinking, feeling, and just being alive.

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When you sleep, they finish the job.

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When you don't, they clock out early,

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and you wake up to a brain

that didn't get fully cleaned.

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And you feel it, you just

never knew what to call it.

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Welcome back to Wellness Fix is the pod.

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I'm your host, Dr.

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Kelsey Vick, a board certified

orthopedic doctor of physical therapy

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and a pelvic floor physical therapist.

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And through the month of April, we

are doing a spring cleaning series,

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not talking necessarily about

home organization or cleaning out

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different parts of our house like we

traditionally think for spring cleaning.

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More like a health and wellness body

and brain style Of spring cleaning.

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Last week we talked about our lymphatic

systems, which is the system in charge

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of how puffy, swollen, heavy you feel in

addition to how your immune system runs.

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It is related to Guha lymphatic massage.

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We talk about a lot of different red

flags that I see when people are talking

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about lymphatic system work so that

you guys are more aware of what to look

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out for, to know who actually knows and

understands the lymphatic system and who

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is just sort of maybe posing as an expert.

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Today.

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We'll talk about a system that.

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I am going to guess majority of you

guys have never even heard of if you've

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been around wellness fixes the pod.

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Two years ago we covered the system

and today we're bringing it back

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because it is so freaking important.

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And that system is your

Glim Phatic system.

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So like lymphatic just with a G,

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and it is the system in charge

of cleaning up your brain.

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So basically the lymphatic

system of your brain.

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Your brain is the one organ in your body

without a traditional lymphatic system.

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Every other organ uses the

lymphatic system that we covered

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last week to help manage waste.

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The brain, your most metabolically

active organ in your body, burning

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more energy per unit of tissue than

anything else, had to invent its own,

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and it was only discovered in 2012.

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And yes, it has a name that sounds

made up, but it works almost

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exclusively while you sleep.

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every single symptom that you might

attribute to stress or hormones or.

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Just being overwhelmed has a

brain cleanliness component.

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So this lymphatic system is a huge part

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of all of those symptoms that

you might be experiencing.

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the brain fog, the emotional sensitivity,

the memory lapses, the headaches.

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The difficulty concentrating.

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These are not character flaws.

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They are the downstream effects.

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Of a cleaning system that didn't

have enough time or the right

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conditions to actually do its job.

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So what are the basic components

of this glymphatic system?

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Our brain and nervous system has

a circulating fluid that we call

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cerebrospinal fluid, cerebro

brain, spinal cord, cerebrospinal

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fluid, or CSF for short.,

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It has a lot of different functions

including helping to cushion

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the brain and the spinal cord.

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It acts as sort of the liquid

that things float in to where

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we have a little bit of play.

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if our neck gets a whiplash injury or

concussion injury, or there might be some

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external trauma to our spinal region,

it acts as that cushioning factor.

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And it also acts as a mode of

transportation for a lot of different

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chemicals, compounds, and

waste within our bodies.

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Just like our lymphatic system, our

glymphatic system, is linked closely

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with our cardiovascular system.

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With the cerebral spinal fluid or CSF

dumping waste products into the venous

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system to eventually get cleared out.

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And this whole system is

primarily active when we sleep.

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Now since this system has only been

recently discovered in the grand scheme

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of things, 2012 sounds like a long time

ago, but when we're talking about science

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and discovering an entirely new system

at the body, 2012 is fairly recent, and

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because of that, a lot of the studies.

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Have started with animal models

before they move into human models.

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So throughout this episode I'll try

and say which studies are related

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more to animal models, and which ones

are related more to human models.

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But just know there's a reason they study

animal models first and they use animals.

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Systems that they're studying are very

similar to humans, so that they can test

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in animals and infer what might happen

in humans to eventually study in humans.

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So just because a lot of these

studies will be animal studies

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doesn't necessarily mean we should

disregard the information completely.

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It just means that, as a

disclaimer, this has been studied

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in animals, not quite in humans.

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But knowing what we know about

said animals' glymphatic system,

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we can infer that this is what

happens in humans as well.

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this first fact does come from

animal studies and it's believed

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to translate to humans based on

what we know about the human brain.

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But the spaces between our brain cells

actually expand by about 60% during sleep.

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Allowing that cerebrospinal fluid and

that fluid to sort of weave in and out,

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picking up waste, collecting waste, and

returning it back into the glymphatic

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system to eventually get rid of.

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And this reminded me of the phrase

we all hear so much, but structure

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determines function when we sleep.

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If our brain cells shrink in size, that

means the space around them gets a little

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bit bigger, allowing for that cleaning,

that waste removal to actually happen.

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When we're awake, they

increase in size again.

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. Which returning back to structure

determines function means that's the time

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that we need to use those brain cells

so they grow back to their normal size

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during the daytime, they shrink at night

to allow that cleaning process to happen.

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In the stage of sleep that this cleansing

happens in is one of the stages that

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we actually don't talk about very much.

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A lot of people have heard of REM

sleep or rapid eye movement sleep.

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However, the deep sleep stage or

the non REM sleep stage is where the

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glymphatic system actually shines.

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This is the stage of sleep where

it is the hardest to wake up.

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Your body feels heavy, but during this

time, your brain's getting cleaned up.

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The glymphatic system exhibits its highest

activity during higher delta wave activity

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in that deep, slow wave sleep stage.

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so if you're waking up tired,

despite having been in bed

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for seven to nine hours.

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This is likely why time in bed does not

equal high glymphatic system efficiency.

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we have to make sure that we are

hitting those cyclical stages during

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sleep, especially that non REM

sleep in order for our lymphatic

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system to actually perform its job.

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And a lot of the things people do

that they think might help sleep,

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scrolling their phone, taking

sleeping pills, drinking alcohol to

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help wind it down before bed, maybe

trading what they think is quality

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sleep for a less efficient sleep,

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where your glymphatic system

isn't actually able to clean

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your brain efficiently.

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So what actually happens in this stage,

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and remember, a lot of these

studies are from animal studies

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that are inferred to humans.

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But they found that overall the

effectiveness of your glymphatic system

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depends on the quality of your deep sleep

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and the quality of your deep sleep is

actually controlled by fluctuations in.

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Norepinephrine and our

brain's vasculature.

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so the more in alignment that

these variables are, the better

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your brain will clear waste.

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They've also found that sleep aids like

sleeping pills negatively affect these

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fluctuations of norepinephrine and

our brain's vasculature during sleep.

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And both of those have been shown to

also contribute to the effectiveness

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of your glymphatic system.

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So although you may be sedated

with a sleeping aid, you aren't

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getting that restorative sleep

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where the actual brain cleaning happens.

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This was a cool study that I believe was

recently published in 2026 and I think

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January, 2026, but they found that in

adults who have good high quality sleep.

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Their bodies exhibit higher plasma

levels of certain Alzheimer's

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biomarkers in the morning,

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which indicates the glymphatic

system's effectiveness

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at moving waste out of the brain into the

bloodstream To eventually be disposed of.

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On the flip side, when healthy young

adults are actually deprived of good

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quality sleep, even for just one night.

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Levels of one of the proteins

associated with Alzheimer's

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increases by 25 to 30% in

your cerebral spinal fluid.

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So even one bad night of sleep alters your

brain chemistry, which is absolutely wild.

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So imagine years and years of that

and that effect on memory loss,

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cognition, and your brain health.

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Speaking of Alzheimer's, a

fun, maybe a not so fun fact.

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Is that women are actually

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at a higher risk of developing Alzheimer's

than men, which makes the connection

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between the female glymphatic system, our

hormones, and our sleep quality as women.

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Super important for us to understand.

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You might not just be dealing with

sleep issues because of stress.

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It might actually be hormonally related.

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Now, given the G lymphatic systems

relatively recent discovery, you

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know, the female specific research

is probably not quite there yet.

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They're still trying to figure

out how all of it works.

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but here's what early research findings

suggest when it comes to our female

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physiology and the glymphatic system

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based on a 2024 Alzheimer's review,

analyzing a lot of different studies.

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They noted that the link between estrogen,

the glymphatic system, and sleep as three

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reasons, women are disproportionately

more affected by Alzheimer's than men.

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Brain imaging studies have also

found the glymphatic system's overall

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efficiency changes around menopause.

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And if you missed our menopause

episode maybe two or three weeks

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ago, I will leave the link below.

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It talks all about menopause and

what we can do in our twenties

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and thirties to help set ourselves

up for success during menopause.

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I am a huge advocate for understanding

what happens to our body, and I feel

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like we have so much information and

education about cycle sinking our

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periods pregnancy postpartum, but.

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If you are like me, you think menopause

is way out in the distance when in reality

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there are so many things we can do now to

help our bodies when we reach that stage.

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So take a listen to that episode as a

little side note, but knowing how much

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our bodies go through during menopause,

all of the hormonal changes that happen.

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These brain imaging studies are

also indicative that these hormonal

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changes that happen during menopause

also affect our glymphatic systems

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and our sleep quality So all of

this female specific research on the

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glymphatic system is still early.

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But what's super clear is

that estrogen plays a role in

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our CSF dynamics and sleep patterns are

affected cyclically by our hormones.

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So what are some ways you can actually

positively affect your glymphatic

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system, both now and to keep in

mind for in the future as well?

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Research has found that things like

sleep position, alcohol intake, exercise,

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hydration, Omega-3 conception and

chronic stress, all factor in to the

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efficiency of URAC glymphatic system.

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Meaning your daily decisions, even from

how much alcohol you drink, how stressed

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you are if you're going to exercise that

day, are directly influencing whether

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your glymphatic system works well or not.

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So how can we actually spring clean our

brains to help out our glymphatic systems?

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Number one, protect that deep

sleep,, that phase of sleep where

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your glymphatic system is the most

active, the quality of your sleep

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matters more than the time in bed.

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So avoid things that suppress deep sleep.

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Things like alcohol,

blue light before bed.

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Sleeping aids may be high

cortisol activities before bed.

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Something like exercising before

bed might affect your quality

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of your deep sleep that night.

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You also wanna enact things that

actually support deep sleep, things

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like consistent sleep in wake times,

which is one of the strongest.

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Drivers of sleep regularity, cooler

room temps, and actually exercising.

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and stay tuned because next week we

are actually going to do a deep dive

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on alcohol and its effects on the body.

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We can't not mention alcohol when

it comes to spring cleaning because

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it affects so many things, and it's

not going to be doom and gloom.

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I drink alcohol.

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I definitely love a cocktail, but it's

going to be, how can we be more mindful

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of alcohol's effects on our bodies and

make choices based on the knowledge

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of how alcohol affects our bodies?

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So stay tuned for the episode next week.

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Another very interesting direction

of research that they're going with.

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This glymphatic system is also

related to sleep position.

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So research published in the Journal of

Neuroscience used brain imaging to measure

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glymphatic transport in different body

positions and found that waist clearance

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was most effective during side sleeping.

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Multiple Other studies have

also confirmed this, but the

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researchers have noted one drawback.

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They're still drawing these

inferences from animal studies.

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However, the reason behind side sleeping,

being more effective for our glymphatic

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system makes sense with absolutely little

to no drawbacks for the person who wants

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to try out different sleep positions

to help with their glymphatic systems.

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So to be clear, this sleeping

position research has not

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been tested in humans yet.

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But the mechanism behind why

it works seems plausible.

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The risk of trying side sleeping

is essentially zero, and most

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humans already naturally prefer

it, which some researchers note

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that might not be a coincidence.

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Another thing you can do to support your

G Lymphatic system is of course exercise.

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Exercise supports the glymphatic

system both directly through

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blood flow and pressure dynamics

within the brain and indirectly.

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By improving the quality of deep sleep

that the glymphatic system relies on.

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And then lastly, this one's always

easier said than done, but managing

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chronic stress, Chronic stress

keeps norepinephrine levels elevated

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throughout the day and night.

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During healthy, deep sleep,

norepinephrine should cycle rhythmically.

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That cycling pattern of norepinephrine

is actually what helps drive

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glymphatic system function and

chronic stress disrupts that rhythm.

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So the result is that you might

be in bed technically asleep,

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but your brain's cleaning crew can't do

its job because the conditions needed for

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efficient cleaning need aren't being met.

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To wrap up, Your brain invented

its own cleaning system because

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it knew how important it was.

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It runs the night shift so that the day

shift, you thinking, feeling, creating,

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connecting, making decisions can run well.

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Every good sleep you get is

your brain cleaning house.

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Every consistently disrupted night of

sleep is leaving residue and waste behind.

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You can't feel that residue the first

night necessarily, but over time.

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You will notice it in how your

brain just feels heavier, thinking

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a little less clear, and you

being slightly more reactive.

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This might be one of the most

convincing arguments I've heard for

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why we should all prioritize sleep.

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Of course, we know it helps in so

many other aspects of our health and

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wellness, but knowing the effects of.

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Poor sleep on our brain's ability to

actually clear out waste and toxins makes

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me that much more excited to prioritize

sleep and prioritize things that can

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help me get a better quality of sleep.

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So I hope you guys enjoyed

our spring cleaning episode

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over the glymphatic system.

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I will leave the episode to the

glymphatic system that we did two years

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ago when I first started the podcast.

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Give me a little grace in how it

turned out because it was early

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on, which is why I wanted to circle

back and do these episodes again.

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Given all that I've learned

in hosting a podcast and the

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newer research involved in.

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All of the systems that we talk about with

the human body, that's what's so freaking

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cool is that we can constantly learn.

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Things are constantly changing,

and I can't wait to bring

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this episode back again.

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Once more of the female specific research

comes into play with how we can positively

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impact our glymphatic systems, knowing

how important they are to our brain

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health, and then also hopefully to

decrease our risk of Alzheimer's disease.

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So super exciting step, but I hope you

guys enjoyed this episode and I'll see

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you guys again next week on Wellness

Fixes the Pod as we cover alcohol.