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

2

clearly, everything's a little foggy.

3

You are more emotionally

reactive and irritable.

4

There's actually a biological reason

for that, and it's not just tiredness.

5

Your brain just didn't get

as cleaned up last night.

6

There is a literal cleaning crew that

comes into your brain every single night.

7

They work the night shift, they clear out

the metabolic waste, the toxic compounds,,

8

the byproducts of a full day of

thinking, feeling, and just being alive.

9

When you sleep, they finish the job.

10

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.

14

I'm your host, Dr.

15

Kelsey Vick, a board certified

orthopedic doctor of physical therapy

16

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.

21

Last week we talked about our lymphatic

systems, which is the system in charge

22

of how puffy, swollen, heavy you feel in

addition to how your immune system runs.

23

It is related to Guha lymphatic massage.

24

We talk about a lot of different red

flags that I see when people are talking

25

about lymphatic system work so that

you guys are more aware of what to look

26

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.

29

We'll talk about a system that.

30

I am going to guess majority of you

guys have never even heard of if you've

31

been around wellness fixes the pod.

32

Two years ago we covered the system

and today we're bringing it back

33

because it is so freaking important.

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And that system is your

Glim Phatic system.

35

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.

38

Your brain is the one organ in your body

without a traditional lymphatic system.

39

Every other organ uses the

lymphatic system that we covered

40

last week to help manage waste.

41

The brain, your most metabolically

active organ in your body, burning

42

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.

44

And yes, it has a name that sounds

made up, but it works almost

45

exclusively while you sleep.

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every single symptom that you might

attribute to stress or hormones or.

47

Just being overwhelmed has a

brain cleanliness component.

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So this lymphatic system is a huge part

49

of all of those symptoms that

you might be experiencing.

50

the brain fog, the emotional sensitivity,

the memory lapses, the headaches.

51

The difficulty concentrating.

52

These are not character flaws.

53

They are the downstream effects.

54

Of a cleaning system that didn't

have enough time or the right

55

conditions to actually do its job.

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So what are the basic components

of this glymphatic system?

57

Our brain and nervous system has

a circulating fluid that we call

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cerebrospinal fluid, cerebro

brain, spinal cord, cerebrospinal

59

fluid, or CSF for short.,

60

It has a lot of different functions

including helping to cushion

61

the brain and the spinal cord.

62

It acts as sort of the liquid

that things float in to where

63

we have a little bit of play.

64

if our neck gets a whiplash injury or

concussion injury, or there might be some

65

external trauma to our spinal region,

it acts as that cushioning factor.

66

And it also acts as a mode of

transportation for a lot of different

67

chemicals, compounds, and

waste within our bodies.

68

Just like our lymphatic system, our

glymphatic system, is linked closely

69

with our cardiovascular system.

70

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.

73

Now since this system has only been

recently discovered in the grand scheme

74

of things, 2012 sounds like a long time

ago, but when we're talking about science

75

and discovering an entirely new system

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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

79

more to animal models, and which ones

are related more to human models.

80

But just know there's a reason they study

animal models first and they use animals.

81

Systems that they're studying are very

similar to humans, so that they can test

82

in animals and infer what might happen

in humans to eventually study in humans.

83

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.

85

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,

88

we can infer that this is what

happens in humans as well.

89

this first fact does come from

animal studies and it's believed

90

to translate to humans based on

what we know about the human brain.

91

But the spaces between our brain cells

actually expand by about 60% during sleep.

92

Allowing that cerebrospinal fluid and

that fluid to sort of weave in and out,

93

picking up waste, collecting waste, and

returning it back into the glymphatic

94

system to eventually get rid of.

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And this reminded me of the phrase

we all hear so much, but structure

96

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

98

bit bigger, allowing for that cleaning,

that waste removal to actually happen.

99

When we're awake, they

increase in size again.

100

. Which returning back to structure

determines function means that's the time

101

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

107

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

111

in that deep, slow wave sleep stage.

112

so if you're waking up tired,

despite having been in bed

113

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

116

sleep, especially that non REM

sleep in order for our lymphatic

117

system to actually perform its job.

118

And a lot of the things people do

that they think might help sleep,

119

scrolling their phone, taking

sleeping pills, drinking alcohol to

120

help wind it down before bed, maybe

trading what they think is quality

121

sleep for a less efficient sleep,

122

where your glymphatic system

isn't actually able to clean

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your brain efficiently.

124

So what actually happens in this stage,

125

and remember, a lot of these

studies are from animal studies

126

that are inferred to humans.

127

But they found that overall the

effectiveness of your glymphatic system

128

depends on the quality of your deep sleep

129

and the quality of your deep sleep is

actually controlled by fluctuations in.

130

Norepinephrine and our

brain's vasculature.

131

so the more in alignment that

these variables are, the better

132

your brain will clear waste.

133

They've also found that sleep aids like

sleeping pills negatively affect these

134

fluctuations of norepinephrine and

our brain's vasculature during sleep.

135

And both of those have been shown to

also contribute to the effectiveness

136

of your glymphatic system.

137

So although you may be sedated

with a sleeping aid, you aren't

138

getting that restorative sleep

139

where the actual brain cleaning happens.

140

This was a cool study that I believe was

141

January, 2026, but they found that in

adults who have good high quality sleep.

142

Their bodies exhibit higher plasma

levels of certain Alzheimer's

143

biomarkers in the morning,

144

which indicates the glymphatic

system's effectiveness

145

at moving waste out of the brain into the

bloodstream To eventually be disposed of.

146

On the flip side, when healthy young

adults are actually deprived of good

147

quality sleep, even for just one night.

148

Levels of one of the proteins

associated with Alzheimer's

149

increases by 25 to 30% in

your cerebral spinal fluid.

150

So even one bad night of sleep alters your

brain chemistry, which is absolutely wild.

151

So imagine years and years of that

and that effect on memory loss,

152

cognition, and your brain health.

153

Speaking of Alzheimer's, a

fun, maybe a not so fun fact.

154

Is that women are actually

155

at a higher risk of developing Alzheimer's

than men, which makes the connection

156

between the female glymphatic system, our

hormones, and our sleep quality as women.

157

Super important for us to understand.

158

You might not just be dealing with

sleep issues because of stress.

159

It might actually be hormonally related.

160

Now, given the G lymphatic systems

relatively recent discovery, you

161

know, the female specific research

is probably not quite there yet.

162

They're still trying to figure

out how all of it works.

163

but here's what early research findings

suggest when it comes to our female

164

physiology and the glymphatic system

165

based on a 2024 Alzheimer's review,

analyzing a lot of different studies.

166

They noted that the link between estrogen,

the glymphatic system, and sleep as three

167

reasons, women are disproportionately

more affected by Alzheimer's than men.

168

Brain imaging studies have also

found the glymphatic system's overall

169

efficiency changes around menopause.

170

And if you missed our menopause

episode maybe two or three weeks

171

ago, I will leave the link below.

172

It talks all about menopause and

what we can do in our twenties

173

and thirties to help set ourselves

up for success during menopause.

174

I am a huge advocate for understanding

what happens to our body, and I feel

175

like we have so much information and

education about cycle sinking our

176

periods pregnancy postpartum, but.

177

If you are like me, you think menopause

is way out in the distance when in reality

178

there are so many things we can do now to

help our bodies when we reach that stage.

179

So take a listen to that episode as a

little side note, but knowing how much

180

our bodies go through during menopause,

all of the hormonal changes that happen.

181

These brain imaging studies are

also indicative that these hormonal

182

changes that happen during menopause

also affect our glymphatic systems

183

and our sleep quality So all of

this female specific research on the

184

glymphatic system is still early.

185

But what's super clear is

that estrogen plays a role in

186

our CSF dynamics and sleep patterns are

affected cyclically by our hormones.

187

So what are some ways you can actually

positively affect your glymphatic

188

system, both now and to keep in

mind for in the future as well?

189

Research has found that things like

sleep position, alcohol intake, exercise,

190

hydration, Omega-3 conception and

chronic stress, all factor in to the

191

efficiency of URAC glymphatic system.

192

Meaning your daily decisions, even from

how much alcohol you drink, how stressed

193

you are if you're going to exercise that

day, are directly influencing whether

194

your glymphatic system works well or not.

195

So how can we actually spring clean our

brains to help out our glymphatic systems?

196

Number one, protect that deep

sleep,, that phase of sleep where

197

your glymphatic system is the most

active, the quality of your sleep

198

matters more than the time in bed.

199

So avoid things that suppress deep sleep.

200

Things like alcohol,

blue light before bed.

201

Sleeping aids may be high

cortisol activities before bed.

202

Something like exercising before

bed might affect your quality

203

of your deep sleep that night.

204

You also wanna enact things that

actually support deep sleep, things

205

like consistent sleep in wake times,

which is one of the strongest.

206

Drivers of sleep regularity, cooler

room temps, and actually exercising.

207

and stay tuned because next week we

are actually going to do a deep dive

208

on alcohol and its effects on the body.

209

We can't not mention alcohol when

it comes to spring cleaning because

210

it affects so many things, and it's

not going to be doom and gloom.

211

I drink alcohol.

212

I definitely love a cocktail, but it's

going to be, how can we be more mindful

213

of alcohol's effects on our bodies and

make choices based on the knowledge

214

of how alcohol affects our bodies?

215

So stay tuned for the episode next week.

216

Another very interesting direction

of research that they're going with.

217

This glymphatic system is also

related to sleep position.

218

So research published in the Journal of

Neuroscience used brain imaging to measure

219

glymphatic transport in different body

positions and found that waist clearance

220

was most effective during side sleeping.

221

Multiple Other studies have

also confirmed this, but the

222

researchers have noted one drawback.

223

They're still drawing these

inferences from animal studies.

224

However, the reason behind side sleeping,

being more effective for our glymphatic

225

system makes sense with absolutely little

to no drawbacks for the person who wants

226

to try out different sleep positions

to help with their glymphatic systems.

227

So to be clear, this sleeping

position research has not

228

been tested in humans yet.

229

But the mechanism behind why

it works seems plausible.

230

The risk of trying side sleeping

is essentially zero, and most

231

humans already naturally prefer

it, which some researchers note

232

that might not be a coincidence.

233

Another thing you can do to support your

G Lymphatic system is of course exercise.

234

Exercise supports the glymphatic

system both directly through

235

blood flow and pressure dynamics

within the brain and indirectly.

236

By improving the quality of deep sleep

that the glymphatic system relies on.

237

And then lastly, this one's always

easier said than done, but managing

238

chronic stress, Chronic stress

keeps norepinephrine levels elevated

239

throughout the day and night.

240

During healthy, deep sleep,

norepinephrine should cycle rhythmically.

241

That cycling pattern of norepinephrine

is actually what helps drive

242

glymphatic system function and

chronic stress disrupts that rhythm.

243

So the result is that you might

be in bed technically asleep,

244

but your brain's cleaning crew can't do

its job because the conditions needed for

245

efficient cleaning need aren't being met.

246

To wrap up, Your brain invented

its own cleaning system because

247

it knew how important it was.

248

It runs the night shift so that the day

shift, you thinking, feeling, creating,

249

connecting, making decisions can run well.

250

Every good sleep you get is

your brain cleaning house.

251

Every consistently disrupted night of

sleep is leaving residue and waste behind.

252

You can't feel that residue the first

night necessarily, but over time.

253

You will notice it in how your

brain just feels heavier, thinking

254

a little less clear, and you

being slightly more reactive.

255

This might be one of the most

convincing arguments I've heard for

256

why we should all prioritize sleep.

257

Of course, we know it helps in so

many other aspects of our health and

258

wellness, but knowing the effects of.

259

Poor sleep on our brain's ability to

actually clear out waste and toxins makes

260

me that much more excited to prioritize

sleep and prioritize things that can

261

help me get a better quality of sleep.

262

So I hope you guys enjoyed

our spring cleaning episode

263

over the glymphatic system.

264

I will leave the episode to the

glymphatic system that we did two years

265

ago when I first started the podcast.

266

Give me a little grace in how it

turned out because it was early

267

on, which is why I wanted to circle

back and do these episodes again.

268

Given all that I've learned

in hosting a podcast and the

269

newer research involved in.

270

All of the systems that we talk about with

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

271

cool is that we can constantly learn.

272

Things are constantly changing,

and I can't wait to bring

273

this episode back again.

274

Once more of the female specific research

comes into play with how we can positively

275

impact our glymphatic systems, knowing

how important they are to our brain

276

health, and then also hopefully to

decrease our risk of Alzheimer's disease.

277

So super exciting step, but I hope you

guys enjoyed this episode and I'll see

278

you guys again next week on Wellness

Fixes the Pod as we cover alcohol.