black woman floating, with most of head underwater — In the last few posts, we’ve talked a lot about neuro-lymphatic drainage.
We know that the neurolymphatic systems are how the brain clears waste - the glymphatic system moves nutrients in and waste out, the waste travels away from the brain in the meningeal lymphatic vessels, and eventually the fluid carrying waste exits the skull and ends up in the lymphatic vessels of the head and neck.
We also know that a lot of nasty conditions are linked to problems with the neurolymphatics - almost any condition related to brain function seems to be affected, plus other conditions we might not have guessed. We know our cognitive function is particularly linked to neurolymphatic function.
So with all this knowledge, what can we do?

Get good sleep

The number one change we can make to improve neuro lymphatic function is to get more high-quality sleep. Specifically, we want to get more of the third stage on non-REM sleep - the stage with the slowest brainwaves. That’s the stage that is the biggest player in memory formation, learning, and the clearance of metabolites. We usually enter that stage about 30-40 minutes into a sleep cycle, and it lasts for an hour or so before we transition to REM sleep.

Why is sleep so important? The vast majority of the glymphatic system’s work happens while we’re in that third stage of non-REM sleep.. The reasons why get technical - the space for the interstitial fluid in the brain expands and the rhythm of the craniosacral fluid changes, so nutrients move into the brain and waste gets cleared out of our brain most effectively. This is a big part of why driving with a sleep deficit is as dangerous as driving drunk - waste clearance in the brain relies on getting enough of that deep sleep.

It isn’t clear which is the chicken and which the egg when it comes to bad sleep and poor glymphatic function, but it is clear which is easier to affect. All the things we know about how to sleep more and better are worth doing.

Allow time for plenty of sleep every night
If you need a CPAP, use it
Practice good sleep hygiene - keeping a consistent sleep schedule, avoiding electronics before bed, and so on.

Manage stress

The effects of stress on glymphatic function are less obvious than sleep, but it still makes a difference. Chronic stress contributes to inflammation and interferes with our sleep, both of which affect the glymphatic system.

Addressing stress is something we know a lot about, and we also know it’s easier said than done. Feeling safe in the world, having time to rest, building loving relationships, and contributing to the world in a meaningful way all help with keeping our stress at helpful levels. Since we live in this world and this time, we do what we can. If we are able to keep our stress at healthy levels, our brains are able to function better.

Exercise

We know that exercise is the closest thing we have to a magic pill that helps (almost) everything. Exercise helps with our cardiovascular fitness, flexibility, ease of movement, and overall health. Unsurprisingly, it helps the glymphatic system work better as well. It helps with the flow of the meningeal lymphatic vessels bringing waste out of the brain, and it helps the heartbeat move the neurolymphatic systems along.

Studies looking specifically at the lymphatics inside the skull found that long-term, regular exercise such as running were helpful. Other studies looking at the overall lymphatic system show that gentle mobility exercises are also helpful.

Deep breathing

Deep breathing is another tool that helps with stress and helps move the neurolymphatic system. Respiration is another driving force for the movement of fluid in the neurolymphatic system, along with the heartbeat and craniosacral rhythm.

Normal resting breathing doesn’t affect neurolymphatic flow much, but “forced” or intentional breathing has been shown to make a difference. One published study found that intentionally breathing in for 2.5 sec and out for 2.5 sec, cycling through 8 cycles, then returning to normal breathing did increase flow of cerebrospinal fluid in healthy people.

40 Hz sound and light

We don’t have a clear explanation for why this is, but there are multiple studies showing that stimulating the brain at 40 Hz helps the glymphatic system work better in humans and animals. 40 Hz is in the gamma wave band, and we know that the brain naturally has more gamma brainwave activity when we’re doing a lot of cognitive and integrative work.

Blue light, vibration, sound, and transcranial magnetic stimulation were all shown to make some difference. Homegrown methods of getting 40 Hz input could be listening to binaural beats at 40 Hz or looking for a 40 Hz light therapy lamp.

Manual therapy

Hands-on neurolymphatic drainage doesn’t have much in the way of high-quality evidence, but the case reports and small studies are exciting. Reported results include:

Reducing fatigue in long COVID
Reducing headaches and anxiety in post-concussion symptoms
Improving smell and taste in long COVID
Reducing brain swelling in moderate brain injuries
Reducing intracranial pressure in people with severe brain diseases
Post-exercise fatigue in chronic fatigue syndrome

One explanation for those results is the work of the regular lymphatic system. We do have good evidence that manual lymphatic drainage (MLD) helps move the lymphatic system, and one of the principles of MLD is that we clear space downstream to help with flow upstream. Since the neurolymphatic system drains into the regular lymphatic system, moving the lymphatics should help with the neurolymphatics as well.

When I do hands-on neurolymphatic drainage, I use manual lymphatic drainage principles and techniques combined with craniosacral therapy techniques. The craniosacral school I’m training with, Upledger Institute, aims at improving the flow of fluids in the central nervous system to improve overall health, so it pairs nicely in addressing neurolymphatic drainage.

Wondering if neurolymphatic drainage massage would work for you? Schedule an appointment with me and try it