Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation

Abstract

Background Sleep disturbance is associated with inflammatory disease risk and all-cause mortality. Here, we assess global evidence linking sleep disturbance, sleep duration, and inflammation in adult humans. Methods A systematic search of English language publications was performed, with inclusion of primary research articles that characterized sleep disturbance and/or sleep duration or performed experimental sleep deprivation, and assessed inflammation by levels of circulating markers. Effect sizes (ES) and 95% confidence intervals (CI) were extracted and pooled using a random effect model. Results A total of 72 studies (n>50000) were analyzed with assessment of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor α (TNF). Sleep disturbance was associated with higher levels of CRP (ES 0.12; 95% CI 0.05 – 0.19) and IL-6 (ES 0.20; 95% CI 0.08 – 0.31). Shorter sleep duration, but not the extreme of short sleep, was associated with higher levels of CRP (ES 0.09; 95% CI 0.01 – 0.17) but not IL-6 (ES 0.03; 95% CI −0.09 – 0.14). The extreme of long sleep duration was associated with higher levels of CRP (ES 0.17; 95% CI 0.01 – 0.34) and IL-6 (ES 0.11; 95% CI 0.02 – 0.20). Neither sleep disturbances nor sleep duration was associated with TNF. Neither experimental sleep deprivation nor sleep restriction was associated with CRP, IL-6, or TNF. Some heterogeneity among studies was found, but no evidence of publication bias. Conclusions Sleep disturbance and long sleep duration, but not short sleep duration, are associated with increases in markers of systemic inflammation.

Prediagnosis Sleep Duration, Napping, and Mortality Among Colorectal Cancer Survivors in a Large US Cohort

“…Several lines of evidence suggest such a link is plausible. In population studies, research has also repeatedly linked insufficient sleep and sleep disorders to obesity, 11 insulin resistance, 12,13 and chronic inflammation, 24,25 all of which have been associated with more rapid cancer progression among CRC patients.…”

Respiratory symptoms are more common among short sleepers independent of obesity

“…41 Also, increased inflammation and elevated cytokines among subjects with respiratory symptoms could lead to increased fatigue and hence produce longer sleep. [43][44][45] Our results show that short sleep is much more strongly related to respiratory symptoms than long sleep, but these associations need to be studied further. There were considerable differences in sleep duration in different centres in our study and the highest percentage of short sleepers were in the Spanish centres.…”

302. Sleep Onset Insomnia, Daytime Sleepiness and Sleep Duration in Relationship to Toxoplasma gondii IgG Seropositivity and Serointensity

“…To the best of our knowledge, there are no previous studies examining the possible relationship between markers of T. gondii infection, sleep duration and daytime sleepiness. Specifically, while the low-grade immune activation necessary to hold T. gondii in check [68][69][70][71][72], and the associations of up-regulated inflammation with longer sleep duration [73][74][75], would lead to hypothesizing an increased EDS and increased sleep duration in T. gondii-positive individuals, the DA producing theory would lead to hypothesizing a decreased EDS and decreased sleep duration. Thus, probably because of these potential contrasting effects, we did not find any association between sleepwake disturbance and T. gondii seropositivity or serointensity after adjustment for confounders.…”