Sleep restoration is associated with reduced plasma C-reactive protein and depression symptoms in military personnel with sleep disturbance after deployment

Heinzelmann, Morgan; Lee, Hyunhwa; Rak, Hannah; Livingston, Whitney S.; Barr, Taura L.; Baxter, Tristin; Scattergood-Keepper, Lindsay; Mysliwiec, Vincent; Gill, Jessica

doi:10.1016/j.sleep.2014.08.004

Cited by 33 publications

(28 citation statements)

References 45 publications

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“…At post-treatment, participants with improved sleep have significantly reduced depression symptoms and changes in gene expression, which most notably reflect reductions in inflammatory cytokine genes. These novel findings provide unique insights into our previous findings, which indicated improved sleep quality is associated with reductions in concentrations of CRP and improvements in health-related quality of life in military personnel ( 23 ). These results suggest that sleep-focused treatments effectively reduce inflammatory gene activity, and may attenuate the risk for inflammatory-related morbidity in this population.…”

Section: Discussionsupporting

confidence: 62%

“…Higher concentrations of IL-6 as well as increased gene-activity are established bio-markers for depression ( 45 ), yet, less is known about the inflammatory mechanisms that result from the interaction of insomnia and depression, and the resolution of symptoms. Previously, we reported that depression and insomnia in military personnel are associated with higher concentrations of CRP ( 23 ), and that improved sleep reduces inflammation ( 24 ). Here, we extend these findings by linking gene expression to sleep improvement and reduction in depression symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Chronic insomnia ( 21 ), as well as PTSD and depression are associated with increased concentrations of inflammatory cytokines ( 22 ). We previously reported that PTSD, depression, and insomnia in military personnel are associated with higher concentrations of inflammatory proteins including C-reactive protein (CRP) ( 23 ), and that improved sleep resulted in reductions in inflammation ( 24 ). Although these findings support the relationship between sleep and inflammation, the underlying molecular mechanisms of changes in inflammation following sleep improvement remain elusive ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

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Improved Sleep in Military Personnel is Associated with Changes in the Expression of Inflammatory Genes and Improvement in Depression Symptoms

et al. 2015

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Study objectivesSleep disturbances are common in military personnel and are associated with increased risk for psychiatric morbidity, including posttraumatic stress disorder (PTSD) and depression, as well as inflammation. Improved sleep quality is linked to reductions in inflammatory bio-markers; however, the underlying mechanisms remain elusive.MethodsIn this study, we examine whole genome expression changes related to improved sleep in 68 military personnel diagnosed with insomnia. Subjects were classified into the following groups and then compared: improved sleep (n = 46), or non-improved sleep (n = 22) following three months of standard of care treatment for insomnia. Within subject differential expression was determined from microarray data using the Partek Genomics Suite analysis program and the ingenuity pathway analysis (IPA) was used to determine key regulators of observed expression changes. Changes in symptoms of depression and PTSD were also compared.ResultsAt baseline, both groups were similar in demographics, clinical characteristics, and gene-expression profiles. The microarray data revealed that 217 coding genes were differentially expressed at the follow-up-period compared to baseline in the participants with improved sleep. Expression of inflammatory cytokines were reduced including IL-1β, IL-6, IL-8, and IL-13, with fold changes ranging from −3.19 to −2.1, and there were increases in the expression of inflammatory regulatory genes including toll-like receptors 1, 4, 7, and 8 in the improved sleep group. IPA revealed six gene networks, including ubiquitin, which was a major regulator in these gene-expression changes. The improved sleep group also had a significant reduction in the severity of depressive symptoms.ConclusionInterventions that restore sleep likely reduce the expression of inflammatory genes, which relate to ubiquitin genes and relate to reductions in depressive symptoms.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Improved Sleep in Military Personnel is Associated with Changes in the Expression of Inflammatory Genes and Improvement in Depression Symptoms

et al. 2015

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“…For instance, studies have reported that victims of assault who are exposed to trauma and have been diagnosed with PTSD have statistically similar IL-6 cytokine levels as those who have been exposed to trauma but have not developed PTSD [56]. In addition, one study reported insignificant alteration in three of the serum proinflammatory cytokine levels between individuals with PTSD versus those without PTSD [57], and another study reported insignificant alteration in IL-6 in relation to PTSD [58]. Moreover, a study reported small but significant decrease in the levels of IL-6 and IFN-γ in individuals with PTSD as compared to those without PTSD [59].…”

Section: Roles Of Proinflammatory Cytokines In Ptsd: Il-1β Il-6 Tnfmentioning

confidence: 99%

Inflammation in Post-Traumatic Stress Disorder (PTSD): A Review of Potential Correlates of PTSD with a Neurological Perspective

2020

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Post-traumatic stress disorder (PTSD) is a chronic condition characterized by symptoms of physiological and psychosocial burden. While growing research demonstrated signs of inflammation in PTSD, specific biomarkers that may be representative of PTSD such as the detailed neural correlates underlying the inflammatory responses in relation to trauma exposure are seldom discussed. Here, we review recent studies that explored alterations in key inflammatory markers in PTSD, as well as neuroimaging-based studies that further investigated signs of inflammation within the brain in PTSD, as to provide a comprehensive summary of recent literature with a neurological perspective. A search was conducted on studies published from 2009 through 2019 in PubMed and Web of Science. Fifty original articles were selected. Major findings included elevated levels of serum proinflammatory cytokines in individuals with PTSD across various trauma types, as compared with those without PTSD. Furthermore, neuroimaging-based studies demonstrated that altered inflammatory markers are associated with structural and functional alterations in brain regions that are responsible for the regulation of stress and emotion, including the amygdala, hippocampus, and frontal cortex. Future studies that utilize both central and peripheral inflammatory markers are warranted to elucidate the underlying neurological pathway of the pathophysiology of PTSD.

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“…Undoubtedly, occurrence of fatigue in these patients could be partly an adverse effect of cancer therapy; however, there are reports that describe severe fatigue in patients even 10 years after completion of treatment associated with high concentrations of C-reactive protein (CRP) and proinflammatory cytokines: IL-6 and IL-1RA [20, 21]. In other studies on people with chronic fatigue syndrome, an increase of IL-8 level, compared with a healthy control group [22] and examined soldiers with insomnia, was associated with higher concentrations of CRP in relation to measurements carried out after sleep disorders had disappeared [23]. Data from observation of patients with rheumatoid arthritis treated with biological agents that modify the course of illness, directed against TNF-α, IL-6 and antigenic CD-20, provide indirect evidence on the influence of inflammation in moderate to severe fatigue.…”

Section: Inflammation In Pathogenesis Of Fatiguementioning

confidence: 99%

Fatigue – an underestimated symptom in psoriatic arthritis

Krajewska–Włodarczyk¹,

Owczarczyk‐Saczonek

Placek

2017

Reumatologia

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The nature of fatigue is very complex and involves physiological, psychological and social phenomena at the same time, and the mechanisms leading to occurrence and severity of fatigue are still poorly understood. The condition of chronic inflammation associated with psoriatic arthritis can be regarded as a potential factor affecting development of fatigue. Only a few studies so far have focused on the occurrence of fatigue in psoriatic arthritis. The problem of chronic fatigue is underestimated in everyday clinical practice. Identification and analysis of subjective fatigue components in each patient can provide an objective basis for optimal fatigue treatment in daily practice. This review presents a definition of chronic fatigue and describes mechanisms that may be associated with development of fatigue, highlighting the role of chronic inflammation, selected fatigue measurement methods and relations of fatigue occurrence with clinical aspects of psoriatic arthritis.

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Sleep restoration is associated with reduced plasma C-reactive protein and depression symptoms in military personnel with sleep disturbance after deployment

Cited by 33 publications

References 45 publications

Improved Sleep in Military Personnel is Associated with Changes in the Expression of Inflammatory Genes and Improvement in Depression Symptoms

Improved Sleep in Military Personnel is Associated with Changes in the Expression of Inflammatory Genes and Improvement in Depression Symptoms

Inflammation in Post-Traumatic Stress Disorder (PTSD): A Review of Potential Correlates of PTSD with a Neurological Perspective

Fatigue – an underestimated symptom in psoriatic arthritis

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