The effects of 40 hours of total sleep deprivation on inflammatory markers in healthy young adults

Frey, Danielle J.; Fleshner, Monika; Wright, Kenneth P.

doi:10.1016/j.bbi.2007.04.003

Cited by 271 publications

(213 citation statements)

References 42 publications

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“…Sleep deprivation may also create a shift in immune activity away from humoral immunity and toward cell-mediated immunity, creating an imbalance in immune function. 60,62 This imbalance can place already compromised critically ill patients at further risk. Last, sleep deprivation stimulates the release of hormonal mediators (eg, cortisol and catecholamines), which can intensify the stress response seen during critical illness.…”

Section: Reviewing the Evidencementioning

confidence: 99%

Examining the Evidence to Guide Practice: Challenging Practice Habits

Makic

Rauen

Watson

et al. 2014

Critical Care Nurse

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I n 2001, the Institute of Medicine challenged all health care professionals to decrease variation in practice through adoption of practice interventions based on best evidence to improve patients' outcomes.1 Current reviews of clinical practice suggest that only 10% to 15% of clinicians consistently implement evidence-based care 2 and indicate that it may take up to 2 decades for original research to be put into routine clinical practice.3 It is well established that evidence-based practice (EBP) is associated with higher quality care and better outcomes for patients than care that is steeped in tradition. 4 Yet at times, clinicians continue to practice on the basis of tradition.

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Section: Reviewing the Evidencementioning

confidence: 99%

Examining the Evidence to Guide Practice: Challenging Practice Habits

Makic

Rauen

Watson

et al. 2014

Critical Care Nurse

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“…We focused on the proinflammatory cytokines IL-6, TNF-α, IL-8, and IL-1β based on prior studies linking these markers to sleep quality and/or pregnancy outcomes. 9,11,19 We examined gestational age at delivery as a continuous variable, as well as categorically defined as preterm, early term, term, late term, and postterm per guidelines from the American College of Obstetricians and Gynecologists (ACOG). 23 It was hypothesized that (1) poorer sleep quality would be associated with shorter gestation, measured continuously as well as categorically; (2) the relationship between sleep quality and length of gestation would be partially mediated by elevations in serum proinflammatory markers; and (3) the relationship between sleep quality and length of gestation would be moderated by race, with stronger associations among African American women compared to European Americans.…”

Section: -12mentioning

confidence: 99%

Poor Sleep Quality and Associated Inflammation Predict Preterm Birth: Heightened Risk among African Americans

Blair

Porter

Leblebicioğlu

et al. 2015

Sleep

160

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1259Sleep and Preterm Birth-Blair et al. INTRODUCTIONIn the United States, preterm birth affects 11.5% of deliveries and is the underlying cause of more than one third of infant deaths.1 A high proportion of surviving preterm infants suffer from severe physical and cognitive consequences, potentially requiring intensive medical and/or educational support throughout the lifespan.2 The morbidity and mortality associated with preterm birth pose significant drains on the financial and emotional resources of afflicted families, and on the nation as a whole, costing more than $26 billion annually in the United States. 3Inflammation is a causal mechanism in the initiation of preterm as well as term labor. 4 Inflammatory mediators can initiate contractions, encourage cervical ripening, and cause rupture of the membranes.4,5 Via these mechanisms, inflammation induced by infection or psychological stress may trigger early parturition. 6,7Importantly, poor sleep promotes inflammation.8 For example, in a population-based cohort of more than 5,000 adults, shorter sleep duration was associated with elevations in Study Objectives: Poor sleep promotes inflammation. In turn, inflammation is a causal mechanism in term as well as preterm parturition. In the United States, a persistent racial disparity in preterm birth exists, with African Americans showing ~1.5 times greater risk. This study examined associations among sleep quality, serum proinflammatory cytokines, and length of gestation in a racially diverse sample of 138 pregnant women. Design: Observational. Measurements: Women completed the Pittsburgh Sleep Quality Index (PSQI) and other psychosocial and behavioral measures during midpregnancy. Serum levels of interleukin (IL)-6, IL-8, IL-1β, and tumor necrosis factor (TNF)-α were determined by high-sensitivity assays. Birth outcomes were determined via medical record review. Results: Among African American women (n = 79), shorter gestation was predicted by poorer overall sleep (r s = −0.35, P = 0.002) as well the following PSQI subscales: subjective sleep quality (r s = −0.34, P = 0.002), sleep latency (r s = −0.27, P = 0.02), and sleep efficiency (r s = −0.27, P = 0.02). African American women with poor sleep quality (PSQI > 5) had 10.2 times the odds of preterm birth compared to those with good sleep quality. In contrast, among European American women (n = 53), gestational length was not significantly predicted by sleep quality (Ps > 0.12). Bootstrapping analyses showed that, among African Americans, IL-8 significantly mediated the association between sleep quality and length of gestation (indirect effect estimate −0.029; 95% confidence interval −0.06, −0.002). Conclusions:The data provide novel evidence that African American women exhibit greater inflammation in response to sleep disturbance than European American women and these effects correspond with length of gestation. Racial differences in susceptibility to sleep induced immune dysregulation may contribute to marked racial disparities in preterm birth.

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“…Repeated hypoxia-reoxygenation is associated with increased production of these inflammatory mediators. Studies report Fırat conflicting findings on CRP levels, including a decrease (26), increase (27) and no change (28). A diurnal variability of CRP in OSAS has been found, with lower levels during sleep and higher levels through the day (29).…”

Section: Discussionmentioning

confidence: 99%

Is Hepcidin a Good Marker for Inflammation in Obstructive Sleep Apnea Syndrome (OSAS) Patients?

Fırat¹,

Özdemir²,

Bilgin³

et al. 2015

jtsm

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Amaç: Obstrüktif Uyku Apne sendromu (OUAS) uykuda defalarca üst solunum yolunun tıkanması ile karakterize klinik bir sendrom olup, kronik aralıklı hipoksi gelişimi sonucu dokuda enflamasyon oluşumuna neden olur. OUAS'da IL-6 ve CRP en sık araştırma yapılan enflamasyon biyobelirteçleridir. Enflamasyon gelişimi sırasında IL-6, hepsidinin önemli bir aktivatörüdür. Bu çalışmada OUAS'lı hastalarda hepsidin düzeyleri araştırılmıştır. Gereç ve Yöntem: Uykuda solunum bozukluğu öntanısı ile polisomnografi uygulanan 44 hasta çalışmaya alınmıştır. Apne Hipopne İndeksine (AHİ) göre AHİ≥15 olan 29 orta-ileri derece OUAS'lı hasta ve AHİ<15 olan hafif derece OUAS'lı veya OUAS olmayan toplam 15 hasta çalışmaya alınmıştır. Tüm hastalardan Polisomnografi (PSG) öncesi (gece) ve PSG sonunda (sabah) hepsidin değerlerini tespit etmek amaçlı kan örnekleri alınmıştır. Bulgular: Orta-ağır derece OUAS'lı hastalarda gece hepsidin düzeyleri daha düşük bulunurken (U=-3,91, p<,001), gece-sabah hepsidin değerleri farkı yine orta-ağır OUAS'lı hastalarda hafif OUAS veya OUAS olmayan gruba göre çok daha yüksek bulunmuştur (t=-2,83, p=,007). AHİ değeri gece ölçülen hepsidin (Hep E) ile negatif yönde korele bulunurken (rs=-0,48, p=0,001), gündüz hepsidin değeri (Hep M) ve gece-gündüz farkı düzeyleri ile bağıntılı bulunmamıştır. Gece ölçülen hepsidin değerleri artışı kovaryanlar kontrol edildikten sonra dahi orta-ağır OUAS sıklığı ile negatif bağıntı bulunmuştur. Hep E ile Hep M arasındaki sayısal fark artışıyla orta-ağır derece OUAS sıklığında 1,08 kat artış tespit edilmiştir. (%95 CI 1,02-1,15, p=,02). Sonuç: Bu araştırma; günümüze dek OUAS ve hepsidin arasındaki ilişkiyi araştıran öncü bir çalışmadır. Orta-ağır derece OUAS'lı hastalar içinde Hep E değerlerinde ciddi artış ve Hep E -Hep M değerleri farkında da ciddi değişiklikler bulunmuştur. Hepsidin, OUAS da hipoksi/reoksijenasyon epizodları ve enflamasyonu belirlemekte iyi bir biyobelirteç olabilir. (JTSM 2015;2:33-7) Anah tar Ke li me ler: Hepsidin, enflamasyon, obstrüktif uyku apne sendromu Çıkar Çatışması: Yazarlar bu makale ile ilgili olarak herhangi bir çıkar çatışması bildirmemiştir.Objective: Obstructive Sleep Apnea syndrome (OSAS) is a clinical syndrome characterized by recurrent episodes of upper airway obstruction during sleep, resulting in chronic intermittent hypoxia and causing inflammation. IL-6 and CRP are the most commonly studied inflammation biomarkers in OSAS. Given that IL-6 is an important activator of hepcidin during inflammation. In this study, hepcidin levels in OSAS patients were examined. Materials and Methods: A total of 44 patients undergoing Polysomnography (PSG) for suspected sleep disorder breathing were studied. Patients were classified as having no to mild OSAS (n=15) or moderate to severe OSAS (n=29) based on apnea-hypopnea index (AHI) (AHI <15 vs. AHI ≥15, respectively). Blood samples were obtained at night before PSG and in morning to obtain hepcidin levels. Results: Patients with moderate to severe OSAS had lower evening hepcidin levels (U=-3.91, p<.001)...

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The effects of 40 hours of total sleep deprivation on inflammatory markers in healthy young adults

Cited by 271 publications

References 42 publications

Examining the Evidence to Guide Practice: Challenging Practice Habits

Examining the Evidence to Guide Practice: Challenging Practice Habits

Poor Sleep Quality and Associated Inflammation Predict Preterm Birth: Heightened Risk among African Americans

Is Hepcidin a Good Marker for Inflammation in Obstructive Sleep Apnea Syndrome (OSAS) Patients?

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