Sleep Research and Treatment Center, Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, PA, USA.
Sleep Research and Treatment Center, Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, PA, USA.
Brain Behav Immun. 2017 Mar;61:110-116. doi: 10.1016/j.bbi.2016.12.026. Epub 2016 Dec 30.
Inflammation has been suggested as a potential pathway by which insomnia and short sleep can affect risk of morbidity in adults. However, few studies have examined the association of insomnia with inflammation in adolescents, despite accumulating evidence that pathophysiologic changes may already occur during this critical developmental period. The present study sought to examine the association of insomnia symptoms with systemic inflammation and the role of objective sleep duration in this association. Participants were 378 adolescents (16.9±2.3y, 45.8% female) from the Penn State Child Cohort, a population-based sample who underwent 9-h polysomnography (PSG) followed by a single fasting blood draw to assess plasma levels of C-reactive protein (CRP) and other inflammatory markers. Insomnia symptoms were defined by a self-report of difficulties falling and/or staying asleep, while objective sleep duration groups were defined as a PSG total sleep time ⩾8, 8-7, and ⩽7h. We assessed the association of insomnia symptoms, objective sleep duration, and their interaction with inflammatory markers, while adjusting for multiple potential confounders. Adolescents reporting insomnia symptoms had significantly higher levels of CRP compared to controls and a significant interaction (p<0.01) showed that objective sleep duration modified this association. Elevated CRP was present in adolescents with insomnia symptoms and ⩽7h of sleep (1.79mg/L) as compared to controls or adolescents with insomnia symptoms and ⩾8h of sleep (0.90mg/L and 0.98mg/L, respectively) or controls with ⩽7h of sleep (0.74mg/L; all p-values <0.01). In sum, insomnia symptoms with objective short sleep duration are associated with systemic inflammation as early as adolescence. This study suggests that chronic low-grade inflammation may be a common final pathway towards morbidity in adulthood in this insomnia phenotype.
炎症被认为是失眠和睡眠不足影响成年人发病风险的潜在途径。然而，尽管有越来越多的证据表明，在这个关键的发育时期，可能已经发生了病理生理变化，但很少有研究调查失眠与青少年炎症之间的关系。本研究旨在探讨失眠症状与全身炎症的关系，以及客观睡眠时间在这种关系中的作用。参与者是来自宾夕法尼亚州立儿童队列的 378 名青少年（16.9±2.3 岁，45.8%为女性），这是一个基于人群的样本，他们接受了 9 小时的多导睡眠图（PSG）检查，随后进行了一次禁食采血，以评估 C 反应蛋白（CRP）和其他炎症标志物的血浆水平。失眠症状通过自我报告的入睡和/或保持睡眠困难来定义，而客观睡眠时间组则定义为 PSG 总睡眠时间 ⩾8、8-7 和 ⩽7 小时。我们评估了失眠症状、客观睡眠时间及其与炎症标志物的相互作用，同时调整了多个潜在的混杂因素。与对照组相比，报告有失眠症状的青少年的 CRP 水平明显更高，且存在显著的交互作用（p<0.01），表明客观睡眠时间改变了这种关联。与对照组或有失眠症状和 ⩾8 小时睡眠时间的青少年（0.90mg/L 和 0.98mg/L）相比，有失眠症状和 ⩽7 小时睡眠时间的青少年（1.79mg/L）的 CRP 水平升高，差异具有统计学意义（所有 p 值均<0.01）。总之，有客观短睡眠时间的失眠症状与青少年时期的全身炎症有关。这项研究表明，慢性低度炎症可能是这种失眠表型成年后发病的共同最终途径。
