Department of Psychology, Sapienza University of Rome, Rome, Italy.
J Sleep Res. 2022 Oct;31(5):e13560. doi: 10.1111/jsr.13560. Epub 2022 Feb 8.
Previous longitudinal evidence suggested that sleep disturbance (i.e., difficulties in sleep onset and sleep maintenance) may be longitudinally associated with systemic inflammation, which is involved in the pathophysiology of mental and somatic illness. The mechanisms underlying this association, however, remain largely unexplored. In the context of health psychology, a substantial body of literature showed that positive affect may have a favourable impact on immune and inflammatory response and buffer the proinflammatory effects of stress. Therefore, the aim of this study was to assess whether subjective sleep disturbance is longitudinally associated with serum high sensitivity C-reactive protein (hs-CRP), a marker of systemic inflammation, and whether this association is mediated by a decrease in positive affect. The data of 1894 participants aged 64.11 ± 8.02 years from the English Longitudinal Study of Ageing (ELSA) across three waves of data collection were analysed. Self-reported sleep disturbance was assessed in 2008-2009, (wave 4), positive affect was assessed in 2010-2011 (wave 5), and hs-CRP was assessed in 2012-2013 (wave 6). Path analysis adjusted for health-related variables including depressive symptoms, cardiovascular disease, BMI, smoking, alcohol consume, and drug intake showed a significant direct effect of sleep disturbance to positive affect; positive affect directly predicted hs-CRP. Lastly, an indirect effect between sleep disturbance to hs-CRP through the mediating role of positive affect emerged. The findings suggest that sleep onset and sleep maintenance difficulties may be associated with inflammation through the mediation of low positive affect. The clinical significance of the findings should be further explored.
先前的纵向研究证据表明，睡眠障碍（即入睡和维持睡眠困难）可能与全身炎症有关，而全身炎症参与了精神和躯体疾病的病理生理学过程。然而，这种关联的机制在很大程度上仍未得到探索。在健康心理学的背景下，大量文献表明积极情绪可能对免疫和炎症反应产生有利影响，并缓冲压力的促炎作用。因此，本研究旨在评估主观睡眠障碍是否与全身炎症的标志物血清高敏 C 反应蛋白（hs-CRP）呈纵向相关，以及这种关联是否通过积极情绪的降低来介导。本研究分析了来自英国老龄化纵向研究（ELSA）的 1894 名年龄为 64.11±8.02 岁的参与者在三个数据采集时间点的数据。2008-2009 年（第 4 波）评估了自我报告的睡眠障碍，2010-2011 年（第 5 波）评估了积极情绪，2012-2013 年（第 6 波）评估了 hs-CRP。路径分析调整了与健康相关的变量，包括抑郁症状、心血管疾病、BMI、吸烟、饮酒和药物摄入，结果显示睡眠障碍对积极情绪有显著的直接影响；积极情绪直接预测 hs-CRP。最后，通过积极情绪的中介作用，睡眠障碍与 hs-CRP 之间出现了间接影响。研究结果表明，入睡和维持睡眠困难可能通过低积极情绪与炎症有关。这些发现的临床意义应进一步探讨。
