Walter Reed Army Institute of Research, Behavioral Biology Branch, Silver Spring, MD, 20910, USA.
Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD, 20910, USA.
Sleep Med. 2022 Dec;100:404-409. doi: 10.1016/j.sleep.2022.09.008. Epub 2022 Sep 16.
Acute diarrhea is the most frequent diagnosis among ill travelers. Sleep loss may weaken the body's defense against pathogens and increase susceptibility to infection. The relationship between sleep and infectious diarrhea has not been studied and was assessed utilizing data from a controlled human infection model (CHIM) for enterotoxigenic Escherichia coli (ETEC).
During a CHIM assessing the efficacy of an immunoprophylactic targeting ETEC against moderate-to-severe diarrhea (MSD) following challenge, we measured sleep via actigraphy over an 8-day inpatient period. We hypothesized better sleep pre-challenge would predict illness symptomatology following challenge.
Among 57 participants (aged 34.4 ± 8.1 years, 64% male), there was no relationship between sleep metrics and incidence of MSD. However, longer total sleep time the night preceding ETEC challenge was associated with lower maximum 24 h diarrhea volume (B = -1.80, p = 0.01) and total diarrhea volume (B = -2.45, p = 0.01).
This novel study showed that shorter sleep duration predicted diarrhea severity over the course of an ETEC infection. Future work should experimentally manipulate sleep to further clarify its impact on diarrhea-related outcomes for ETEC and other important enteric pathogens.
急性腹泻是旅行者患病时最常见的诊断。睡眠不足可能会削弱身体对病原体的防御能力，增加感染的易感性。睡眠与传染性腹泻之间的关系尚未得到研究，并利用肠产毒性大肠杆菌（ETEC）的人体感染模型（CHIM）的数据进行了评估。
在一项评估针对 ETEC 的免疫预防对中度至重度腹泻（MSD）的疗效的 CHIM 中，我们通过活动记录仪在 8 天的住院期间测量了睡眠。我们假设挑战前更好的睡眠会预测挑战后疾病的症状。
在 57 名参与者（年龄 34.4 ± 8.1 岁，64%为男性）中，睡眠指标与 MSD 的发生率之间没有关系。然而，在 ETEC 挑战前一天晚上总睡眠时间较长与 24 小时内最大腹泻量（B = -1.80，p = 0.01）和总腹泻量（B = -2.45，p = 0.01）较低相关。
这项新研究表明，较短的睡眠时间预示着 ETEC 感染过程中腹泻的严重程度。未来的工作应该通过实验来操纵睡眠，以进一步阐明其对 ETEC 和其他重要肠道病原体引起的腹泻相关结果的影响。
