Ballestar-Tarín María Luisa, Ibáñez-Del Valle Vanessa, Mafla-España Mayra Alejandra, Cauli Omar, Navarro-Martínez Rut
Department of Nursing, University of Valencia, 46010 Valencia, Spain.
Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 Valencia, Spain.
Diseases. 2023 Oct 5;11(4):136. doi: 10.3390/diseases11040136.
Poor sleep quality is a major public health concern for all ages. In particular, university students often face stress levels and changes in social life habits that negatively influence their quality of sleep. This could be associated with psychological well-being in terms of anxiety and depressive symptoms, stress levels, and a poor self-perceived health status. The increases in the pro-inflammatory cytokine interleukin 6 (IL-6), IL-1 beta (IL-1β), and tumor necrosis factor alpha (TNFα), in blood have been linked to poor sleep quality in many diseases, but data on salivary cytokine levels in students are missing or are seldom analyzed. In this study we determined the quality of sleep in a sample of university students and the role of psychological assessment and factors affecting sleep (alcohol intake, tobacco, consumption of stimulant drinks, exercise, and body mass index). We also aimed to shed new light on the associations between sleep quality and salivary inflammatory cytokines (IL-1β, IL-6, and TNFα). Sleep quality was measured with the Athens Insomnia Scale (AIS) and Pittsburgh Sleep Quality Index (PSQI). Perceived stress was assessed using Cohen's Perceived Stress Scale (PSS), and the Goldberg Anxiety and Depression Scale (GADS) was used to assess the level of anxiety or depression. Perceived health status was measured with a visual analogue. Saliva samples was taken in the morning and the inflammatory cytokines was measured via enzyme-linked immunoassay. There was a direct and significant association between the salivary IL-1β concentration and AIS score (r = 0.248; = 0.038, Pearson correlation) and Pittsburgh scale score (r = 0.274; = 0.022, Pearson correlation). The relationship between IL-1β and AIS controlling for sex, age, and chronic disease, is still significant (r = 0.260; = 0.033). The relationship between IL-1β and PSQI controlling for the influence of these variables is also significant (r = 0.279; = 0.022). Salivary IL-1β concentrations were not significantly associated with any of the scores of the other psychological assessments (PSS, anxiety, depression symptoms, or self-perceived health). Salivary TNFα was significantly and inversely associated with self-perceived health (r = -0.259; = 0.033, Pearson correlation), but the salivary IL-6 concentration was not associated with any of the sleep quality scale or psychological assessment scores. Our results provide a novel relationship between pro-inflammatory cytokine IL-1β in saliva and poor sleep quality. However, the role of inflammation in poor sleep quality requires further study to identify strategies that could lower inflammation and thus, likely improve sleep quality.
睡眠质量差是各年龄段都面临的一个主要公共卫生问题。尤其是大学生,他们经常面临压力以及社交生活习惯的改变,这些都会对他们的睡眠质量产生负面影响。这可能与焦虑、抑郁症状、压力水平以及自我感觉不佳的健康状况等心理健康问题有关。血液中促炎细胞因子白细胞介素6(IL-6)、白细胞介素1β(IL-1β)和肿瘤坏死因子α(TNFα)的升高与多种疾病的睡眠质量差有关,但关于学生唾液中细胞因子水平的数据缺失或很少被分析。在本研究中,我们测定了一组大学生的睡眠质量,以及心理评估和影响睡眠的因素(酒精摄入、烟草、刺激性饮料消费、运动和体重指数)的作用。我们还旨在揭示睡眠质量与唾液炎症细胞因子(IL-1β、IL-6和TNFα)之间的关联。睡眠质量通过雅典失眠量表(AIS)和匹兹堡睡眠质量指数(PSQI)进行测量。使用科恩感知压力量表(PSS)评估感知压力,使用戈德堡焦虑抑郁量表(GADS)评估焦虑或抑郁水平。通过视觉模拟法测量自我感觉的健康状况。早晨采集唾液样本,通过酶联免疫吸附测定法测量炎症细胞因子。唾液中IL-1β浓度与AIS评分(r = 0.248;P = 0.038,皮尔逊相关性)和匹兹堡量表评分(r = 0.274;P = 0.022,皮尔逊相关性)之间存在直接且显著的关联。在控制性别、年龄和慢性病的情况下,IL-1β与AIS之间的关系仍然显著(r = 0.260;P = 0.033)。在控制这些变量影响的情况下,IL-1β与PSQI之间的关系也显著(r = 0.279;P = 0.022)。唾液中IL-1β浓度与其他心理评估(PSS、焦虑、抑郁症状或自我感觉的健康状况)的任何评分均无显著关联。唾液TNFα与自我感觉的健康状况呈显著负相关(r = -0.259;P = 0.033,皮尔逊相关性),但唾液IL-6浓度与任何睡眠质量量表或心理评估评分均无关联。我们的研究结果揭示了唾液中促炎细胞因子IL-1β与睡眠质量差之间的新关系。然而,炎症在睡眠质量差中的作用需要进一步研究,以确定可以降低炎症从而可能改善睡眠质量的策略。