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Relationship between sleep characteristics and markers of inflammation in Swedish women from the general population
Author(s) -
Ghilotti Francesca,
Bellocco Rino,
Trolle Lagerros Ylva,
Thorson Anna,
TheorellHaglöw Jenny,
Åkerstedt Torbjörn,
Lindberg Eva
Publication year - 2021
Publication title -
journal of sleep research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.297
H-Index - 117
eISSN - 1365-2869
pISSN - 0962-1105
DOI - 10.1111/jsr.13093
Subject(s) - medicine , percentile , polysomnography , population , confidence interval , linear regression , sleep (system call) , morning , insomnia , regression analysis , statistics , psychiatry , environmental health , computer science , operating system , apnea , mathematics
Abstract Systemic inflammation is thought to mediate the link between sleep and cardiovascular outcomes, but previous studies on sleep habits and inflammation markers have found inconsistent results. This study investigated the relationship between sleep characteristics and C‐reactive protein (CRP), interleukin‐6 (IL‐6) and tumor necrosis factor α (TNFα). A representative sample of 319 Swedish women was randomly selected from the general population for in‐home polysomnography, sleep questionnaire and blood samples. As variables were highly correlated, principal component analysis was used to reduce the number of original variables. Linear regression with log‐transformation of the outcomes (lnCRP, lnIL‐6 and lnTNFα) and quantile regression were fitted to estimate cross‐sectional relationships. Multivariable linear regression models suggested a significant association of insomnia symptoms (self‐reported) with higher lnCRP levels (β = 0.11; 95% confidence interval [CI] = 0.02; 0.21), but not with lnIL‐6 and lnTNFα. From quantile regression analysis we found that a high non‐restorative index (subjective) and insomnia symptoms (self‐reported) were associated with higher values of CRP, especially in the highest quantiles of the CRP distribution (90th percentile: β = 0.71; 95% CI = 0.17; 1.24. β = 1.23; 95% CI = 0.44; 2.02, respectively). Additionally, higher amounts of rapid eye movement (REM) sleep were associated with lower CRP values (90th percentile: β = −0.80; 95% CI = −0.14; −1.46). In conclusion, sleep disturbances (self‐reported), specifically difficulties maintaining sleep and early morning awakenings, but not sleep duration (neither subjective nor objective), were associated with higher CRP levels. No association was found with IL‐6 or TNFα. Elevated REM sleep was associated with lower CRP levels. The results suggest that inflammation might be an intermediate mechanism linking sleep and health in women.

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