Insomnia and High-Sensitivity C-Reactive Protein

Laugsand, Lars Erik; Vatten, Lars J.; Bjørngaard, Johan Håkon; Hveem, Kristian; Janszky, Imre

doi:10.1097/psy.0b013e31825904eb

Cited by 43 publications

(34 citation statements)

References 53 publications

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“…Inflammatory processes are assumed to represent an important biological mechanism linking poor sleep to cardiovascular disease [4], [5]. Although experimental studies clearly indicated that sleep deprivation and insomnia can increase inflammatory processes, the relationships of sleep with inflammation remain far from being settled [4].…”

Section: Introductionmentioning

confidence: 99%

Complaints of Sleep Disturbances Are Associated with Cardiovascular Disease: Results from the Gutenberg Health Study

et al. 2014

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BackgroundDespite their high prevalence, sleep disorders often remain unrecognized and untreated because of barriers to assessment and management. The aims of the present study were to examine associations of complaints of sleep disturbances with cardiovascular disease, related risk factors, and inflammation in the community and to determine the contribution of sleep disturbances to self-perceived physical health.MethodThe sample consists of n = 10.000 participants, aged 35 to 74 years of a population based community sample in Germany. Cross-sectional associations of complaints of sleep disturbances with cardiovascular risk factors and disease, biomarkers of inflammation, depression, anxiety, and physical health status were analyzed.Results19% of our sample endorsed clinically significant sleep disturbances. In the unadjusted analyses severity of sleep disturbances increased with female sex, low socioeconomic status, living without a partnership, cardiovascular disease, depression, anxiety, poor physical health, increased levels of C-reactive protein and fibrinogen. After multivariate adjustment robust associations with coronary heart disease, myocardial infarction and dyslipidemia remained. Complaints of sleep disturbances were strong and independent contributors to self-perceived poor physical health beyond depression, anxiety and medical disease burden.ConclusionsGiven the high prevalence of complaints of sleep disturbances and their strong impact on health status, increased efforts should be undertaken for their identification and treatment.

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Section: Introductionmentioning

confidence: 99%

Complaints of Sleep Disturbances Are Associated with Cardiovascular Disease: Results from the Gutenberg Health Study

et al. 2014

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“…Some studies have identified an independent association between sleep characteristics (namely, disordered breathing, duration, and quality ratings) and inflammation (22-33). Other studies have reported that associations between these sleep characteristics and inflammation are accounted for by confounders like disease and adiposity (34-39)). However, previous literature on sleep and inflammation has been limited by sample size and/or reliance upon subjective measures of sleep.…”

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confidence: 98%

“…The current report therefore aimed to determine whether objectively measured sleep characteristics are associated with mortality risk independent of concurrent inflammation. Several factors other than sleep may also be associated with inflammation and mortality, and the relationship between sleep and inflammatory markers may be confounded by factors like adiposity and overt disease (34-39). Therefore, we assessed the relative roles of inflammatory burden and other health factors (that may be related to sleep, inflammation, and mortality (e.g.…”

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confidence: 99%

Actigraphy- and Polysomnography-Measured Sleep Disturbances, Inflammation, and Mortality Among Older Men

et al. 2016

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Objectives To evaluate whether objectively-measured sleep characteristics are associated with mortality risk independent of inflammatory burden and comorbidity. Methods The MrOS Sleep Study (conducted in 2003-2005) included community-dwelling older men (n=2531; average age of 76.3 (5.5 s.d.)). Sleep measures from in-home polysomnography and wrist actigraphy and assessments of serum inflammatory markers levels (C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), tumor necrosis factor-α soluble receptor II (sTNF-RII) and interferon–γ (IFN-γ)) were obtained. Vital status was ascertained over an average follow-up of 7.4 (1.9 s.d.) years. Results Three of the seven main sleep measures examined were independently associated with greater inflammatory burden. Mortality risk associated with prolonged (≥10% total sleep time) blood oxygen desaturation and short (<5 hours) sleep duration was attenuated to non-significance after adjusting for inflammatory burden or medical burden/lifestyle factors. Severe blood oxygen desaturation (adjusted hazard ratio (aHR)=1.57, 95% confidence interval (CI): 1.11-2.22), sleep fragmentation (aHR=1.32, 95% CI: 1.12-1.57), and a lower percentage of sleep in rapid eye movement (REM; aHR per s.d.=0.90, 95% CI: 0.93-0.97) were independently associated with mortality. Conclusions Short sleep duration and prolonged blood oxygen desaturation were independently associated with inflammatory burden, which attenuated associations between these sleep characteristics and mortality. Medical and lifestyle factors also substantially attenuated most sleep-mortality associations, suggesting complex relations between sleep, inflammation, and disease. Sleep fragmentation, severe blood oxygen desaturation, and the percentage of sleep time in REM were independently related to mortality risk. Future studies with repeated measures of mediators/confounds will be necessary to achieve a mechanistic understanding of sleep-related mortality risk.

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“…It has been proposed that people with insomnia have physiologic hyperarousal as evidenced by greater nighttime resting HR, 23,24 central and sympathetic nervous system dysregulation, 23,25-29 heightened hypothalamic-pituitary adrenal axis activation, 30-32 and greater nighttime whole-body metabolism. 33 Other, but not all, 34 studies reported a relationship between insomnia symptoms and higher levels of inflammatory markers (IL-6, 35-37 CRP 37,38 ) compared to good sleepers. In our study we did not find that daytime resting heart rate or CRP differed between people with symptoms of insomnia or good sleepers.…”

Section: Discussionmentioning

confidence: 99%

Insomnia Symptoms Are Associated With Abnormal Endothelial Function

Routledge¹,

Dunbar

Higgins³

et al. 2017

J Cardiovasc Nurs

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Background Insomnia is a prevalent sleep disorder and it has been increasingly associated with cardiovascular morbidity and mortality. The reasons for this relationship are not completely understood but may involve endothelial dysfunction. In this study, we hypothesized that insomnia symptoms would be associated with reduced endothelial function. Methods Working adults [n=496, 67.5% female, 78.6% white, mean age: 48.7±10.8 years, body mass index (BMI): 28.2±6.7 kg/m2, diabetes: 5.8%, hypertension: 20.0%, hyperlipidemia: 17.9%, heart disease: 2.6%] enrolled in the Emory-Georgia Tech Predictive Health Institute study completed baseline demographic, clinical, depression (Beck Depression Inventory II; BDI-II), anxiety (General Anxiety Disorder-7; GAD-7) sleep (Pittsburg Sleep Quality Index , PSQI) and non-invasive endothelial function (brachial artery flow-mediated dilation; FMD) measures. Insomnia symptoms were defined as subjective sleep latency of ≥ 30 minutes, nighttime or early morning awakenings and/or sleep medication use occurring ≥ 3 times per week in the past month. Results Insomnia symptoms were reported by 39.5% of participants. Multivariable regression models showed that insomnia symptoms, age, baseline artery diameter and dyslipidemia were inversely related to FMD. After adjusting for age, baseline artery diameter, and dyslipidemia participants reporting insomnia symptoms had lower FMD than participants reporting better sleep (adjusted FMD means= 6.13%±0.28 vs 6.83%±0.26, p=.035). Conclusion In this study insomnia symptoms were associated with reduced FMD. Research examining the therapeutic benefits of treating insomnia on endothelial function and future cardiovascular risk is warranted.

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Insomnia and High-Sensitivity C-Reactive Protein

Abstract: There were no consistent associations between symptoms of insomnia and hsCRP levels. Our results do not support the hypothesis that inflammation, as reflected by elevated levels of hsCRP, is an important factor linking insomnia to coronary heart disease.

Cited by 43 publications

References 53 publications

Complaints of Sleep Disturbances Are Associated with Cardiovascular Disease: Results from the Gutenberg Health Study

Complaints of Sleep Disturbances Are Associated with Cardiovascular Disease: Results from the Gutenberg Health Study

Actigraphy- and Polysomnography-Measured Sleep Disturbances, Inflammation, and Mortality Among Older Men

Insomnia Symptoms Are Associated With Abnormal Endothelial Function

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