Very-Short-Term Sleep Deprivation Slows Early Recovery of Lymphocytes in Septic Patients

Abstract

Sleep plays an important role in immune function. However, the effects of very-short-term sleep deprivation on the early recovery of immune function after sepsis remain unclear. This study was conducted in the intensive care unit to investigate the effects of 2 consecutive days of sleep deprivation (SD) on lymphocyte recovery over the following few days in septic patients who were recovering from a critical illness. The patients' self-reports of sleep quality was assessed using the Richards–Campbell Sleep Questionnaire at 0 and 24 h after inclusion. The demographic, clinical, laboratory, treatment, and outcome data were collected and compared between the good sleep group and poor sleep group. We found that 2 consecutive days of SD decreased the absolute lymphocyte count (ALC) and ALC recovery at 3 days after SD. Furthermore, post-septic poor sleep decreased the plasma levels of atrial natriuretic peptide (ANP) immediately after 2 consecutive days of SD. The ANP levels at 24 h after inclusion were positively correlated with ALC recovery, the number of CD3+ T cells, or the number of CD3+ CD4+ cells in the peripheral blood on day 5 after inclusion. Our data suggested that very-short-term poor sleep quality could slow down lymphocyte recovery over the following few days in septic patients who were recovering from a critical illness. Our results underscore the significance of very-short-term SD on serious negative effects on the immune function. Therefore, it is suggested that continuous SD or several short-term SD with short intervals should be avoided in septic patients.

RhANP attenuates endotoxin-derived cognitive dysfunction through subdiaphragmatic vagus nerve-mediated gut microbiota–brain axis

“…and adhesion molecules (vascular cell adhesion molecules, intercellular cell adhesion molecule-1, E-selectin, etc.) [ 17 , 28 – 31 ], suppressing LPS and TNF-α-induced increased permeability of endothelial cells [ 18 ], and alleviating post-septic intestinal injury [ 25 ]. However, the molecular mechanisms by which ANP modulates immune responses/immune cell activation are unclear.…”

“…[ 17 – 27 ]. ANP has immunomodulatory capacity by regulating innate immunity and adaptive immunity, including increasing macrophage phagocytosis and reactive oxygen species release, enhancing natural killer (NK) cytotoxicity, promoting dendritic cell-mediated T cell polarization, stimulating the differentiation of naive CD4 + cells toward the T helper (Th) 2 and/or Th17 phenotype, inhibiting the expression of proinflammatory mediators and adhesion molecules [ 17 , 28 – 31 ]. We previously reported a significantly positive correlation between the plasma ANP levels and early recovery of immune function in septic patients [ 32 ].…”

Goodnight, Sleep Tight, Don’t Let the Microbes Bite: A Review of Sleep and Its Effects on Sepsis and Inflammation

“…Patients with sleep apnea or sleep disordered breathing were shown to have higher rates of sepsis after medical procedures (70,71) and had increased mortality rates after a sepsis diagnosis (72); however, the contribution of sleep versus hypoxia has not been fully established in this context. A recent study by Zhang et al found that among hospitalized septic patients, those who showed poor short-term sleep quality had significantly lower blood albumin, plasma atrial natriuretic peptide, and lymphocyte counts (in particular, Tcells and NK cells) in comparison with patients with good sleep quality (73). Only a few studies have used animal models to delineate how sleep affects sepsis and endotoxemia.…”

Association between sleep duration and albumin in US adults: a cross-sectional study of NHANES 2015–2018

“…A retrospective study showed that hypoalbuminemia in patients with coronavirus disease 2019 was associated with illness progression to more severe stages and increased mortality [ 5 ]. Additionally, a recent study found that among patients with sepsis, the sleep deprivation group had significantly lower albumin than the good sleep group [ 6 ].…”