Insomnia symptoms with objective short sleep duration are associated with systemic inflammation in adolescents.
Insomnia symptoms with objective short sleep duration are associated with systemic inflammation in adolescents.
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DOI：
10.1016/j.bbi.2016.12.026
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发表时间：
2017-03
期刊：
影响因子：
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通讯作者：
Bixler EO
中科院分区：
文献类型：
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作者：
Fernandez-Mendoza J;Baker JH;Vgontzas AN;Gaines J;Liao D;Bixler EO
炎症被认为是失眠和睡眠不足可能影响成人发病风险的潜在途径。然而，很少有研究探讨了失眠与青少年炎症的关系，尽管越来越多的证据表明，在这个关键的发育时期可能已经发生了病理生理变化。本研究旨在研究失眠症状与全身炎症的关系以及客观睡眠时间在这种关系中的作用。参与者是来自宾夕法尼亚州立大学儿童队列的378名青少年（16.9 ± 2.3岁，45.8%为女性），这是一个基于人群的样本，他们接受了9小时多导睡眠图（PSG），随后进行了单次空腹抽血，以评估C反应蛋白（CRP）和其他炎症标志物的血浆水平。失眠症状定义为自我报告入睡困难和/或保持睡眠困难，而客观睡眠持续时间组定义为PSG总睡眠时间≥ 8、8-7和≤ 7小时。我们评估了失眠症状、客观睡眠时间及其与炎症标志物的相互作用之间的关系，同时调整了多种潜在的混杂因素。与对照组相比，报告有失眠症状的青少年CRP水平显著更高，并且显著的交互作用（p < 0.01）表明客观睡眠时间改变了这种关联。与对照组或有失眠症状且睡眠时间≥ 8小时的青少年（分别为0.90 mg/L和0.98 mg/L）或睡眠时间≤ 7小时的对照组（0.74 mg/L;所有p值均< 0.01）相比，有失眠症状且睡眠时间≤ 7小时的青少年（1.79 mg/L）的CRP升高。总之，失眠症状与客观睡眠时间短早在青春期全身炎症。这项研究表明，慢性低度炎症可能是这种失眠表型在成年期发病的共同最终途径。
Inflammation has been suggested as a potential pathway by which insomnia and short sleep can affect risk of morbidity in adults. However, few studies have examined the association of insomnia with inflammation in adolescents, despite accumulating evidence that pathophysiologic changes may already occur during this critical developmental period. The present study sought to examine the association of insomnia symptoms with systemic inflammation and the role of objective sleep duration in this association. Participants were 378 adolescents (16.9 ± 2.3y, 45.8% female) from the Penn State Child Cohort, a population-based sample who underwent 9-hour polysomnography (PSG) followed by a single fasting blood draw to assess plasma levels of C-reactive protein (CRP) and other inflammatory markers. Insomnia symptoms were defined by a self-report of difficulties falling and/or staying asleep, while objective sleep duration groups were defined as a PSG total sleep time ≥ 8, 8–7, and ≤ 7 hours. We assessed the association of insomnia symptoms, objective sleep duration, and their interaction with inflammatory markers, while adjusting for multiple potential confounders. Adolescents reporting insomnia symptoms had significantly higher levels of CRP compared to controls and a significant interaction (p < 0.01) showed that objective sleep duration modified this association. Elevated CRP was present in adolescents with insomnia symptoms and ≤ 7 hours of sleep (1.79 mg/L) as compared to controls or adolescents with insomnia symptoms and ≥ 8 hours of sleep (0.90 mg/L and 0.98 mg/L, respectively) or controls with ≤ 7 hours of sleep (0.74 mg/L; all p-values < 0.01). In sum, insomnia symptoms with objective short sleep duration are associated with systemic inflammation as early as adolescence. This study suggests that chronic low-grade inflammation may be a common final pathway towards morbidity in adulthood in this insomnia phenotype.