title: Sleep and inflammation: psychoneuroimmunology in the context of cardiovascular disease.
abstract: BACKGROUND
  Poor sleep is prospectively linked to all-cause and cardiovascular mortality. Inflammatory processes may be an important biological mechanism linking poor sleep to cardiovascular disease. Such processes involve active participation of signaling molecules called cytokines in development of atherosclerotic plaques.
  
  
  OBJECTIVE
  I review evidence from experimental sleep deprivation and clinical observational studies suggesting a bidirectional relationship between sleep and inflammatory cytokines.
  
  
  RESULTS
  Findings from sleep deprivation studies indicate that sleep loss is associated with increases in these cytokines. Similarly, studies in clinical populations with sleep problems, such as primary insomnia patients and those diagnosed with major depression, also show elevations in these same cytokines.
  
  
  CONCLUSIONS
  Bidirectional communication between the brain and the immune system is carried out through a complex network of autonomic nerves, endocrine hormones, and cytokines. Disturbed sleep appears to perturb the functioning of this network and therefore contribute to elevations in inflammatory mediators linked to cardiovascular disease.
authors: Cousins Center for Psychoneuroimmunology, UCLA Semel Institute, 300 Medical Plaza, Los Angeles, CA 90095-7057, USA. smotivala@mednet.ucla.edu
authors: Sarosh J
authors: SJ
authors: Motivala