Sleep disturbance and longitudinal risk of inflammation: Moderating influences of social integration and social isolation in the Coronary Artery Risk Development in Young Adults (CARDIA) study.
Both sleep disturbance and social isolation increase the risk for morbidity and mortality. Systemic inflammation is suspected as a potential mechanism of these associations. However, the complex relationships between sleep disturbance, social isolation, and inflammation have not been examined in a population-based longitudinal study. This study examined the longitudinal association between sleep disturbance and systemic inflammation, and the moderating effects of social isolation on this association. The CARDIA study is a population-based longitudinal study conducted in four US cities. Sleep disturbance - i.e., insomnia complaints and short sleep duration - was assessed in 2962 African-American and White adults at baseline (2000-2001, ages 33-45years). Circulating C-reactive protein (CRP) was measured at baseline and follow-up (2005-2006). Interleukin-6 (IL-6) and subjective and objective social isolation (i.e., feelings of social isolation and social network size) were measured at follow-up. Sleep disturbance was a significant predictor of inflammation five years later after full adjustment for covariates (adjusted betas: 0.048, P=0.012 for CRP; 0.047, P=0.017 for IL-6). Further adjustment for baseline CRP revealed that sleep disturbance also impacted the longitudinal change in CRP levels over five years (adjusted beta: 0.044, P=0.013). Subjective social isolation was a significant moderator of this association between sleep disturbance and CRP (adjusted beta 0.131, P=0.002). Sleep disturbance was associated with heightened systemic inflammation in a general population over a five-year follow-up, and this association was significantly stronger in those who reported feelings of social isolation. Clinical interventions targeting sleep disturbances may be a potential avenue for reducing inflammation, particularly in individuals who feel socially isolated.
Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, United States. Electronic address: hjcho@mednet.ucla.edu.
Hyong Jin
HJ
Cho
Division of Geriatrics, David Geffen School of Medicine at UCLA, United States.
Teresa E
TE
Seeman
Department of Quantitative Health Sciences, University of Massachusetts Medical School, United States.
Catarina I
CI
Kiefe
Department of Health Studies, University of Chicago, United States.
Diane S
DS
Lauderdale
Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, United States.
Michael R
MR
Irwin
D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D003324:Coronary Artery Disease / Q000209:etiology* / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications* / Q000378:metabolism; D015850:Interleukin-6 / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012890:Sleep / Q000502:physiology; D012893:Sleep Wake Disorders / Q000150:complications* / Q000378:metabolism; D012919:Social Behavior; D012934:Social Isolation
C508600:IL6 protein, human; D015850:Interleukin-6; D002097:C-Reactive Protein
C-reactive protein; Interleukin-6; Moderation; Population-based longitudinal study; Sleep disturbance; Social isolation; Systemic inflammation