title: Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation.
abstract: Sleep disturbance is associated with inflammatory disease risk and all-cause mortality. Here, we assess global evidence linking sleep disturbance, sleep duration, and inflammation in adult humans.
  
  
  
  A systematic search of English language publications was performed, with inclusion of primary research articles that characterized sleep disturbance and/or sleep duration or performed experimental sleep deprivation and assessed inflammation by levels of circulating markers. Effect sizes (ES) and 95% confidence intervals (CI) were extracted and pooled using a random effect model.
  
  
  
  A total of 72 studies (n > 50,000) were analyzed with assessment of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor α (TNFα). Sleep disturbance was associated with higher levels of CRP (ES .12; 95% CI = .05-.19) and IL-6 (ES .20; 95% CI = .08-.31). Shorter sleep duration, but not the extreme of short sleep, was associated with higher levels of CRP (ES .09; 95% CI = .01-.17) but not IL-6 (ES .03; 95% CI: -.09 to .14). The extreme of long sleep duration was associated with higher levels of CRP (ES .17; 95% CI = .01-.34) and IL-6 (ES .11; 95% CI = .02-20). Neither sleep disturbances nor sleep duration was associated with TNFα. Neither experimental sleep deprivation nor sleep restriction was associated with CRP, IL-6, or TNFα. Some heterogeneity among studies was found, but there was no evidence of publication bias.
  
  
  
  Sleep disturbance and long sleep duration, but not short sleep duration, are associated with increases in markers of systemic inflammation.
authors.affiliation: Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, University of California, Los Angeles, Los Angeles, California.; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.; Department of Psychology, University of California, Los Angeles, Los Angeles, California.. Electronic address: mirwin1@ucla.edu.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Irwin
authors.affiliation: Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, University of California, Los Angeles, Los Angeles, California.; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
authors.forename: Richard
authors.initials: R
authors.lastname: Olmstead
authors.affiliation: Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, University of California, Los Angeles, Los Angeles, California.; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
authors.forename: Judith E
authors.initials: JE
authors.lastname: Carroll
mesh_terms: D000328:Adult; D006801:Humans; D007249:Inflammation / Q000209:etiology* / Q000276:immunology; D012890:Sleep / Q000502:physiology*; D012892:Sleep Deprivation / Q000150:complications* / Q000276:immunology; D012893:Sleep Wake Disorders / Q000150:complications* / Q000276:immunology
keywords: Inflammation; Insomnia; Interleukin-6; Meta-analysis; Sleep deprivation; Sleep disturbance; Sleep duration