title: Excessive daytime sleepiness and antipathogen drug consumption in the elderly: a test of the immune theory of sleep.
abstract: The evolutionary reasons for sleep remain controversial. The immune theory of sleep suggests that sleep is essential to the immune system, allowing organisms to allocate more energy to their immunity. This hypothesis was tested by exploring the links between excessive daytime sleepiness (EDS) and vulnerability to infectious diseases in a large (n = 9294) cohort of elderly individuals, with information on socio-demographics, daily habits, and medical characteristics. At the two-year and four-year follow-ups, we obtained individual data from the national healthcare insurance about all medications prescribed to the participants between 2001 and 2003 (n = 2865). We found an independent positive association between EDS and the consumption of some anti-pathogen drugs. This relationship was mostly explained by fungal and parasitic infections rather than by viral and bacterial ones. These results, although based on correlations, are consistent with the idea that EDS as a proxy of altered sleep quality/quantity may affect the efficiency of the immune system, and hence vulnerability to infections.
authors.affiliation: Institute of Evolutionary Sciences, University of Montpellier, Montpellier, France. (CNRS UMR 5554, IRD, EPHE).
authors.forename: Claire
authors.initials: C
authors.lastname: Berticat
authors.affiliation: IRD, MIVEGEC, (UMR CNRS/IRD/), Montpellier Cedex 5, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Thomas
authors.affiliation: Centre de Référence Maladies Rares Narcolepsie et Hypersomnie Idiopathique, Service de Neurologie, Unité des Troubles du Sommeil, Hôpital Gui-de-Chauliac, CHU Montpellier, France.|INSERM U1061, La Colombière Hospital, University of Montpellier, Montpellier, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Dauvilliers
authors.affiliation: INSERM U1061, La Colombière Hospital, University of Montpellier, Montpellier, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jaussent
authors.affiliation: INSERM U1061, La Colombière Hospital, University of Montpellier, Montpellier, France.|Faculty of Medicine, Imperial College, St Mary's Hospital, London, United Kingdom.
authors.forename: Karen
authors.initials: K
authors.lastname: Ritchie
authors.affiliation: INSERM, ISPED, UMR897, University of Bordeaux, Bordeaux, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Helmer
authors.affiliation: INSERM, Neuroepidemiology, UMR897,University of Bordeaux, Bordeaux, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Tzourio
authors.affiliation: Institute of Evolutionary Sciences, University of Montpellier, Montpellier, France. (CNRS UMR 5554, IRD, EPHE).
authors.forename: Michel
authors.initials: M
authors.lastname: Raymond
authors.affiliation: INSERM U1061, La Colombière Hospital, University of Montpellier, Montpellier, France.
authors.forename: Sylvaine
authors.initials: S
authors.lastname: Artero
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003141:Communicable Diseases / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology*; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology / Q000209:etiology / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male
chemical_list: D000890:Anti-Infective Agents