Sleep Habits and Susceptibility to Upper Respiratory Illness: the Moderating Role of Subjective Socioeconomic Status.
BACKGROUND
Sleep is a predictor of infectious illness that may depend on one's socioeconomic status (SES).


OBJECTIVE
This study aimed to investigate the moderating effects of objective and subjective SES on sleep-clinical cold risk link and test whether nasal inflammation serves as a plausible biological pathway.


METHODS
This study combined data (n = 732) from three viral challenge studies. Measures of self-reported sleep and objective and subjective measures of SES were obtained. Participants were quarantined and administrated rhinovirus (RV) or influenza virus and monitored over 5 (RV) or 6 (influenza) days for the development of a cold. Symptom severity, including mucus production and nasal clearance time, and levels of nasal cytokines (interleukin (IL)-6 and IL-1β) were measured prior to administration and each day during the quarantined period.


RESULTS
Subjective SES, but not objective SES, moderated associations between shorter sleep duration and increased likelihood of a clinical cold. Compared to ≥8-hour sleepers, ≤6-hour sleepers with low subjective SES were at increased risk for developing a cold (OR = 2.57, 95% CI 1.10-6.02). There was no association between sleep duration and colds in high subjective SES participants. Among infected individuals who reported low subjective SES, shorter sleep duration was associated with greater mucus production. There was no evidence that markers of nasal inflammation mediated the link between sleep duration and cold susceptibility among those reporting low subjective SES.


CONCLUSIONS
Subjective SES may reflect an important social factor for understanding vulnerability to and protection against infectious illness among short sleepers.
Department of Psychiatry, University of California, San Francisco, CA, USA. aric.prather@ucsf.edu.|Center for Health and Community, University of California, San Francisco, CA, USA. aric.prather@ucsf.edu.
Aric A
AA
Prather
Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA.
Denise
D
Janicki-Deverts
Department of Psychiatry, University of California, San Francisco, CA, USA.|Center for Health and Community, University of California, San Francisco, CA, USA.
Nancy E
NE
Adler
Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Martica
M
Hall
Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA. scohen@cmu.edu.
Sheldon
S
Cohen
D000328:Adult; D004198:Disease Susceptibility; D005260:Female; D006184:Habits; D006801:Humans; D008297:Male; D012141:Respiratory Tract Infections / Q000209:etiology* / Q000503:physiopathology; D012890:Sleep / Q000502:physiology*; D012923:Social Class; D012959:Socioeconomic Factors; D055815:Young Adult
Cytokines; Sleep; Socioeconomic status; Upper respiratory infection
Psychol Bull. 2003 Jan;129(1):10-51
12555793
Curr Biol. 2007 Oct 23;17(20):R877-8
17956744
Biol Psychiatry. 2016 Jul 1;80(1):40-52
26140821
J Health Soc Behav. 1983 Dec;24(4):385-96
6668417
Soc Sci Med. 2001 Jun;52(11):1661-76
11327139
Arch Intern Med. 2009 Jan 12;169(1):62-7
19139325
Brain Behav Immun. 2014 Aug;40:174-81
24675032
Diabetes Care. 2010 Feb;33(2):414-20
19910503
Emotion. 2012 Oct;12(5):1015-20
22309720
J Psychiatr Res. 2013 Sep;47(9):1228-35
23746737
Health Psychol. 2012 Jan;31(1):11-9
22004465
Psychosom Med. 2003 May-Jun;65(3):461-70
12764220
Health Psychol. 2008 Mar;27(2):268-74
18377146
Soc Sci Med. 2008 Mar;66(5):1034-45
18180089
Psychosom Med. 2008 Jul;70(6):646-52
18606725
Psychosom Med. 1999 Mar-Apr;61(2):175-80
10204970
Annu Rev Psychol. 2009;60:501-24
19035829
Psychosom Med. 2010 Apr;72(3):290-300
20100883
Psychol Bull. 2004 Jul;130(4):601-30
15250815
Sleep. 2009 Feb;32(2):200-4
19238807
FASEB J. 1996 Apr;10(5):643-53
8621064
Brain Behav Immun. 2006 Mar;20(2):175-81
16023829
Am Psychol. 1994 Jan;49(1):15-24
8122813
Annu Rev Psychol. 2015 Jan 3;66:143-72
25061767
Circulation. 2007 Nov 20;116(21):2383-90
18025402
Psychosom Med. 2011 Oct;73(8):679-82
21949422
Annu Rev Clin Psychol. 2013;9:723-49
23245339
J Exp Med. 1971 Feb 1;133(2):400-9
5002522
Clin Exp Immunol. 2009 Feb;155(2):231-8
19040608
JAMA. 1997 Jun 25;277(24):1940-4
9200634
Natl Vital Stat Rep. 2013 May 8;61(4):1-117
24979972
Sleep. 2014 Jan 01;37(1):9-17
24470692
JAMA Intern Med. 2015 Apr;175(4):494-501
25686304
Sleep. 2014 Sep 01;37(9):1543-52
25142571
Sleep. 2012 Jun 01;35(6):727-34
22654183
Pflugers Arch. 2012 Jan;463(1):121-37
22071480
Pediatr Infect Dis J. 1988 Mar;7(3):229-38
3282216
Ann N Y Acad Sci. 1999;896:131-44
10681894
J Pers Soc Psychol. 2009 Dec;97(6):992-1004
19968415
Soc Sci Med. 2009 Aug;69(3):451-9
19524346
Brain Behav Immun. 2004 Jul;18(4):341-8
15157951
Clin Infect Dis. 2010 Jun 1;50(11):1439-47
20426575
Sleep. 2015 Sep 01;38(9):1353-9
26118561
Health Psychol. 2000 Nov;19(6):586-92
11129362
Psychiatry Res. 1989 May;28(2):193-213
2748771
PLoS Negl Trop Dis. 2008 Jun 25;2(6):e256
18575621
Ann N Y Acad Sci. 2010 Feb;1186:190-222
20201874
J Epidemiol Community Health. 2008 Jun;62(6):484-91
18477746
Eur Heart J. 2011 Jun;32(12):1484-92
21300732
Ann N Y Acad Sci. 2010 Feb;1186:223-39
20201875