Self-reported symptoms of sleep disturbance and inflammation, coagulation, insulin resistance and psychosocial distress: Evidence for gender disparity
Open accessAbstract
Self-reported ratings of sleep quality and symptoms of poor sleep have been linked to increased risk of coronary heart disease (CHD), Type 2 diabetes and hypertension with recent evidence suggesting stronger associations in women. At this time, the mechanisms of action that underlie these gender-specific associations are incompletely defined. The current study examined whether gender moderates the relation of subjective sleep and sleep-related symptoms to indices of inflammation, coagulation, insulin resistance (IR) and psychosocial distress, factors associated with increased risk of cardiovascular and metabolic disorders. Subjects were 210 healthy men and women without a history of sleep disorders. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality and frequency of sleep symptoms. In multivariate-adjusted models, overall poor sleep quality, more frequent problems falling asleep (>2 night/week) and longer periods to fall asleep (>30 min) were associated with greater psychosocial distress, higher fasting insulin, fibrinogen and inflammatory biomarkers, but only for women. The data suggest that subjective ratings of poor sleep, greater frequency of sleep-related symptoms, and longer period of time to fall asleep are associated with a mosaic of biobehavioral mechanisms in women and that these gender-specific associations have direct implications to recent observations suggesting gender differences in the association between symptoms of poor sleep and cardiovascular disease.
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Overall poor sleep quality was associated with increased inflammatory biomarkers only in women.
“Suarez (2008) found that overall poor sleep quality was associated with increased inflammatory biomarkers, but only for women, similar to the findings of Friedman et al (2005) in older adults.”
From Sleep health: Reciprocal regulation of sleep and innate immunity (2017) · cites this paper as Suarez, 2008
Recognition and response take place during the early immediate pro-inflammatory phase that is supported by actions of the stress axes, such as priming of immune cells and inflammation, and mobilization of energy substrates to fuel the immune system.
“Recognition and response take place during the early immediate pro-inflammatory phase that is supported by actions of the stress axes, such as priming of immune cells and inflammation, and mobilization of energy substrates to fuel the immune system (86, 288, 528).”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [528]
Many observational studies have found cross-sectional associations indicating a higher prevalence of diabetes among short sleepers and among those with poor subjective sleep quality.
“Many have found cross-sectional associations that indicated a higher prevalence of diabetes among short sleepers (7–9) and among those with poor subjective sleep quality (10,11).”
From Cross-Sectional Associations Between Measures of Sleep and Markers of Glucose Metabolism Among Subjects With and Without Diabetes (2011) · cites this paper as [11]
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- Authors
- Suarez, E. C.
- Affiliations
- Duke University (US)
- Corresponding author
- Suarez, Edward C.
- ORCID
- Suarez, Edward C.
- Venue
- Brain, Behavior, and Immunity
- Publisher
- Elsevier BV
- Published
- 2008-08
- Volume
- 22
- Issue
- 6
- Pages
- 960-968
- ISSN
- 0889-1591 (ISSN-L)
- PMC
- PMC3652592
- OpenAlex
- W2076304654
- Cited by
- 248
- References
- 71
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 6 · 2023: 11 · 2022: 18 · 2021: 12 · 2020: 18 · 2019: 15 · 2018: 15 · 2017: 8 · 2016: 16 · 2015: 19 · 2014: 13 · 2013: 27 · 2012: 15
- FWCI
- 19.96
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- Locations
- Brain Behavior and Immunity (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL067459, HL67459)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- sleep disorders, sleep quality, gender differences, psychosocial distress, inflammation, coagulation, insulin resistance, fibrinogen, insulin, Pittsburgh Sleep Quality Index, sleep latency, cardiovascular risk, metabolic disorders
- MeSH terms
- Adult, Blood Coagulation, Cardiovascular Diseases, Fasting, Female, Fibrinogen, Humans, Inflammation, Insulin, Insulin Resistance, Male, Surveys and Questionnaires, Risk Factors, Sex Factors, Sleep Wake Disorders, Biomarkers
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