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
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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.
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Subjective social isolation moderated the association between sleep disturbance and inflammation, making it stronger in those reporting social isolation.
“subjective social isolation was a significant moderator of this association between sleep disturbance and inflammation in which this relationship was significantly stronger in those who reported feelings of social isolation.”
From Sleep health: Reciprocal regulation of sleep and innate immunity (2017) · cites this paper as Cho et al, 2015
In CARDIA, sleep disturbance predicted inflammation (CRP and IL-6) 5 years later.
“sleep disturbance (ie, insomnia complaints and short sleep duration) was a significant predictor of inflammation (CRP and IL-6) 5 years later (Cho et al, 2015)”
From Sleep health: Reciprocal regulation of sleep and innate immunity (2017) · cites this paper as Cho et al, 2015
Important ramifications of low-grade inflammation include insulin resistance, endothelial dysfunction, atherosclerosis, neuroinflammation, and immunodeficiency due to impaired dendritic cell, T, and B cell functions, which can promote failure of tumor and pathogen defense.
“Important ramifications of low-grade inflammation are insulin resistance, endothelial dysfunction, atherosclerosis, and neuroinflammation (109, 244, 336, 485, 572), as well as immunodeficiency due to impaired DC, T, and B cell functions (80, 199, 422), which in turn can promote failure of tumor and pathogen defense (123, 426) (reviewed in Ref. 198).”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [109]
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- Authors
- Cho, H. J., Seeman, T. E., Kiefe, C. I., Lauderdale, D. S., & Irwin, M. R.
- Affiliations
- University of California, Los Angeles (US)
- University of Massachusetts Chan Medical School (US)
- University of Chicago (US)
- Corresponding author
- Cho, Hyong Jin
- Venue
- Brain, Behavior, and Immunity
- Publisher
- Elsevier BV
- Published
- 2015-05
- Volume
- 46
- Pages
- 319-326
- ISSN
- 0889-1591 (ISSN-L)
- PMC
- PMC4414819
- OpenAlex
- W2045027490
- Cited by
- 108
- References
- 51
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 18 · 2023: 9 · 2022: 14 · 2021: 17 · 2020: 10 · 2019: 8 · 2018: 6 · 2017: 6 · 2016: 4 · 2015: 4
- FWCI
- 10.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Brain Behavior and Immunity (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- University of Alabama at Birmingham (N01-HC-95095, N01-HC-48047)
- University of Minnesota (N01-HC-48048)
- Northwestern University (N01-HC-48049)
- Kaiser Foundation Research Institute (N01-HC-48050)
- University of California (N01-HC-45134)
- Harbor-University of California (N01-HC-05187)
- Wake Forest University (N01-HC-45205)
- New England Medical Center (N01-HC-45204)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- sleep disorders, insomnia, short sleep duration, systemic inflammation, C-reactive protein, interleukin-6, social isolation, social integration, social network size, moderating effect, young adults, CARDIA study
- MeSH terms
- Adult, C-Reactive Protein, Coronary Artery Disease, Female, Humans, Inflammation, Longitudinal Studies, Male, Middle Aged, Sleep, Sleep Wake Disorders, Social Behavior, Social Isolation, Interleukin-6
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