Sleep disturbances and inflammatory biomarkers in schizophrenia: focus on sex differences
Open accessAbstract
Objectives Persons with schizophrenia, and women in particular, are at high risk for sleep disturbances and inflammatory activation. The sleep-inflammation link has been reported to be stronger in women within the general population. This study sought to examine the sleep-inflammation link in persons with schizophrenia and its relationship with demographic, clinical and cognitive variables.Design Cross-sectional case-control study.Participants Community-dwelling outpatients with schizophrenia (N=144, 46% women) and non-psychiatric comparison (NC) participants (N=134, 52% women), age 26-65 years.Measurements Reported sleep disturbances (sleep quality and duration), and mental and physical health were assessed. Cognitive assessments included executive functioning (Delis-Kaplan Executive Function System) and global cognitive functioning (Telephone Interview for Cognitive Status - modified.) Inflammatory biomarkers included pro-inflammatory cytokines [high sensitivity C-Reactive Protein (hs-CRP), Interleukin (IL)-6, Tumor Necrosis Factor-α (TNF-α)] and an anti-inflammatory cytokine (IL-10).Results The schizophrenia group had longer sleep duration, worse sleep quality, and increased levels of hs-CRP, IL-6, and TNF-α compared to NCs. Women with schizophrenia were less likely to have good sleep quality and had elevated levels of hs-CRP and IL-6 compared to men with schizophrenia. In the schizophrenia group, worse sleep quality and global cognitive functioning were associated with higher hs-CRP and IL-6 levels. Female sex and younger age were also associated with higher hs-CRP levels.Conclusions Sleep disturbances and increased inflammation, which were common in schizophrenia, were associated in persons with schizophrenia. Moreover, women with schizophrenia had worse sleep quality and inflammation than men. Further examination of the sleep-inflammation links, their contribution to clinical outcomes, and sex-specific factors is warranted.
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In patients diagnosed with schizophrenia, poorer sleep is cross-sectionally associated with inflammatory markers.
“In patients diagnosed with schizophrenia, poorer sleep is cross-sectionally associated with inflammatory markers.”
From Towards an Integrative Account of Potential Mechanisms Mediating the Path From Sleep Dysfunction to Hallucinations (2025) · cites this paper as [80]
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References 77 · Cited by 58
Research works printed but not linked: 1
- [48]First M, Spitzer RL, Gibbon M, Wiliams JBW: Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition. (SCID-I/P), New York, Biometrics Research, New York State Psychiatric Institute, 11 2002
- Authors
- Lee, E. E., Ancoli-Israel, S., Eyler, L. T., Tu, X. M., Palmer, B. W., Irwin, M. R., & Jeste, D. V.
- Affiliations
- University of California San Diego (US)
- University of California, Los Angeles (US)
- Corresponding author
- Jeste, Dilip V.
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2019-01
- Volume
- 27
- Issue
- 1
- Pages
- 21-31
- ISSN
- 1064-7481 (ISSN-L)
- PMC
- PMC6489497
- OpenAlex
- W2897989682
- Cited by
- 58
- References
- 77
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 7 · 2023: 10 · 2022: 8 · 2021: 11 · 2020: 5 · 2019: 2 · 2017: 2
- FWCI
- 1.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Mental Health (R01MH094151, T32MH019934)
- Topics
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- schizophrenia, sleep disorders, sleep quality, sleep duration, inflammatory markers, sex differences, women with schizophrenia, C-reactive protein, interleukin-6, TNF-α, IL-10, cytokines, cognitive function, executive function, mental health
- MeSH terms
- Adult, Aged, C-Reactive Protein, Cross-Sectional Studies, Female, Humans, Inflammation, Male, Middle Aged, Schizophrenia, Sex Characteristics, Sleep Wake Disorders, Tumor Necrosis Factor-alpha, Interleukin-6, Comorbidity, Case-Control Studies, Cognitive Dysfunction
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