Gender differences in the prospective associations of self-reported sleep quality with biomarkers of systemic inflammation and coagulation: Findings from the Heart and Soul Study
Open accessAbstract
Systemic inflammation is proposed as a putative mechanism underlying the link between poor sleep and cardiovascular disease. The aim of present study was to investigate the cross-sectional and prospective associations of self-reported sleep quality with biomarkers of inflammation and coagulation implicated in coronary heart disease (CHD) and to explore whether these associations differed between men and women. To this end, measures of sleep quality and markers of inflammation, including circulating levels of interleukin-6 (IL-6), high-sensitivity C-reactive protein (CRP), and fibrinogen were assessed at baseline in 980 participants with established CHD and 626 at 5-year follow-up. In the sample as a whole, subjective sleep quality was unrelated to inflammatory markers in cross-sectional and prospective analyses. However, in gender stratified analyses, adjusting for age, ethnicity, education, body mass index, and regular snoring, poorer subjective sleep quality at baseline was prospectively associated with 5-year increases in IL-6 (b = 0.14, SE = 0.05, p = 0.003), CRP (b = 0.21, SE = 0.09, p = 0.02), and fibrinogen (b = 18.02, SE = 7.62, p = 0.02) in women but not men. These associations remained independent of lifestyle/psychosocial factors, medical comorbidities, medication use, and cardiac function. Women who reported baseline sleep disturbances characterized by a tendency to wake up too early in the morning also showed significant 5-year increases in circulating IL-6 that withstood covariate adjustment. Further research is necessary to elucidate the pathways that underlie gender-specific associations between subjective sleep quality and markers of inflammation and coagulation as this may help clarify gender disparities in CHD.
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In a prospective study of 980 participants with cardiovascular disease, poorer subjective sleep quality was prospectively associated with 5-year increases in IL-6, CRP, and fibrinogen in women but not men.
“poorer subjective sleep quality was prospectively associated with 5year increase in IL-6, CRP, and fibrinogen in women but not men (Prather et al, 2013).”
From Sleep health: Reciprocal regulation of sleep and innate immunity (2017) · cites this paper as Prather et al, 2013
Other studies reported an association between self-reported indices of sleep disturbances and higher CRP levels in women only.
“Other studies reported such an association in women only”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [445]
In a longitudinal study in over 600 adults, lower subjective sleep quality at baseline (PSQI) was prospectively associated with 5-year increases in IL-6 levels in females, but not males.
“a longitudinal study in over 600 adults, in which lower subjective sleep quality at baseline (assessed with the PSQI) was prospectively associated with 5-yr increases in IL-6 levels in females, but not males”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [445]
Poorer sleep quality was associated with greater IL-6 reactivity following a psychosocial stressor in postmenopausal women.
“poorer sleep quality was recently found to be associated with greater IL-6 reactivity following a psychosocial stressor in postmenopausal women”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [445]
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- Authors
- Prather, A. A., Epel, E. S., Cohen, B. E., Neylan, T. C., & Whooley, M. A.
- Affiliations
- University of California, San Francisco (US)
- San Francisco VA Medical Center (US)
- Corresponding author
- Prather, Aric A.
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2013-09
- Volume
- 47
- Issue
- 9
- Pages
- 1228-1235
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC3864775
- OpenAlex
- W2082580858
- Cited by
- 100
- References
- 67
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 9 · 2023: 9 · 2022: 10 · 2021: 8 · 2020: 11 · 2019: 12 · 2018: 2 · 2017: 4 · 2016: 9 · 2015: 6 · 2014: 5 · 2013: 4
- FWCI
- 10.81
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (K08HL112961, R01HL079235)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- sleep quality, subjective sleep quality, systemic inflammation, coagulation, interleukin-6, C-reactive protein, fibrinogen, coronary artery disease, gender differences, women, cardiovascular risk, early morning awakening, sleep disorders, Heart and Soul Study
- MeSH terms
- Aged, C-Reactive Protein, Coronary Disease, Cross-Sectional Studies, Female, Fibrinogen, Hospitals, Veterans, Humans, Inflammation, Longitudinal Studies, Male, Middle Aged, Retrospective Studies, Sex Characteristics, Sleep Wake Disorders, Biomarkers, Interleukin-6, Self Report
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