Sleep characteristics as predictor variables of stress systems markers in insomnia disorder
Abstract
Summary: This study investigates the extent to which sleep characteristics serve as predictor variables for inflammatory, hypothalamic–pituitary–adrenal and autonomic systems markers. Twenty‐nine participants with a diagnosis of insomnia disorder based on the Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (age 25.3 ± 1.6 years, insomnia duration 6.6 ± 0.8 years) and 19 healthy control sleepers (age 25.4 ± 1.4 years) underwent a 2‐week at‐home evaluation keeping a sleep diary and wearing an actigraph, followed by a visit to the Research Center to measure blood pressure, and collect blood and urine samples. The actigraphy‐ and diary‐based variables of sleep duration, sleep‐onset latency, wake after sleep onset and sleep fragmentation/number of night‐time awakenings were averaged and entered as dependent variables in regression analyses. Composite scores were calculated for the autonomic (blood pressure, norepinephrine), inflammatory (monocyte counts, interleukin‐6, C‐reactive protein) and hypothalamic–pituitary–adrenal systems (cortisol), and used as predictor variables in regression models. Compared with controls, individuals with insomnia had a shorter sleep duration ( P < 0.05), and a higher hypothalamic–pituitary–adrenal and inflammatory composite score ( P < 0.05). The higher inflammatory score was mainly due to higher circulating monocytes ( P < 0.05), rather than differences in interleukin‐6 or C‐reactive protein. In persistent insomnia disorder, cortisol is upregulated and associated with actigraphy‐ and diary‐based wake after sleep onset, suggesting that wake after sleep onset may serve as a marker to identify individuals at increased risks for disorders associated with a hyperactive hypothalamic–pituitary–adrenal system. The absence of autonomic and pro‐inflammatory changes (interleukin‐6, C‐reactive protein), despite a substantial decrease in actigraphic sleep duration, may relate to a higher resilience to the adverse biological consequences of insomnia in this young age group.
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From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [192]
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- Authors
- Floam, S., Simpson, N., Nemeth, E., Scott‐Sutherland, J., Gautam, S., & Haack, M.
- Affiliations
- Harvard University (US)
- Stanford University (US)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Haack, Monika
- ORCID
- Haack, Monika
- Venue
- Journal of Sleep Research
- Publisher
- Wiley
- Published
- 2014-12-18
- Volume
- 24
- Issue
- 3
- Pages
- 296-304
- ISSN
- 0962-1105 (ISSN-L)
- 1365-2869
- OpenAlex
- W2095668709
- Cited by
- 103
- References
- 35
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 10 · 2023: 15 · 2022: 9 · 2021: 10 · 2020: 10 · 2019: 13 · 2018: 12 · 2017: 4 · 2016: 6 · 2015: 2
- FWCI
- 5.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Sleep Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources to the Harvard Clinical and Translational Science Centre (RR025758, M01-RR-01032)
- Sleep Research Foundation Society
- Sepracor Inc.
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- insomnia, sleep characteristics, hypothalamic-pituitary-adrenal axis, inflammatory markers, autonomic nervous system, cortisol, interleukin-6, C-reactive protein, monocytes, norepinephrine, sleep duration, wake after sleep onset, sleep latency, sleep fragmentation, actigraphy, sleep diary, young adults, resilience
- MeSH terms
- Adolescent, Adult, Blood Pressure, C-Reactive Protein, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Inflammation, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Monocytes, Norepinephrine, Pituitary-Adrenal System, Sleep, Stress, Physiological, Time Factors, Biomarkers, Interleukin-6, Case-Control Studies, Young Adult, Actigraphy
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