Perceived Immune Status and Sleep: A Survey among Dutch Students
Open accessAbstract
Reduced immune functioning may have a negative impact on sleep and health, and vice versa. A survey among Dutch young adults (18–35 years old) was administered to collect information on perception of reduced immunity and its relationship to sleep disorders, sleep duration, and quality. Sleep disorders were assessed with the SLEEP-50 questionnaire subscales of sleep apnea, insomnia, circadian rhythm disorder, and daily functioning. Dutch young adults (N= 574) completed the survey. Among them, subjects (N= 209; 36.4%) reported perceived reduced immunity. Relative to those with a normal immune status, subjects reporting reduced immunity had significantly higher scores(p=0.0001)on sleep apnea (2.6 versus 3.6), insomnia (5.1 versus 6.8), and circadian rhythm disorder (2.1 versus 2.7). Subjects reporting reduced immunity also had significantly poorer daily functioning scores (5.4 versus 7.6,p=0.0001). No differences were observed in total sleep time, but those reporting reduced immunity had significantly poorer ratings of sleep quality (6.8 versus 7.2,p=0.0001). Our findings suggest that perceived reduced immunity is associated with sleep disturbances, impaired daily functioning, and a poorer sleep quality. Experimental studies including the assessment of immune biomarkers and objective measures of sleep (polysomnography) should confirm the current observations.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Leukocytes can sense and synthesize neuroendocrine mediators of the hypothalamic, pituitary, and glandular level and can form their own local neuroendocrine axis in an autocrine and paracrine manner.
“Leukocytes can sense and synthesize a plethora of neuroendocrine mediators of the hypothalamic, pituitary, and glandular level [e.g., corticotropin releasing hormone, adrenocorticotropic hormone, cortisol; growth hormone releasing hormone, growth hormone (GH), insulin-like growth factor-1; dopamine, prolactin] and can even form an own, local neuroendocrine axis in an autocrine and paracrine manner”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [155]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The effect of infections on susceptibility to autoimmune and allergic diseases.
Bach, J. (2002) · New England Journal of Medicine · doi:10.1056/nejmra020100 · Cited by 2,714 · see citing works
Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk
Meier-Ewert, H. K., Ridker, P. M., Rifai, N., Regan, M. M., Price, N. J., Dinges, D. F., & Mullington, J. M. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2003.07.050 · Cited by 1,195 · see citing works
Yokoe, T., Minoguchi, K., Matsuo, H., Oda, N., Minoguchi, H., Yoshino, G., Hirano, T., & Adachi, M. (2003) · Circulation · doi:10.1161/01.cir.0000052627.99976.18 · Cited by 961 · see citing works
Sleep Deprivation and Activation of Morning Levels of Cellular and Genomic Markers of Inflammation
Irwin, M. R. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.16.1756 · Cited by 850 · see citing works
How (and why) the immune system makes us sleep
Imeri, L., & Opp, M. R. (2009) · Nature Reviews Neuroscience · doi:10.1038/nrn2576 · Cited by 710 · see citing works
Effects of sleep and circadian rhythm on human circulating immune cells
Born, J., Lange, T., Hansen, K., Mölle, M., & Fehm, H. L. (1997) · The Journal of Immunology · doi:10.4049/jimmunol.158.9.4454 · Cited by 611 · see citing works
Sleep habits and susceptibility to the common cold
Cohen, S., Doyle, W. J., Alper, C. M., Janicki-Deverts, D., & Turner, R. B. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2008.505 · Cited by 605 · see citing works
Effects of sleep and circadian rhythm on the human immune system
Lange, T., Dimitrov, S., & Born, J. (2010) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2009.05300.x · Cited by 591 · see citing works
Davis, M. S. (2002) · The Concise Dictionary of Crime and Justice · doi:10.4135/9781452229300.n390 · Cited by 507 · see citing works
Serum Inflammatory Markers in Obstructive Sleep Apnea: A Meta-Analysis
Nadeem, R. N., Molnár, J., Madbouly, E. M., Nida, M., Aggarwal, S., Hassan, S., Naseem, J., & Loomba, R. S. (2013) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.3070 · Cited by 486 · see citing works
Immune, inflammatory and cardiovascular consequences of sleep restriction and recovery
Faraut, B., Boudjeltia, K. Z., Vanhamme, L., & Kerkhofs, M. (2012) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2011.05.001 · Cited by 418 · see citing works
Irwin, M. R., Thompson, J., Miller, C., Gillin, J. C., & Ziegler, M. G. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.6.5788 · Cited by 389 · see citing works
Effects of sleep and sleep loss on immunity and cytokines
Irwin, M. R. (2002) · Brain Behavior and Immunity · doi:10.1016/s0889-1591(02)00003-x · Cited by 366 · see citing works
Irwin, M. R., Olmstead, R., Carrillo, C., Sadeghi, N., Breen, E. C., Witarama, T., Yokomizo, M., Lavretsky, H., Carroll, J. E., Motivala, S. J., et al. (2014) · Sleep · doi:10.5665/sleep.4008 · Cited by 303 · see citing works
Links between the innate immune system and sleep
Majde, J. A., & Krueger, J. M. (2005) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2005.08.005 · Cited by 277 · see citing works
Kronholm, E., Partonen, T., Laatikainen, T. K., Peltonen, M., Härmä, M., Hublin, C., Kaprio, J. A., Aro, A. R., Partinen, M., Fogelholm, M., et al. (2008) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2008.00627.x · Cited by 268 · see citing works
Sleep deprivation and human immune function
Dinges, D. F., Douglas, S. D., Hamarman, S., Zaugg, L., & Kapoor, S. C. (1995) · Advances in Neuroimmunology · doi:10.1016/0960-5428(95)00002-j · Cited by 234 · see citing works
Initial Validation of the SLEEP-50 Questionnaire
Spoormaker, V. I., Verbeek, I., van den Bout, J., & Klip, E. C. (2005) · Behavioral Sleep Medicine · doi:10.1207/s15402010bsm0304_4 · Cited by 229 · see citing works
The relationship of interleukin-1 and immune functions to sleep in humans.
Moldofsky, H., Lue, F. A., Eisen, J. S., Keystone, E., & Gorczynski, R. M. (1986) · Psychosomatic Medicine · doi:10.1097/00006842-198605000-00001 · Cited by 229 · see citing works
Sleep and Antibody Response to Hepatitis B Vaccination
Prather, A. A., Hall, M., Fury, J. M., Ross, D. C., Muldoon, M. F., Cohen, S., & Marsland, A. L. (2012) · SLEEP · doi:10.5665/sleep.1990 · Cited by 207 · see citing works
Chronic Insomnia and Immune Functioning
Savard, J., Laroche, L., Simard, S., Ivers, H., & Morin, C. M. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000033126.22740.f3 · Cited by 189 · see citing works
Irwin, M. R., Witarama, T., Caudill, M. M., Olmstead, R., & Breen, E. C. (2014) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2014.09.017 · Cited by 163 · see citing works
Sleep and Inflammation: Psychoneuroimmunology in the Context of Cardiovascular Disease
Motivala, S. J. (2011) · Annals of Behavioral Medicine · doi:10.1007/s12160-011-9280-2 · Cited by 151 · see citing works
Lorton, D., Lubahn, C. L., Estus, C., Millar, B. A., Carter, J. L., Wood, C. A., & Bellinger, D. L. (2006) · NeuroImmunoModulation · doi:10.1159/000104864 · Cited by 147 · see citing works
Ruiz, F. S., Andersen, M. L., Martins, R. C., Zager, A., Lopes, J. D., & Tufik, S. (2012) · Innate Immunity · doi:10.1177/1753425910385962 · Cited by 132 · see citing works
The Sleep-Immunity Relationship
Gamaldo, C. E., Shaikh, A. K., & McArthur, J. C. (2012) · Neurologic Clinics · doi:10.1016/j.ncl.2012.08.007 · Cited by 124 · see citing works
Interleukin-6 serum levels in healthy persons correspond to the sleep-wake cycle
Bauer, J., Hohagen, F., Ebert, T. H., Timmer, J., Ganter, U., Krieger, S., Lis, S., Postler, E., Voderholzer, U., & Berger, T. (1994) · Journal of Molecular Medicine · doi:10.1007/bf00180048 · Cited by 89 · see citing works
Sleep and Quality of Life in Clinical Medicine
Verster, J. C. (2008) · Humana Press eBooks · doi:10.1007/978-1-60327-343-5 · Cited by 81 · see citing works
Self-citationEffects of an experimentally induced rhinovirus cold on sleep, performance, and daytime alertness
Drake, C. L., Roehrs, T. A., Royer, H., Koshorek, G., Turner, R. B., & Roth, T. (2000) · Physiology & Behavior · doi:10.1016/s0031-9384(00)00322-x · Cited by 71 · see citing works
Self-citationImpact of partial sleep deprivation on immune markers
Wilder‐Smith, A., Mustafa, F., Earnest, A., Gen, L., & MacAry, P. A. (2013) · Sleep Medicine · doi:10.1016/j.sleep.2013.07.001 · Cited by 65 · see citing works
Sleep patterns are associated with common illness in adolescents
Orzech, K. M., Acebo, C., Seifer, R., Barker, D., & Carskadon, M. A. (2013) · Journal of Sleep Research · doi:10.1111/jsr.12096 · Cited by 63 · see citing works
Social and Demographic Factors Related to Sleep Duration
Patel, S. R. (2007) · SLEEP · doi:10.1093/sleep/30.9.1077 · Cited by 61 · see citing works
Mossad, S. B. (1998) · BMJ · doi:10.1136/bmj.317.7150.33 · Cited by 58 · see citing works
Dimitrov, S., Besedovsky, L., Born, J., & Lange, T. (2015) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2014.11.017 · Cited by 56 · see citing works
Biological consequences of disturbed sleep: Important mediators of health?1
Okun, M. L. (2011) · Japanese Psychological Research · doi:10.1111/j.1468-5884.2011.00463.x · Cited by 47 · see citing works
Smith, A. P. (2012) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2012.09.002 · Cited by 44 · see citing works
Viral Respiratory Infections Due to Rhinoviruses: Current Knowledge, New Developments
Fendrick, A. M. (2003) · American Journal of Therapeutics · doi:10.1097/00045391-200305000-00006 · Cited by 41 · see citing works
Roth, T. G. (2009) · Sleep Medicine · doi:10.1016/j.sleep.2009.07.006 · Cited by 19 · see citing works
Self-citation
Flagged first, then by citations
1 of the 39 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
The Sleep-Immune Crosstalk in Health and Disease
Besedovsky, L., Lange, T., & Haack, M. (2019) · Physiological Reviews · doi:10.1152/physrev.00010.2018 · Cited by 1,479 · see citing works
“This notion is in line with a study showing that participants reporting a perceived reduced immunity had poorer ratings of sleep quality, but did not differ in sleep duration compared with participants reporting a normal immune status (154).”
ResultDevelopment and Validation of the Immune Status Questionnaire (ISQ)
Versprille, L. J. F. W., van de Loo, A. J. A. E., Mackus, M., Arnoldy, L., Sulzer, T. A. L., Vermeulen, S. A., Abdulahad, S., Huls, H., Baars, T., Scholey, A. B., et al. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16234743 · Cited by 111 · see citing works
Self-citationMental resilience, perceived immune functioning, and health
Lantman, M. V. S., Mackus, M., Otten, L., de Kruijff, D., van de Loo, A. J., Kraneveld, A., Garssen, J., & Verster, J. (2017) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s130432 · Cited by 69 · see citing works
Self-citationCOVID-19 Lockdown-Related Changes in Mood, Health and Academic Functioning
Hendriksen, P. A., Garssen, J., Bijlsma, E. Y., Engels, F., Bruce, G., & Verster, J. C. (2021) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe11040103 · Cited by 48 · see citing works
Self-citationSleep Immune Cross Talk and Insomnia
Akkaoui, M. A., Palagini, L., & Geoffroy, P. A. (2023) · Advances in experimental medicine and biology · doi:10.1007/978-981-19-7376-5_12 · Cited by 41 · see citing works
The Assessment of Immune Fitness
Verster, J. C., Kraneveld, A. D., & Garssen, J. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm12010022 · Cited by 38 · see citing works
Self-citationThe Association of Insomnia, Perceived Immune Functioning, and Irritable Bowel Syndrome Complaints
Balikji, S., Mackus, M., Brookhuis, K., Garssen, J., Kraneveld, A. D., Roth, T. G., & Verster, J. C. (2018) · Journal of Clinical Medicine · doi:10.3390/jcm7090238 · Cited by 30 · see citing works
Self-citationThe Impact of Mood and Subjective Intoxication on Hangover Severity
Verster, J. C., Arnoldy, L., van de Loo, A. J. A. E., Benson, S., Scholey, A. B., & Stock, A. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9082462 · Cited by 26 · see citing works
Self-citationVerster, J. C., Išerić, E., Ulijn, G. A., Oskam, S. M. P., & Garssen, J. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13175217 · Cited by 22 · see citing works
Self-citationRelationship between Alcohol Hangover and Physical Endurance Performance: Walking the Samaria Gorge
Verster, J. C., Anogeianaki, A., Kruisselbrink, L. D., Alford, C., & Stock, A. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm9010114 · Cited by 20 · see citing works
Self-citationAbdulahad, S., Huls, H., Balikji, S., van de Loo, A. J. A. E., Roth, T. G., & Verster, J. C. (2019) · Sleep and Vigilance · doi:10.1007/s41782-019-00066-4 · Cited by 19 · see citing works
Self-citationThe Impact of Having a Holiday or Work in Fiji on Perceived Immune Fitness
Verster, J. C., Arnoldy, L., van de Loo, A. J. A. E., Kraneveld, A. D., Garssen, J., & Scholey, A. B. (2021) · Tourism and Hospitality · doi:10.3390/tourhosp2010006 · Cited by 16 · see citing works
Self-citationPoluektov, M. G. (2021) · Neuroscience and Behavioral Physiology · doi:10.1007/s11055-021-01113-2 · Cited by 14 · see citing works
Koyun, A. H., Hendriksen, P. A., Kiani, P., Merlo, A., Balikji, J., Stock, A., & Verster, J. C. (2022) · Data · doi:10.3390/data7090125 · Cited by 12 · see citing works
Self-citationMackus, M., de Kruijff, D., Otten, L. S., Kraneveld, A. D., Garssen, J., & Verster, J. C. (2017) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph14040409 · Cited by 10 · see citing works
Self-citationPoluektov, M. G. (2020) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro20201200926 · Cited by 10 · see citing works
Balikji, J., Hoogbergen, M. M., Garssen, J., Roth, T. G., & Verster, J. C. (2022) · Medicina · doi:10.3390/medicina58081049 · Cited by 11 · see citing works
Self-citationRong, M., Jia, J., Lin, M.-Q., He, X., Xie, Z., Wang, N., Zhang, Z.-H., Dong, Y., Xu, W., Huang, J.-H., et al. (2024) · Chinese Medicine · doi:10.1186/s13020-024-00939-5 · Cited by 9 · see citing works
Fan, C.-W., Drumheller, K., Chen, I., & Huang, H. (2021) · Sleep Epidemiology · doi:10.1016/j.sleepe.2021.100004 · Cited by 9 · see citing works
The concept and assessment of immune fitness
Verster, J. C., Išerić, E., & Garssen, J. (2023) · Exploration of Immunology · doi:10.37349/ei.2023.00116 · Cited by 8 · see citing works
Self-citationAre questionnaires reliable in diagnosing sleep-disordered breathing in university students?
Migacz, E., Wichniak, A., & Kukwa, W. (2017) · The Journal of Laryngology & Otology · doi:10.1017/s0022215117001839 · Cited by 7 · see citing works
Hendriksen, P. A., Kiani, P., Merlo, A., Karadayian, A. G., Czerniczyniec, A., Lores‐Arnaiz, S., Bruce, G., & Verster, J. C. (2022) · Data · doi:10.3390/data7090131 · Cited by 6 · see citing works
Self-citationAlharbi, A. S., Altwaim, S. A., Alharbi, A. S., & Alsulami, S. (2023) · Cureus · doi:10.7759/cureus.33211 · Cited by 4 · see citing works
Jayanthi, C. R., HR, A., Sridhar, S., Akhila, K., Sridhar, S., & Kumawat, R. (2021) · Asian Journal of Pharmaceutical and Clinical Research · doi:10.22159/ajpcr.2021.v14i8.42035 · Cited by 3 · see citing works
Immune fitness and lifestyle habits of Saudi medical students: a cross sectional study
Alharbi, A. S. (2023) · PeerJ · doi:10.7717/peerj.14363 · Cited by 3 · see citing works
Hubungan Kadar HbA1c dan Kualitas Tidur pada Pasien Diabetes Melitus Tipe 2
Zahra, A. N., & Farida, M. E. (2020) · Jurnal Persatuan Perawat Nasional Indonesia (JPPNI) · doi:10.32419/jppni.v3i3.170 · Cited by 3 · see citing works
Matsui, K., Suzuki, M., Arai, K., Sekiguchi, H., Inoue, F., Hagiwara, N., & Nishimura, K. (2023) · Sleep Medicine · doi:10.1016/j.sleep.2023.02.020 · Cited by 2 · see citing works
Predictors of Immune Fitness and the Alcohol Hangover: Survey Data from UK and Irish Adults
Verster, J. C., Merlo, A., Zijlstra, M. N., van der Weij, B. R. C., Boogaard, A. S., Schulz, S., Balikji, J., Kim, A. J., Stewart, S. H., Sherry, S. B., et al. (2025) · Data · doi:10.3390/data10040049 · Cited by 1 · see citing works
Self-citationLee, J.-Y., Liu, Y.-H., Hsieh, C. L., & Lung, F. (2025) · Science Progress · doi:10.1177/00368504251405328 · Cited by 1 · see citing works
Alharbi, A. S. (2026) · Healthcare · doi:10.3390/healthcare14081046 · Cited by 1 · see citing works
Development of the immune status questionnaire (ISQ)
van de Loo, A. J. A. E., Versprille, L. J. F. W., Mackus, M., Kraneveld, A. D., Garssen, J., & Verster, J. C. (2019) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2018.11.468 · Cited by 1 · see citing works
Self-citationKiani, P., Hendriksen, P. A., Kim, A. J., Garssen, J., & Verster, J. C. (2024) · Viruses · doi:10.3390/v16071031 · Cited by 1 · see citing works
Self-citationInnovative drug monitoring of factor VIII and emicizumab in haemophilia A
Donners, A. A. M. T. (2023) · doi:10.33540/1772
Self-citationIšerić, E., Ulijn, G. A., Oskam, S. M. P., Bruce, G., Garssen, J., & Verster, J. C. (2025) · Brain Behavior and Immunity Integrative · doi:10.1016/j.bbii.2025.100126
Self-citation
- Authors
- Donners, A. A. M. T., Tromp, M. D. P., Garssen, J., Roth, T., & Verster, J. C.
- Affiliations
- Henry Ford Health (US)
- Utrecht University (NL)
- Corresponding author
- Verster, Joris C.
- Venue
- Sleep Disorders
- Publisher
- Hindawi Limited
- Published
- 2015
- Volume
- 2015
- Pages
- 1-5
- ISSN
- 2090-3545 (ISSN-L)
- 2090-3553
- PMC
- PMC4581572
- OpenAlex
- W1907355990
- Cited by
- 40
- References
- 39
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 10 · 2022: 4 · 2021: 5 · 2020: 3 · 2019: 5 · 2018: 1 · 2017: 3
- FWCI
- 2.01
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Sleep Disorders (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Figshare (submittedVersion, cc-by)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion, cc-by)
- Swinburne figshare (Swinburne University of Technology) (cc-by)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- sleep apnea, insomnia, circadian rhythm disorders, sleep quality, daily functioning, young adults
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review