Extreme sleep durations and increased C-reactive protein: effects of sex and ethnoracial group
Open accessAbstract
STUDY OBJECTIVES: We hypothesize that extremes of sleep duration are associated with elevated C-reactive protein (CRP), a pro-inflammatory marker for cardiovascular disease risk. DESIGN: Cross-sectional. SETTING: Population-based research. PARTICIPANTS: Nationally representative sample of 2007-2008 National Health and Nutrition Examination Survey participants (n = 5,587 adults). INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Associations between CRP and self-reported total sleep time (TST) were examined. Explanatory models considered contributions of sex, age, race/ethnicity, body mass index (BMI), and BMI squared (BMI2). Models also explored the role of insomnia symptoms, sleep apnea, active medical illness, and antidiabetic/antihypertensive treatment. Differential patterns among race/ethnicity groups were examined using interactions and stratified analyses. Nonlinear relationships between CRP and TST were assessed using polynomial and multinomial regression models (< 5, 5, 6, 7, 8, 9, and > 9 h). Linear and squared terms were significant in all models in the complete sample, with notable differences by sex and ethnoracial group. Overall, in models adjusted for sociodemographics and BMI, different patterns were observed for non-Hispanic white (elevated CRP for < 5 h and > 9 h), black/African-American (elevated CRP for < 5 h and 8 h), Hispanic/Latino (elevated CRP for > 9 h), and Asian/ Other (higher in 9 and > 9 h and lower in 5 h and 6 h) groups. Ethnoracial groups also demonstrated patterning by sex. CONCLUSION: In a representative sample of American adults, elevated CRP was associated with extreme sleep durations. Sex, race/ethnicity, sleep disorders, and medical comorbidity influenced these associations. Differences in CRP along these dimensions should be considered in future research on sleep related disparities influencing cardiometabolic disease risk.
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Grandner et al found elevated CRP at extremes of sleep duration with different patterns by ethnoracial group.
“Grandner et al (2013) found that elevated levels of CRP were found at extremes of sleep duration, but different patterns were observed for various ethnic groups”
From Sleep health: Reciprocal regulation of sleep and innate immunity (2017) · cites this paper as Grandner et al, 2013
The relationship between sleep duration and C-reactive protein differed by race/ethnicity.
“Also, Grandner and colleagues(56) found that the relationship between sleep duration and C-reactive protein (a cardiovascular risk marker) differed by race/ethnicity.”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [56]
Several studies have shown that the relationship between sleep and cardiometabolic disease risk does depend on race/ethnicity.
“Although this has not yet been directly tested, several studies have shown that the relationship between sleep and cardiometabolic disease risk does depend on race/ethnicity.”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [56]
The study used previously established categories of self-reported sleep duration.
“previously established categories of self-reported sleep duration[2, 17, 47, 48]”
From Habitual sleep duration associated with self-reported and objectively determined cardiometabolic risk factors (2014) · cites this paper as [48]
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- Authors
- Grandner, M. A., Buxton, O. M., Jackson, N., Sands-Lincoln, M., Pandey, A., & Jean-Louis, G.
- Affiliations
- University of Pennsylvania (US)
- Brigham and Women's Hospital (US)
- Center for Evidence Based Medicine, Elsevier Inc., Philadelphia, PA
- SUNY Downstate Health Sciences University (US)
- Brooklyn Health Disparities Center, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY
- Corresponding author
- Grandner, Michael A.
- Venue
- SLEEP
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-05-01
- Volume
- 36
- Issue
- 5
- Pages
- 769-779
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC3624831
- OpenAlex
- W2092230362
- Cited by
- 178
- References
- 72
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 16 · 2023: 10 · 2022: 20 · 2021: 14 · 2020: 15 · 2019: 12 · 2018: 11 · 2017: 13 · 2016: 14 · 2015: 19 · 2014: 16 · 2013: 4
- FWCI
- 23.88
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- SLEEP (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (12S DG9180007)
- National Institute on Aging (P01AG009975)
- National Heart, Lung, and Blood Institute (T32HL007713, K23HL110216, R01HL107240)
- National Institute of Environmental Health Sciences (R21ES022931)
- National Center for Research Resources (UL1RR024134)
- 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 duration, C-reactive protein, inflammation, cardiovascular risk, sex differences, racial and ethnic differences, insomnia symptoms, sleep apnea, body mass index, cardiometabolic disease
- MeSH terms
- Adult, Aged, C-Reactive Protein, Cross-Sectional Studies, Ethnicity, Female, Humans, Male, Middle Aged, Nutrition Surveys, Sex Factors, Sleep Wake Disorders, United States, Biomarkers, White People, Self Report
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