Sleep Habits and Susceptibility to Upper Respiratory Illness: the Moderating Role of Subjective Socioeconomic Status
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ORIGINAL ARTICLE
Sleep Habits and Susceptibility to Upper Respiratory Illness: the Moderating Role of Subjective Socioeconomic Status Aric A. Prather, PhD 1,2 & Denise Janicki-Deverts, PhD 4 & Nancy E. Adler, PhD 1,2 & Martica Hall, PhD 3 & Sheldon Cohen, PhD 4
# The Society of Behavioral Medicine 2016
Abstract Background Sleep is a predictor of infectious illness that may depend on one’s socioeconomic status (SES). Purpose This study aimed to investigate the moderating effects of objective and subjective SES on sleep-clinical cold risk link and test whether nasal inflammation serves as a plausible biological pathway. Methods This study combined data (n = 732) from three viral challenge studies. Measures of self-reported sleep and objective and subjective measures of SES were obtained. Participants were quarantined and administrated rhinovirus (RV) or influenza virus and monitored over 5 (RV) or 6 (influenza) days for the development of a cold. Symptom severity, including mucus production and nasal clearance time, and levels of nasal cytokines (interleukin (IL)-6 and IL-1β) were measured prior to administration and each day during the quarantined period. Results Subjective SES, but not objective SES, moderated associations between shorter sleep duration and increased likelihood of a clinical cold. Compared to ≥8-hour sleepers, ≤6-hour sleepers with low subjective SES were at increased * Aric A. Prather [email protected] * Sheldon Cohen [email protected] 1
Department of Psychiatry, University of California, San Francisco, CA, USA
2
Center for Health and Community, University of California, San Francisco, CA, USA
3
Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
4
Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
risk for developing a cold (OR = 2.57, 95% CI 1.10–6.02). There was no association between sleep duration and colds in high subjective SES participants. Among infected individuals who reported low subjective SES, shorter sleep duration was associated with greater mucus production. There was no evidence that markers of nasal inflammation mediated the link between sleep duration and cold susceptibility among those reporting low subjective SES. Conclusion Subjective SES may reflect an important social factor for understanding vulnerability to and protection against infectious illness among short sleepers. Keywords Sleep . Upper respiratory infection . Socioeconomic status . Cytokines
Introduction Sleep has emerged as a critical factor in the promotion and maintenance of physical health [1, 2]. Poor sleep, as characterized by short sleep duration (e.g., sleeping fewer than 6 h per night), poor sleep efficiency, and poor subjective sleep quality, predicts incidence and severity of a number of chronic medical conditions, including cardiovascular disease, type 2 diabetes [3, 4], and susceptibility to acute infectious illness [5, 6]. While the mechanisms that underlie these associations remain unclear, there is growing appreciation for the i
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