Original Article

Sleep Duration and C-Reactive Protein in US Adults

Authors: Michael R. Richardson, MSH, ACSM EP-C, James R. Churilla, PhD, MPH

Abstract

Objective: To use gender-stratified logistic regression analysis to examine the associations between elevated C-reactive protein (CRP; >3–10 mg/L) and sleep duration.

Methods: The study sample included male (n = 5033) and female (n = 4917) adult (20 years old and older) participants in the 2007–2010 National Health and Nutrition Examination Survey. Sleep duration was categorized as short (≤6 hours/day), adequate (7–8 hours/day), or long (≥9 hours/day). Logistic regression models were adjusted for age, race, smoking status, physical activity, and waist circumference.

Results: Analysis revealed significantly (P = 0.0151) higher odds of elevated CRP in men reporting ≤6 hours/day of sleep (odds ratio 1.26, 95% confidence interval 1.05–1.52) when compared with a referent group of men reporting 7 to 8 hours/day of sleep. Similar associations were not revealed in women.

Conclusions: Short sleep duration was significantly associated with elevated serum CRP concentration independent of waist circumference and moderate physical activity in men but not in women.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Black S, Kushner I, Samols D. C-reactive protein. J Biol Chem 2004;279:48487-48490.
 
2. Ridker PM. High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation 2001;103:1813-1818.
 
3. Grandner MA, Sands-Lincoln MR, Pak VM, et al. Sleep duration, cardiovascular disease, and proinflammatory biomarkers. Nat Sci Sleep 2013;5:93-107.
 
4. Meier-Ewert HK, Ridker PM, Rifai N, et al. Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol 2004;43:678-683.
 
5. Knutson KL. Sleep duration and cardiometabolic risk: a review of the epidemiologic evidence. Best Pract Res Clin Endocrinol Metab 2010;24:731-743.
 
6. Grandner MA, Buxton OM, Jackson N, et al. Extreme sleep durations and increased C-reactive protein: effects of sex and ethnoracial group. Sleep 2013;36:769-779E.
 
7. Ferrie JE, Kivimaki M, Akbaraly TN, et al. Associations between change in sleep duration and inflammation: findings on C-reactive protein and interleukin 6 in the Whitehall II Study. Am J Epidemiol 2013;178:956-961.
 
8. Koo M, Lai NS, Chiang JK. Short duration of sleep is associated with hyperleptinemia in Taiwanese adults. J Clin Sleep Med 2013;9:1049-1055.
 
9. Dowd JB, Goldman N, Weinstein M. Sleep duration, sleep quality, and biomarkers of inflammation in a Taiwanese population. Ann Epidemiol 2011;21:799-806.
 
10. Patel SR, Zhu X, Storfer-Isser A, et al. Sleep duration and biomarkers of inflammation. Sleep 2009;32:200-204.
 
11. Miller MA, Kandala NB, Kivimaki M, et al. Gender differences in the cross-sectional relationships between sleep duration and markers of inflammation: Whitehall II study. Sleep 2009;32:857-864.
 
12. Jackowska M, Kumari M, Steptoe A. Sleep and biomarkers in the English Longitudinal Study of Ageing: associations with C-reactive protein, fibrinogen, dehydroepiandrosterone sulfate and hemoglobin. Psychoneuroendocrinology 2013;38:1484-1493.
 
13. Nakamura K, Sakurai M, Miura K, et al. Overall sleep status and high sensitivity C-reactive protein: a prospective study in Japanese factory workers. J Sleep Res 2014;23:717-727.
 
14. Centers for Disease Control and Prevention. National Health and Nutrition Examination Survey methods and analytic guidelines. http://www.cdc.gov/nchs/nhanes/survey_methods.htm. Accessed May 2016.
 
15. Centers for Disease Control and Prevention. Codebook for data collection Sleep Disorders Section of the SP and MEC CAPI Questionnaire. https://wwwn.cdc.gov/Nchs/Nhanes/2007-2008/SLQ_E.htm and https://wwwn.cdc.gov/nchs/nhanes/2009-2010/SLQ_F.htm. Accessed January 2017.
 
16. Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003;107:499-511.
 
17. Laboratory procedure manual. http://www.cdc.gov/nchs/data/nhanes/nhanes_07_08/crp_e_met.pdf. Revised April 9, 2007. Accessed June 1, 2016.
 
18. Laboratory procedure manual. http://www.cdc.gov/NCHS/data/nhanes/nhanes_09_10/CRP_F_met.pdf. Revised January 26, 2011. Accessed June 1, 2016.
 
19. SAS 9.3 System Options: Reference, Second Edition. Cary, NC:SAS Institute, 2011.
 
20. SUDAAN. Language Training Manual 11.0. Research Triangle Park, NC: Research Triangle Institute 2012.
 
21. US Department of Health and Human Services. Physical activity guidelines for Americans. http://www.health.gov/paguidelines. Accessed June 1, 2016.
 
22. US Department of Health and Human Services. Your guide to healthy sleep. https://www.nhlbi.nih.gov/files/docs/public/sleep/healthy_sleep.pdf. Revised 2011. Accessed January 19, 2017.
 
23. Church TS, Earnest CP, Thompson AM, et al. Exercise without weight loss does not reduce C-reactive protein: the INFLAME study. Med Sci Sports Exerc 2010;42:708-716.
 
24. Kasapis C, Thompson PD. The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review. J Am Coll Cardiol 2005;45:1563-1569.