Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan 13:13:1080782.
doi: 10.3389/fimmu.2022.1080782. eCollection 2022.

The association between sedentary behavior, exercise, and sleep disturbance: A mediation analysis of inflammatory biomarkers

Yanwei You  1   2 , Yuquan Chen  3 , Wen Fang  1   2 , Xingtian Li  1   2 , Rui Wang  1   2 , Jianxiu Liu  1   4 , Xindong Ma  1   5
Affiliations

The association between sedentary behavior, exercise, and sleep disturbance: A mediation analysis of inflammatory biomarkers

Yanwei You et al. Front Immunol. .

Abstract

Background: Two related lifestyle behaviors associated with sleep disturbance are sedentary behavior and physical exercise participation. We aimed to use a population-based study to disentangle the relationships between sedentary behavior, exercise, and sleep disturbance based on blood-cell-based inflammatory biomarkers.

Methods: A total of 22,599 participants from the National Health and Nutrition Examination Survey (NHANES) were included in the analyses. Sleep disturbance was assessed according to the NHANES questionnaire. Exercise participation ansd sedentary behavior were evaluated by the global physical activity questionnaire. The inflammatory biomarkers in the examination were white blood cell (WBC) count, neutrophil count (NEU), neutrophil-to-lymphocyte ratio (NLR), and systemic immune inflammation index (SII). A complex multistage sampling design and weighted multivariable logistic regression were applied for further analysis. Mediation models were constructed to figure out the mediating role of inflammatory biomarkers.

Results: The weighted prevalence of sleep disturbance was 24.17%. Sedentary behavior and exercise were associated with sleep disturbance after full adjustment [for sedentary behavior, OR (95% CI): 1.261 (1.154, 1.377); for exercise, OR (95% CI): 0.849 (0.757, 0.953)]. In severe sedentary behavior groups, the mitigation effect of exercise on sleep disturbance was observed [OR (95% CI): 0.687 (0.551, 0.857)]. For the mechanism, strong associations were detected between inflammatory biomarkers and sleep disturbance. Mediation analysis showed that WBC, NEU, NLR, and SII mediated the statistical association between sedentary behavior and sleep disturbance with proportions (%) of 2.09, 2.27, 1.76, and 0.82, respectively.

Conclusions: Our data suggested that sedentary behavior was a risk factor for sleep disturbance. Blood-cell-based inflammatory biomarkers were an easily accessible and cost-effective strategy for identifying sleep disturbance and also significantly mediated the association between sedentary behavior and sleep disturbance. Exercise was proved to be effective in severe sedentary behavior groups to improve sleep disturbance symptoms, while the internal mechanism needed further exploration.

Keywords: blood-cell based inflammatory biomarkers; exercise; population-based study; sedentary behavior; sleep disturbance.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study design and participants excluded from the study.
Figure 2
Figure 2
Correlations of the four blood inflammatory biomarkers.
Figure 3
Figure 3
Path diagram of the mediation analysis of inflammatory biomarkers on the relationship between sedentary behavior and sleep disturbance. The graphs in (A–D) represented the mediating role of WBC, neutrophils, NLR, and SII, respectively.
Figure 4
Figure 4
Path diagram of the mediation analysis of inflammatory biomarkers on the relationship between exercise and sleep disturbance in the severe sedentary groups. The graphs in (A–D) represented the mediating role of WBC, neutrophils, NLR, and SII, respectively.
See this image and copyright information in PMC

References

    1. Ford ES, Wheaton AG, Cunningham TJ, Giles WH, Chapman DP, Croft JB. Trends in outpatient visits for insomnia, sleep apnea, and prescriptions for sleep medications among US adults: Findings from the national ambulatory medical care survey 1999-2010. Sleep (2014) 37:1283–93. doi: 10.5665/sleep.3914 - DOI - PMC - PubMed
    1. Leger D, Poursain B, Neubauer D, Uchiyama M. An international survey of sleeping problems in the general population. Curr Med Res Opin (2008) 24:307–17. doi: 10.1185/030079907x253771 - DOI - PubMed
    1. Hui SK, Grandner MA. Trouble sleeping associated with lower work performance and greater health care costs: Longitudinal data from Kansas state employee wellness program. J Occup Environ Med (2015) 57:1031–8. doi: 10.1097/JOM.0000000000000534 - DOI - PMC - PubMed
    1. Gangwisch JE, Heymsfield SB, Boden-Albala B, Buijs RM, Kreier F, Pickering TG, et al. . Sleep duration as a risk factor for diabetes incidence in a large U.S. sample. Sleep (2007) 30:1667–73. doi: 10.1093/sleep/30.12.1667 - DOI - PMC - PubMed
    1. St-Onge MP, Grandner MA, Brown D, Conroy MB, Jean-Louis G, Coons M, et al. . Sleep duration and quality: Impact on lifestyle behaviors and cardiometabolic health: A scientific statement from the American heart association. Circulation (2016) 134:e367–86. doi: 10.1161/CIR.0000000000000444 - DOI - PMC - PubMed

Publication types