Individual Heterogeneity in the Relations Between Sleep, Inflammation, and Somatic Symptoms

Abstract

Objective: Poor sleep is associated with the experience of more somatic symptoms and a proinflammatory state, whereas a proinflammatory state may also result in the experience of more somatic symptoms. However, existing studies ignore individual differences in these associations. We aimed to study relations between sleep, inflammatory markers, and somatic symptoms at a within-individual level.

Methods: Time series of daily data on sleep, somatic symptoms, and inflammation markers in 10 healthy individuals (age, 19-58 years; three men) for 63 days were analyzed. Bidirectional lagged ( t - 1) and contemporaneous ( t ) relations between sleep duration, inflammatory markers (C-reactive protein, interferon-α, interleukin 1RA), and somatic symptoms were analyzed using 24-hour urine and diary data. Unified structural equation modeling was used to analyze the association between sleep duration, the three inflammatory markers, and the amount of somatic symptoms at the individual level.

Results: Associations were found between sleep and at least one of three inflammatory markers in four individuals, both positive (three associations) and negative (five associations) and contemporaneous (four associations) and lagged (four associations). Sleep was related to somatic symptoms in four individuals, both positive ( n = 2) and negative ( n = 2) and contemporaneous ( n = 3) and lagged ( n = 1). Inflammatory markers were associated with somatic symptoms in three individuals, both positive (three associations) and negative (one association) and contemporaneous (three associations) and lagged (one associations). Two individuals showed no associations between sleep, inflammatory markers, and somatic symptoms.

Conclusions: We observed a large variability in presence, strength, and direction of associations between sleep, inflammatory markers, and somatic symptoms.

FIGURE 1

Overview of associations in all individuals. β values of significant correlations are reported. Dark gray lines show negative associations, light gray lines show positive associations, straight lines show contemporaneous associations, and dotted lines show lagged associations. A circular arrow toward the same variable means an autocorrelation, so higher values on 1 day predicted higher values the following days. CRP = C-reactive protein; IFN-α = interferon α; IL1-ra = interleukin 1 receptor antagonist; SS = somatic symptom score.