The relevance of sleep abnormalities to chronic inflammatory conditions

The relevance of sleep abnormalities to chronic inflammatory conditions
Journal Inflammation Research
Publisher Birkhäuser Basel
ISSN 1023-3830 (Print) 1420-908X (Online)
Issue Volume 56, Number 2 / February, 2007
Category Review
DOI 10.1007/s00011-006-6067-1
Pages 51-57
Subject Collection Biomedical and Life Sciences
SpringerLink Date Tuesday, March 13, 2007

Z. Ranjbaran1 Contact Information, L. Keefer1, E. Stepanski1, A. Farhadi1 and A. Keshavarzian1
(1) Section of Gastroenterology and Nutrition, Rush University Medical Center, 1725 W. Harrison, Suite 206, Chicago, IL 60612, USA

Abstract. Sleep is vital to health and quality of life while sleep abnormalities are associated with adverse health consequences. Nevertheless, sleep problems are not generally considered by clinicians in the management of chronic inflammatory conditions (CIC) such as asthma, RA, SLE and IBD. To determine whether this practice is justified, we reviewed the literature on sleep and chronic inflammatory diseases, including effects of sleep on immune system and inflammation.
We found that a change in the sleep-wake cycle is often one of the first responses to acute inflammation and infection and that the reciprocal effect of sleep on the immune system in acute states is often protective and restorative. For example, slow wave sleep can attenuate proinflammatory immune responses while sleep deprivation can aggravate those responses.
The role of sleep in CIC is not well explored. We found a substantial body of published evidence that sleep disturbances can worsen the course of CIC, aggravate disease symptoms such as pain and fatigue, and increase disease activity and lower quality of life. The mechanism underlying these effects probably involves dysregulation of the immune system. All this suggests that managing sleep disturbances should be considered as an important factor in the overall management of CIC.

Keywords: Sleep - Immune system - Inflammation - Asthma - Rheumatoid arthritis - Systemic Lupus Erythematosus - Inflammatory bowel disease
Received 28 April 2006; returned for revision 30 May 2006; accepted by I. Ahnfelt-Rønne 13 August 2006

Contact Information Z. Ranjbaran
Email: ziba_ranjbaran@rush.edu