期刊
BIOLOGICAL PSYCHIATRY
卷 68, 期 10, 页码 942-949出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.biopsych.2010.04.019
关键词
Cortisol; cytokines; depression; fatigue; hepatitis C; hyperarousal; insomnia; interferon-alpha; neuropsychology poly; somnography sleep
资金
- National Institutes of Health [K23 MH064619, R01 MH070553, K05 MH069124, R01 HL073921, 132 MH020018]
- National Institutes of Health National Center for Research Resources [ULL RR025008, M01 RR0039]
- Centocor GlaxoSmithKline
- Schering-Plough
Background Consequences of chronic exposure to cytokines of the innate immune system on sleep in humans and the association of cytokine induced sleep alterations with behavior motor performance and cortisol secretion are unknown Methods Thirty one patients with hepatitis C without pre-existing sleep disorders underwent nighttime polysomnography, daytime multiple sleep latency testing behavioral assessments neuropsychological testing and serial blood sampling at baseline and after 12 weeks of either treatment with the innate immune cytokine interferon (IFN)-alpha (n = 19) or no treatment (n = 12) Fatigue and sleepiness were assessed using the Multidimensional Fatigue Inventory and Epworth Sleepiness Scale Results Interferon alpha administration led to significant increases in wake after sleep onset and significant decreases in stage 3/4 sleep and sleep efficiency Rapid eye movement latency and stage 2 sleep were significantly increased during IFN-alpha treatment Decreases in stage 3/4 sleep and increases in rapid eye movement latency were associated with increases in fatigue whereas decreases in sleep efficiency were associated with reduced motor speed Increased wake after sleep onset was associated with increased evening plasma cortisol Despite IFN-alpha-induced increases in fatigue, daytime sleepiness did not increase In fact IFN alpha treated patients exhibited decreased propensity to fall asleep during daytime nap opportunities Conclusions Chronic exposure to an innate immune cytokine reduced sleep continuity and depth and induced a sleep pattern consistent with insomnia and hyperarousal These data suggest that innate immune cytokines may provide a mechanistic link between disorders associated with chronic inflammation including medical and/or psychiatric illnesses and insomnia which in turn is associated with fatigue motor slowing and altered cortisol
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