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Are sleep time and quality associated with inflammation in children and adolescents? A systematic review
Vanessa Cassia Medeiros-Oliveira1,2, Raytta Silva Viana1,2, Ariclecio Cunha de Oliveira3
1Department of Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil.
Insights
Poor sleep quality in children is linked to increased C-reactive protein (CRP), a marker of inflammation. Sleep duration, however, showed no consistent link with inflammatory biomarkers in children and adolescents.
Area of Science:
- Pediatric Health
- Sleep Medicine
- Immunology
Background:
- Sleep restriction in children is associated with cognitive, behavioral, cardiovascular, and metabolic issues.
- Sleep patterns can significantly influence the inflammatory profile of children and adolescents.
Purpose of the Study:
- To systematically review and analyze the relationship between sleep duration and sleep quality with inflammatory biomarkers in pediatric populations.
- To synthesize current evidence on how sleep impacts inflammation in children and adolescents.
Main Methods:
- A comprehensive literature search was conducted across MEDLINE, Web of Science, and Scopus databases.
- Search terms included "children and adolescents," "sleep," and "inflammatory profile."
- Objective sleep measurement utilized accelerometers, while subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI).
Main Results:
- The association between sleep duration and C-reactive protein (CRP) was inconsistent across studies.
- While sleep duration showed no significant link with inflammatory biomarkers, poor sleep quality demonstrated a positive association with CRP, albeit of lower magnitude.
- The Pittsburgh Sleep Quality Index (PSQI) was frequently used for subjective sleep assessment.
Conclusions:
- Sleep duration does not appear to be significantly associated with inflammatory biomarkers in children and adolescents.
- Poor sleep quality, however, shows a notable positive association with CRP, indicating a potential inflammatory impact.
- Further research may clarify the nuanced relationship between sleep parameters and inflammation in pediatric populations.
Abstract:
Sleep restriction in children can trigger the development of problems such as impaired cognition, behavioral problems, cardiovascular problems, and obesity. In addition, the inflammatory profile of children can also be influenced by sleep restriction. The aimed to review and analyze the association between time and sleep quality with inflammatory biomarkers in children and adolescents. Three electronic databases (MEDLINE, Web of Science and Scopus) were searched from August 30, 2022. The search strategy used the following descriptors: children and adolescents; sleep, and inflammatory profile. This review protocol is registered in the PROSPERO database (CRD42020188969). We obtained 2.724 results of articles with potentially relevant titles. Sixteen percent of the articles were excluded because they were duplicates, 84.3% were excluded after reading the title, and 0.9% were studied from systematic reviews or textbooks (0.9%). Accelerometers are the most commonly used method for the objective measurement of sleep time, while the PSQI questionnaire is the most commonly used subjective method to measure sleep quality. The results indicated an inconsistent association between sleep time and CRP in the literature. Sixty percent of studies used the Pittsburgh Sleep Quality Index (PSQI) for subjective assessment of sleep quality and possible sleep disorders. However, only one retrieved study showed significant association between sleep quality and CRP. Thus, sleep time does not present significant association with inflammatory biomarkers; whereas, poor sleep quality shows positive association with CRP with a lower magnitude.
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