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The associations between sleep trouble, sleep duration, and peripheral blood inflammatory markers in adults: NHANES
Wenjie Huang1, Mengqiu Lan2, Jiaoyan Liu1
1Reproductive Genetics Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032, China.
Background:
The primary objective of this study was to investigate the associations between sleep trouble, sleep duration, and peripheral blood composite inflammatory markers among U.S. adults.
Methods:
We analyzed 29,605 adults from NHANES 2005-2020. Sleep trouble was self-reported, and sleep duration was categorized as short (<7 h), normal (7-9 h), or long (>9 h). Inflammatory markers included WBC, neutrophils, lymphocytes, monocytes, platelets, and six composite indices (NLR, PLR, LMR, SII, SIRI, PIV). Multivariable linear regression models, stratified analyses by BMI, sex, and age, interaction tests, and restricted cubic spline analyses were performed. Multiple imputation addressed missing covariates.
Results:
A total of 29,605 adults were included, comprising 7691 participants with sleep trouble and 21,914 without. In fully adjusted models, sleep trouble was not significantly associated with systemic inflammatory markers in the overall population. Stratified analyses revealed that participants with BMI ≥25, males, and older adults (age 40-59 and ≥60 years) with sleep trouble had higher NLR, SII, SIRI, and PIV. Long sleep (>9 h) was consistently linked to elevated NLR, SII, SIRI, and PIV, whereas short sleep (<7 h) showed no robust associations after full adjustment, indicating inflammatory marker levels were elevated primarily among participants with long sleep duration. Interaction analyses confirmed modifying effects of BMI, sex, and age on these associations.
Limitations:
Cross-sectional design and self-reported sleep measures preclude causal inference; residual confounding may remain.
Conclusion:
Sleep trouble was not robustly associated with systemic inflammation overall, although this finding should be interpreted cautiously given the limitations of the sleep-trouble measure; significant associations were observed in high-risk subgroups. Long sleep was linked to elevated inflammatory indices, indicating an association between sleep characteristics and systemic inflammatory status in high-risk adults.
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