Systemic inflammatory response index: a potential mediator between substance use disorder and sleep disturbance

Substance use disorder (SUD) and sleep disturbance share a complex, bidirectional relationship. However, the role of the systemic inflammation response index (SIRI) in this relationship remains to be explored, which will be beneficial for detecting SUD-related sleep disturbances.

Utilizing diverse samples from the National Health and Nutrition Examination Survey (NHANES) (n = 2,533) as well as self-collected clinical data (n = 88), we explored the associations among SUD, SIRI, and sleep disturbance. In NHANES dataset, weighted logistic regression and multiple machine learning (ML) models were employed to assess the relationship between SIRI and sleep disturbance, as well as SIRI importance in SUD group. Mediation analysis examined the role of SIRI in mediating the SUD-sleep disturbance association. During clinical confirmation, a two-sample t-test was used to discover differences in SIRI between opioid use disorder (OUD) and healthy controls (HC). Correlation of SIRI and Pittsburgh Sleep Quality Index (PSQI) was performed by partial correlation within OUD group.

The analyses on NHANES datasets uncovered significant "SUD-SIRI-sleep disturbance" relationships, and SIRI ranked first in diagnosing sleep status of SUD subjects. Through validation via clinical datasets, OUD individuals also had higher SIRI levels and sleep disturbance risk than HC.

Our findings suggest that SIRI statistically mediates the relationship between SUD and sleep disturbance in a cross-sectional context, positioning it as a potential adjunctive monitoring indicator for SUD-related psychiatric management. These results offer preliminary correlational evidence for mitigating sleep disruption through anti-inflammatory approaches, warranting further longitudinal and experimental validation.