睡眠和昼夜节律紊乱是自身免疫性疾病的危险因素：一项基于人群的研究

Q2 Medicine

Neurobiology of Sleep and Circadian Rhythms Pub Date : 2025-05-01 DOI:10.1016/j.nbscr.2025.100129

Amber R. Li , Bhaavyaa Shah , Michael L. Thomas , Michael J. McCarthy , Alejandro D. Meruelo

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引用次数: 0

摘要

背景：睡眠和昼夜节律紊乱与免疫失调的联系越来越紧密，但在人群水平上与自身免疫性疾病的关联仍未得到充分探讨。我们研究了延迟睡眠阶段障碍（DSPD）、阻塞性睡眠呼吸暂停（OSA）、原发性失眠和嗜睡是否与自身免疫性疾病有关。方法数据来自All of Us Research Program注册Tier Dataset v8。根据临床诊断，参与者被分为睡眠障碍组，正常睡眠者作为对照组。自身免疫性疾病的定义使用snomed编码记录。采用罕见病logistic回归分析DSPD与原发性失眠症；采用1:5倾向评分匹配法对OSA和嗜睡症进行分析。调整后的logistic回归模型包括年龄、出生性别、种族、民族、收入、BMI和慢性炎症诊断。e值评估了对未测量混杂的稳健性。结果4个睡眠障碍组的自身免疫诊断率均高于正常睡眠组(p <；2.2 × 10−16)。调整后的优势比为：DSPD (OR = 0.26；95% ci: 0.15-0.45), osa (or = 0.46；95% CI: 0.41-0.52)，原发性失眠(OR = 0.46；95% CI: 0.41-0.52)和嗜睡症(OR = 0.48；95% ci: 0.46-0.50)。年龄较大、女性和慢性炎症与较高的自身免疫性患病率相关。亚洲人种和BMI与自身免疫风险呈负相关；高收入出乎意料地与更高的自身免疫诊断相关。结论不同的睡眠表型与自身免疫性疾病相关。这些关联可能反映了睡眠中断和免疫失调之间的共享或双向联系。

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Sleep and circadian disorders as risk factors for autoimmune disease: A population-based study

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Sleep and circadian disorders as risk factors for autoimmune disease: A population-based study

Background

Sleep and circadian disruption have been increasingly linked to immune dysregulation, yet population-level associations with autoimmune disease remain underexplored. We examined whether delayed sleep phase disorder (DSPD), obstructive sleep apnea (OSA), primary insomnia, and hypersomnia were associated with autoimmune conditions in a large, diverse U.S. cohort.

Methods

Data were drawn from the All of Us Research Program Registered Tier Dataset v8. Participants were categorized into sleep disorder groups based on clinical diagnoses, with regular sleepers serving as controls. Autoimmune disease was defined using SNOMED-coded records. DSPD and primary insomnia were analyzed using rare disease logistic regression; OSA and hypersomnia were analyzed using 1:5 propensity score matching. Adjusted logistic regression models included age, sex at birth, race, ethnicity, income, BMI, and chronic inflammatory diagnosis. E-values assessed robustness to unmeasured confounding.

Results

All four sleep disorder groups showed significantly higher odds of autoimmune diagnosis relative to regular sleepers (p < 2.2 × 10⁻¹⁶). Adjusted odds ratios were: DSPD (OR = 0.26; 95 % CI: 0.15–0.45), OSA (OR = 0.46; 95 % CI: 0.41–0.52), primary insomnia (OR = 0.46; 95 % CI: 0.41–0.52), and hypersomnia (OR = 0.48; 95 % CI: 0.46–0.50). Older age, female sex, and chronic inflammation were associated with higher autoimmune prevalence. Asian race and BMI were inversely associated with autoimmune risk; higher income was unexpectedly associated with greater autoimmune diagnosis.

Conclusions

Distinct sleep phenotypes were associated with autoimmune conditions. These associations may reflect shared or bidirectional links between sleep disruption and immune dysregulation.

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来源期刊

Neurobiology of Sleep and Circadian Rhythms Neuroscience-Behavioral Neuroscience

CiteScore

4.50

自引率

0.00%

发文量

审稿时长

69 days

期刊介绍： Neurobiology of Sleep and Circadian Rhythms is a multidisciplinary journal for the publication of original research and review articles on basic and translational research into sleep and circadian rhythms. The journal focuses on topics covering the mechanisms of sleep/wake and circadian regulation from molecular to systems level, and on the functional consequences of sleep and circadian disruption. A key aim of the journal is the translation of basic research findings to understand and treat sleep and circadian disorders. Topics include, but are not limited to: Basic and translational research, Molecular mechanisms, Genetics and epigenetics, Inflammation and immunology, Memory and learning, Neurological and neurodegenerative diseases, Neuropsychopharmacology and neuroendocrinology, Behavioral sleep and circadian disorders, Shiftwork, Social jetlag.