Gender Differences in the Prospective Associations of Self-Reported Sleep Quality with Biomarkers of Systemic Inflammation and Coagulation

This study investigates the associations between self-reported sleep quality and biomarkers of inflammation and coagulation, which are connected to coronary heart disease.



The Issue:

Evidence suggests that disturbed sleep is a biological risk factor for the incidence of coronary heart disease (CHD). 


Key Findings:

  • Overall, subjective sleep quality is unrelated to inflammatory markers in both cross-sectional and prospective analysis among the sample.
  • Poorer subjective sleep quality at baseline was associated with five-year increases in women, however, when adjusting for age, ethnicity, education, body mass index, and regular snoring.
  • Specifically, women who noted a tendency to “wake up far too early” as a sleep disturbance at baseline was associated with five-year increase in IL-6 and some elevation in fibrinogen.


About the Study:

This is a cross-sectional and prospective study of Heart and Soul Study participants from two Veterans Affairs Medical Centers in California. Subjective sleep quality was measured using a single item from the Pittsburgh Sleep Quality Index (PSQI), and biomarkers were tested. The PSQI subjective sleep quality was compared at baseline and at five-years in biomarkers of inflammation and coagulation, specifically IL-6, CRP, and fibrinogen, in men and women with stable CHD. Participants (980) were assessed at baseline and 626 at the five-year follow-up.



These findings indicate that inflammation may be a way through which disturbed sleep contributes to CHD progression in women. Additional studies are needed to confirm these findings.

Health care providers shouldn't "hit the snooze button" when it comes to asking their patients about sleep, RWJF Health & Society Scholars alumnus Aric A. Prather says. Read the blog post