Research On The Correlation Of Immunity In Patients With Chronic Insomnia

Purpose: Sleep and the immune system are closely related.Adequate sleep promotes the immune system’s ability to defend against infection and inflammation,while chronic insomnia is recognized as a chronic stress state that can increase the risk of infection and inflammatory diseases.This study aimed to investigate the changes in immune function and clinical infection events in patients with chronic insomnia.Materials and methods:From November 2021 to June 2022,42 patients with chronic insomnia were selected from the Department of General Medicine and Sleep Disorders of Chaohu Hospital affiliated to Anhui Medical University based on the diagnosis criteria of the International Classification of Sleep Disorders,3rd Edition(ICSD-3).47 healthy sleepers were recruited from the Physical Examination Department and Department of General Medicine.General demographic data such as gender,age,ethnicity,education level,and history of chronic diseases were collected.Fasting venous blood and blood pressure were collected from all subjects from 7:30-8:30 a.m.Blood routine,biochemical indicators,lymphocyte subsets,immunoglobulin(Ig),complement C3,C4,and interleukin-6(IL-6)were detected before 10:00 a.m.The Pittsburgh Sleep Quality Index(PSQI)was used to evaluate subjective sleep quality,the Hamilton Depression Rating Scale-17(HAMD-17)was used to assess the severity of depressive symptoms,and the Hamilton Rating Scale for Anxiety(HAM-A)was used to evaluate the severity of anxiety symptoms.A questionnaire was used to understand the occurrence of clinical infection events in the past 3 months.The chronic insomnia group completed polysomnography(PSG)to assess objective sleep quality and exclude other sleep disorders.SPSS 26.0 was used to analyze and compare differences in indicators between the two groups.Results:1.There were no significant differences between the two groups in terms of gender,age,blood pressure,and history of chronic diseases(hypertension,type 2 diabetes,hyperlipidemia)(p > 0.05).The total sleep time(TST),rapid eye movement(REM) sleep,and sleep efficiency of patients with chronic insomnia were decreased,while non-rapid eye movement(NREM)sleep and wake-time after sleep onset(WASO)were increased,indicating that patients with chronic insomnia had shorter objective sleep time and poorer sleep quality.2.There were statistically significant differences in red blood cells,hemoglobin,hematocrit,total protein,albumin,globulin,creatinine,platelet-lymphocyte ratio(PLR),and neutrophil-lymphocyte ratio(NLR)between the chronic insomnia group and the control group(p < 0.05).However,there were no significant differences in white blood cell count,platelet count,alanine aminotransferase,aspartate aminotransferase,glucose,blood lipids,and other indicators(p > 0.05).3.Patients with chronic insomnia signifificantly varied from their controls(p < 0.05)in terms of IgG,IgG/IgM ratio,CD4+ T-lymphocyte count/CD8+ T-lymphocyte count ratio,lymphocyte count,CD3 T lymphocytes,CD4 T lymphocytes,CD8 T lymphocytes,and NK lymphocytes(CD56),while showing no apparent differences in complement C3 and C4,immunoglobulin A and M,IL-6,B lymphocytes(CD19),IgG/IgA ratio,IgM/IgA ratio,or C3/C4 ratio(p > 0.05).4.The incidence of clinical infection events and the incidence of infection events in chronic insomnia group increased significantly compared with the control group.A binary logistics regression analysis was used,Showed that the incidence of clinical infection events in chronic insomnia patients increased significantly compared with the control group(p=0.045),OR(95%CI)=2.618(1.020-6.719),The incidence of respiratory infection in chronic insomnia patients was 4.2 times higher(p=0.015),OR(95%CI)=4.200(1.320-13.365),Oral ulcers was 4.135 times(p=0.027),OR(95%CI)=4.135(1.176-14.542),5.Point-biserial correlation analysis was performed to assess the correlation between chronic insomnia and each index.The results suggest that chronic insomnia has a negative correlation with erythrocytes(r=-0.248,P=0.027),hemoglobin(r=-0.222,P=0.048),hematocrit(r=-0.240,P=0.032),albumin(r=-0.259,P=0.033),globulin,(r=-0.287,P=0.018)creatinine(r=-0.253,P=0.023),IgG(r=-0.436,P<0.001),IgG/IgM ratio(r=-0.277,P=0.013),lymphocyte count(r=-0.504,P<0.001),CD3 T lymphocytes(r=-0.407,P<0.001),CD8 T lymphocyte count(r=-0.389,P<0.001),CD4 T lymphocyte count(r=-0.338,P=0.002)and NK lymphocyte count(r=-0.276,P=0.013),while maintaining a positive correlation with CD4+ T-lymphocyte count/CD8+ T-lymphocyte count ratio(r=0.251,P=0.028),neutrophil-to-lymphocyte ratio(r=0.318,P=0.004),platelet-to-lymphocyte ratio(r=0.582,P<0.001),clinical infection events(r=0.509,P<0.001),respiratory infection(r=0.279,p=0.011)and oral ulcer(r=0.255,p=0.020).Conclusion: Patients with chronic insomnia have decreased immune function and increased clinical infection events.