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...
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Elsevier
2025-05-01
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| Series: | Neurobiology of Sleep and Circadian Rhythms |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451994425000185 |
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| author | Amber R. Li Bhaavyaa Shah Michael L. Thomas Michael J. McCarthy Alejandro D. Meruelo |
| author_facet | Amber R. Li Bhaavyaa Shah Michael L. Thomas Michael J. McCarthy Alejandro D. Meruelo |
| author_sort | Amber R. Li |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-d9e00a0468be4a62b011bb34fcb5fc86 |
| institution | DOAJ |
| issn | 2451-9944 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Neurobiology of Sleep and Circadian Rhythms |
| spelling | doaj-art-d9e00a0468be4a62b011bb34fcb5fc862025-08-20T03:20:22ZengElsevierNeurobiology of Sleep and Circadian Rhythms2451-99442025-05-011810012910.1016/j.nbscr.2025.100129Sleep and circadian disorders as risk factors for autoimmune disease: A population-based studyAmber R. Li0Bhaavyaa Shah1Michael L. Thomas2Michael J. McCarthy3Alejandro D. Meruelo4University of California, 9500 Gilman Dr, La Jolla, San Diego, CA, 92093, USAUniversity of California, 9500 Gilman Dr, La Jolla, San Diego, CA, 92093, USAColorado State University, 1876 Campus Delivery, Fort Collins, CO, 80523-1876, USAUniversity of California, VA San Diego Healthcare System, 3350 La Jolla Village Dr San Diego, CA, 92161, USAUniversity of California, 9500 Gilman Dr, La Jolla, San Diego, CA, 92093, USA; Corresponding author.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.http://www.sciencedirect.com/science/article/pii/S2451994425000185ChronotypeDelayed sleep phase disorderObstructive sleep apneaPrimary insomniaHypersomniaAutoimmune disease |
| spellingShingle | Amber R. Li Bhaavyaa Shah Michael L. Thomas Michael J. McCarthy Alejandro D. Meruelo Sleep and circadian disorders as risk factors for autoimmune disease: A population-based study Neurobiology of Sleep and Circadian Rhythms Chronotype Delayed sleep phase disorder Obstructive sleep apnea Primary insomnia Hypersomnia Autoimmune disease |
| title | Sleep and circadian disorders as risk factors for autoimmune disease: A population-based study |
| title_full | Sleep and circadian disorders as risk factors for autoimmune disease: A population-based study |
| title_fullStr | Sleep and circadian disorders as risk factors for autoimmune disease: A population-based study |
| title_full_unstemmed | Sleep and circadian disorders as risk factors for autoimmune disease: A population-based study |
| title_short | Sleep and circadian disorders as risk factors for autoimmune disease: A population-based study |
| title_sort | sleep and circadian disorders as risk factors for autoimmune disease a population based study |
| topic | Chronotype Delayed sleep phase disorder Obstructive sleep apnea Primary insomnia Hypersomnia Autoimmune disease |
| url | http://www.sciencedirect.com/science/article/pii/S2451994425000185 |
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