Abstract

The evolutionary reasons for sleep remain controversial. The immune theory of sleep suggests that sleep is essential to the immune system, allowing organisms to allocate more energy to their immunity. This hypothesis was tested by exploring the links between excessive daytime sleepiness (EDS) and vulnerability to infectious diseases in a large (n = 9294) cohort of elderly individuals, with information on socio-demographics, daily habits, and medical characteristics. At the two-year and four-year follow-ups, we obtained individual data from the national healthcare insurance about all medications prescribed to the participants between 2001 and 2003 (n = 2865). We found an independent positive association between EDS and the consumption of some anti-pathogen drugs. This relationship was mostly explained by fungal and parasitic infections rather than by viral and bacterial ones. These results, although based on correlations, are consistent with the idea that EDS as a proxy of altered sleep quality/quantity may affect the efficiency of the immune system, and hence vulnerability to infections.

Highlights

  • We tested the immune theory of sleep in humans by exploring the links between excessive daytime sleepiness (EDS) and vulnerability to infectious diseases

  • To estimate changes in sleep quality/quantity, we focused on the complaint of EDS because subjective it represents a unique relative individual estimate of sleep alteration whatever the total daily amount of time spent sleeping

  • We detected a positive relationship between the consumption of some anti-pathogen drugs and excessive daytime somnolence, which is consistent with the idea that sleep deprivation may affect immune system efficiency and vulnerability to infections[15]

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Summary

Introduction

We tested the immune theory of sleep in humans by exploring the links between excessive daytime sleepiness (EDS) and vulnerability to infectious diseases. We focused our study on elderly individuals because the effects of sleep changes are expected to be especially elevated in populations at particular risk of infections, like older adults[14]. Aging is often associated with a decrease in both the quality and quantity of sleep, with large variations among individuals[24,25,26,27], and EDS is frequently reported in the elderly[28,29]. To estimate changes in sleep quality/quantity, we focused on the complaint of EDS because subjective it represents a unique relative individual estimate of sleep alteration whatever the total daily amount of time spent sleeping. Using a four-year longitudinal study based on an elderly population, we examined whether EDS was associated with the consumption of anti-pathogen drugs

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