Sleep and biomarkers in the English Longitudinal Study of Ageing: associations with C-reactive protein, fibrinogen, dehydroepiandrosterone sulfate and hemoglobin

Psychoneuroendocrinology. 2013 Sep;38(9):1484-93. doi: 10.1016/j.psyneuen.2012.12.015. Epub 2013 Jan 25.


Sleep duration and quality are associated with adverse physical health outcomes. The mechanisms are not well understood, and little is known about associations with biomarkers in older population cohorts. This study assessed cross-sectional associations between self-reported sleep measures and biomarkers in a representative sample of British people aged 50 years and above. Participants were 6465 men and women aged 50-99 years from the English Longitudinal Study of Ageing (ELSA). Associations of sleep duration and sleep disturbance with C-reactive protein (CRP), fibrinogen, dehydroepiandrosterone sulfate (DHEAS) and hemoglobin were analyzed, adjusting for age, wealth, body mass index (BMI), smoking, physical activity, limiting long-standing illness and depressive symptoms. In men, long sleep duration (OR: 1.50, 1.05-2.14) and greater sleep disturbance (OR: 1.29, C.I. 1.05-1.59) were associated with raised CRP levels, while long sleep was also related to raised plasma fibrinogen (P=0.001). DHEAS levels were lower among men reporting more sleep disturbances (P=0.016), but were not related to sleep duration. Sleep duration (P=0.015) and sleep disturbance (P=0.039) were associated with lower hemoglobin levels, and anemia was more prevalent among men with disturbed sleep (OR: 1.73, C.I. 1.13-2.65). In women more disturbed sleep was associated with greater likelihood of anemia (OR: 1.59, C.I. 1.02-2.46), but there was no relationship between sleep disturbance or duration with other biomarkers. This study suggests that self-reported sleep duration and disturbance are related to biological risk factors in community-dwelling older adults, with different associations being present in men and women. A better understanding of these relationships using longitudinal cohort studies will broaden our understanding of the mechanisms relating sleep indices and ill health in advancing age.

Keywords: Anemia; CRP; DHEAS; Fibrinogen; Hemoglobin; Inflammation; Sleep disturbance; Sleep duration.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging / physiology*
  • Anemia / blood
  • Anemia / epidemiology
  • Biomarkers
  • Body Mass Index
  • C-Reactive Protein / analysis*
  • Chronic Disease
  • Comorbidity
  • Cross-Sectional Studies
  • Dehydroepiandrosterone Sulfate / blood*
  • Depression / blood
  • Depression / epidemiology
  • England / epidemiology
  • Female
  • Fibrinogen / analysis*
  • Follow-Up Studies
  • Hemoglobins / analysis*
  • Humans
  • Male
  • Middle Aged
  • Motor Activity
  • Prospective Studies
  • Self Report
  • Sex Factors
  • Sleep / physiology*
  • Sleep Wake Disorders / blood
  • Sleep Wake Disorders / epidemiology
  • Smoking / blood
  • Smoking / epidemiology
  • Socioeconomic Factors


  • Biomarkers
  • Hemoglobins
  • Dehydroepiandrosterone Sulfate
  • Fibrinogen
  • C-Reactive Protein