Sleep duration, insomnia, and markers of systemic inflammation: results from the Netherlands Study of Depression and Anxiety (NESDA)

J Psychiatr Res. 2015 Jan;60:95-102. doi: 10.1016/j.jpsychires.2014.09.018. Epub 2014 Sep 26.


Systemic inflammation has emerged as a potential pathway linking depressive and anxiety disorders with disease risk. Short and long sleep duration, as well as insomnia, are common among psychiatric populations and have previously been related to increased inflammation. The aim of the present study was to investigate associations between sleep duration and insomnia with biomarkers of inflammation and to explore whether these associations varied by psychiatric diagnostic status. To this end, self-reported measures of sleep duration, insomnia symptoms, and markers of inflammation, including C-reactive protein (CRP), interleukin-(IL)-6, and tumor necrosis factor (TNF)-α, were obtained in 2553 adults (aged 18-65 years) diagnosed with current/recent or remitted depressive and/or anxiety disorders and healthy controls enrolled in the Netherlands Study of Depression and Anxiety (NESDA). Regression analyses revealed associations between sleep duration and levels of CRP and IL-6 with higher levels observed in long sleepers. These associations remained statistically significant after controlling for age, gender, education, body mass index, smoking, alcohol consumption, medical comorbidities, medication use, psychotropic medication use, and psychiatric diagnostic status. There were no clear associations between insomnia symptoms and levels of inflammation. Relationships between sleep duration and inflammation did not vary as a function of psychiatric diagnostic status. These findings suggest that elevated levels of systemic inflammation may represent a mechanism linking long sleep duration and disease risk among those with and without depressive and anxiety disorders.

Keywords: Anxiety; Depression; Inflammation; Insomnia; Sleep duration.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety / blood
  • Anxiety / psychology*
  • Biomarkers / blood*
  • C-Reactive Protein / immunology
  • Depression / blood
  • Depression / psychology*
  • Female
  • Humans
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Regression Analysis
  • Sex Factors
  • Sleep / immunology*
  • Sleep Initiation and Maintenance Disorders / blood*
  • Time Factors
  • Tumor Necrosis Factor-alpha / blood
  • Young Adult


  • Biomarkers
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein