The sleep-immune crosstalk in health and disease.


Besedovsky L, Lange T, Haack M. The sleep-immune crosstalk in health and disease. Physiological Reviews. 2019;99 (3) :1325-1380.


Sleep and immunity are bidirectionally linked. Immune system activation
alters sleep, and sleep in turn affects the innate and adaptive arm of our body’s defense
system. Stimulation of the immune system by microbial challenges triggers an inflammatory
response, which, depending on its magnitude and time course, can induce an increase in sleep
duration and intensity, but also a disruption of sleep. Enhancement of sleep during an infection is
assumed to feedback to the immune system to promote host defense. Indeed, sleep affects various
immune parameters, is associated with a reduced infection risk, and can improve infection outcome
and vaccination responses. The induction of a hormonal constellation that supports immune functions
is one likely mechanism underlying the immune-supporting effects of sleep. In the absence of an
infectious challenge, sleep appears to promote inflammatory homeostasis through effects on several
inflammatory mediators, such as cytokines. This notion is supported by findings that prolonged sleep
deficiency (e.g., short sleep duration, sleep disturbance) can lead to chronic, systemic low-grade
inflammation and is associated with various diseases that have an inflammatory component, like
diabetes, atherosclerosis, and neurodegeneration. Here, we review available data on this regulatory
sleep-immune crosstalk, point out methodological challenges, and suggest questions open for future

Publisher's Version

Last updated on 03/28/2019