CHRONIC insomnia, already known for its toll on mental and physical health, has now been linked to an increased risk of developing specific autoimmune diseases, according to a recent large-scale cohort study conducted in the United States. The findings, published in a high-impact medical journal, offer compelling evidence that sleep disorders may play a critical role in immune system dysfunction, leading to conditions such as rheumatoid arthritis, cutaneous lupus erythematosus, Sjögren syndrome, and autoimmune thyroiditis.
Researchers analyzed electronic health records from the TriNetX US Global Collaborative Network, assessing over 700,000 individuals, with 351,366 participants in each propensity score-matched group. The study evaluated the incidence of 20 autoimmune diseases, utilizing robust matching and sensitivity analyses to ensure the validity of the results. The data revealed that individuals with insomnia faced a significantly elevated risk of several autoimmune conditions.
Cutaneous lupus erythematosus showed the most pronounced association with insomnia, with a hazard ratio (HR) of 2.119 (confidence interval [CI] 1.674–2.682; p < 0.0001), suggesting more than double the risk compared to those without sleep impairment. Similarly, the risk for Sjögren syndrome increased by 84% (HR = 1.84; CI 1.64–2.066; p < 0.0001), while rheumatoid arthritis (HR = 1.404; CI 1.313–1.501; p < 0.0001) and autoimmune thyroiditis (HR = 1.348; CI 1.246–1.458; p < 0.0001) also showed significant risk elevations. The authors propose that insomnia and other circadian rhythm disruptions impair neuroimmune and autonomic regulation, leading to inflammatory dysregulation and loss of immune tolerance. These mechanisms could underlie the observed associations between sleep disorders and autoimmune disease onset. Importantly, no autoimmune diseases examined in the study were found to have a reduced risk associated with insomnia, and while four diseases showed no significant hazard increase, the broader trend suggests sleep disruption may be a key modifiable risk factor. This research emphasizes the need for healthcare providers to recognize and address sleep disorders not only for overall wellbeing but also as a potential preventive strategy against autoimmune disease development. Reference: Lee S et al. Insomnia increases the risk for specific autoimmune diseases: a large-scale retrospective cohort study. J Transl Autoimmun. 2024;8:100308.
